DISEASES IN VIETNAM

DISEASES IN VIETNAM

Visitors to Vietnam sometimes have health problems. The food and health standards are below those of European or North American countries. Dysentery, hepatitis, stomach parasites, dengue fever and malaria occur in Vietnam. Outbreaks of cholera and bubonic plague have occurred in Vietnam.

In 2007, Vietnam dealt with various diseases, including cholera, dengue fever that has infected 75,200 people and killed 64, bird flu and the "blue ear" disease in pigs. In 2006, Grant McCool of Reuters wrote: “A U.N. World Health Organization study found that 55 million of Vietnam's 83 million people had intestinal worms, which can cause weight loss and listlessness, leading to absences from work and school and malnutrition in children. The list of diseases is long in the densely-populated tropical country where 75 percent of people still live in rural areas or are engaged in agriculture. It includes HIV and AIDS, tuberculosis, meningitis, malaria, dengue, encephalitis and more. [Source: Grant McCool, Reuters, October 5, 2006 *=*]

Major infectious diseases: degree of risk: high. Food or waterborne diseases: bacterial diarrhea, hepatitis A, and typhoid fever. Vectorborne diseases: dengue fever, malaria, Japanese encephalitis, and plague. Water contact disease: leptospirosis. highly pathogenic H5N1 avian influenza has been identified in this country; it poses a negligible risk with extremely rare cases possible among US citizens who have close contact with birds (2009)

See Food Scares Under Food

Hans Troedsson, WHO representative in Vietnam, told Reuters he links the battle to prevail over these diseases to the country's ambitions to develop the economy and lift people out of poverty. "My constant advice to the government is that if you don't have a healthy population you can't compete economically," said Troedsson. "You not only have the burden of diseases, but also they can't function in production." Malaria is far less prevalent in Vietnam than it used to be, partly due to a campaign to distribute mosquito nets and encourage their use. Trachoma, a leading cause of blindness among rural poor but treatable by surgery, has also been reduced by Vietnam's participation in a global program to fight the disease. [Source: Grant McCool, Reuters, October 5, 2006 *=*]

Disease in Vietnam in the 1980s

The most common diseases were malaria, tuberculosis, trachoma, intestinal infections, leprosy, diphtheria, tetanus, whooping cough, measles, poliomyelitis, chicken pox, typhoid fever, acute encephalitis, and acute meningitis. Hanoi claimed in 1970 that alcoholic cirrhosis and venereal diseases were "seldom found in North Vietnam because of the wholesome and temperate life of the population and the cadres." In November 1984, however, the government admitted that the incidence of these diseases had increased "significantly" since 1976, "especially in the major cities." [Source: Library of Congress *]

Vietnam claimed to have eliminated cholera, smallpox, and typhoid in the North as early as 1959 and poliomyelitis by 1961. Much progress was reported also in the containment of trachoma, tuberculosis, and other diseases, but an official assessment made public in November 1984 acknowledged that, except for smallpox, contagious and infectious diseases had yet to be brought under control and that the mortality rate associated with these diseases remained high. *

Tuberculosis, responsible for the death of about 1 percent of the national population, or nearly 600,000 persons annually, remained a major problem although the rate fell from the 1.7 percent reported in 1976. In 1984 as many as 92 percent of the people examined in many different localities were found to be afflicted with one or more diseases. Authorities judged from these results that as few as 48 to 60 percent of the people in the localities sampled were in good health. Gastroenteritis and such childhood diseases as diphtheria, and whooping cough accounted for the extremely high 35 percent mortality rate among children, but the annual death rate for the population as a whole in 1983 was 7.4 per 1000 persons, a decline from 26 per 1000 in 1945. *

The prevalence of epidemics of bacterial, viral, and parasitic diseases was attributed to the unsanitary environment. For this reason the government introduced programs to improve hygiene habits. Sanitary stations emphasizing water and environmental purification were established in every district, and campaigns such as the Three Cleans movement (clean food, water, and living conditions) and the Three Exterminations movement (extermination of flies, mosquitoes, and rats) were instituted. In addition, officials encouraged district residents to dig wells and construct septic tanks. They recommended regular vaccinations and inoculations against diphtheria, tetanus, whooping cough, polio-myelitis, tuberculosis, and measles. *

Seventy Die of Tuberculosis Each Day in Vietnam

Tuberculosis (TB) cases are on the rise, with 57 deaths per day reported in May 2004. With an intensified vaccination program, better hygiene, and foreign assistance, Vietnam hopes to reduce sharply the number of TB cases and annual new TB infections. [Source: Library of Congress]

In March 2013, Thanh Nien reported: “Tuberculosis is still a major health risk in Vietnam, which ranks 12th in the world for most TB patients with nearly 200,000 new cases and 30,000 deaths recorded every year, according to reports heard at a March 20 meeting. One of the challenges to the country’s fight against TB is the high number of TB patients who are resistant to medicines prescribed for the disease, heard the meeting. Vietnam now has 5,000-6,000 drug-resistant TB patients, and it was estimated that up to 20 percent of TB patients cannot be treated due to their resistance to drugs. [Source: Thanh Nien, March 21, 2013 <<>>]

“Dr. Tran Ngoc Buu from Ho Chi Minh City’s Pham Ngoc Thach Hospital, which specializes in TB cases, said most TB patients quit treatment when they begin feeling better after having taken the prescribed drugs for a couple of months. The incomplete treatment renders patients susceptible to relapse and likely to have developed resistance to TB drugs, he stressed. It takes 19-24 months to treat drug-resistant TB patients, who may suffer from many unwanted side-effects atypical of the six-months of treatment regular TB patients receive, according to the doctor. He warned that if patients repeatedly fail to “strictly” follow the treatment prescribed for drug-resistant TB patients, they will become “super-resistant,” a condition which carries a high death rate. As TB drugs have not changed much over the years, treating the population will be exceedingly difficult if more patients develop resistance to the drugs, which in turn will pose high risks to the entire community, Buu said. “ <<>>

In 2001, Associated Press reported: “Tuberculosis kills about 20,000 people every year in Vietnam, or about 55 people each day, an official said Tuesday. About 145,000 people, including 20,000 children, contract TB each year out of a population of 78 million, said Nguyen Viet Co, director of the Institute of Tuberculosis and Lung Diseases. Most are from poor families. With the addition of patients who were previously diagnosed, the total number of TB patients is about 220,000, Co said. Vietnam ranks 11th in the world in terms of the number of TB patients and third in Asia after China and the Philippines, he said. Co blamed the country's high rate of TB on the low level of social and economic development, including widespread poverty, poor environmental hygiene, low investment in TB treatment and prevention, and increasing levels of HIV-AIDS infections, which increase susceptibility to TB. [Source: Associated Press, May 30, 2001 */*]

“In 1995, the government launched a national anti-TB program budgeted at between 15 billion dong ($1 million) and 18 billion dong (dlrs 1.2 million) per year, enough to satisfy only one fourth of the need, Co said. The World Bank is assisting the anti-TB program with dlrs 16.5 million over five years starting in 1998, he said. The Dutch government is also providing $7.5 million to battle the disease over the next five years, he said. Vietnam has been recognized by the World Health Organization as one of seven countries which are successfully battling TB by meeting its criteria of recognizing more than 70 percent of TB patients and curing more than 85 percent, he said. */*

Plague in Vietnam

From 1954 to the early 1980s, most cases of plague worldwide were reported from Asia. Myanmar and Viet Nam have reported cases of human plague virtually every year between 1954 and 1985. There were outbreaks of the disease in Vietnam during the Vietnam War and an outbreak in the late 1990s and early 2000s.

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p> According to the paper “Correlates of environmental factors and human plague: an ecological study in Vietnam” by Pham HV, Dang DT, Tran Minh NN, Nguyen ND, Nguyen: In recent years “outbreaks of plague have occasionally occurred in Vietnam's Central Highlands region. From 1997 through 2002, 472 cases of plague were reported, of whom 24 (5.1 percent) died. The incidence of plague peaked during the dry season, with approximately 63 percent of cases occurring from February through April. The risk of plague occurrence was associated with an increased monthly flea index (RR and 95 percent CI: 1.93; 1.61-2.33 for months with the flea index >1) and increased rodent density (RR 1.23; 1.15-1.32 per each 3 percent increase in density). Moreover, the risk of plague increased during the dry season (RR 2.07; 1.64-2.62), when rainfall fell <10 mm (RR 1.44; 1.17-1.77). [Source: Correlates of environmental factors and human plague: an ecological study in Vietnam. Pham HV, Dang DT, Tran Minh NN, Nguyen ND, Nguyen TV. International Journal of J Epidemiology, December 2009 ]

Human plague caused by Yersinia pestis remains a public health threat in endemic countries, because the disease is associated with increased risk of mortality and severe economic and social consequences. The bubonic plague spread by fleas. Pneumonic plague is spread by human sputum and septicemic plague spread by insects.

