Saturday, June 22, 2013

#MERS PCR Confirmed In Asymptomatic HCWs In Taif KSA

Recombinomics Commentary
June 22, 2013
The other three cases are female health care workers aged 29, 39 and 45 from Taif governorate who cared for two previously confirmed MERS-CoV cases and were detected as part of the outbreak investigation and contact tracing. Two of these three cases were asymptomatic and all three tested weakly positive by PCR.

The above comments from the June 22 WHO update represents the first reported PCR confirmed MERS-CoV infections in asymptomatic contacts.  The reporting of “weak positives” as confirmed MERS-CoV represents a sea change in MERS-CoV surveillance.  

This report is likely due to a series of recent reports which highlighted serious MERS-CoV detection failures using prior approaches, and the finding of weak positives in mild or asymptomatic cases.  These developments should help end media myths which overweight negatives generated by highly suspect assays and discount positives on asymptomatic contacts such as one report that assumed the positives in Italy were false and the negatives were true, as well as another report that called the antibody positive data in asymptomatic or mild contacts inJordan “anomalies”.
The sea change began with testing of asymptomatic contacts of the MERS-CoV index case in Italy.  8-10 contacts, including at least five health care workers gave weak PCR positives.  Re-testing by a second lab, using different primers failed to confirm the positive results, so the cases remained suspect (while at least one media report called the weak positives false.
The weak positives in Italy were followed by antibody testing of contacts linked to an ICU outbreak in Jordan in the spring of 2012.  Retrospective testing confirmed MERS-CoV in the two fatal cases (one by antibody and the other by PCR and sequencing).  Testing in 2012 (for SARS coronavirus and other known human respiratory viruses) had exhausted swab samples, but serum sample were collected in 124 contacts and tested with two antibody targets.  This testing re-confirmed the two fatal cases as well as 8 contacts.  6 were from the testing of 9 contacts which had been classified as probable cases based on clinical presentation and contact with the two fatal cases.  However two cases were confirmedwho had not been previously classified as suspect because one had mild symptoms and was not hospitalized, while the other was asymptomatic.  The confirmation of the asymptomatic case was the first confirmation of MERS-CoV in an asymptomatic case.  Moreover, 7 additional cases tested positive with one of the two antibody test.  Further refinements will likely confirm the 7 additional cases.  CIDRAP called the positive antibody tests anomalies, since the cases were mild or asymptomatic.

In addition to the above positive data on mild and asymptomatic contacts, the recent New England Journal of Medicine report on the significant nosocomial outbreak in four hospitals in th eastern region of the Kingdom of Saudi Arabia highlighted detection failures in serious and fatal caseswhich were classified as probable based on clinical presentation and linkage to one or more confirmed cases.

The reporting of mild PCR cases as confirmed cases may reflect a lowering of the cut-off level, or confirmation of weak positives through sequencing of inserts (both of which are long overdue).  However, the PCR detection of MERS-CoV in asymptomatic contacts suggest confirmed cases will increase significantly, which will be accompanied by a drop in the case fatality rate.

These weak positives will also impact the monitoring of pilgrims coming to KSA to perform Umrah during Ramadan and demonstrate the sustain transmission of MERS-CoV in humans.

WHO: Middle East respiratory syndrome coronavirus (MERS-CoV) - update 22 June 2013


The Ministry of Health in Saudi Arabia has announced an additional four laboratory-confirmed cases with Middle East respiratory syndrome coronavirus (MERS-CoV).

The first case is a 43 year-old female in the Eastern Region who has recovered. The other three cases are female health care workers aged 29, 39 and 45 from Taif governorate who cared for two previously confirmed MERS-CoV cases and were detected as part of the outbreak investigation and contact tracing. Two of these three cases were asymptomatic and all three tested weakly positive by PCR.

Globally, from September 2012 to date, WHO has been informed of a total of 68 laboratory-confirmed cases of infection with MERS-CoV, including 38 deaths.

WHO has received reports of laboratory-confirmed cases originating in the following countries in the Middle East to date: Jordan, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). France, Germany, Italy, Tunisia and the United Kingdom also reported laboratory-confirmed cases; they were either transferred there for care of the disease or returned from the Middle East and subsequently became ill. In France, Italy, Tunisia and the United Kingdom, there has been limited local transmission among patients who had not been to the Middle East but had been in close contact with the laboratory-confirmed or probable cases.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.

Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.

All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

WHO continues to closely monitor the situation.

Dir. CDC Epidemic Intelligence Ctr: "There has never been reports of human infection of this strain of virus until now" #H6N1

[editing is mine]
Taipei, June 21 (CNA) A 20-year-old Taiwanese woman has been infected with the H6N1 avian influenza virus, the first time the flu strain has been reported in humans anywhere in the world, a Department of Health (DOH) official said Friday.

Yang Ching-hui, a division chief at the DOH's Centers for Disease Control (CDC), said the case was first reported to the center by a local hospital May 20.

"The hospital said it was unable to classify the subtype of avian influenza A virus found in the patient's respiratory specimen," Yang said.

The patient, who lives in central Taiwan and works at a breakfast shop, developed mild pneumonia in early May and was hospitalized on May 5, Yang said.

"The patient was discharged from the hospital on May 11 after recovering from her illness," Yang said.

According to Yang, the patient had never been abroad and had no history of contact with poultry.

The CDC eventually determined that the woman's virus was the H6N1 strain after further examining her respiratory specimen and looking at their whole genome sequence, Yang said.

The CDC later found that 36 people had come into contact with the patient, and four of them had flu-like symptoms.

"But after examining them, we found that none were infected with the H6N1 virus," Yang said.

Chuang Jen-hsiang, director of the CDC's Epidemic Intelligence Center, said H6N1 is a low pathogenic bird flu strain and is commonly found in poultry.

"There had never been reports of human infection of this strain of virus until now," Chuang said, adding that there was no evidence of person-to-person transmission in this case.

The genome sequencing of the virus isolated from the Taiwanese patient's respiratory specimen most closely resembles the H6N1 virus isolated from locally grown chickens, Chuang said.

Antiviral medications Tamiflu and Relenza have proved effective in treating the virus so far, he said.
The DOH has informed the World Health Organization, the United States, the European Union, Japan, South Korea, China and Hong Kong of the case, Chuang said.

Wang Jen-hsien, commander of the CDC's infectious diseases prevention and control network in central Taiwan, said the case was a sporadic one.

"It probably resulted from environmental pollution," Wang said.

According to Wang, the H6N1 virus mainly spreads among poultry and has been detected in poultry raised in Taiwan in the past.

Chao Pan-hua, deputy director-general of the Bureau of Animal and Plant Health Inspection and Quarantine, said the agency had collected samples from two poultry farms in the vicinity of the patient's home, but did not find any sign of the H6N1 virus.
"We have ordered the poultry farm operators to tighten sanitation management," he added.

Chao said the government's decision to ban the slaughter of live poultry at traditional marketplaces from May 17 will contribute to protecting people from being infected by avian flu viruses.

(By Kung Jui-yun and Sofia Wu)

#H7N7 Hong Kong: HK bans import of poultry products from Scott County, Arkansas, US

June 21, 2013

Hong Kong (HKSAR) - The Centre for Food Safety (CFS) of the Food and Environmental Hygiene Department today (June 21) announced that in view of a notification from the World Organisation for Animal Health (OIE) about an outbreak of low-pathogenic H7N7 avian influenza on a poultry farm in Scott County, Arkansas, the US, it has banned the import of poultry and poultry products, including poultry eggs, from the county with immediate effect for the protection of Hong Kong's public and animal health.

A CFS spokesman said about 320 000 tonnes of frozen poultry meat, 9 tonnes of chilled poultry meat and 520 000 000 poultry eggs were imported into Hong Kong from the US last year.

"We have contacted the American authorities over the issue and will closely monitor information issued by the OIE on the avian influenza outbreaks in the country. Appropriate action will be taken in response to the development of the situation," the spokesman said.

