PMID- 20502525
OWN - NLM
STAT- MEDLINE
DCOM- 20100810
LR  - 20231105
IS  - 1549-1676 (Electronic)
IS  - 1549-1277 (Print)
IS  - 1549-1277 (Linking)
VI  - 7
IP  - 5
DP  - 2010 May 18
TI  - Early pandemic influenza (2009 H1N1) in Ho Chi Minh City, Vietnam: a clinical 
      virological and epidemiological analysis.
PG  - e1000277
LID - 10.1371/journal.pmed.1000277 [doi]
LID - e1000277
AB  - BACKGROUND: To date, little is known about the initial spread and response to the 
      2009 pandemic of novel influenza A ("2009 H1N1") in tropical countries. Here, we 
      analyse the early progression of the epidemic from 26 May 2009 until the 
      establishment of community transmission in the second half of July 2009 in Ho Chi 
      Minh City (HCMC), Vietnam. In addition, we present detailed systematic viral 
      clearance data on 292 isolated and treated patients and the first three cases of 
      selection of resistant virus during treatment in Vietnam. METHODS AND FINDINGS: 
      Data sources included all available health reports from the Ministry of Health 
      and relevant health authorities as well as clinical and laboratory data from the 
      first confirmed cases isolated at the Hospital for Tropical Diseases in HCMC. 
      Extensive reverse transcription (RT)-PCR diagnostics on serial samples, viral 
      culture, neuraminidase-inhibition testing, and sequencing were performed on a 
      subset of 2009 H1N1 confirmed cases. Virological (PCR status, shedding) and 
      epidemiological (incidence, isolation, discharge) data were combined to 
      reconstruct the initial outbreak and the establishment of community transmission. 
      From 27 April to 24 July 2009, approximately 760,000 passengers who entered HCMC 
      on international flights were screened at the airport by a body temperature scan 
      and symptom questionnaire. Approximately 0.15% of incoming passengers were 
      intercepted, 200 of whom tested positive for 2009 H1N1 by RT-PCR. An additional 
      121 out of 169 nontravelers tested positive after self-reporting or contact 
      tracing. These 321 patients spent 79% of their PCR-positive days in isolation; 
      60% of PCR-positive days were spent treated and in isolation. Influenza-like 
      illness was noted in 61% of patients and no patients experienced pneumonia or 
      severe outcomes. Viral clearance times were similar among patient groups with 
      differing time intervals from illness onset to treatment, with estimated median 
      clearance times between 2.6 and 2.8 d post-treatment for illness-to-treatment 
      intervals of 1-4 d, and 2.0 d (95% confidence interval 1.5-2.5) when treatment 
      was started on the first day of illness. CONCLUSIONS: The patients described here 
      represent a cross-section of infected individuals that were identified by 
      temperature screening and symptom questionnaires at the airport, as well as 
      mildly symptomatic to moderately ill patients who self-reported to hospitals. 
      Data are observational and, although they are suggestive, it is not possible to 
      be certain whether the containment efforts delayed community transmission in 
      Vietnam. Viral clearance data assessed by RT-PCR showed a rapid therapeutic 
      response to oseltamivir.
FAU - Hien, Tran Tinh
AU  - Hien TT
AD  - Oxford University Clinical Research Unit, Wellcome Trust Major Overseas Program, 
      Hospital for Tropical Diseases, Ho Chi Minh City, Vietnam.
FAU - Boni, Maciej F
AU  - Boni MF
FAU - Bryant, Juliet E
AU  - Bryant JE
FAU - Ngan, Tran Thuy
AU  - Ngan TT
FAU - Wolbers, Marcel
AU  - Wolbers M
FAU - Nguyen, Tran Dang
AU  - Nguyen TD
FAU - Truong, Nguyen Thanh
AU  - Truong NT
FAU - Dung, Nguyen Thi
AU  - Dung NT
FAU - Ha, Do Quang
AU  - Ha do Q
FAU - Hien, Vo Minh
AU  - Hien VM
FAU - Thanh, Tran Tan
AU  - Thanh TT
FAU - Nhu, Le Nguyen Truc
AU  - Nhu le NT
FAU - Uyen, Le Thi Tam
AU  - Uyen le TT
FAU - Nhien, Pham Thi
AU  - Nhien PT
FAU - Chinh, Nguyen Tran
AU  - Chinh NT
FAU - Chau, Nguyen Van Vinh
AU  - Chau NV
FAU - Farrar, Jeremy
AU  - Farrar J
FAU - van Doorn, H Rogier
AU  - van Doorn HR
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
GR  - G0600718/MRC_/Medical Research Council/United Kingdom
GR  - 077078/Z/05/Z/WT_/Wellcome Trust/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20100518
PL  - United States
TA  - PLoS Med
JT  - PLoS medicine
JID - 101231360
RN  - 20O93L6F9H (Oseltamivir)
SB  - IM
MH  - Aircraft
MH  - *Disease Outbreaks
MH  - Disease Transmission, Infectious/prevention & control/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - *Influenza A Virus, H1N1 Subtype
MH  - Influenza, Human/drug therapy/*epidemiology/transmission
MH  - *Mass Screening
MH  - Oseltamivir/therapeutic use
MH  - Time Factors
MH  - Travel
MH  - Vietnam/epidemiology
PMC - PMC2872648
COIS- The authors have declared that no competing interests exist.
EDAT- 2010/05/27 06:00
MHDA- 2010/08/11 06:00
PMCR- 2010/05/18
CRDT- 2010/05/27 06:00
PHST- 2009/11/04 00:00 [received]
PHST- 2010/04/08 00:00 [accepted]
PHST- 2010/05/27 06:00 [entrez]
PHST- 2010/05/27 06:00 [pubmed]
PHST- 2010/08/11 06:00 [medline]
PHST- 2010/05/18 00:00 [pmc-release]
AID - 09-PLME-RA-3143R3 [pii]
AID - 10.1371/journal.pmed.1000277 [doi]
PST - epublish
SO  - PLoS Med. 2010 May 18;7(5):e1000277. doi: 10.1371/journal.pmed.1000277.