Saturday, June 8, 2013

#H1N1 Vietnam Case List


Vietnam H1N1 2013

Name—From—Adm--Condition
46M—Yen Bai—Early April—DOD early April
72M--HCMC Dist. 11—Cho Ray Hosp--DOD early May
56M—Ha Giang—April—DOD 5/21
61M--Dong Thap-Cho Ray Hosp--DOD 6/3
3yo—Dong Thap—Childrens Hosp HCMC—contact of 61M--recovered 
24F—HCMC Dist. 9—6/1 Cho Ray Hosp-- DOD 6/5
49M—HCMC Dist. 3—5/24 Gia Dinh Hosp HCMC--DOD 6/3 
48M—Ben Tre—6/6 Cho Ray Hosp.--ICU



Name:  46(M)
From:  Yen Bai
Adm:  April (beginning) Hosp. for Tropical Diseases, Central
DOD:  Beginning of April, 2 days after admission.

Name:  72(M)
From:  HCMC – District 11
Adm:  Cho Ray Hospital
Sym’s on Adm:  Breathlessness
DOD:  Early May

Name:  56(M)
From:  Lung Sinh, Lam Commune, Xuyen Dist. Ha Giang Province
DOD:  5/21

Name:  Ly Kim Sen (61M)
From:  Dong Thap, Farmer
Adm:  6/1  Cho Ray Hospital
Adm:  5/24 Dong Thap General Hospital
Sym’s on Adm:  Abdominal pain, cough fever, shortness of breath
Note:  patient sellf-medicated, condition worsened.
DOD:  6/1 a few hours after admission

Name:  Hiện 3yo (contact of 61M above)
From:  Dong Thap
Adm:  Children’s Hospital 1,  HCMC
Note:  Granddaughter of Ly Kim Sen (61M) above. 
Confirmed:  Positive, PCR Test

Name:  Le Thi Cam Van  (24F)
From:  HCMC – District 9 (worked)
From:  Native of Kom Tum Province.
Adm:   6/1 Cho Ray Hospital
Syms on Adm:  respiratory failure
Adm:   5/31 Tu Du Obstetric Hospital, delivered baby, lived.
Note:  Husband had flu 3 days prior to onset of wife.  She worked at TPHCM (Tech Park, HCM)
DOD:  6/5

Name:  Nguyen Xuan Thien  (49M)
From:  HCMC – District 3
Adm:  5/24 Gia Dinh People’s Hospital
Sym’s on Adm:  fever, diarrhea, entered gastroenterology
DOD:  6/3

Name  48(M)
From:  Ben Tre
Adm:  Cho Ray Hospital
Sym’s on Adm:  fever, cough, respiratory ventilator

#H1N1 Vietnam: 3 Articles - Many Details, Including Rpts of 2 Previous Confirmed/Deaths

[I have updated my list with the details from these articles, and will re-post the results]

Translation
Excerpt:
Saturday, 08.06.2013, 07:37 (GMT +7)
Repeatedly in 2 days 4 and 5-6 had 2 patients die from influenza A/H1N1 in HCM Cho Ray Hospital. Before that, there are also deaths from A/H1N1 flu cases in the city and another 3 in the north.


Translation
Excerpt:
The latest addition to the deaths, in the area of ​​the southern provinces of the region appear more A/H1N1 flu patients. TS-BS Hoang Lan Phuong, Vice-Dean for Tropical Diseases, Cho Ray Hospital, said the department is treating influenza A/H1N1cho male patient (48 years old, Ben Tre). Patients who are in a state of fever, cough, respiratory ventilator to.

Gia Dinh People's Hospital for treatment and patients are male (50 years old, live Q3) of influenza A/H1N1 infection, respiratory failure and severe lung damage. In addition, the nephew of LKS patients ( recently died 5 days ago ) also has flu symptoms appear due to infection from his grandfather. Time 3-year-old girl is being treated at Children's Hospital 1. PCR tests showed that she tested positive for H1N1. At the Hospital for Tropical Diseases are treating other patients with influenza A/H1N1 infection.