Humans stricken with the plague in Byzantine times showed symptoms almost immediately. Victims ran a high fever and suffered excruciating swelling in their groin, upper legs and armpit areas—the buboes, which the bubonic plague is named after. Abscesses and carbuncles sometimes also appeared on the skin, and a white coasting covered the tongue. Most Bubonic plague victims died within five days. Sometimes the infection spread via the bloodstream to the lungs; then death came in three days or less, with victims spitting up blood before they died. This was pneumonic plague, the deadliest form of the disease."

The study in Vietnam included all 510 communes of the Central Highlands region (with a total population of approximately 4 million) where 95 percent of incidence of plague cases in Vietnam had been reported from 1997 through 2002. Plague was clinically ascertained by using a standard protocol by WHO. Data on domestic fleas and rodents were obtained by using traps and periodic surveillance in accordance with the WHO guidelines. Temperature, duration of sunshine, rainfall and humidity were recorded as monthly averages by local meteorological stations. The association between these ecological factors and plague was assessed by using the Poisson regression model. These data suggest that the flea index, rodent density and rainfall could be used as ecological indicators of plague risk in Vietnam. The data also suggest that the occurrence of plague in Vietnam's Central Highlands is likely resulted from multiple causes that remain to be delineated.

Leprosy and Trachoma in Vietnam

In 2005, Xinhua reported: “Vietnam reported the rate of leprosy cases nationwide dropped to an average of 0.1 per 10,000 residents in 2004 from 0.7 per 10,000 in 1995. With the drop, Vietnam attained the World Health Organization's leprosy elimination target of less than 1 per 10,000 population, according to the Vietnam News Agency on Monday. Over the past decade, nearly 23,370 leprosy patients have been cured, while more than 10,000 disabled others have been given annual functional rehabilitation, said the agency. To eliminate the disease totally in the country, the Health Ministry will increase social involvement in combating the disease, give high-risk remote and rural areas greater access to leprosy control services and improve functional rehabilitation services for disabled patients. [Source: Xinhuanet, July 26, 2005]

In 2005, AFP reported: “Vietnam is aiming to eradicate trachoma, which causes blindness, within five years, a decade before the global elimination target date of 2020 set by the World Health Organization (WHO), officials said. "We are proud to have reduced the incidence of trachoma so dramatically as a result of our national trachoma control strategy," Vice Minister of Health Tran Chi Liem said in a statement. Vietnam, where the International Trachoma Initiative was launched in 2000, has proven to be a model in the fight against the disease, according to the statement issued to coincide with a visit by former US supermodel Cheryl Tiegs to promote awareness. Trachoma is the world's leading cause of preventable blindness. [Source: Agence France Presse, July 7, 2005 <*>]

It is easily spread from mother to child and through casual contact, but health officials said it could be controlled through improved hygiene, sanitation, use of antibiotics and simple surgery in advanced cases. Approximately eight million people are visually impaired as a result of trachoma all over the world. The WHO estimates that 10 percent of the world's population is at risk of contracting trachoma, making it a major public health threat. In Vietnam, an estimated 11 million people are at risk of infection, with 300,000 cases of trachoma-related blindness. <*>

Dengue Fever in Vietnam

Dengue Fever is a problem in Vietnam. In the first six months of 2004, dengue fever killed at least 33 people and infected more than 16,650, more than double the previous year. It is found mostly in southern Vietnam, particularly around Ho Chi Minh City and in the Mekong Delta. During the 2004 outbreak, 90 percent of the cases were in southern Vietnam. Outbreaks are most likely early in the rainy season from May to August.

Dengue fever infects between 50,000 and 100,000 people in Vietnam every year, killing nearly 100, according to figures from Vietnam’s Health Ministry cited in a report on the government website. Large outbreaks of the virus, which first appeared in Vietnam in 1969, tend to occur every three or five years, according to health experts, and this year is within the circle of heavy infection. Dengue fever strikes mostly in the rainy season in the summer. September marks the peak of the annual dengue fever season.

In 1998 there were 235,000 cases in Vietnam, with 383 deaths. In 2005 Vietnam reported 49,400 cases of dengue fever infections, including 51 fatalities, 32.7 percent and 49.5 percent from the previous year, respectively, according to the country's General Statistics Office. In 2004 Vietnam reported 73,300 cases of dengue fever infections, including 101 fatalities, up 108 percent and 74 percent against the year earlier, respectively. To minimize the number of new infections, local health workers have encouraged residents to kill mosquitoes and their larvae more actively. More chemicals used to kill the insect are given to the residents.

Vietnam has responded to the increase in cases in the Mekong Delta by spraying for mosquitoes in urban areas and urging rural families to kill mosquitoes and try to avoid their bites. Most of the sufferers are from the provinces of Hau Giang, An Giang and Dong Thap, where weather conditions and local people's habit of storing water in containers at their houses favored the development of mosquitoes -- the disease's transmitter.

In Vietnam, the WHO said some 29,010 dengue cases with 20 deaths were reported in 2012 up to the end of July 2012 with 22,853 cases and 22 deaths in all of 2011. [Source: Radio Free Asia, September 20, 2012]

Dengue Fever

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aegypti mosquito
Dengue fever is a nasty, viral disease transmitted by the Aedes mosquito, usually the Aedes aegypti , the same mosquito that often carries yellow fever. Sometimes called "breakbone fever" or "break-heart" because of the intense pain it can produce, the disease is characterized by sudden onset of fever; intense pounding, frontal headaches; aching bones and joints; nausea and vomiting; and a feeling of being too sick to eat anything. Other symptoms include severe sweats, symptoms: eye pain, rash, chills, and excruciating chest pains. Tests foe dengue rely on the presence of antibodies, which can take up to a week to develop.

Dengue fever is found in 100 countries and kills about 20,000 people annually. Nine out of 10 people who get dengue fever don’t even feel it or get a mild case in which they feel something akin to a slight flu. People who get full-blown dengue fever are sick for a week or more. Many patients have a rash, which appears 3 to 5 days after the onset of the disease, and experience severe emotional and mental depression during the recovery period. Most cases of the disease are benign and self-limiting although convalescence may take a long time.

A few people with dengue fever suffer gastrointestinal bleeding. Fewer still suffer brain hemorrhages. In about 1 percent of cases dengue fever can cause a severe and often fatal hemorrhagic disease called dengue hemorrhagic fever (DHF) that occurs when capillaries leak and the circulatory system collapses.. Those that die of dengue fever often get DHF hemorrhaging in the final stage of the sickness. Failing to realize they are infected, they go don’t get treatment soon enough and lose blood plasma and go into shock after the initial fever passes. Some victims die within 10 hours of developing serious symptoms if they don’t get appropriate treatment.

There are several strains of dengue fever (the four main one are immunologically related). Those who get the disease develop an immunity to the strain they were infected by but are more likely to get DHF and get seriously sick if they get infected with a second, different strain. Scientists are not sure why this happens but think it may be because the immune system reacts the second time as if the invader were the first strain, wasting precious energy and leaving the body vulnerable to an attack by the second strain. Many doctors believe that since so few people show symptoms the when get dengue those that do display symptoms probably have gotten the disease a second time from a second strain. Getting the disease twice for two different strains seems to provide immunity for life from all strains of dengue fever.

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mosquito stages of development

History of Dengue Fever

Dengue fever and yellow fever are so closely related they are regarded as sister diseases. Dengue was first identified about 300 years ago but remained an isolated problems until it was spread around Asia and Pacific by troops during World War II. Both dengue and yellow fever were thought to have been close to eradication in the 1940s but have since made comebacks. The disease took off in crowded conditions in Asia. By 1975 it was a leading cause of hospitalization and death among children in the region.

