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Do LP, Van TTT, Nguyen DTM, Van Khang P, Pham QT, Tran MT, Dang AD, Komase K. Epidemiological and molecular characteristics of a measles outbreak in northern Vietnam, 2013-2014. J Clin Virol 2021; 139:104840. [PMID: 33962181 DOI: 10.1016/j.jcv.2021.104840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 03/29/2021] [Accepted: 04/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND A nationwide measles outbreak occurred in Vietnam between 2013 and 2014. OBJECTIVES To provide an overview on the 2013-2014 measles outbreak in northern Vietnam using epidemiological and molecular analysis of the measles virus (MeV). STUDY DESIGN Epidemiological information was collected from all suspected cases of measles/rubella. Serum and/or throat swabs were collected for laboratory confirmation of measles. MeV genomes were detected and sequenced for phylogenetic analysis. RESULTS A total of 9577 confirmed measles cases were reported in northern Vietnam with an incidence rate of 116.4/1,000,000 population. Of these, approximately 76.3% had unvaccinated or unknown vaccination history and 55.7% were under five years old. The outbreak started in a minority population from the mountainous area bordering Lao PDR and China and exploded in high-density population areas. Molecular analysis of MeV revealed co-circulation of genotypes H1 and D8, with H1 as the predominant strain, and divided into two clusters: cluster 1, sharing high similarity with those detected in China and Lao PDR, and cluster 2, circulating locally with unidentified origin. The minor D8 strains belonged to the D8-Frankfurt cluster. CONCLUSION The outbreak originated in and spread from a population with limited access to vaccines. Molecular analysis revealed co-circulation of MeVs with three different origins during the outbreak. This is the first report to provide an overview of the 2013-2014 measles outbreak in northern Vietnam, demonstrating the need for vaccination strategies against measles that are tailored to local conditions with enhanced molecular surveillance to achieve measles elimination.
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Affiliation(s)
- Loan Phuong Do
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi 10000, Vietnam.
| | - Trieu Thi Thanh Van
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi 10000, Vietnam
| | - Duyen Thi Mai Nguyen
- Department of Virology, National Institute of Hygiene and Epidemiology, Hanoi 10000, Vietnam
| | - Pham Van Khang
- Department of Communicable Disease Prevention and Control, National Institute of Hygiene and Epidemiology, Hanoi, 10000, Vietnam
| | - Quang Thai Pham
- Department of Communicable Disease Prevention and Control, National Institute of Hygiene and Epidemiology, Hanoi, 10000, Vietnam; Institute of Preventive Medicine and Public health, Hanoi Medical University, Hanoi, 10000, Vietnam
| | - Manh Tung Tran
- Department of Communicable Disease Prevention and Control, National Institute of Hygiene and Epidemiology, Hanoi, 10000, Vietnam
| | - Anh Duc Dang
- Department of Bacteriology, National Institute of Hygiene and Epidemiology, Hanoi, 10000, Vietnam
| | - Katsuhiro Komase
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, 1-23-1 Toyama, Shinjuku-ku, Tokyo, 162-8640, Japan
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Lu L, Robertson G, Ashworth J, Pham Hong A, Shi T, Ivens A, Thwaites G, Baker S, Woolhouse M. Epidemiology and Phylogenetic Analysis of Viral Respiratory Infections in Vietnam. Front Microbiol 2020; 11:833. [PMID: 32499763 PMCID: PMC7242649 DOI: 10.3389/fmicb.2020.00833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Accepted: 04/07/2020] [Indexed: 12/18/2022] Open
Abstract
Acute respiratory infections (ARIs) impose a major public health burden on fragile healthcare systems of developing Southeast Asian countries such as Vietnam. The epidemiology, genetic diversity and transmission patterns of respiratory viral pathogens that circulate in this region are not well characterized. We used RT-PCR to screen for 14 common respiratory viruses in nasal/throat samples from 4326 ARI patients from 5 sites in Vietnam during 2012-2016. 64% of patients tested positive for viruses; 14% tested positive multiple co-infecting viruses. The most frequently detected viruses were Respiratory syncytial virus (RSV, 23%), Human Rhinovirus (HRV, 13%), Influenza A virus (IAV, 11%) and Human Bocavirus (HBoV, 7%). RSV infections peaked in July to October, were relatively more common in children <1 year and in the northernmost hospital. IAV infections peaked in December to February and were relatively more common in patients >5 years in the central region. Coinfection with IAV or RSV was associated with increased disease severity compared with patients only infected with HBoV or HRV. Over a hundred genomes belonging to 13 families and 24 genera were obtained via metagenomic sequencing, including novel viruses and viruses less commonly associated with ARIs. Phylogenetic and phylogeographic analyses further indicated that neighboring countries were the most likely source of many virus lineages causing ARIs in Vietnam and estimated the period that specific lineages have been circulating. Our study illustrates the value of applying the state-of-the-art virus diagnostic methods (multiplex RT-PCR and metagenomic sequencing) and phylodynamic analyses at a national level to generate an integrated picture of viral ARI epidemiology.