Translation
5 June 2013
The second patient Southern H1N1 flu fatalities 

The 61-year-old man has died in The Tower at Cho Ray Hospital (HCMC), the samples tested positive for A/H1N1 flu virus.

  The patient was taken to Cho Ray Hospital on 6/1 in the state severely damaged lungs. Previous 7 days, cough patients with abdominal pain, but not bought medication from. In Dong Thap General Hospital, patients with shortness of breath, severe respiratory distress should be moved to a higher level.
PhD - Doctor Hoang Lan Phuong, deputy department for Tropical Diseases, Cho Ray Hospital, said the results showed that X-rays of patients with pulmonary infiltrates, lung tissue of two seriously injured.  Patients with antibiotic treatment and sampling tests H1N1, H5N1 and H7N9. Then a positive result for H1N1.

Patients treated immediately isolated, wide-awake and good exposure but breathing coal. This situation can not last long and although progress has been actively emergency. The patient died a few hours after admission.
The doctor says, patients admitted to the hospital when the condition was so severe that the cause of the treatment is not effective. The family has 9 adult patients, but so far no one else feels feverish.
-snip-
In the North, 21/5, Ha Giang Provincial Health Department confirmed 56-year-old male patient, in rural Lùng Sinh, Vietnam Lâm, Commune,  Xuyên district, the first cases of H1N1 flu this year locally. On 21/5, the patient died. 

Prior to that, beginning in April, Hospital for Tropical Diseases, Central received a 46-year-old male patient, the Yen Bai, H1N1 flu pandemic in very serious condition and died after only 2 days. 
http://tinyurl.com/lwslegs 

#H1N1 Vietnam: Influenza A/H1N1 Ongoing Danger...

Excerpt:
8 June 13
Influenza A/H1N1 Ongoing Danger...

Along with fatal cases mentioned above, in Gia Dinh People's Hospital is currently treating three other suspected cases of influenza A/H1N1 infection. According to Dr. Snow, the health status of all 3 patients are relatively positive developments. Some other information at Cho Ray Hospital, said the hospital is treating another patient had a positive result for influenza A/H1N1. Meanwhile, the survey of the Pasteur Institute, Ho Chi Minh City showed that for every 100 people who visit the sick, two influenza A/H1N1 infection.

Since the beginning of this year, at the hospital in the city there were 4 deaths from A/H1N1 flu. Including 3 deaths occurred repeatedly from 2/6 to day 5/6. At the seminar on the prevention of influenza by the Center for Health Information and Education organization, MA Le Van Tuan, representatives of the World Health organization in the city said that the consecutive cases of H1N1 flu deaths, not of the possibility that this strain of influenza virus has modified. H1N1 flu does not appear seasonal pathogens that are spread in every time of year.

http://www.xaluan.com/modules.php?name=News&file=article&sid=623131

#H1N1 Vietnam Case List 2013

The first death came in Early May.  This is the list I've created with what I know now.

-->
Name—From—Adm--Condition
72M--HCMC Dist. 11—Cho Ray Hosp--DOD early May
61M--Dong Thap-Cho Ray Hosp--DOD 6/3
3yo—Dong Thap—Childrens Hosp HCMC—contact of 61M--recovered 
24F—HCMC Dist. 9—6/1 Cho Ray Hosp-- DOD 6/5
49M—HCMC Dist. 3—5/24 Gia Dinh Hosp HCMC--DOD 6/3



Name:  72(M)
From:  HCMC – District 11
Adm:  Cho Ray Hospital
Sym’s on Adm:  Breathlessness
DOD:  Early May

Name:  Ly Kim Sen (61M)
From:  Dong Thap, Farmer
Adm:  Cho Ray Hospital
Sym’s on Adm:  Fever, sore throat, cough
Note:  patient sellf-medicated, condition worsened.
DOD:  6/3

Name:  3yo (contact of 61M above)
From:  Dong Thap
Adm:  Children’s Hospital 1,  HCMC
Note:  Recovered

