Peter Horby, Annette Fox and the NIHE team

Preliminary results from the Ha Nam influenza cohort study

Influenza is one of the most important respiratory infections of humans, responsible for 250,000 to 500,000 deaths annually, and capable of causing global epidemics that are at best disruptive and at worst devastating. South East Asia is an area of special interest to influenza researchers for two main reasons. First, the presence of highly pathogenic avian influenza viruses such as H5N1 in domestic and wild birds and the extensive mixing of humans, swine and poultry increase the risk of new influenza viruses emerging in this region. Second, it has been postulated that South East Asia may be the source of some influenza strains that cause annual outbreaks in the Northern and Southern hemispheres. Despite the potential importance of influenza in South East Asia, the burden and epidemiology are poorly described. In partnership with the National Institute for Hygiene and Epidemiology and the Ha Ham Centre for Preventive Medicine, the Respiratory Infections Group of OUCRU set out to try to better understand the epidemiology of influenza in Vietnam.
In late 2007 a cohort of households was established to determine the true influenza infection and clinical attack rates in the community. 908 people from 269 randomly selected households have been followed since then with active surveillance to detect influenza-like-illness (ILI) and serology before and after each wave of infection. Figure 1 shows the proportion of the people seroconverting to various influenza A viruses by age group. Seroconversion rates for seasonal influenza infection ranged from 2-14%, and were highest for a drifted H3N2 strain that appeared in 2009. The pandemic H1N1 seroconversion rate was higher again, at 18%, but similar to rates reported for other parts of the world. The proportion of infections that presented as ILI (9-24%) was similar across strains and subtypes. Seroconversion rates decreased sharply with age for pandemic H1N1 and to a lesser extent for seasonal H1N1, but not for H3N2.

How common is influenza infection in VietnamFigure caption : The figure shows the proportion of people in the cohort by age group who seroconverted to different influenza A viruses. Seroconversion was defined as a four-fold or greater rise in antibody titre as measured by haemagglutination inhibition assay, with the convalescent titre being at least 1 in 40.

Professor Tran Tinh Hien, Director of Clinical Research at the Hospital for Tropical Diseases and the Wellcome Trust Major Overseas Programme - Oxford University Clinical Research Unit Viet Nam has been awarded the 2010 Mackay Medal by the Royal Society of Tropical Medicine and Hygiene (RSTMH) for his outstanding work in infectious diseases in Vietnam for over twenty years.

http://www.rstmh.org/awards/medals/medals-available-2010/donald-mackay-medal

Professor Tran Tinh Hien has made seminal contributions to Malaria, Typhoid, Diphtheria, Influenza, Fasciola, Tetanus and Plague and he has inspired generations of Vietnamese and international clinicians and scientists. Hien graduated from Saigon University in 1978. His brilliance as a clinician was recognised by Cho Quan Hospital and he was made Head of the Intensive Care Unit at 27 years of age and Vice-Director at 38. He has published more than 150 scientific articles in the international literature. Hien played a major role in dealing with malaria in Viet Nam between 1975 and 1990 and helped establish successful approaches to the control typhoid in rural Viet Nam. He has lead work on plague in the central highlands, fasciola on the coast, and tetanus and diphtheria in southern Viet Nam. Professor Hien has been a leading figure in the response to Bird Flu, Swine Flu and Dengue. Prof. Hien is the most inspirational leader and teacher and without doubt one of the most respected infectious disease clinicians in Viet Nam. He has played a leading role at the Hospital for Tropical Diseases since 1989 and officially retired from government work after 34 years.

The RSTMH Mackay Medal is awarded annually in alternating years by the Royal Society of Tropical Medicine and Hygiene and by the American Society of Tropical Medicine and Hygiene. The award is for outstanding work in tropical health, especially relating to improvements in the health of rural or urban workers in the tropics. The medals ceremony will be taking place in RSTMH meeting in Liverpool in September 2010.