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Affiliation(s)
- Lu Lu
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Gail Robertson
- Statistical Consultancy Unit, School of Mathematics, The University of Edinburgh, Edinburgh, United Kingdom
| | - Jordan Ashworth
- Institute of Evolutionary Biology, The University of Edinburgh, Edinburgh, United Kingdom
| | - Anh Pham Hong
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Ting Shi
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Alasdair Ivens
- Institute of Immunology and Infection Research, The University of Edinburgh, Edinburgh, United Kingdom
| | - Guy Thwaites
- Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Stephen Baker
- Cambridge Institute of Therapeutic Immunology and Infectious Disease (CITIID), Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Mark Woolhouse
- Usher Institute, The University of Edinburgh, Edinburgh, United Kingdom
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Koniushevska AA, Parkhomenko TA, Sharunova MV, Kazantsev AB, Yakovenko DV. Epidemiology and features of the measles course in children during the outbreak of 2018–2019 in the city of Mariupol. REGULATORY MECHANISMS IN BIOSYSTEMS 2020. [DOI: 10.15421/022010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
In 2017, Ukraine ranked in the top three among European countries in terms of measles incidence, and ranked first in measles growth in 2018. High morbidity, mortality and development of complications make the problem of knowing features of the measles clinical course, timely diagnosis and active prevention highly relevant. The purpose of the research is to study the dynamics of the incidence and clinical features of measles in children during the outbreak of 2018–2019 in the city of Mariupol, Donetsk region. A peculiarity of the measles outbreak in 2018–2019 in Mariupol is prevalence of the disease in preschool children (60.4%), including 30.2% – those under one year of age; low vaccination rate: 52.3% of children unvaccinated; only 22.2% of children were vaccinated twice, according to the schedule. In all age groups, a moderately severe measles course prevailed (69.8%). The clinical course of measles in preschool and school age children had definitive features. Thus, Belsky–Filatov–Koplik spots were observed three times more frequently in preschool children than in schoolchildren (63.9% and 23.3%, respectively). Abdominal pain and diarrhea were only observed in children under 6 years of age (30.2%). Skin pigmentation was absent in children under one year of age and was detected in preschool and school-age children (69.8%). Skin sloughing was only observed in schoolchildren (10.4%). Severe disease course occurred in patients of all ages (29.3%), but children aged under one year and preschool children with severe disease were two times more numerous than those of the school age. Among the observed complications, the vast majority were associated with the respiratory organs: pneumonia (38.3%), subcutaneous emphysema (1.7%), bronchitis (53.2%), laryngitis (3.3%), otitis media (5%). No fatalities were observed. The city should form a commitment to immunization, restore public trust in vaccination, using all forms and means of information, and develop a program to implement the vaccination schedule into practice.