Name:  Le Thi Cam Van  (24F)
From:  HCMC – District 9 (worked)
From:  Native of Kom Tum Province.
Adm:   6/1 Cho Ray Hospital
Syms on Adm:  respiratory failure
Adm:   5/31 Tu Du Obstetric Hospital, delivered baby, lived.
Note:  Husband had flu 3 days prior to onset of wife.
DOD:  6/5

Name:  Nguyen Xuan Thien  (49M)
From:  HCMC – District 3
Adm:  5/24 Gia Dinh People’s Hospital
Sym’s on Adm:  fever, diarrhea, entered gastroenterology
DOD:  6/3

#H1N1 Vietnam: Add 1 Death in HCMC

Excerpt:
June 8, 2013
Afternoon 7/6, information from Gia Dinh People's Hospital, there was 1 death due to influenza A/H1N1 ...
Nguyen Xuan Thien patients (male, born in 1964, lived in District 3). The patient was hospitalized on 24/5, with fever, with diarrhea, is entered in gastroenterology Gia Dinh People's Hospital. After that, patients with respiratory manifestations. The patient tested positive for H1N1. Despite aggressive treatment, but the patient did not survive.
Before the disease, the patient was diagnosed with liver cirrhosis, renal failure due to alcohol.
Earlier, Cho Ray Hospital in Ho Chi Minh City, just had 2 deaths caused by influenza A/H1N1. A singer is a tool he moved up in Dong Thap and a singer is the woman who resides in District 9, Ho Chi Minh City. BV also currently being treated for a defined cases positive for A/H1N1 quite severe lung damage and is being ventilated.
Up to this point, there were 4 deaths from A/H1N1 flu occurred. The first death was recorded as a tool he lives in District 11, HCMC.
-snip-
While the health sector is trying to deal with the pandemic A/H5N1 and proactively prevent A/H7N9 influenza strains intrusion, then in recent times in a number of provinces to "welcome" the return of A/H1N1 flu is more dominant than the other flu. Due to spread through the respiratory tract of patients should increase rapidly.

Sixth death from A/H1N1 in Vietnam confirmed

24(F)--HCMC-- DOD 6/5 
Ly Kim Sen61(M)--Dong Thap--DOD 6/3 
72(M)--DOD early May  

[In English, no translation]
06/06/2013
VietNamNet Bridge – A 24-year-old female factory worker died from A/H1N1 flu at the Cho Ray Hospital in HCM City on June 5. This is the second consecutive death of A/H1N1 in the last three days in the hospital and the sixth death in Vietnam so far this year.

The patient is identified as V.T.C.V, a native of Kon Tum Province, who worked in District 9, HCM City.
She contracted A/H1N1 after eating rice gruel with chicken. The woman had delivered a baby at Tu Du Obstetric Hospital one day before she was admitted to Cho Ray Hospital.
Test results of molecular biology at Cho Ray Hospital and the Pasteur Institute in Ho Chi Minh City were both positive for A/H1N1 strain.
Despite aggressive treatment, the patient suffered from respiratory failure, cardiovascular collapse and died on the morning of June 5. This is the third death by A/H1N1 in HCM City.
Just two days ago, on June 3, a man named Ly Kim Sen, 61, from the southern province of Dong Thap died at Cho Ray due to heart failure and severe respiratory problems, caused by A/H1N1.
Sen’s grandchild, a three-year-old girl in Dong Thap Province, is also reported to contract A/H1N1 flu. Thanks to early treatment, the baby is recovering from the disease.
The first death from the virus strain in the city occurred in early May when a 72-year-old man died from respiratory failure after only a day of treatment.
According to the World Health Organization, there are no signs of changes in the genes of the H1N1 virus.
 

Vietnam: Ministry to tighten control over news-gathering websites

1 June 2013


VietNamNet Bridge – Staff members of websites run by enterprises and organisations will no longer be allowed to work as official newspapers, according to the Ministry of Information and Communications. 
 