From Southeast Asia dengue fever made its way to India, Africa, the eastern Mediterranean and finally to the Americas where it emerged as a threat in the 1970s just as campaigns to stamp out yellow fever in Latin America were declared a success.

Several new strains of the dengue virus have emerged in Asia and Latin America since the mid-1970s. The disease was a problem in Latin America and the Caribbean in the 1980s and 90s. It first took hold in Central and South America and progressed into Caribbean and the southern United States. There were 116,000 infections in Latin America alone in 1990. Cases have been reported in Florida and Hawaii.

In recent years there have been severe outbreaks of nasty forms of dengue fever and of DHF in Southeast Asia. See Thailand, Indonesia and Southeast Asia.

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One Person’s Experience with Dengue Fever

Dengue fever often begins with a headache and an achy feeling. The headaches seems to migrate towards the eyes behind the sockets as fever takes hold rises. If full-blown symptoms take hold the pain spreads throughout the entire body.

One suffer who was struck by dengue fever in Singapore wrote in the New York Times, “Not for nothing is dengue also known as breakbone fever...I, for one, felt as though someone had tied a Brink’s truck to my lower back. My skin was flushed, I could not eat, and I slept 12 to 14 hours at stretch. When I went to my doctor two days later, I could hardly open my blood-stained eyes...The doctor had little choice but to send me home with the painkiller Panadal and some muscle relaxants.”

“A week after my first feverish night, a doctor looked at the tiny pinpricks of blood under the skin on my shoulders, and sent me for a blood test, which confirmed that I had dengue...My first blood tests also revealed that my platelets---the cells that allow blood to clot and prevent hemorrhaging---had dropped to almost half of what doctors consider normal. They weren’t low enough for me to be hospitalized for transfusions, fortunately, but they were low enough to earn me daily blood tests to make sure.”

“The virus had inflamed my liver, as well, sending liver enzymes into my bloodstream, another mysterious symptom. For weeks after my fever subsided and my platelets returned to normal, I was still laid out, lethargic and giddy. My appetite returned slightly, but food and even water tasted strangely unpleasant...A month of afternoon naps later I was completely recovered.”

Dengue Fever Mosquitos

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Where dengue fever is found in Africa, Asia and Oceania
Aedes aegypti is a small, dark mosquito with white markings and banded legs. It originated in Africa and made its way around the globe centuries ago when it hitchhiked on transoceanic voyages.

Aedes aegypti mosquitos prefer to feed on humans during the daytime and are most frequently found in or near human habitations. They are most likely to bite during a period of several hours in the late afternoon before dark and for several hours after day break.

In 2007, scientists published the genome---a map of all the DNA---of the Aedes aegypti, the mosquito that carries yellow fever and dengue fever. It turns out the genetic make up of this mosquito is more complex than the one that carries malaria. Both Aedes aegypti and the mosquito that carries malaria have about 16,000 genes but the genome for Aedes aegypti is about five times larger.

Dengue Fever Treatment and Prevention

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spread in Western Hemisphere
Dengue fever has no vaccine and no cure. Most victims that show symptoms recover on their own with rest and hospital care. Dengue fever can be avoided by staying out of endemic areas (the Center of Disease Control can tell you where they are) and protecting oneself against mosquitos.

Dengue outbreaks often have followed unusually hot, rainy and humid conditions. The danger of dengue fever rises when there is a lot of stagnant water for mosquitos to breed in. In some places where it rains a lot people get infected every two or three years as their immunity from the previous illness lasts only a year and they get infected again..

Developing a vaccine against dengue fever is difficult because one a vaccine has to be developed that can work on all the strains.. Scientists are tinkering with the genetic material of 17D to come with a vaccination for dengue fever. See Yellow Fever.

Scientist were able to wipe out mosquitos that carry Dengue fever in a village in northern Vietnam by using a one-eyed crustaceans that lives in ponds where mosquitos breed and has a large appetite for the larvae mosquitos that carry Dengue fever.

There are concerns dengue fever could spread northwards, even becoming common place in the United States, as result of global warming. Already species capable of carrying the disease have been found in 28 states in the U.S. and as far north as the Netherlands in Europe. Cases of dengue fever have been reported in all 50 U.S. states but people who had it contacted the disease abroad and brought it home.

Dengue Fever in Vietnam in 2013

In the first six months of 2013 dengue fever infected more than 13,900 people, killing ten, Vietnam health ministry said.“Thang Noen reported: “Dengue fever is raging again in many central Vietnam provinces. Tran Nhu Son, 41, was confirmed the first casualty of dengue fever in Phu Yen Province this year. He died on July 3 of stomach hemorrhage two days after admitted to hospital, news website VnExpress reported. Nine people in his neighborhood were later found to have the same fever. The Phu Yen Health Department has counted around 1,140 cases of dengue fever so far this year, up nearly four times year-on-year. Its neighbor Binh Dinh Province has reported nearly 1,300 infections including one death during the first half, and although specific figures have not been given, officials say the number is many times more than during the same period last year. [Source: Thanh Nien, July 12, 2013 \=/]

“Bui Ngoc Lan, director of the Binh Dinh Preventive Health Center, said he is worried about a sharp increase in the number of cases during the remaining months of the year, especially with the onset of the rainy reason. He said local authorities need to work with the residents to destroy larvae at each house. “That is the only way we can hope to prevent dengue fever.” \=/

“A Lao Dong report cited authorities in Khanh Hoa, south of Phu Yen, as saying the province has recorded the highest number of dengue fever infections in the country this year at 3,180 as of the end of last month, 3.5 times more than the same period last year, including two deaths. It cited an unnamed source from the provincial health department as saying the disease has not reached its peak, but all medical facilities are already filled up with patients. \=/

“The provincial government has allocated an additional VND1 billion (US$47,090) from its budget towards urgent preventive measures. Khanh Hoa was also the hardest hit in the central region last year with 5,300 infections including five fatalities. Vien Quang Mai, deputy head of the Pasteur Institute for the central region, located in Nha Trang, said people in the coastal provinces have unwittingly turned the lack of tap water supply into an advantage for mosquitoes to breed. He said locals would store rainwater in jars which are “very convenient environments” for the mosquitoes. \=/

“Furthermore, the situation in the area has become complicated due to the existence of four different strains of the virus, possibly a result of climate change, Mai said. Health authorities in the region have been sending out teams to kill mosquitoes and their larvae using chemicals and by cleaning water containers. Officials from Khanh Hoa Health Department and experts from the National Institute of Hygiene and Epidemiology as well as the Nha Trang Pasteur Institute are also working on a scientific project that seeks to erase dengue fever from the country by replacing the current species of mosquito with new ones that carry Wolbachi, a bacteria genus that has been linked to viral resistance in mosquito species. The project, which follows similar ones in China, Brazil, Singapore and Thailand, started with the release of around 200,000 Wolbachi-carrying larvae into local water containers in early April. Family Health International, a US-based non-governmental organization specializing in public health issues, is the project sponsor. \=/

Vietnam Releases Mosquito with Bacteria That Blocks Dengue Fever

In November 2013, Associated Press reported from Tri Nguyen Island: “Nguyen Thi Yen rolls up the sleeves of her white lab coat and delicately slips her arms into a box covered by a sheath of mesh netting. Immediately, the feeding frenzy begins. Hundreds of mosquitoes light on her thin forearms and swarm her manicured fingers. They spit, bite and suck until becoming drunk with blood, their bulging bellies glowing red. Yen laughs in delight while her so-called "pets" enjoy their lunch and prepare to mate. [Source: Associated Press, November 15, 2013 |:|]

“The petite, grandmotherly entomologist -- nicknamed Dr. Dracula -- knows how crazy she must look to outsiders. But this is science, and these are very special bloodsuckers. She smiles and nods at her red-hot arms, swollen and itchy after 10 minutes of feeding. She knows those nasty bites could reveal a way to greatly reduce one of the world's most menacing infectious diseases. All her mosquitoes have been intentionally infected with bacteria called Wolbachia, which essentially blocks them from getting dengue. And if they can't get it, they can't spread it to people. |:|

“So how can simple bacteria break this cycle? Wolbachia is commonly found in many insects, including fruit flies. But for reasons not fully understood, it is not carried naturally by certain mosquitoes, including the most common one that transmits dengue, the Aedes aegypti. The germ has fascinated scientist Scott O'Neill his entire career. He started working with it about two decades ago at Yale University. But it wasn't until 2008, after returning to his native Australia, that he had his eureka moment. |:|