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Seki F, Miyoshi M, Ikeda T, Nishijima H, Saikusa M, Itamochi M, Minagawa H, Kurata T, Ootomo R, Kajiwara J, Kato T, Komase K, Tanaka-Taya K, Sunagawa T, Oishi K, Okabe N, Kimura H, Suga S, Kozawa K, Otsuki N, Mori Y, Shirabe K, Takeda M. Nationwide Molecular Epidemiology of Measles Virus in Japan Between 2008 and 2017. Front Microbiol 2019; 10:1470. [PMID: 31333607 PMCID: PMC6620789 DOI: 10.3389/fmicb.2019.01470] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 06/12/2019] [Indexed: 11/13/2022] Open
Abstract
Genotyping evidence that supports the interruption of endemic measles virus (MV) transmission is one of the essential criteria to be verified in achieving measles elimination. In Japan since 2014, MV genotype analyses have been performed for most of the measles cases in prefectural public health institutes nationwide. With this strong molecular epidemiological data, Japan was verified to have eliminated measles in March, 2015. However, even in the postelimination era, sporadic cases and small outbreaks of measles have been detected repeatedly in Japan. This study investigated the nationwide molecular epidemiology of MV between 2008 and 2017. The 891 strains in the total period between 2008 and 2017 belonged to seven genotypes (D5, D4, D9, H1, G3, B3, and D8) and 124 different MV sequence variants, based on the 450-nucleotide sequence region of the N gene (N450). The 311 MV strains in the postelimination era between 2015 and 2017 were classified into 1, 7, 8, and 32 different N450 sequence variants in D9, H1, B3, and D8 genotypes, respectively. Analysis of the detection period of the individual N450 sequence variants showed that the majority of MV strains were detected only for a short period. However, MV strains, MVs/Osaka.JPN/29.15/ [D8] and MVi/Hulu Langat.MYS/26.11/ [D8], which are named strains designated by World Health Organization (WHO), have been detected in many cases over 2 or 3 years between 2015 and 2017. The WHO-named strains have circulated worldwide, causing outbreaks in many countries. Epidemiological investigation revealed repeated importation of these WHO-named strains into Japan. To demonstrate the elimination status (interruption of endemic transmission) in situations with repeated importation of the same strains is challenging. Nevertheless, the detailed sequence analysis of individual MV strains and chronological analysis of these strains provided sufficient evidence to show that Japan has still maintained its measles elimination status in 2017.
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Affiliation(s)
- Fumio Seki
- Department of Virology 3, National Institute of Infectious Diseases, Tokyo, Japan
| | | | - Tatsuya Ikeda
- Yamagata Prefectural Institute of Public Health, Yamagata, Japan
| | | | - Miwako Saikusa
- Yokohama City Institute of Public Health, Yokohama, Japan
| | | | | | | | - Rei Ootomo
- Tottori Prefectural Institute of Public Health and Environmental Science, Tottori, Japan
| | - Jumboku Kajiwara
- Fukuoka Institute of Health and Environmental Sciences, Dazaifu, Japan
| | - Takashi Kato
- Okinawa Prefectural Institute of Health and Environment, Uruma, Japan
| | - Katsuhiro Komase
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Keiko Tanaka-Taya
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Tomimasa Sunagawa
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Kazunori Oishi
- Infectious Disease Surveillance Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Nobuhiko Okabe
- Kawasaki City Institute for Public Health, Kawasaki, Japan
| | - Hirokazu Kimura
- Graduate School of Health Science, Gunma Paz University, Takasaki, Japan
| | - Shigeru Suga
- Department of Pediatrics, National Mie Hospital, Tsu, Japan
| | - Kunihisa Kozawa
- Graduate School of Medicine, Yokohama City University, Yokohama, Japan
| | - Noriyuki Otsuki
- Department of Virology 3, National Institute of Infectious Diseases, Tokyo, Japan
| | - Yoshio Mori
- Department of Virology 3, National Institute of Infectious Diseases, Tokyo, Japan
| | - Komei Shirabe
- Yamaguchi Prefectural Institute of Public Health and Environment, Yamaguchi, Japan
| | - Makoto Takeda
- Department of Virology 3, National Institute of Infectious Diseases, Tokyo, Japan
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Hong DT, Hien ND, Thao PTP, Anh DD, Mai HH, Huyen DTT, Huong NL, Phuong BH, Iijima M, Ito T, Nakayama T. Immunogenicity of the AIK-C measles vaccine in infants aged <9 months in Vietnam. Vaccine 2019; 37:4576-4580. [PMID: 31174936 DOI: 10.1016/j.vaccine.2019.04.025] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 04/10/2019] [Accepted: 04/12/2019] [Indexed: 10/26/2022]
Abstract
Measles-associated deaths have been reported in infants <9 months during outbreaks. A cohort study was conducted on 210 infants aged 6-8 months to evaluate the immunogenicity and safety of the AIK-C measles vaccine containing 104.21 plaque-forming units (PFU)/0.5 mL produced in Vietnam. Paired serum samples were obtained from 196 subjects. Seropositivity was defined as ≥120 mIU/mL. The seroresponse rate was 173/196 (88.27%, 95% confidence interval (CI): 83.77-92.77%) with geometric mean titer (GMT) of 511 mIU/mL (95% CI: 688-880 mIU/mL), and no significant differences were observed by different age groups. Among 196 paired sera, they were categorized into four groups: 122 subjects <14 IU/mL, 28 subjects 14-<60 mIU/mL, 30 subjects 60-<120 mIU/mL, and 16 subjects ≥ 120 mIU/mL. The seroresponse rate was 112/122 (91.8%, 95% CI: 86.94-96.67%) with GMT (597 mIU/mL, 95% CI: 749-1002 mIU/mL) in the <14 mIU/L group. In the 14-<60 mIU/mL group, the seroresponse rate was 18/28 (64.29%) with 184 mIU/L of GMT and was significantly lower (p < 0.01) than that in the <14 mIU/mL group. In the 16 seropositive group, all subjects showed seroconversion (4-fold higher than before) with a higher GMT of 1078 mIU/mL. Local pain and itching at the injection site were observed in 8 subjects (3.8%) within 7 days of the vaccination. Regarding systemic adverse reactions, febrile illness ≥37.5 °C was observed in 14 subjects (6.7%). These results indicate that the AIK-C measles vaccine is effective and safe for infants aged 6-8 months and will contribute to reducing the number of measles-associated deaths in future outbreaks.