Vietnam: A/H1N1 flu is spreading rapidly

June 22, 2013

Latest survey shows HCMC Pasteur Institute, for every 100 people who visit the sick, two influenza A/H1N1 infection.
Repeatedly A/H1N1 flu deaths
Ben Tre has recorded deaths from A/H1N1 flu on the first day of this province 12/6 past. Thus, only the southern provinces in the past two months have been 5 deaths due to this disease.  
Do not disregard
Dr. Nguyen Thi Minh Phuong-Science for Disease Control HCMC Pasteur Institute, currently circulating influenza is strongest in Vietnam. Influenza virus vaccine, but there are many strains of A and B is determined likely to change each year, with the potential to cause serious illness and becoming epidemic.

Dr Nguyen Anh Tuyet said, although there are many risks, but most patients still subjective because of the onset of flu usually cough, fever, sore throat so confusing as many colds caused all agency. By analyzing the severity of the flu, onset phase initially people are very difficult to distinguish seasonal influenza A/H1N1 and influenza A/H5N1, A/H3N2.
Dr. Nguyen Thi Minh Phuong said that can not be underestimated by the A/H1N1 flu more severe disease progression if not detected early. In addition, influenza can cause high mortality for the elderly, children, pregnant women and people with chronic diseases.
With a tropical climate, time of the season between the dry season and the rainy season is considered to be present ideal conditions for virus growth. "Solutions prevent major initiative currently vaccinated with the flu vaccine as soon as possible" - Phoenix doctors recommend.
Flu Vaccine is indicated for the use of adults and children from 6 months old, can prevent the A/H3N2, A/H1N1 and B strains About 2 weeks after vaccination, the body will create antibodies to be fully protected to help you prevent disease. /.

Vietnam: MOH Statistics - Number of #H1N1 Cases More Severe Compared to 2 Years Ago

June 22, 2013

Ho Chi Minh City Pasteur Institute has announced the results of research to the doctor for every 100 people there are 2 people with influenza A/H1N1 infection.

Quick Spread
Dr. Hoang Lan Phuong, deputy Faculty of Tropical Cho Ray hospital in two days 3 and 4/6 with 2 hospital deaths due to influenza A/H1N1 stick.

This physician is concerned Local flu from the family, from the healthy to the weak condition of existence. There are grounds for this assertion, by maternal MV, 24 in District 9, the mortality at this hospital because of influenza disease infected from their husbands.
"Prior to his wife's illness, her husband flu for 3 days and then off and then infect wives" - The doctors said.
It is worth mentioning, and the spread of influenza A/H1N1 deaths increasing signs. Only the first 3 consecutive days in June in the City had 3 deaths due to H1N1.

Dr Nguyen Anh Tuyet, Deputy Director of Gia Dinh People's Hospital, Ho Chi Minh City said outside A/H1N1 flu deaths recently, is being treated in hospital for another three suspected cases of influenza A/H1N1 .

According MA Le Van Tuan, representing the World Health Organization in Vietnam H1N1 does not appear in previous seasons that tend to spread germs in all times of the year. He said that most likely the death row because new H1N1 strain this does not exclude the changes.

Meanwhile, statistics from the Ministry of Health in the first five months of 2013 also shows that there are over 300,000 people infected with the flu, including H1N1 sub type accounts for 46% of all specimens tested positive for influenza virus . Number of A/H1N1 flu cases more severe compared to 2 years ago.
According to Mr. Tran Nhu Duong, Deputy Director of the Institute of Hygiene and Epidemiology INVESTMENT, in recent weeks the pandemic influenza A/H1N1 2009 vaccine in humans tends to increase, on average four months of the year accounted for 46% of patients flu, while in 2012 only accounted for 5.6% of the total number of influenza patients.

#Coronavirus #MERS Case List updated

The 81yo reported death today, is from the Saudi Arabia Cluster, case #18.  The updated list is below:

Saudi Arabia Cluster Stat:  13 Deaths, 22 Cases
Total Global cases:  66
Total Global Deaths:  39
Saudi Arabia:  55 Cases; 33 Deaths
France, Europe:  2
Tunisia, N Africa:  2 (3rd probable)
Italy, Europe:  3