“One of his research students figured out how to implant the bacteria into a mosquito so it could be passed on to future generations. The initial hope was that it would shorten the insect's life. But soon, a hidden benefit was discovered: Wolbachia-infected mosquitoes not only died quicker but they also blocked dengue partially or entirely, sort of like a natural vaccine. "The dengue virus couldn't grow in the mosquito as well if the Wolbachia was present," says O'Neill, dean of science at Monash University in Melbourne. "And if it can't grow in the mosquito, it can't be transmitted." The Australians tapped 58-year-old Yen at Vietnam's National Institute of Hygiene and Epidemiology, where she's worked for the past 35 years. Their plan was to test the Wolbachia mosquitoes on a small island off the country's central coast this year, with another release expected next year in Indonesia. |:|

“Just getting the mosquitoes to Tri Nguyen Island was an adventure. Thousands of tiny black eggs laid on strips of paper inside feeding boxes had to be hand-carried inside coolers on weekly flights from Hanoi, where Yen normally works, to Nha Trang, a resort city near the island. The eggs had to be kept at just the right temperature and moisture. The mosquitoes were hatched in another lab before finally being transported by boat. Yen insisted on medical checks for all volunteer feeders to ensure they weren't sickening her mosquitoes. She deemed vegetarian blood too weak and banned anyone recently on antibiotics, which could kill the Wolbachia. "When I'm sleeping, I'm always thinking about them," Yen says, hunkered over a petri dish filled with dozens of squiggling mosquito pupae. "I'm always worried about temperature and food. I take care of them same-same like baby. If they are healthy, we are happy. If they are not, we are sad." |:|

“Vietnam has logged lower numbers this year overall, but the country's highest dengue rate is in the province where Yen is conducting her work. At the area's main hospital in Nha Trang, Dr. Nguyen Dong, director of infectious diseases, says 75 of the 86 patients crammed into the open-air ward are infected with the virus. Before jabbing his fingers into the stomach of one seriously ill patient to check for pain, he talks about how the dengue season has become much longer in recent years. And despite the government's increased education campaigns and resources, the disease continues to overwhelm the hospital. |:|

“If the experiment going on just a short boat ride away from the hospital is successful, it eventually will be expanded across the city and the entire province. The 3,500 people on Tri Nguyen island grew accustomed to what would be a bizarre scene almost anywhere else: For five months, community workers went house-to-house in the raging heat, releasing cups of newborn mosquitoes. And the residents were happy to have them. "We do not kill the mosquitoes. We let them bite," says fisherman Tran To. "The Wolbachia living in the house is like a doctor in the house. They may bite, but they stop dengue." |:|

“Specimens collected from traps are taken back to the lab for analysis to determine how well Wolbachia mosquitoes are infiltrating the native population. The strain of bacteria used on the island blocks dengue 100 percent, but it's also the hardest to sustain. At one point, 90 percent of the mosquitoes were infected, but the rate dropped to about 65 percent after the last batch was released in early September. A similar decrease occurred in Australia as well, and scientists switched to other Wolbachia strains that thrive better in the wild but have lesser dengue-blocking abilities. The job is sure to keep Yen busy in her little mosquito lab, complete with doors covered by long overlapping netting. And while she professes to adore these pests nurtured by her own blood, she has a much stronger motivation for working with them: Dengue nearly claimed her own life many years ago, and her career has been devoted to sparing others the same fate. "I love them," she says, "when I need them." |:|

Tiny a One-eyed Crustaceans Conquers Dengue in Vietnam Village

Scientist were able to wipe put mosquitos that carry dengue fever in a village in northern Vietnam by using a one-eyed crustaceans that lives in ponds where mosquitos breed and has a large appetite for the larvae mosquitos that carry Dengue fever. Reuters reported from Nam Dinh: “Scientists have wiped out mosquitoes that carry the potentially fatal dengue fever in a village in northern Vietnam, a feat believed to be a world first.Pivotal to their success is a microscopic, one-eyed crustacean, which is eating its way into medical history with a voracious appetite for the larvae of dengue-carrying mosquitoes. The experiment was pioneered by Australian and Vietnamese scientists, who say the results could have global implications for combating a disease for which there is still no vaccine nor specific cure. [Source: Reuters, July 30, 1999 ^^]

"Dengue-carrying mosquitoes were wiped out in the village of Phan Boi within 18 months,'' said Ahmet Bektas, country director for the Australian Foundation for Peoples of Asia and the Pacific, which oversees the scientific project. The American Society of Tropical Medicine and Hygiene recently hailed the project as the first anywhere in the world to eradicate the dengue-carrying Aedes mosquitoes. "The great fear is that it's spreading,'' Jeremy Farrar, a dengue fever expert at Britain's Oxford University, said after observing the project in Nam Dinh, south of Hanoi. But in Vietnam, which has one of the highest regional rates of dengue infection, the shrimp-like crustacean mesocyclops -- named partly after the one-eyed maneaters of Greek mythology -- is making inroads by preventing the spread of the disease. ^^

It has enabled scientists in Vietnam to reduce dengue-carrying mosquitoes by 96 percent across 45 villages, completely wiping them out in at least one, Phan Boi. But the tiny creature does not act alone. Villagers ensure the mesocyclops, which occurs naturally in Vietnam and other countries, are put into household water supplies where mosquitoes commonly breed. It is too early to predict the global implications of the experiment's success, but long-time project participant John Aaskov, who works with the WHO in Australia, is optimistic. "This program is going to be of benefit wherever people want to try it, certainly throughout the region,'' said Aaskov, adding it could also be used in Africa and South America. ^^

Dengue Fever and Flooding in the Mekong Delta

In December 2001, Associated Press reported: “Dengue fever is renewing its grip in Vietnam as devastating flood waters help to provide an ideal breeding ground for disease-carrying insects, official media said Friday. Eighty-one people died from the disease this year, marking a 59 percent increase on the previous 12 months, Tuoi Tre (The Youth) newspaper said. An epidemic of the mosquito-borne ailment, which has coincided with disastrous flooding in parts of the country, has also left more than 39,563 people sick, The outbreak is particularly rife in the Mekong Delta region in the south, where moist and humid conditions provide perfect conditions for mosquitoes, the paper added. Dengue fever, an infectious disease of African origin which first appeared in Vietnam in 1969, killed 380 Vietnamese in 1998 but only about 50 people in each of the subsequent two years. [Source: The Associated Press, December 28, 2001]

In 2004, AFP reported: “Eighty-seven people have died in Vietnam from mosquito-borne dengue fever since the beginning of the year, an increase of 64 percent over the same period in 2003, officials said on Thursday. The deaths were among nearly 60,000 reported infections, an 83 percent rise year-on-year, said Tran Hung, head of the health ministry's epidemiology department. The worst affected provinces were in the southern Mekong Delta region where moist and humid conditions provide ideal breeding grounds for mosquitoes. The region accounted for more than 95 percent of cases, Hung said. Experts have also blamed an unusually lengthy spell of hot and humid weather for the increased infection rate. Health authorities have launched clean-up campaigns to eliminate stagnant water to prevent mosquitoes from breeding. They have also set up mobile emergency teams to treat victims. [Source: Agence France Presse, October 21, 2004]

in 2007, Deutsche Presse Agentur reported: “Mosquito-borne dengue fever has killed at least 60 people in Vietnam so far this year with a nearly 50-per-cent rise in reported cases, an official said Tuesday. At least 68,000 people have come down with dengue fever in Vietnam so far this year, up 48 percent from the same time last year, said Nguyen Huy Nga, director of the Preventative Medicine Department under the Ministry of Health. "Most of the victims are people under 15 years old in the Mekong Delta region, which is exposed to rainfall and a long period of sunshine," Nga said. "Those are perfect conditions for the proliferation of mosquitoes." However, speedy treatment and public awareness has meant that the number of deaths have not risen significantly in Vietnam, where 55 people died of dengue during all of last year. [Source: Deutsche Presse Agentur - September 25, 2007]

Twelve Million Vietnamese Infected with Hepatitis B

In 2000, Associated Press reported: About 12 million Vietnamese, or 15 percent of the population, are infected with Hepatitis B, a government official said on Wednesday. The figure is based on several surveys conducted by various health organizations nationwide since 1995, said Prof. Pham Hoang Phiet, president of Ho Chi Minh City's Liver and Gall Association. [Source: Associated Press, May 25, 2000 >>>]