Asked about this award, Professor Hien said he is extremely honoured to be awarded prestigious Medal in recognition of the contributions of all his colleagues in Hospital for Tropical Diseases as well as in all the Provincial Hospitals who he has worked with since his career began. Professor Jeremy Farrar, the director of OUCRU-VN, who recommended Professor Hien for the Mackay Medal, remarks “In the year he officially retires from government work after 34 years the award of the Donald MacKay Medal is the perfect tribute to his enormous and unparalleled contribution and to the legacy of Donald MacKay”.

The UK-South East Asia Expert Meeting on the Effects of Climate Change and Urbanisation on Infectious Diseases was held on 29th June 2010 in Pham Ngoc Thach University, Ho Chi Minh City, Vietnam.

The primary objective of the workshop was to bring together scientific experts from across Asia and Europe to identify opportunities for future collaboration in this critical area.

More than 100 multidisciplinary scientists met in Ho Chi Minh City to examine how trends in urbanization and the potential effects of environment and climate change may interact to influence future patterns of infectious diseases in South East Asia and the resilience of communities and health systems to respond to these new patterns.

The workshop was organized into four sections and presented by 12 international multi-disciplinary experts. The symposium was followed by a round table discussion organised at the Wellcome Trust Major Overseas Programme & OUCRU-VN. This was an opportunity for people from very different scientific backgrounds, different countries and cultures to discuss future collaborations and to brain storm ideas on these.

The workshop was sponsored by the UK-South East Asia Partners in Science and Program and the British High Commission in Singapore, and supported by the Pham Ngoc Thach University, Hospital for Tropical Diseases and the Wellcome Trust Major Overseas Programme & OUCRU-VN Ho Chi Minh City, Vietnam.

Agenda:

Tuesday, 29th June 2010 - Identifying opportunities for Collaboration

Wednesday, 30th June 2010 - Round Table: Future Collaborations and Brain Storming Ideas

On 17 June 2010, the Department of Health of HCM City (DoH) inaugurated a completely refurbished suite of offices dedicated to the support of Health Research in Ho Chi Minh City and in doing so opened up a new era in the collaboration between DoH & OUCRU-VN and Wellcome Trust Major Overseas Programme in Viet Nam. The new Office for Health Research DoH includes a large training and meeting room (80m2) and an office (60m2) with an integrated electronic library available for anyone in the health sector in HCMC to use. The funding for this renovation was approximately 50,000 USD and has been supported by the Oxford University Clinical Research Unit and Wellcome Trust Major Overseas Programme. The DoH and OUCRU-VN & WT have worked together for 18 years but this represents a major new programme of collaborative work named “Strengthening the capacity of management and development of research activities of HCMC health sector”.

Professor Jeremy Farrar Director of OUCRU-VN, said: ‘The new Office for Health Research is a symbol and a strong foundation for our collaborative clinical and scientific research programme. In the future, we hope this collaboration will develop further with DoH and the hospitals and health sector of HCMC. In the future the health sector in HCM City will inevitably face new challenges. Viet Nam has made great advances in the control of malaria and typhoid, but now we are faced with problems from dengue fever, influenza, emerging infections, TB, drug resistance and increasingly in areas such as cardio-vascular diseases, stroke and mental health. We are delighted that this new Office of Health Research, an idea suggested from the DoH, will work to coordinate and develop a research strategy for HCMC in the years ahead and we look forward to working closely with the DoH and all partners.
The project will be conducted over a three - year period (2009-2012) in which the main objectives are establishment of the Office of Health Research at DoH, the setting up an Ethics Council for Biomedical Research at DoH; training on research methodology and skills for healthcare staff of HCMC health sector; sharing expertise, knowledge and skills in research between DoH and OUCRU-VN and the WT; cooperating in implementation of applied research topics; transferring technology and applying research achievements in disease prevention and taking care of patients as well as in the community.

Chau Nguyen Van, Director of DoH, said: ‘We are very glad to see the results of the collaboration between DoH and OUCRU-VN supported by Wellcome Trust and the South East Asia Clinical Infectious Disease Research Network (SEAICRN). The professional development in the health sector of HCM City has benefitted hugely from the work of OUCRU-VN and the Wellcome Trust, especially in tropical and infectious diseases field. I would like our cooperation will strengthen further in the future, particularly in clinical research and public health.