Under the ministry’s recently-issued document, which tightens controls over operations of the websites, “News-compilation websites run by enterprises and organistions will only entitled to collect information about economics, politics, culture and society from official news sources of party and state agencies in strict compliance with copyright regulations mapped out by the Law on Press. These websites must directly and accurately quote information from these official sources and include the name of author and the management agency of the original source as well as the date of publication. Such websites will be specifically banned from including user comments on the information cited."
In addition, staff members of compilation websites will be barred from attending press conferences and forums as reporters organised by agencies or ministries.
A number of websites, including cafef.vn, gafin.vn, vietstock.vn, xzone.vn and stockbiz.vn, have been denounced for attending press conferences and seminars, providing the same information as official news outlets.
Recently, Petrotimes Newspaper requested that baomoi.com to stop using information taken from their publication without permission. Subsequently the website was forced to make a public apology to Petrotimes.
Nghe An Province’s Propaganda and Education Department also had to deal with a number of websites, including includingwww.kinhtehoinhap.vn, http://ngheannews.vn and http://lamhongonline.vn which illegally operated as if they were official press agencies.  
Source: DTriNews

#MERS #Coronavirus All of Canada is on Guard

Canadian health community monitoring deadly SARS-like virus from Mideast


 

About 50 people in Canada with respiratory symptoms have been tested for the new SARS-like coronavirus that has the world on edge. So far, none of the suspected Canadian cases has tested positive and the risk to Canadians is considered low, but health officials are on alert.
“We are watching it as closely as we can. We are … talking to everybody we can and getting input in every way possible,” said Dr. Gregory Taylor, Canada’s deputy chief public health officer, in an interview Friday. “What is going to happen next? Who knows. (But) all of Canada is on guard.”

Continued:  http://www.ottawacitizen.com/health/Canadian+health+community+monitoring+deadly+SARS+like+virus/8495691/story.html

#H7N9 Comments....Vietnam has to have had human infectiions

I find it so hard to believe with all the smuggling of poultry across the border in Vietnam, from China, that there has been NO human infections with H7N9.  Below is an excerpt from the CDC Health Alert Network update I made in the previous post.

End Notes:    

1 As of June 3, 2013, China was the only country where H7N9 viruses were known to be circulating in animals or where human cases have become infected. Patients with direct or close contact with wild birds or poultry, or animal settings, such as live poultry markets while traveling in these areas should be strongly considered for H7N9 testing. For more information on countries affected, please see the CDC avian influenza A (H7N9) information page at http://www.cdc.gov/flu/avianflu/h7n9-virus.htm.

CDC Emergency Prepardness & Response Health Update: Human Infections with Avian Influenza A (H7N9) Viruses

Distributed via the CDC Health Alert Network
June 7, 2013, 14:00 ET 02:00 PM ET
CDCHAN-00347

This health advisory provides an update on the avian influenza A (H7N9) virus [H7N9] situation and includes new recommendations on who should be tested for H7N9 in the United States. This document replaces guidance published on April 5, 2013, in CDC Health Advisory 344 “Human Infections with Novel Influenza A (H7N9) Viruses,” found at http://emergency.cdc.gov/HAN/han00344.asp. The updated guidance reflects the most current epidemiology of H7N9 cases, which indicates that almost all H7N9 human infections have resulted in severe respiratory illness; H7N9 has been found rarely among those with milder disease. For that reason, CDC is changing its recommendations for H7N9 testing: The primary changes from previous guidance are (i) a new recommendation to test only patients with an appropriate exposure history and severe respiratory illness requiring hospitalization and (ii) a request that only confirmed and probable cases of human infection with H7N9 be reported to CDC. In the previous guidance issued on April 5, CDC recommended that all persons with relevant exposure history and illness compatible with influenza, regardless of severity be tested. CDC will continue to update these recommendations as more information becomes available. The current guidance is consistent with interim surveillance recommendations by the World Health Organization for H7N9 found at http://www.who.int/influenza/human_animal_interface/influenza_h7n9/InterimSurveillanceRecH7N9_10May13.pdf