Saudi Arabia Cluster*
Case Number—Name—From--Onset—Condition—DOD
#1--59M—al Hofuf--4/14—Died--4/19*
#2--24M—al Hofuf--4/17—Died 5/29*
#3--87M—al Hofuf--4/17—Died--4/28*
#4--58M—al Hofuf--4/22—Died--5/29*
#5--94M—al Hofuf--4/22--Died--4/26*
#6--56M—al Hofuf--4/22—Died--4/30*
#7--56M—al Hofuf--4/22—Died--4/29*
#8--53F—al Hofuf--4/27--ICU Critical/Stable*--Recovered
#9--50M —al Hofuf--4/30—ICU Critical**--Recovered
#10-- Hussein al-Sheikh 33M—al Hofuf--4/28—Recovered, discharged.
#11—62F—al Hofuf--4/19—Died—5/3*
#12—71M—al Hofuf--4/15—Died—5/3*
#13—58F—al Hofuf--5/1—ICU Critical/Stable*--Recovered
#14—48M—al Hofuf—4/29—Died—6/9
#15—58M—al Hofuf—4/6—Recovered, discharged 5/3
#16—69F—al Hofuf—4/25—Died 5/8
#19—56M—al-Hofuf—5/7—Recovered, discharged
#20—45M HCW—al Hofuf—5/2—Critical—Recovered
#21—43F HCW—al Hofuf—5/8—Stable**--Recovered
#22—81F—HCF patient—4/28—Died 5/26

5/26 KSA MOH Announces 9 Recovered.
*1 Death reported is not noted in above list (60yo) by WHO (5/31) & KSA MOH (5/29)
6/1 – 3 Deaths Reported, not designated as “deaths” in list above.

France Cluster [visited Dubai]
Case Number—Name—From--Onset—Condition—DOD
#1—65(M)--Valenciennes—4/23—DOD 5/27

Tunisia [visited KSA & Qatar]
Case Number—Name—From—Onset—Condition--DOD
#1—66(M)—Monastir Tunisia—4/30—Negative Conf.—Father--Died 5/10
#2—34(M)—Monastir Tunisia—confirmed--sibling--recovered (after 5/3)
#3—35(F)—Monastir Tunisia--confirmed—sibling—recovered (after 5/3)

Italy –[traveled to Jordan]
#1—45(M)—Florence—Approx. 5/24—Stable
#2—18mos.(F)—Florence—Adm 6/1—Discharged 6/5
#3—52(F)—Florence—Adm 6/1—Discharged 6/6

Saudi Arabia*
Case Number—Name—From—Onset—Condition--DOD
#1—63(M)—Qassim—Died 5/20
#2—56(M)—Eastern Reg.—5/12—DOD 5/20*
#3—85(F)—Eastern Reg.—5/17—Critical*
#4—76(F)—Eastern Reg.—5/24—Discharged 5/27&
#5—77(M)—Eastern Reg.—5/19—DOD 5/26*
#6—73(M)—Eastern Reg.—5/28—DOD 5/26*
#7—61—Al-Ahsa—Reported on 5/29
#8—14(F)—Eastern Reg.—5/29--—Stable*
#9—83(M)—Al-Ahsa—5/27—DOD 5/31
#10—21(M)—Hafr Al-Batin—DOD 6/12
#11—63(F)—Eastern Region—Stable
#13—65(M)—Taif, Mekkah Prov.—end of May—Related 68(F) -DOD 6/16
#14—68(F)—Taif, Mekkah Prov.—6/6—Related 65(M)—DOD 6/16
#15—46(M)—Wadi Al-Dawasir, Riyadh Prov.—5/29—DOD 6/14
#16—42(M)--Eastern Reg.—Reported on 6/16
#17—63(F)—Riyadh—ICU—Reported on 6/16
#18—2—Jeddah—ICU—Reported on 6/16
#19—42(F)—Eastern Reg.—Recovered—Rptd on 6/20
#20—45(F)—Taif—Healthcare worker—Recovered—Rptd 6/20
#21—39(F)—Taif—Healthcare worker—Recovered—Rptd 6/20
#22—29(F)—Taif—Healthcare worker—Recovered—Rptd 6/20
#23—41—Riyadh—contact of another confirmed—Rptd 6/21
#24—32—Eastern Province—suffering from cancer—Rptd 6/21

*2 Deaths reported KSA MOH 6/16 not reflected above list.