Hepatitis B is a serious, sometimes fatal, disease caused by a virus that attacks the liver. It can cause lifelong infection, cirrhosis -- scarring -- of the liver, and cancer. Vietnam's rate of infection is roughly double the average rate of 8 percent in other Southeast Asian countries, Phiet said. Other studies in the region show that between 20 percent and 40 percent of those infected are expected to develop cirrhosis of the liver and between 1 percent and 4 percent of those already in the cirrhosis stage may develop liver cancer, he said. >>

Hepatitis B, which kills about 2 million people a year worldwide, is transmitted through blood transfusions, sexual intercourse and from mother to unborn child. Last year, Vietnam launched a hepatitis vaccination program for newborns. About 1.7 million babies were each given three injections free of charge, Phiet said. It may take 10 years to reduce the number of hepatitis B patients, he said. >>>

Chronic hepatitis B and hepatitis B associated liver cancer is a major health disparity among Vietnamese Americans, who have a chronic hepatitis B prevalence rate of 7–14 percent and an incidence rate for liver cancer six times that of non-Latino whites (Nguyen, McPhee, Stewart, Gildengorin, Zhang, Wong, Maxwell, Bastani, Taylor, & Chen, 2010).

Cholera Outbreak in Vietnam in 2006 and 2007

In November 2007, Ho Binh Minh of Reuters wrote: “A cholera outbreak in northern Vietnam has affected more than 150 people, the first such spate of cases in three years, state-run newspapers reported on Saturday. The ruling Communist Party's daily Nhan Dan (People) quoted Health Minister Nguyen Quoc Trieu as saying 1,378 people have suffered acute diarrhea, 159 of whom tested positive for cholera bacteria. The reports did not say whether anyone had died in an epidemic of acute diarrhea since October 23 in 13 provinces and cities out of 64 in Vietnam, where the last widespread cholera outbreak was in 2004. Health ministry officials could not be reached for comment on Saturday. [Source: Ho Binh Minh, Reuters, November 10, 2007 ***]

“Lao Dong (Labor) newspaper quoted Nguyen Tran Hien, head of the National Hygiene and Epidemiology Institute, as saying the epidemic "erupted at the same time in many places, progressing rapidly and with symptoms typical of cholera." He said the diarrhea epidemic had passed its peak and the number of patients was falling in Hanoi. "But it is difficult to confirm this trend in other cities and provinces," Hien said. Cholera is transmitted by contaminated water or food. Hien said all patients during the first week of the epidemic ate shrimp paste, but more fell sick later without touching the sauce. At its most acute, cholera causes diarrhea that can lead to death by severe dehydration and kidney failure. ***

In January 2007, AFP reported: “Vietnam plans to vaccinate 400,000 children in the capital against cholera, and officials warned Wednesday that cases of acute diarrhoea could flare up again after an outbreak sickened thousands last year. Nearly 2,000 acute diarrhoea cases were reported in Hanoi and 12 other provinces and cities in October and November, of which 295 cases tested positive for cholera, the state-controlled Vietnam News daily said. [Source: Agence France Presse, January 16, 2007 <->]

“The health ministry, which declared the epidemic under control in December, has approved funding to vaccinate 400,000 children aged over 10 in areas of Hanoi where the outbreaks struck hardest last year, state media reported. No deaths were reported from the outbreak of cholera, an intestinal infection spread by bacteria in drinking water or food that causes watery diarrhoea and can be deadly in severe cases of dehydration and kidney failure. Dozens more cases of severe acute diarrhoea have been reported in Hanoi this month, but none have tested positive for cholera, health officials said. The health ministry warned that good personal and food hygiene are essential to containing the diseases ahead of the Tet lunar New Year in February. "There is a high risk of a new outbreak of acute diarrhoea during Tet as food consumption will go up rapidly," Nguyen Van Binh, deputy director of the Preventive Medical Department of the Ministry of Health, told AFP. The World Health Organization reported two human deaths in neighbouring Laos in early January after a cholera outbreak sickened about 180 people in the country. <->

Malaria in Vietnam

Malaria is found in rural areas, but there is no risk in the Mekong Delta and Red River area or for that matter Hanoi, Ho Chi Minh City and the major tourist areas. If you are traveling in the wilderness or jungle areas, be especially careful in swampy areas and during the monsoon season. Chloroquine resistant strains have been confirmed. This means you should take a prophylaxis and mefloquine. The main thing is to take precautions against mosquitos. Many of the antimalarial medicines sold in Southeast Asia are fake. A study by Lancet in 2001, found that a third of antimalarial drugs sold in Cambodia, Thailand, Vietnam, Laos and Burma contained no active ingredient.

Vietnam has made progress in combating malaria, for which the mortality rate declined sharply in the 2000s, to about 5 percent of the rate in the early 1990s, after the country introduced antimalarial drugs and treatment. DDT is still used, in part because it is effective in controlling mosquitos that carry the malaria parasite.

Malaria, once endemic, was said to have been eradicated in many provinces of the North by 1965. Still it was a problem for U.S. forces in the Vietnam War. During the war there places in which the number of malaria cases reported by G.I.s equaled or even exceeded the number of U.S. troops. The high mortality rate associated with malaria was a matter of particular concern, especially in the provinces along the Vietnam-Laos border, the Central Highlands, the central region, and the northern border provinces.

In 2000, the number of malaria-related deaths in Vietnam decreased 44.9 percent and the number of malarial infections fell 2.6 percent to 242,018 cases in 2001 compared with the previous year, Tuoi Tre said. Malaria is particularly prevalent in recently flood hit central provinces and in the remote highlands, where most of the country's of ethnic minorities live. [Source: The Associated Press, December 28, 2001]

Program Cuts Vietnam Village Malaria Deaths to Zero

Reuters reported: “According to experts at the United Nation's World Health Organization, after just four years into the program, the 1,028 residents of Phan Tien saw their annual rate of malaria deaths plummet from 30 in 1994 to zero in 1998. A combination of improved access to health workers and anti-malarial drugs, as well as residents' use of insecticide-laden bed nets, "brought malaria under control remarkably quickly," according to researchers led by Le Q. Hung. They published their findings in the August issue of the Bulletin of the World Health Organization. [Source: Reuters, August 9, 2002 :::]

“Phan Tien, located in malaria-endemic southern Vietnam, has a long history of battling the disease. However, beginning in 1994, researchers set up what they called a village "health post"—two trained health care workers armed with the anti-malarial drug artesunate—to help spot and control the disease. They also recruited 10 community members as "health co-workers" to distribute insecticide-impregnated bed nets to villagers, and to educate them on how best to protect themselves and their families against malaria. :::

“Those efforts paid off. Within just four years, deaths linked to malaria were eliminated in the village, even though its population had grown by nearly 50 percent over the same period of time. Similar gains were charted across Vietnam, which is implementing these strategies on a national scale. But the WHO cautions that the fight against malaria cannot waver. They note that in the fifth year of the Phan Tien experiment annual deaths due to malaria rose again to 18, due in part to the feeling among villagers that malaria "was not a problem any more." According to Dr. Kamini Mendis of WHO's global Roll Back Malaria campaign, "The whole challenge of malaria control can be seen in this one example. The means exist and they can be very effective, but only if they are fully used and on a continuous basis."

