4 results on '"Vo Cong Dong"'
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2. Avian influenza H5N1 and healthcare workers
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Menno D. de Jong, Christiane Dolecek, Vo Cong Dong, Wilina Lim, Nguyen Van Vinh Chau, Constance Schultsz, Jeremy Farrar, Tran Tan Thanh, Nguyen Thi Hanh Le, Tran Tinh Hien, and Other departments
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Microbiology (medical) ,Adult ,Male ,medicine.medical_specialty ,Infectious Disease Transmission, Patient-to-Professional ,Letter ,Epidemiology ,Health Personnel ,lcsh:Medicine ,medicine.disease_cause ,Airborne transmission ,health care workers ,law.invention ,lcsh:Infectious and parasitic diseases ,Avian Influenza A Virus ,law ,Internal medicine ,Influenza, Human ,medicine ,Infection control ,Microneutralization Assay ,Humans ,lcsh:RC109-216 ,Avian influenza A virus ,Seroconversion ,Intensive care medicine ,Keywords: Avian influenza A virus ,Infection Control ,business.industry ,Transmission (medicine) ,lcsh:R ,Middle Aged ,Intensive care unit ,Influenza A virus subtype H5N1 ,Infectious Diseases ,Vietnam ,Hong Kong ,Female ,business - Abstract
To the Editor: Since January 2004, 35 human cases of avian influenza A virus H5N1 have been reported in Vietnam. Human-to-human transmission of H5N1 is a major concern, particularly because of reported family clustering (1). Two probable cases of human-to-human transmission were recently reported from Thailand (2), and evidence for human-to-human transmission was found in the 1997 Hong Kong outbreak (3). We evaluated healthcare workers exposed to 2 patients (patients 5 and 6 [1], referred to as patients A and B, respectively, in this article) with H5N1 infection, confirmed by polymerase chain reaction (PCR), to determine the potential risk for nosocomial human-to-human transmission of H5N1. Patient A was admitted to a general ward of a pediatric hospital in Ho Chi Minh City on January 15, 2004, on day 8 of illness; no infection control measures were taken at that time. On January 18, 2004, she was transferred to the intensive care unit (ICU). Eight hours after ICU admission, limited infection control measures were implemented: the patient was transferred to a single room, and healthcare workers were required to use disposable surgical masks and gloves and wear nondisposable gowns. However, because resources were limited, each healthcare worker wore only 1 glove. On January 23, patient A was transferred to another hospital. Patient B was admitted to the infectious diseases ward of the pediatric hospital on January 19, 2004, on day 6 of illness; he was transferred to the ICU after 4 hours and stayed there until he died on January 23. Infection control measures were implemented 2 days after ICU admission; these measures were similar to those taken for patient A except that no single room was available. From January 25 to 27, 2004, a nasal swab specimen and baseline serum sample were collected from healthcare workers at the hospital; each worker also completed a questionnaire. On February 9 and 10, follow-up serum samples were collected. Nasal swab samples were tested by reverse transcription (RT)-PCR to detect the H5 gene (1). Paired serum samples were subjected to enzyme-linked immunosorbent assay (ELISA) (Virion/Serion, Wurzburg, Germany) to detect immunoglobulin G against the nucleoprotein of influenza A; samples were also subjected to an H5-specific microneutralization assay (4). Of 62 healthcare workers involved in caring for patient A, patient B, or both, 60 (97%) provided both samples and questionnaires: 16 who cared for patient A on the general ward, 33 who cared for patients A and B in the ICU, and 11 who cared for patient B on the infectious diseases ward or who were consulted for diagnostic or clinical procedures involving either patient. Characteristics of the workers and their exposures are shown in the Table. Table Characteristics of 60 healthcare workers exposed to avian influenza patient A, patient B, or both The median time between last exposure and collection of the nasal swab and the baseline serum samples was 7 days (range 2–12 days). The median time between last exposure and collection of the follow-up serum sample was 21 days (range 17–26 days). All 60 nasal swab samples were negative by RT-PCR. Paired serum samples were available from 46 healthcare workers, and 42 were negative in the influenza A–specific ELISA, 2 reacted with a negative-to-borderline response, 1 had a borderline-to-positive response, and 1 had 2 positive responses. A positive response indicates recent infection. All paired serum samples, 12 additional baseline samples, and 2 additional follow-up samples were negative in the H5-specific microneutralization assay. None of the paired samples from 4 healthcare workers that were reactive in the ELISA showed 4-fold or greater changes in titer in H1- and H3-specific hemagglutination inhibition and microneutralization assays, which indicates they had not recently been infected with human influenza. None of these 4 healthcare workers reported any illness or potential exposure to H5N1 other than to patient A or B. The ELISA results were considered nonspecific. Paired serum samples from patient A showed clear seroconversion in both ELISA and H5 microneutralization. Serum specimens were not available from patient B. We found no transmission of H5N1 to healthcare workers, despite the lack of infection control measures, which suggests inefficient human-to-human H5N1 transmission; similar results were found in Hanoi (5). Droplet and contact transmission are considered the most effective means of transmitting influenza A in hospitals, and the clinical importance of airborne transmission has not been fully elucidated (6). Diarrhea in H5N1-infected patients potentially contains viable virus (1,7) and may affect the H5N1 transmission route. While these results appear reassuring, the limited options that were available to prevent nosocomial infection are worrisome. If reassortment between avian and human influenza A virus were to occur, resulting in a virus with pandemic potential, nosocomial transmission would be a concern. Infection control measures are crucial in all cases of avian influenza, and resources to prevent nosocomial infection must be made available in affected countries.