*multiple comorbidities
**with comorbidiity

MOH: "Two New Cases of Novel Coronavirus Recorded and One Case Passed Away"

English version

21 June 2013
Within the framework of the epidemiological surveillance of the novel Coronavirus (MERS-CoV), the Ministry of Health (MOH) has announced that two confirmed cases of this virus have been recorded. The first case is for a 41-old-year Saudi female in Riyadh, from the contacted people to one of the confirmed cases, but her conditions is stable. The second case is for a 32-year-old Saudi citizen in the Eastern Region, who is suffering from Cancer and now at the ICU receiving the proper treatment.

Within the same vein, MOH has announced the death of one case in the Eastern Region, who had been previously announced to be infected with this virus and admitted to hospital on 26th of April, 2013 (corresponding to 16th of Jumada Al-Akhera, 1434 H), May Allah have mercy upon him.

I222 Neuraminidase Mutations Further Reduce Oseltamivir Susceptibility of Indonesian Clade 2.1 Highly Pathogenic Avian Influenza A(H5N1) Viruses


PLoS One
2013 Jun 11
McKimm-Breschkin JL, Barrett S, Pudjiatmoko, Azhar M, Wong FY, Selleck P, Mohr PG, McGrane J, Kim M.

Commonwealth Scientific and Industrial Research Organisation, Materials Science and Engineering, Parkville, Victoria, Australia ; Commonwealth Scientific and Industrial Research Organisation, Australian Animal Health Laboratory, Geelong, Victoria, Australia.

We have tested the susceptibility to neuraminidase inhibitors of 155 clade 2.1 H5N1 viruses from Indonesia, isolated between 2006-2008 as well as 12 clade 1 isolates from Thailand and Cambodia from 2004-2007 using a fluorometric MUNANA-based enzyme inhibition assay. The Thailand and Cambodian clade 1 isolates tested here were all susceptible to oseltamivir and zanamivir, and sequence comparison indicated that reduced oseltamivir susceptibility we observed previously with clade 1 Cambodian isolates correlated with an S246G neuraminidase mutation. Eight Indonesian viruses (5%), all bearing I222 neuraminidase mutations, were identified as mild to extreme outliers for oseltamivir based on statistical analysis by box plots. IC50s were from 50 to 500-fold higher than the reference clade 1 virus from Viet Nam, ranging from 43-75 nM for I222T/V mutants and from 268-349 nM for I222M mutants. All eight viruses were from different geographic locales; all I222M variants were from central Sumatra. None of the H5N1 isolates tested demonstrated reduced susceptibility to zanamivir (IC50s all <5 nM). All I222 mutants showed loss of slow binding specifically for oseltamivir in an IC50 kinetics assay. We identified four other Indonesian isolates with higher IC50s which also demonstrated loss of slow binding, including one virus with an I117V mutation. There was a minimal effect on the binding of zanamivir and peramivir for all isolates tested. As H5N1 remains a potential pandemic threat, the incidence of mutations conferring reduced oseltamivir susceptibility is concerning and emphasizes the need for greater surveillance of drug susceptibility.

[PubMed - in process]

Free full text

Friday, June 21, 2013

#MERS #Coronavirus Saudi Arabia Health announces two new cases of infection with HIV Corona New Sharqia and Riyadh .. and deaths Sharqia

Under investigation epidemic disease virus Corona new (MERS-CoV) be announced the Ministry of Health Tsjelhalh confirmed cases of citizenship in the Riyadh region at the age of 41 years, which is in contact with one of the confirmed cases and in stable condition, in addition to record the status of certain other citizen Fayalmntqh East of 32-year-old, suffering from cancer, a currently under Annaahantrzh. 
also announces the death of a citizen in the eastern region of the 81-year-old, who previously announced the injury, and had been admitted to hospital on 16 Jumada II, God's mercy.