10,000 in Vietnam Hit by Hand-Foot-Mouth Disease

In March 2013 Over 10,000 Vietnamese have been affected by the hand-foot-mouth disease, a contagious viral illness that affects mostly infants and children, the health ministry said on Tuesday. Nguyen Van Binh, head of the ministry's Preventive Health Department, said the disease has spread to 60 of the country's 64 provinces, Xinhua reported. [Source: IANS, March 12, 2013 ~~]

“The disease shows symptoms of fever and a rash most frequently seen on the palms of the hands, soles of the feet, and inside the mouth. In Vietnam, the most common strain is Enterovirus 71 (EV-71). A four-month-old baby died in southern An Giang province Feb 28, just one day after contracting the virus. The same viral toxicity has been seen in Cambodia, where 54 children recently died within 24 hours of contracting the disease. ~~

“Japan, Macau, South Korea and Singapore have also reported high numbers of new patients. Vietnam expects an estimated 100,000 patients this year, the health official said. The disease can be transmitted though digestive tracts. There are no vaccines or specific medicines to combat the disease and children under five are most vulnerable to it. The main preventive measures are following hygienic practices in eating and drinking. In 2012, the disease affected 151,100 people, of which 45 died, according to Vietnam's official records. ~~

AFP reported: “A suspected outbreak of enterovirus 71 (EV71) has killed 26 children under the age of three in southern Vietnam since the end of January. Huynh Thu Thuy, a spokeswoman for the health ministry's Pasteur Institute in Ho Chi Minh City, said 40 children have been infected with what they feared was EV71, which produces symptoms ranging from fever and diarrhoea to extreme neurological complications such as viral meningitis and encephalitis and hand-foot-and-mouth disease.[Source: Agence France Presse, May 13, 2003 }{]

"We are temporarily calling the illness 'acute encephalitis syndrome' but most clinical experts suspect it is enterovirus 71," she said Tuesday. "All the children are under the age of three." Samples from the infected children have been sent to laboratories in Japan and the United States to confirm if the disease is EV71, but the results have not yet come back, she said. Nineteen children died at Ho Chi Minh City's Paediatric Hospital Number 1, while seven others passed away in An Giang hospital in Long Xuyen, the capital of An Giang province. }{

Sexually Transmitted Diseases in Vietnam

According to the Encyclopedia of Sexuality, “There is no information on venereal diseases in the early days of what is now Vietnam, although some descriptions of Sino-Annamese medicine suggest that this "scholarly" medicine did already know a distinction between the early and late symptoms of syphilis. Altogether, the frequencies of STDs were apparently only high in those regions that had a close contact with Europeans. Figures for the early French period are also difficult to obtain. The first French colonial physicians were largely concerned with malaria and dysentery, since these were responsible for decimating the troops. However, as rates of morbidity for sexually transmitted diseases (STDs) in the colonial army increased to one in ten in 1887, the French colony of 1890 reached first place, along with Madagascar, in all reports on venereal diseases. The situation did not improve at the beginning of the twentieth century. Between 1903 and 1911, morbidity attributed to syphilis increased among the French troops to account for 23 to 40 hospital admissions per 1000 men. In a division stationed in Tonkin, the medical officer noted that in 1902, venereal diseases accounted for 8.4 percent of total morbidity (508 admissions), of which 1.1 percent were for syphilis, 3.7 percent for gonorrhea, and 3.5 percent for chancroid and its complications. In 1904, out of 607 admissions, the total percentage of venereal diseases went up to 19.1 percent, with percentages for each of the three conditions at 3.7 percent, 9.7 percent, and 5.7 percent, respectively. For the medical officer, the spectacular rise coincided with the 1901-1902 expedition to China, which had mobilized contingents from Tonkin (Guénel 1997). [Source: Encyclopedia of Sexuality, 2.hu-berlin.de/sexology \*/ ]

According to Assistance Médicale d’Indochine, founded in 1904, STDs became the second most common reason for hospitalization after malaria in the 1910s. The first statistics regarding STDs in the Vietnamese population are available through the maternity hospital in Cholon: During the first quarter of 1927, out of 2,500 births, 40 percent of the children had congenital syphilis. Guénel (1997) suggests this accounted for a large part of the perinatal mortality of 38 percent. In the North, at Hanoi, one in four children was estimated to die of syphilis during the first year. But one has to keep in mind that even in 1930, not more than 10 percent of the population in the big cities was accessing the services of the Assistance Médicale, and hardly any of the rural population did. All over Indochina, 92 percent of the prostitutes were infected with STDs compared with 10 percent in France. \*/

Although hospital admissions because of syphilis infections decreased slightly during the 1930s, from 61 percent in 1930 to 21 percent in 1938, gonorrhea increased from 49 percent in 1930 to 70 percent in 1938. The two Indochina wars reactivated the problem of infected servicemen: Between 1945 and 1954, 12 percent of the 1.6 million men (700,000 of whom were Indochinese) were suffering from one of the four STDs then diagnosed. In 1975, the South Vietnamese government estimated that 10 percent of the population, or one million people, were infected, compared with a paltry 350 STD-infected American soldiers in 1963 (Greenberg 1972). In North Vietnam, as well as later in the unified country, the existence of venereal diseases was denied. \*/

According to the WHO (1993), in 1991, gonorrhea still accounted for the highest percentage among STDs with 11 cases per 100,000 inhabitants. The Ho Chi Minh City Dermato-Venereology Institute, reorganized in 1975, reported a certain stabilization of STDs since 1985, representing, on average, 10 percent of all consultations (13,700 in 1993 for STDs alone), with a still marked prevalence of syphilis and gonorrhea, 25 percent and 17 percent, respectively, of STDs in 1993) according to Guénel (1997). The National Institute situated in Hanoi assesses the prevalence of syphilis at 10,000 cases per annum. But as Guénel points out, the incidence of STDs in Vietnam elude national statistics, much more so than in industrialized countries. \*/

HIV-AIDS in Vietnam

Around 280,000 people are living with human immunodeficiency virus (HIV) cases and acquired immune deficiency syndrome (AIDS) in Viet Nam. Adult prevalence rate: 0.4 percent (2009 est.), country comparison to the world: 73. HIV/AIDS - people living with HIV/AIDS: 280,000 (2009 est.), country comparison to the world: 21. HIV/AIDS - deaths: 14,000 (2009 est.), country comparison to the world: 21. [Source: CIA World Factbook]

Injecting drug users, female sex workers and men who have sex with men are the groups primarily affected with HIV-AIDS in Vietnam. The number of people living with HIV in Vietnam doubled between 2000 and 2005. This rise included a large increase in the number of people who became infected through injecting drug use. Despite a five-year nationwide campaign to improve condom use among one of Vietnam's most at risk groups, sex workers, condom use remains disappointingly low. Continued difficulty in accessing prevention services is among a number of factors that are undermining HIV prevention efforts among high risk groups. [Source: Avert, International AIDS-HIV charity website]

Adults and children living with HIV in Vietnam still face high levels of stigma and discrimination. One reason for this is that HIV is often strongly associated with immorality. The connection between HIV and ‘social evils’ is exacerbated through the official use of this type of language, with HIV and AIDS falling under the remit of the Government ‘Department of Social Evils Prevention'. One reported result of this stigma is that people living with HIV remain untreated due to a fear of being seen taking medication, and their status being publicly discovered. In order to dispel myths and misconceptions about HIV life skills-based HIV education needs to be taught in schools. However, only a third of schools in Viet Nam were providing this education in 2009. [Ibid]

History and Causes of HIV-AIDS in Vietnam

Injecting drug users are a driving force behind HIV infections across Vietnam. Intravenous drug use causes about two thirds of all known HIV infections. In 2011 Vietnam said there are 138,000 drug addicts in the country and 30 percent them are HIV positive, down from 60 percent in 2006.

Like China, Vietnam was late in recognizing the AIDS problem and combating its association with drug users and commercial sex. In Vietnam, the first AIDS case was identified in 1990. It is safe to say that the epidemic will continue to spread, although the prevalence and distribution of AIDS, as well as the future of other STDs (sexually transmitted diseases) such as syphilis and gonorrhea, will vary widely among Asian countries. Countries with low STD-prevalence rates should not expect to have high rates of HIV and AIDS, but countries and populations with high STD rates are at high risk of developing high HIV/AIDS rates in the future, the reason being that syphilis and other STDs are spread through the same routes as HIV. [Source: Encyclopedia of Sexuality, 2.hu-berlin.de/sexology \*/ ]

A study conducted by Franklin on HIV/AIDS in late 1993 found that 54 percent of the men interviewed in cafés, restaurants, nightclubs, parks, and the streets where sex was sold or where dates for sex could be made, had had two or more sexual partners in the previous two weeks (as cited by Goodkind 1997). Within three years, from 1996 to 1999, the number of reported HIV cases doubled. By late 1999, approximately 15,800 Vietnamese were reported HIV-positive, and approximately 1,500 had died of AIDS. The actual number of infections, however, could be ten times that number. Most cases go undetected because HIV testing is only done selectively. The actual number of people infected with HIV by the end of 1999 was expected to exceed 129,000. Vietnam’s biggest city, Ho Chi Minh City, claimed the highest number with 2,600 cases. The disease is expected to have an especially harmful effect, not only on individual lives, but also on the economy, because 50 percent of those infected are between 15 and 24 years old. \*/