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Affiliation(s)
- Duong Thi Hong
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Nguyen Dang Hien
- Center for Research and Production of Vaccine and Biological, Hanoi, Viet Nam
| | | | - Dang Duc Anh
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | - Hoang Hong Mai
- National Institute of Hygiene and Epidemiology, Hanoi, Viet Nam
| | | | | | - Bui Huy Phuong
- Hai Duong Center for Diseases Control, Hai Duong, Viet Nam
| | | | - Takashi Ito
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan
| | - Tetsuo Nakayama
- Laboratory of Viral Infection II, Kitasato Institute for Life Sciences, Tokyo, Japan.
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Kien VD, Van Minh H, Giang KB, Mai VQ, Tuan NT, Quam MB. Trends in childhood measles vaccination highlight socioeconomic inequalities in Vietnam. Int J Public Health 2017; 62:41-49. [PMID: 27695901 PMCID: PMC5348557 DOI: 10.1007/s00038-016-0899-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2016] [Revised: 09/12/2016] [Accepted: 09/13/2016] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES To describe trends in measles vaccine coverage rates and their association with socioeconomic characteristics among children from age 12 to 23 months in Vietnam from the year 2000 to 2014. METHODS Data were drawn from the Vietnam Multiple Indicator Cluster Surveys in years 2000, 2006, 2011, and 2014. Concentration indices were used to determine the magnitude of socioeconomic inequalities in measles vaccine coverage. Associations between measles vaccine coverage and relevant social factors were assessed using logistic regression. RESULTS Socioeconomic inequalities in measles vaccine coverage rates decreased during 2000-2014. Children belonging to ethnic minority groups, having mothers with lower education, and belonging to the poorest group were less likely to receive measles vaccine; although, their vaccine coverage rates did increase with time. Measles vaccine coverage declined among children of mothers with more education and belonging to the wealthiest socioeconomic group. CONCLUSIONS Understanding the social factors influencing adherence to recommend childhood vaccination protocols is essential. Attempts to regain and retain herd immunity must be guided by an understanding of these social factors if they are to succeed.
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Affiliation(s)
- Vu Duy Kien
- Center for Population Health Sciences, Hanoi School of Public Health, No. 138, Giang Vo Street, Dong Da, Hanoi, Vietnam
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hoang Van Minh
- Center for Population Health Sciences, Hanoi School of Public Health, No. 138, Giang Vo Street, Dong Da, Hanoi, Vietnam
| | - Kim Bao Giang
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Vu Quynh Mai
- Center for Population Health Sciences, Hanoi School of Public Health, No. 138, Giang Vo Street, Dong Da, Hanoi, Vietnam
| | - Ngo Tri Tuan
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Mikkel B. Quam
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
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Complete Genome Characterization of Two Wild-Type Measles Viruses from Vietnamese Infants during the 2014 Outbreak. GENOME ANNOUNCEMENTS 2016; 4:4/2/e00250-16. [PMID: 27081130 PMCID: PMC4832158 DOI: 10.1128/genomea.00250-16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
A large measles virus outbreak occurred across Vietnam in 2014. We identified and obtained complete measles virus genomes in stool samples collected from two diarrheal pediatric patients in Dong Thap Province. These are the first complete genome sequences of circulating measles viruses in Vietnam during the 2014 measles outbreak.
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