#16,890
Yesterday, in Vietnam Reporting Summer Surge In Influenza, we looked at multiple media reports on a recent summertime surge of influenza A in Vietnam. At that time I mentioned that their Ministry of Health's website had yet to publish any information on the outbreak.
A return to Vietnam's MOH 24 hours later finds a couple of reports - originally published by Suckhoedoisong.vn (Health & Life Newspaper) - the self described `mouthpiece of the MOH'.
As we saw yesterday, these reports only refer to `Influenza A', without providing a subtype. Recent outbreaks in China, Australia, and New Zealand have all been attributed to H3N2, and so it would be natural to assume H3N2 in this case as well.
However, the demographics of cases being treated at the Central Hospital for Tropical Diseases are heavily weighted towards small children (under-5 age group at 44.1%) and young adults (18-49 years - 39.7%), while adults 50 and up make up only 4.4% of cases.
An age-shift more associated with seasonal H1N1, than with H3N2.
Of course, after two years of masking and social distancing for COVID, we are seeing a lot of unexpected behavior with influenza.
Two (translated) reports, with the second dealing primarily with concerns over a steep rise in encephalitis-like presentations in young children.
Hanoi recorded more than 2,600 flu cases, with some severe cases requiring mechanical ventilation
20/07/2022 | 15:18 PM
As of July 18, Hanoi recorded more than 2,600 flu cases. The number of cases increased sharply in June and the first two weeks of July.
On July 20, the Center for Disease Control (CDC) in Hanoi informed that, according to statistics from the infectious disease surveillance system, from the beginning of the year to the end of July 18, the city recorded 2,605 cases. cases of influenza, no deaths have been recorded.
If the period from January to April, the number of cases is less than 400 cases/month, in May the number of cases increased to 556 cases, then in June, the number of cases increased to 887 cases.
According to information from the Central Hospital for Tropical Diseases, in recent weeks, there has been an increase in the number of people coming for medical examination due to influenza. Specifically, from July 1 to 15, the hospital received examination and screening for 1,068 suspected cases of influenza infection. This number is larger than the number of suspected flu cases in the first 6 months of the year combined at this hospital.
Of these, more than 35% of patients (equivalent to 375 cases) had a positive rapid test for influenza. In particular, up to 366 cases were positive for influenza A. The number of cases with indications for hospitalization was 71 cases (18.9%), including 2 cases of pneumonia with advanced respiratory failure (ARDS) hospitalized.
The Hanoi Department of Health also said that in Hanoi, there are 252 influenza A patients treated at the Central Hospital for Tropical Diseases, these patients are distributed in 23/30 districts, towns.
Most patients with mild symptoms are treated as outpatients. In 71 cases with indications for hospitalization, mainly pregnant women, children, people with underlying diseases, most of them recover after 3-4 days of treatment.
Hanoi recorded a case of severe pneumonia and respiratory failure in a patient in Chuong My, 78 years old with heart failure and pneumonia. This case developed severe, respiratory failure, requiring mechanical ventilation at the Central Hospital for Tropical Diseases.
This facility also has about 20 patients under treatment.
Regarding the distribution of patients by age group among patients treated at the Central Hospital for Tropical Diseases, the Hanoi Department of Health said: The number of flu cases was highest in the under-5 age group at 44.1%, followed by the age group of 18-49 years old accounting for 39.7%, the age group of 6-18 years old accounting for 11.8% and the age group over 50 years old accounting for 4.4%.
According to the Department of Health, the current flu situation is on an increasing trend. Also today, July 20, Deputy Director of Hanoi CDC Khong Minh Tuan signed a document to the health centers of districts and towns to direct on strengthening surveillance and prevention of seasonal flu. .
Accordingly, the Hanoi CDC requested Health Centers of districts, towns of the city to strengthen surveillance for early detection of seasonal flu cases in the community and at medical examination and treatment facilities, especially in Hanoi. high-risk areas (child care facilities, social protection centers, rental apartments, living quarters of workers in industrial zones,...) to promptly detect and handle these areas early. areas with many patients, minimizing the number of cases and deaths.
At the same time, review and strengthen the rapid response teams for epidemic prevention and control, prepare a sufficient number of epidemic prevention and control equipment to be ready to respond to situations when the epidemic spreads in the area; Strengthen communication on epidemic prevention measures; synthesize monthly report data and report immediately to severe cases, areas with many patients...
Source: Suckhoedoisong.vn
Due to its length, I've only posted excerpts from the following report. I'll have a brief postscript after the break.
Fear of encephalitis after influenza A
19/07/2022 | 19:31 PM
At the National Children's Hospital, only on July 18, the Children's Tropical Diseases Center treated up to 45 children with influenza A. The hospital beds here are always full. The youngest patient is less than 1.5 months old.