HIV cases among Vietnam’s prison inmates have tripled since 1998, now comprising one fifth of all infections in the country, according to a government newspaper. A total of 22,161 inmates had tested HIV-positive as of July 20, 1999, with 3,621 AIDS cases and 1,895 inmate deaths from AIDS since the first case detection in 1990. A National AIDS Committee official said that the actual number of HIV infections in Vietnam’s prisons could be 10 times higher. Infected inmates remain in the general prison population until they develop AIDS, when they are transferred to the prison’s clinic. Hoping to curb the spread of the virus, the Ministry of Public Security launched an HIV/AIDS-awareness campaign in prisons and correctional institutions in 1999 (Associated Press, 7/28/99). \*/

In 2000, Vietnam had 120,000 HIV carriers, and 15,000 people with AIDS. At that time disease was spread mainly by intravenous drug use and also linked with prostitution. There were fears that it would increase spread through prostitution like it had in Thailand.As of September 2005, Vietnam had diagnosed 101,291 human immunodeficiency virus (HIV) cases, of which 16,528 developed acquired immune deficiency syndrome (AIDS) and 9,554 died. But the actual number of HIV-positive individuals was estimated to be much higher. An average of 40–50 new infections were reported every day in Vietnam. \*/

HIV-AIDS Victims in Vietnam

The HIV rate among drug users and prostitutes is high. The rate among drug addicts in Haiphong rose from near zero in 1997 to 65 percent in 2000. In Saigon, the rate rose from 30 percent to 50 percent in same period. The HIV infection rate among prostitutes in Ho Chi Minh City leapt from 9 percent in 1992 to 38 percent in 1995. A third of the addicts seeking treatment at the Ho Chi Minh City Drug Prevention Center at that time were HIV positive. The HIV rate among prostitutes at that was also high. In 1994, fewer than 1 percent of the prostitutes carried the HIV virus, In the late 1990s about 3.5 percent did. The HIV rate among prisoners is also high. According to survey, one fifth of all HIV carriers are in prison. The number of HIV-infected prisoners tripled between 1998 and 2002.

In 2004, AIDS-HIV infection rates were reaching new highs. In 2007, Xinhua reported: By Vietnam, Vietnam had detected over 128,367 HIV carriers, including 25,219 AIDS patients, of whom, 14,042 died. Some local men contract the disease after having sex with infected prostitutes, according to the ministry's latest statistics. The country had file records on 13,000 prostitutes in 2006.

In 2002, AFP reported: “More than half of registered prostitutes in the Vietnamese capital now carry the AIDS virus following a huge surge of infection in the communist state's large sex industry, a government survey suggested. Infection rates at the capital's Social Support Center Number Two, a home for women with repeat convictions for solliciting, reached 55.4 percent in 2001 against 39.2 percent the previous year, the labor and social affairs ministry survey showed. The infection rates for Hanoi were even higher than those for Ho Chi Minh City, normally regarded as the country's vice center, the survey results carried by the police daily Cong An Nhan Dan (People's Police) suggested. In the commercial capital's Thu Duc Women's Education Center, the survey found that 24 percent of prostitutes were HIV positive against 21 percent at the 05 Center in the northern port city of Haiphong. [Source: Agence France Presse, March 13, 2002 \>\]

Across Vietnam's big cities infection rates among registered prostitutes saw an increase of 18.4 percent on 2000. The survey results seemed to contradict suggestions by some aid workers that intravenous drugs use remained the primary means of transmission of the AIDS virus in Vietnam, even among prostitutes. Prostitutes who were also heroin users accounted for just 11.3 percent of the HIV infections in Hanoi, although the proportion rose to 18 percent in Ho Chi Minh City. The figures were the latest in a series of surveys to suggest an explosion of HIV infection in Vietnam's sex and hospitality industry. A nationwide study published by the labor and social affairs ministry in March last year found that infection among prostitutes had leapt from 2.8 percent in 1998 to 21.6 percent in 2000. Western donors have expressed mounting alarm about the potential for HIV infection to spread from prostitutes into the general population and Washington announced six millions dollars in assistance for AIDS prevention here in November 2000. \>\

Stigmatization of HIV-AIDS Victims in Vietnam

The stigmatization of HIV-AIDS victims is more severe than almost anywhere else in the world, according to a United Nations official. It is commonplace for families to abandon relatives that have AIDS. According to Avert: “Adults and children living with HIV in Vietnam still face high levels of stigma and discrimination. One reason for this is that HIV is often strongly associated with immorality. The connection between HIV and ‘social evils’ is exacerbated through the official use of this type of language, with HIV and AIDS falling under the remit of the Government ‘Department of Social Evils Prevention'. One reported result of this stigma is that people living with HIV remain untreated due to a fear of being seen taking medication, and their status being publicly discovered. In order to dispel myths and misconceptions about HIV life skills-based HIV education needs to be taught in schools. However, only a third of schools in Viet Nam were providing this education in 2009. [Source: Avert, International AIDS-HIV charity website]

In 2012, Pratibha Mehta, United Nations Resident Coordinator in Vietnam, reported: “A shadow darkens the road ahead – a shadow of ignorance and fear. Many children living with HIV are denied schooling even though they pose absolutely no risk to their teachers and their fellow students. Many adults living with HIV are denied employment and forced out of their homes, even though they pose no risk to their co-workers and their neighbors. And the people most at risk of HIV infection – people who inject drugs, sex workers and men who have sex with men – are often rejected by society for committing so-called "social evils." When these people are driven to the fringes of society, vital gateways are missed to engage them with the knowledge and tools they need to keep their bodies free of HIV. [Source: By Pratibha Mehta, United Nations Resident Coordinator in Vietnam, November 30, 2012 ||||]

“Vietnam’s leaders are leading lights against the shadow. The Deputy Prime Minister recently called on schools to open their doors to HIV-positive children. A law was recently passed by the National Assembly that will end the practice of sending sex workers to "05" compulsory detention centers. And the government recently enacted a new decree that will guide the scale up of methadone maintenance treatment for recovering heroin addicts. Every province, every city, every district, every commune and each individual, now has a special opportunity to do their part – to shine their own lights, contributing to ending AIDS. ||||

Combating HIV-AIDS in Vietnam

The Vietnamese government has launched nationwide campaigns to raise people’s awareness. Using mass media and other avenues, the campaigns are designed to provide Vietnamese students and 90 percent of people between ages 15 and 50 with general knowledge of the epidemic and how to protect themselves. However, cultural taboos have proven to be a hindrance to tackling the issue. An estimated 200,000 intravenous drug users and 100,000 prostitutes are blamed for the spread of AIDS.

In the mid 2000s Vietnam had hoped to contain the HIV infection rate at the official rate at that time of 0.35 percent, which was about average worldwide, by limiting the disease as much as possible to sex workers and intravenous drug users. One of the impediments to containing HIV/AIDS is that the victims face discrimination and stigmatization that are more severe than almost anywhere else in the world, according to a United Nations official. In June 2004, the Bush Administration announced that Vietnam would be one of 15 nations to receive funding as part of a US$15 billion global AIDS plan. [Source: Library of Congress]

Vietnam has focused publicity about HIV/ AIDS with contents expanding into areas of virtues, lifestyle and behavior, including encouraging youths to use "ABC" preventive approach (Abstinence, Being faithful and Condom use) and keep away from such evils as drug addiction and prostitution. Anti-AIDS campaigns include the creation Condom Care, where appearances are made from time to time by Mr. Condom. Vietnam targeted reducing the HIV/AIDS infection rate to below 0.3 percent by 2010, and keep it unchanged after 2020.

According to the 2002 Pew Global Attitudes Project: Asked to rate the five dangers posing the greatest threat to the world, Vietnam broke away from the pack to pick infectious diseases and AIDS as the number-one threat. Other Asian countries were far more worried about nuclear weapons, religious and ethic hatred, environmental troubles or the gap between rich and poor. Vietnam's focus was heartening to the United Nations Development Programme chief representative Jordan Ryan, whose agency has been promoting HIV and Aids prevention and awareness in Vietnam."This seems evidence that the information campaign is reaching people," said Hanoi-based Ryan. 2002 Pew Global Attitudes Project; at http://yaleglobal.yale.edu/display.article?id=1764&page=1.