Summary and Background

As of June 3, 2013, Chinese public health officials have reported >130 cases of human infection with H7N9 from 10 provinces and municipalities in mainland China and Taiwan [1, 2]. Most patients were hospitalized with severe respiratory illness and reported poultry contact prior to illness onset [2, 3]. Preliminary results from influenza-like illness surveillance suggest that H7N9 has not caused widespread mild illness in China [4].
Although several clusters of human infection with H7N9 have been identified in China, sustained person-to-person transmission of the virus has not been demonstrated. At this time, no cases of human infection with H7N9 have been detected in the United States, despite testing of >60 persons with respiratory illness who reported recent travel to China.
Clinicians should consider the possibility of H7N9 infection in persons presenting with respiratory illness requiring hospitalization and an appropriate travel or exposure history. Influenza diagnostic testing in patients with severe respiratory illness for whom an etiology has not been confirmed may identify human cases of H7N9.
Confirmed and probable cases of human infection with H7N9 in the United States should be reported to CDC within 24 hours of initial detection. See http://www.cdc.gov/flu/avianflu/h7n9/case-definitions.htm. However, state health departments are encouraged to investigate all potential cases of H7N9 infection as described below in order to determine case status.

Interim Recommendations for Clinicians and State and Local Health Departments

CDC recommends the following testing practices based on the current epidemiology of H7N9 cases.

Case Investigation and Testing

  • Patients who meet both the clinical and exposure criteria described below should be considered for H7N9 testing by reverse-transcription polymerase chain reaction (RT-PCR) methods. Decisions on diagnostic testing for influenza using RT-PCR should be made using available clinical and epidemiologic information, and additional persons in whom clinicians suspect H7N9 infection should also be tested.
Clinical Illness Criteria
i. Patients with new-onset severe acute respiratory infection requiring hospitalization (i.e., illness of suspected infectious etiology that is severe enough to require inpatient medical care in the judgment of the treating clinician).
AND
ii. Patients for whom no alternative infectious etiology is identified.
Exposure Criteria
i. Patients with recent travel (within 10 days of illness onset) to areas where human cases of H7N9 have become infected or to areas where avian influenza A (H7N9) viruses are known to be circulating in animals 1.
OR
ii. Patients who have had recent close contact (within 10 days of illness onset) with confirmed cases of human infection with H7N92. Close contact may be regarded as coming within about 6 feet (2 meters) of a confirmed case while the case was ill (beginning 1 day prior to illness onset and continuing until resolution of illness). Close contact includes healthcare personnel providing care for a confirmed case, family members of a confirmed case, persons who lived with or stayed overnight with a confirmed case, and others who have had similar close physical contact.
  • If infection with H7N9 is suspected based on current clinical and epidemiological screening criteria recommended by public health authorities, respiratory specimens should be collected with appropriate infection control precautions for novel virulent influenza viruses and sent to the state or local health department for testing. Clinicians should obtain a respiratory specimen from these patients, place the swab or aspirate in viral transport medium, and contact their state or local health department to arrange transport and request a timely diagnosis at a state public health laboratory or CDC. Viral culture should not be attempted in these cases. For additional guidance on diagnostic testing of patients under investigation for H7N9 infection, please see http://www.cdc.gov/flu/avianflu/h7n9/specimen-collection.htm.
  • Commercially available rapid influenza diagnostic tests (RIDTs) may not detect H7N9 viruses in respiratory specimens. Therefore, a negative rapid influenza diagnostic test result does not exclude infection with H7N9. In addition, a positive test result for influenza A cannot confirm avian influenza virus infection because these tests cannot distinguish between influenza A virus subtypes (they do not differentiate between human influenza A viruses and novel3 influenza viruses). Therefore, when RIDTs are positive for influenza A and there is concern for novel influenza A virus infection, respiratory specimens should be collected and sent for RT-PCR testing at a state public health laboratory. Clinical treatment decisions should not be made on the basis of a negative rapid influenza diagnostic test result since the test has only moderate sensitivity (http://www.cdc.gov/flu/professionals/diagnosis/clinician_guidance_ridt.htm).  

Infection Control

Clinicians should be aware of appropriate infection control guidelines for patients under investigation for infection with novel influenza A viruses. For guidance on infection control precautions for H7N9 see http://www.cdc.gov/flu/avianflu/h7n9-infection-control.htm.