In Hanoi and many northern provinces and cities, the number of influenza A patients is increasing abnormally.
At the National Children's Hospital, since half a month now, when the number of patients increases, the beds here are always full, sometimes they have to temporarily add extra beds while not being arranged in time.
The youngest patient being treated here is HTM, who has just passed a full month of 11 days. The baby from Son La was brought to the National Children's Hospital in a state of high fever, breastfeeding, and pneumonia.
Every day, the Center receives 15-25 pediatric patients hospitalized with severe symptoms such as high fever over 39 degrees Celsius that does not go down, respiratory failure, pneumonia, influenza, high fever, convulsions, organ dysfunction, injury. nerve...
In addition to the number of patients hospitalized for inpatient treatment, patients with mild influenza A who come to the clinic are prescribed outpatient treatment by doctors. Most children infected with influenza A go to the National Children's Hospital under the age of 5, in Hanoi and some surrounding provinces.
At the Central Hospital for Tropical Diseases, Thanh Nhan Hospital, and Dong Da Hospital (Hanoi), the number of patients coming for examination and treatment has increased abnormally.
At the National Hospital for Tropical Diseases , on average, the Department of General Infections receives 30-40 cases of influenza A infection every day. The cases requiring hospitalization are mainly the elderly, people with underlying medical conditions, and pregnant women.
In particular, the hospital recorded a cluster of nearly 20 cases with flu symptoms, all of which were workers in an industrial park in Dong Anh district (Hanoi).
In the pediatric department of this institute, in hundreds of cases every day, up to 1/4 - 1/5 of the patients have influenza A.
At the Department of Infectious Diseases, Dong Da General Hospital (Hanoi), by the morning of July 19, there were about 30 influenza A patients being treated, accounting for the majority of patients being treated here. Every day, this department has about 15-20 patients coming for examination, about half of these (7 cases) have indications for hospitalization.
In just one day on July 18, the Children's Tropical Diseases Center under the National Children's Hospital treated up to 45 children with influenza A.
Many influenza A patients develop severe symptoms, even requiring ECMO. Typically, a pediatric patient in Nghe An is being treated at the National Children's Hospital. After 1 week of treatment in Nghe An, the baby had severe respiratory failure, lung damage, and was moved to Hanoi quickly for ECMO intervention.
Assoc. Prof. Dr. Ta Anh Tuan, Head of the Intensive Care Unit of Pediatrics (National Children's Hospital), said that this patient suffered severe lung damage. Doctors are maintaining vital functions within normal limits, but lung damage is very severe and recovery is slow.
(SNIP)
Worried about post-influenza encephalitis
According to Dr. Do Thien Hai - Deputy Director of the Center for Tropical Diseases, National Children's Hospital, through analysis, it can be seen that influenza A this year compared to 2009 (statistics every 10 years) has many points difference.
Symptoms are also more severe than before.
Worth mentioning, there are now 40-45% of children having convulsions compared to only a few 2009 cases. According to Dr. Hai, previously only 1-2 cases of encephalitis after influenza A, but this year the number of encephalitis is up to 3- 3. 6%.
A dangerous complication that appears recently is encephalitis after influenza. About 3-5 days after the flu, some children show signs of central nervous system damage such as lethargy, lethargy, convulsions ... ", Dr. Do Thien Hai
Post-influenza encephalitis with CNS damage is currently an issue that needs to be studied because this condition did not appear before, according to Dr. Hai.
Influenza A is usually mild and recovers within 2-7 days. However , some patients at high risk for complications from influenza are children under 5 years of age, with children under 2 at particularly high risk; adults over 65 years of age; people with chronic medical condition, women in the 2nd or 3rd month of pregnancy ", Dr. Hai said.
Doctor Hai recommends that, to prevent the flu from spreading, it is necessary to use the air conditioner properly, not to turn it on all day, but to have a period of time to turn off the air conditioner, open the door for air circulation and kill the virus.
In addition, people need to get an annual flu vaccine two weeks to one month before the flu outbreak occurs (March, April, September, October of the year).
Along with that, everyone should wear masks, limit contact with flu patients or suspected cases when not necessary. When having symptoms of cough, fever, runny nose, headache, fatigue, it is necessary to immediately go to a medical facility for timely examination and treatment.
Source: Suckhoedoisong.vn
In the translated article above, Doctor Do Thien Hai appears to compare this year's flu epidemic to 2009's pandemic H1N1, and calls this year's virus `more severe'. He then describes a marked increase in post-influenza encephalitis, particularly among very young children.
Since it would make sense to compare years with the same influenza subtype, this may be another indication that they are dealing with H1N1.
Whether any of this is due to recent changes in the virus, or simply to reduced immunity and diminished health resilience in the community following two years of COVID, remains to be seen.
Hopefully we'll get some clarification soon.