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- 2005
3. Avian Influenza H5N1 and Healthcare Workers.
- Author
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Schultsz, Constance, Vo Cong Dong, Nguyen Van Vinh Chau, Nguyen Thi Hanh Le, Lim, Wilina, Tran Tan Thanh, Dolecek, Christiane, De Jong, Menno D., Hien, Tran Tinh, and Farrar, Jeremy
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LETTERS to the editor , *AVIAN influenza - Abstract
Presents a letter to the editor in response to an article on cases of avian influenza A virus H5n1.
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- 2005
- Full Text
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4. Avian influenza A (H5N1) in 10 patients in Vietnam.
- Author
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Tran TH, Nguyen TL, Nguyen TD, Luong TS, Pham PM, Nguyen vV, Pham TS, Vo CD, Le TQ, Ngo TT, Dao BK, Le PP, Nguyen TT, Hoang TL, Cao VT, Le TG, Nguyen DT, Le HN, Nguyen KT, Le HS, Le VT, Christiane D, Tran TT, Menno de J, Schultsz C, Cheng P, Lim W, Horby P, and Farrar J
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- Adolescent, Adult, Animals, Anti-Bacterial Agents therapeutic use, Antiviral Agents therapeutic use, Chickens virology, Child, Child, Preschool, Ducks virology, Female, Humans, Influenza, Human diagnostic imaging, Influenza, Human epidemiology, Influenza, Human therapy, Lung diagnostic imaging, Male, RNA, Viral analysis, Radiography, Reverse Transcriptase Polymerase Chain Reaction, Treatment Outcome, Vietnam epidemiology, Influenza A Virus, H5N1 Subtype, Influenza A virus genetics, Influenza A virus isolation & purification, Influenza in Birds transmission, Influenza, Human virology
- Abstract
Background: Recent outbreaks of avian influenza A (H5N1) in poultry throughout Asia have had major economic and health repercussions. Human infections with this virus were identified in Vietnam in January 2004., Methods: We report the clinical features and preliminary epidemiologic findings among 10 patients with confirmed cases of avian influenza A (H5N1) who presented to hospitals in Ho Chi Minh City and Hanoi, Vietnam, in December 2003 and January 2004., Results: In all 10 cases, the diagnosis of influenza A (H5N1) was confirmed by means of viral culture or reverse transcriptase-polymerase chain reaction with primers specific for H5 and N1. None of the 10 patients (mean age, 13.7 years) had preexisting medical conditions. Nine of them had a clear history of direct contact with poultry (median time before onset of illness, three days). All patients presented with fever (temperature, 38.5 to 40.0 degrees C), respiratory symptoms, and clinically significant lymphopenia (median lymphocyte count, 700 per cubic millimeter). The median platelet count was 75,500 per cubic millimeter. Seven patients had diarrhea. In all patients, there were marked abnormalities on chest radiography. There was no definitive evidence of human-to-human transmission. Eight patients died, one patient has recovered, and one is recovering., Conclusions: Influenza A (H5N1) infection, characterized by fever, respiratory symptoms, and lymphopenia, carries a high risk of death. Although in all 10 cases the infection appears to have been acquired directly from infected poultry, the potential exists for genetic reassortment with human influenzaviruses and the evolution of human-to-human transmission. Containment of influenza A (H5N1) in poultry throughout Asia is therefore urgently required., (Copyright 2004 Massachusetts Medical Society)
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- 2004
- Full Text
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