Treatment

For guidance on treatment of patients under investigation for H7N9 with antiviral medications, or for guidance on antiviral chemoprophylaxis of exposed contacts, see http://www.cdc.gov/flu/avianflu/h7n9-antiviral-treatment.htm.

For More Information

End Notes:
1 As of June 3, 2013, China was the only country where H7N9 viruses were known to be circulating in animals or where human cases have become infected. Patients with direct or close contact with wild birds or poultry, or animal settings, such as live poultry markets while traveling in these areas should be strongly considered for H7N9 testing. For more information on countries affected, please see the CDC avian influenza A (H7N9) information page at http://www.cdc.gov/flu/avianflu/h7n9-virus.htm.
2 Contact investigation protocols for confirmed cases may supersede the recommendations described here; testing of close contacts with any level of respiratory illness may be pursued, if in the judgment of the investigators, this is warranted.
3 Influenza viruses that do not typically infect humans are called "novel" influenza viruses; this includes influenza viruses that typically infect birds and swine.
References:
1. Centers for Disease Control and Prevention. Emergence of Avian Influenza A(H7N9) Virus Causing Severe Human Illness - China, February-April 2013. MMWR 2013; 62(18): 366-71. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6218a6.htm?s_cid=mm6218a6_w
2. Li Q, Zhou L, Zhou M, et al. Preliminary Report: Epidemiology of the Avian Influenza A (H7N9) Outbreak in China. N Engl J Med. 2013 Apr 24. [Epub ahead of print]. http://www.ncbi.nlm.nih.gov/pubmed/?term=Epidemiology+of+the+Avian+Influenza+A+(H7N9)+Outbreak+in+Chin
3. Lee SS, Wong NS, Leung CC. Exposure to avian influenza H7N9 in farms and wet markets. Lancet May 25;381(9880):1815. doi: 10.1016/S0140-6736(13)60949-6. Epub 2013 May 10. http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(13)60949-6/fulltext?rss=yes
4. Xu C, Havers F, Wang L, Chen T, Shi J, Wang D. Monitoring avian influenza A(H7N9) virus through national influenza-like illness surveillance, China. Emerging Infectious Diseases [Internet], 2013 Jul [June 3, 2013]. http://dx.doi.org/10.3201/eid1908.130662.






http://emergency.cdc.gov/HAN/han00347.asp

2013 Coronavirus Emergency Use Authorization (Potential Emergency)

On May 29, 2013 Secretary Kathleen Sebelius determined that Middle East respiratory syndrome coronavirus (MERS-CoV) poses a significant potential for a public health emergency that has a significant potential to affect national security or the health and security of United States citizens living abroad. On the basis of this determination the Secretary declared that circumstances exist justifying the authorization of emergency use of in vitro diagnostics for detection of the Middle East respiratory syndrome coronavirus (MERS-CoV).* http://www.phe.gov/emergency/news/healthactions/phe/Pages/mers-cov.aspx
On June 5, 2013, the FDA issued an Emergency Use Authorization (EUA) for the CDC Novel Coronavirus 2012 Real-time RT-PCR Assay. This test is for the presumptive detection of Middle East Respiratory Syndrome Coronavirus (MERS-CoV), formerly known as Novel Coronavirus 2012 or NCV-2012, in patients with signs and symptoms of MERS-CoV infection in conjunction with clinical and epidemiological risk factors.   This device will be distributed by CDC to qualified laboratories.
* Note that the Secretary’s determination and declaration were issued based on revised authorities under the Pandemic and All-Hazards Preparedness Reauthorization Act of 2013 (PAHPRA).
Diagnostic TestDateLetter of
Authorization
Fact Sheet for Healthcare ProvidersFact Sheet for PatientsLabeling (PDF)
CDC Novel Coronavirus 2012 Real-time RT-PCR Assay6/5/13[Authorization][Healthcare][Patients][Labeling]
 http://www.fda.gov/MedicalDevices/Safety/EmergencySituations/ucm161496.htm#coronavirus