Recent avian influenza virus A/H5N1 evolution in vaccinated and unvaccinated poultry from farms in Southern Vietnam, January-March 2010

We report 15 new avian influenza virus A/H5N1 haemagglutinin (HA) sequences sampled from visibly sick domestic poultry in southern Vietnam, between 1 January 2010 and 6 March 2010. These HA sequences form a new sub-clade of the clade 1 H5N1 viruses that have been circulating in Vietnam since 2003/2004. The viruses are characterized by a change from isoleucine to valine at position 514 (I514V) and are 1.8% divergent at the nucleotide level from HA sequences sampled in Vietnam in 2007. Five new amino acid changes were observed at previously identified antigenic sites, and three were located within structural elements of the receptor-binding domain. One new mutation removed a potential N-linked glycosylation site, and a methionine insertion was observed in one virus at the polybasic cleavage site. Five of these viruses were sampled from farms where poultry were vaccinated against H5N1, but there was no association between observed amino acid changes and flock vaccination status. Despite the current lack of evidence for antigenic drift or immune escape in Vietnamese H5N1 viruses, continued surveillance remains a high priority.

Association between dioxin concentrations in breast milk and food group intake in Vietnam

OBJECTIVES

To clarify the association between dioxin concentrations in breast milk and food group intake in herbicide-sprayed and nonsprayed areas in Vietnam.

METHODS

This survey was conducted in August 2007 in sprayed and nonsprayed areas, respectively. The interviews were performed using a questionnaire to obtain information on personal characteristics and usual dietary intake. Eighty mothers of sprayed area and 42 mothers of nonsprayed area participated in the study. Breast milk was analyzed for concentration of polychlorinated dibenzo-p-dioxins (PCDDs) and polychlorinated dibenzofurans (PCDFs).

RESULTS

Multiple regression analysis showed that location (sprayed or nonsprayed area) has the highest association with the toxic equivalents (TEQ)-PCDDs, TEQ-PCDFs, and TEQ-Total rather than other factors. In the sprayed area, the adjusted R (2) values of regression were approximately 0.1. On the other hand, the adjusted R (2) values in the nonsprayed areas were higher than those in the sprayed area, i.e., between 0.2 and 0.3, and showed that there were significant associations with body mass index (BMI) in all models.

CONCLUSIONS

Dioxin exposure was less affected by usual dietary intake in the sprayed area than in the nonsprayed area in Vietnam. It was clear that past exposure rather than present dietary intake may affect present dioxin concentrations in breast milk in the sprayed area in Vietnam. This study suggests that present dioxin concentrations in breast milk were maintained by continuous past exposure even after 30-40 years had passed.

Dioxin reservoirs in southern Viet Nam--a legacy of Agent Orange

In the isolated Aluoi Valley of central Viet Nam, very high levels of 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) were measured in soil, fish fat, duck fat, pooled human blood and breast milk samples collected from A So village between 1996 and 1999. The village was situated on a former military base occupied by US Special Forces between 1963 and 1966. TCDD was a contaminant of the herbicide "Agent Orange", aerially sprayed in the valley between 1965 and 1970, and stored at the A So base. Measured levels were lower near the sites of two other former US bases in the valley which had been occupied for shorter periods of time. In areas where Agent Orange had been applied by low-flying aircraft, levels of TCDD in soil, food and human samples were elevated, but lower than those near the three former US bases. We confirm the apparent food chain transfer of TCDD from contaminated soil to cultured fish pond sediments to fish and duck tissues, then to humans as measured in whole blood and breast milk. We theorize that the Aluoi Valley is a microcosm of southern Viet Nam, where numerous reservoirs of TCDD exist in the soil of former military installations south of the former demilitarized zone. Large quantities of Agent Orange were stored at many sites, used in ground and aerial applications, and spilled. TCDD, through various forms of soil disturbance, can be mobilized from these reservoirs after decades below the surface, and subsequently, introduced into the human food chain.

Clinical aspects of acute vs persistent diarrhea in Ho Chi Minh City, Vietnam

A retrospective clinical study of acute and persistent diarrhea in children younger than three years of age was conducted for 12 months (October 1989 to September 1990) in a Pediatric Hospital in Ho Chi Minh City, South Vietnam. Most of the 3833 episodes of diarrhea identified were of short duration, with 77.7% lasting only 1-7 days. Only 5.3% of episodes lasted more than 14 days. Episodes of longer duration were associated with young age (0-5 months). Bloody stool was present in more than 40% of persistent episodes. Severe malnutrition was associated with persistent episodes that lasted 14-21 days (33%) or more than 22 days (59%). It is important that all patients with diarrhea have appropriate dietary management in addition to fluid therapy, and that future analysis examines etiologic factors to determine the optimal treatment of bloody diarrhea.