#MERS #Coronavirus Saudi Arabia 55 Global Cases; 33 Global Deaths

From Health Awareness at Ministry of Health website

Saudi Arabia: Citizen refuses to receive the bodies of his two daughters after their death Krona disease in Najran #MERS #Coronavirus


Citizen Hadi refused Hamad Al Zmanan the receipt bodies daughters Almtovian, from the maternity hospital, after twenty-four hours of entering the hospital.
He demanded a neutral committee commissioned to uncover the reasons the death of Taflth "Shaden and Slav", which died yesterday and the day before yesterday, and separated by only twenty-four hours.
He said "Al Zmanan," According to the site it already Monday evening draw Btaflth to Maternity and Children Hospital in Najran to Maanathma of high temperature and chest infections, were Tnoimama intensive care, under the negligence or carelessness of the crew located Balotflten the two Zlta Tsaraan death.
He added "Al Zmanan that the hospital had told him that the cause of death on suspicion of being infected with HIV Koruna, before caused her sister on Wednesday evening, without clarification of the real causes of death, making it refuses to receive her body.

Vietnam: Vinh Long - Temperatur monitoring daily for contacts of 2 patients that died #H1N1

Prior complicated of A/H1N1 flu in the area with 2 patients died, Vinh Long Department of Health has purchased 500 rounds emergency treatment medications Tamiflu for treatment and prevention, care priorities, the treatment, advocacy, prevention, epidemic accordance with the procedures and guidelines of the Ministry of Health specialist, Department of Preventive Medicine and Pasteur Institute of Ho Chi Minh City.
Vinh Long enhance communication so that people do not know how confused and prevention; reviewing and consolidating operations in the BCD preventive-market all-in 8 districts, 107 communes-ward-town and epidemic prevention team maneuver.preventive health system in the province, especially in Mang Thít District and Vinh Long City 2 had local H1N1 deaths increase testing, close monitoring, early detection, timely treatment and environment temperature monitoring daily prescribed for those exposed to 2 patients died of A/H1N1 flu. Province prepared epidemic maneuver forces , the number of drugs, chemical disinfection to ensure thorough handling the outbreak.

The provincial hospitals and district-to-market plans prepared when disease, assigning 24/24 hours; prepare enough where isolation, collection and treatment of timely and regimen of the Health. Particularly Provincial Hospital, Dr. Nguyen Thanh Aluminum Director said: The hospital has established Steering and prevention of influenza A team of nearly 20 doctors and nurses, nursing; 20 beds for in Science Spread - infection (50% of the department's bed) for the receipt, collection, isolating, treating infected or suspected cases of influenza A. If an outbreak, the hospital will spend the entire 40-bed infectious diseases department for combating infectious epidemic.
The health sector Vinh Long advised people to enhance personal hygiene, if you have signs such as fever, sore throat, cough, headache, fatigue, rapid progression, require immediate medical facilities to be examination, monitor and treat promptly. 

Vietnam: Ca Mau: Detection of influenza A/H1N1 patients first #H1N1

Ca Mau Province is located in the extreme southern tip of Vietnam.


Ca Mau province has 1 reception and treatment of patients infected with influenza A/H1N1. This is the first patient infected with A/H1N1 flu in Ca Mau province since early this year. According to the treating physician, before admission, 1 male patient, age 69, residing in the commune Nguyen Plugs, U Minh districts showed signs of breathing room and the expression of influenza. The doctors conducted isolation, monitoring and aggressive treatment for patients. Upon sampling tests, the results showed that patients positive for A/H1N1 flu virus.

Vietnam: Number of #H1N1 Cases Up 30% from Last Year Same Period

500 who received Tamiflu for prevention of influenza

+ Number of flu cases increased nearly 30% over the same period
On 20/06/2013, Dr. Nguyen Thanh Tu-director of the Center for Preventive Medicine Vinh Long province, said the center has received 500 industry members from Tamiflu function to serve the prevention of influenza in the province province. Basis drugs were issued for provincial hospitals, local hospitals and medical centers affiliated. This is the latest move in the prevention of influenza in the direction of the Chairman of Vinh Long, after 2 deaths and samples are Ho Chi Minh City Pasteur Institute concluded positive for influenza A / H1N1.
Leadership Centre for Preventive Medicine, said Vinh Long province, the province in 2012 recorded 1,639 cases of influenza (the flu-season), down 77.8% from 2011. The first months of 2013, the province recorded 1,283 cases of influenza, increased 29.9% over the same period in 2012.