In the mid 2000s, according to Vietnam’s Ministry of Health, only about 1,000 of Vietnam's AIDS patients were receiving government-funded antiretroviral drug treatment.

Ending Aids: Vietnam’s Progress and Opportunities: the United Nations

In 2012, Pratibha Mehta, United Nations Resident Coordinator in Vietnam, reported: “In Vietnam, there has been great progress. According to the latest data from the Ministry of Health, 60,935 adults and children are now on antiretroviral treatment – 54 percent of all in need – a 22-fold increase since 2005. There is evidence that the number of new infections has decreased in many provinces. Last week, Deputy Prime Minister Nguyen Xuan Phuc launched a new national HIV strategy with ambitious targets to greatly reduce HIV infections and provide many more people with life-saving treatment. [Source: By Pratibha Mehta, United Nations Resident Coordinator in Vietnam, November 30, 2012 ||||]

“Local action is now critical as Vietnam grows more prosperous. In recent years, Vietnam’s HIV response has benefitted from strong international support. And although the United Nations and individual UN Member States remain firmly at Vietnam’s side, a combination of Vietnam’s recent economic success and global economic troubles is contributing to a steady decrease in foreign support for HIV efforts. As Vietnam shares responsibility to meet the costs of its HIV response, international community financing must be predictable. In the medium term, it will be difficult for Vietnam to fully replace international funding for HIV. All partners in the response will be therefore challenged to spend resources where they are most needed. This can be achieved by focusing on populations at greatest risk, and on the approach of continuum of HIV prevention, treatment and care services, which is proven to be effective and sustainable. ||||

“Within the general population of Vietnam, very few people are living with HIV – only 0.45 percent of people between the ages of 15 and 49 – or less than one in 200. By comparison, nearly one in two men who inject drugs are living with HIV in Quang Ninh, Ho Chi Minh City and Hai Phong. HIV prevalence among men who have sex with men in An Giang, Hanoi and Ho Chi Minh City is 8.5 percent, or about one in 12. Among sex workers in Hanoi and Hai Phong, one in five are living with HIV. We know who is at risk, and we know where that risk is greatest. And we know what works and what does not work. Ensuring that drug users have access to clean needles and methadone works. Sending drug users to compulsory detention does not. Ensuring that sex workers have access to condoms and are empowered to demand their use with every client works. Arresting sex workers and forcing them to change their jobs does not. Raising awareness among men who have sex with men and providing them with condoms and lubricant works. Insisting that they pretend they are heterosexual does not. And we now know that early diagnosis and early initiation of antiretroviral treatment is the best way to prevent new HIV infections.” ||||

Pham Thi Hue: Vietnamese HIV-Positive AIDS Activist Honoured by Time Magazine

Pham Thi Hue was honored was honoured in 2004 as one of the 20 Asia heroes by Time magazine. The Voice of Vietnam reported: “Six years have elapsed since I met Pham Thi Hue Beyond all expectations, she looks healthier than when I went to see her in Hai Phong City. She told me that she had just spent nearly a month in Ho Chi Minh City playing the lead role in a film directed by Vinh Phuong. In the film, Hue acted as a prostitute working to bring up her disabled brother. One day she fell on her head and found out that she had the HIV virus, and from then on everybody began to stay away from her. She lived in despair until she died worrying that her soul would not be reincarnated into the afterlife. With a great deal of sympathy for the unfortunate woman, a 70-year-old man took pity on her. [Source: Voice of Vietnam, June 8, 2010 +++]

“Hue said on hearing the news that producer Vinh Khuong wanted her in his film, she could not sleep for many nights. "I was not worried about myself after I dared to publicise my health status nearly 10 years ago. I was afraid that everybody would misunderstand me, because they thought, by taking part in the film, I would become notorious." Hue said that she had feared filming at night for nearly a month would worsen her health, but eventually the film script convinced her. "The film focuses on spiritual issues and is a new way of disseminating information about HIV/AIDS prevention that helps people to live more fuller lives. I hope when the film is released, it will attract a lot of attention from audiences." In line with her wishes the film producers agreed to contribute most of the proceeds to a charity for children with HIV. +++

Hue said she is fine and has not used any medicine since she contracted HIV. "I was given a medical check-up 20 days ago and all my health indicators are stable. The more I get involved in community activities, the healthier I feel." "In addition, my 9-year-old son is fine, he studies hard and gets on well with his classmates. My husband’s health has also improved a lot. He has taken part in a pilot Methadone treatment programme for drug users. My family has not faced any economic difficulties since he registered for the programme." +++

“The couple have moved into a new house they bought recently. Local residents no longer show them and other HIV carriers any discrimination or stigma. Many people have even come and asked Hue for advice. "I do not feel worried any longer because I have suffered much worse. This is a great source of encouragement to HIV carriers like me to continue living and contributing to society." +++

Hue says she has told his son the truth about her health. "I am not worried about my son when I stay away for long periods of time because my parents and husband take care of him very carefully….. Several years ago, I told my son the truth that his parents had HIV. I taught him to face the truth and encouraged him to overcome social discriminations. I also taught him how to live an independent life should his parents die one day. Anyway I am happy that the stigma and discrimination against him has lessened, though it sometimes exists here and there." +++

"Many people are surprised when they see me, or watch me on TV. They wonder how I have been able to survive with HIV for nearly 10 years, and have even put on weight. Many people asked me if I have any secret of keeping myself in a good shape." "In fact there are no secrets at all. First of all, I tell them to feel comfortable in life and get much involved in family and community activities, because this is invaluable food for thought. They need to have a balanced and healthy diet every day under doctors’ instructions. They should also drink more milk and avoid eating uncooked vegetables." +++

Activities of Pham Thi Hue, Vietnam’s HIV-Positive AIDS Activist

The Voice of Vietnam reported: “Currently, Hue is trying her best to get more people with HIV/AIDS involved in a UN-funded project launched in Hai Phong since 2005. The project encourages people living with HIV to participate in information campaigns to help change the public attitude towards those infected. It also helps to establish a network of clubs and groups involved in HIV prevention, and links carriers, banks and businesses together so that the carriers can take out loans and get steady jobs. [Source: Voice of Vietnam, June 8, 2010 +++]

“Besides the project, Hue also manages the Hoa Phuong Do Cooperative which is made up of people living with HIV. Established in 2003, the cooperative has become a meeting place where hundreds of members come to share their hardships, get medical check-ups and other services to enable them to lead a healthy life. The cooperative runs a garment workshop in Kien An district, generating jobs for 15 HIV-infected people who earn between VND1.2-1.7 million each per month. It also operates a farm raising Geoduck clams on Cat Ba island. The farm earned VND300 million in 2008 and nearly VND400 million in 2009, with each worker earning nearly VND2 million a month. Deputy Prime Minister Truong Vinh Trong also visited and praised the project. +++

“Hue is busy shuttling between provinces and cities such as Hai Phong, Hanoi and Quang Ninh to carry out projects. She also often travels to the US, the Republic of Korea and China to attend conferences on HIV/AIDS organized by the United Nations. Luckily, she receives a great deal of sympathy and support from her husband and relatives. Anyone who meets Hue can realise that she is not almost obsessed by the deadly virus she is carrying. She says she feels at ease and knows how to take care of herself and take part in community activities. +++

“Despite being busy, Hue spends some of her time taking part in contests on HIV/AIDS prevention. In 2006, she won a first prize with Happiness in Your Hand organized by the Vietnam Red Cross Society and the Vietnam Writers Association. She has been invited to speak at workshops on HIV/AIDS run by the Vietnam General Confederation of Labor, the Ministry of Public Security and other organizations. She has also been presented with a certificate of merit by the Hai Phong Municipal People’s Committee. +++

SARS in Vietnam

Vietnam was one of the first countries to be struck by SARS and it was also one of the first to control it and stop it from spreading. Five people died and 63 people came down with disease. All of them could be traced to a single person.

Vietnam was lucky in that the disease was introduced by a single person, an America who brought it from Hong Kong, and the disease he was quickly diagnosed as something unusual and steps were taken quickly to isolate it and keep it from spreading. Vietnam was declared clear if SARS in April 2003. The first country to be declared free of the disease after the outbreak.

The American businessman was treated at the Vietnam French Hospital in Hanoi, where he spread the disease to 20 health care workers, including Carlo Urbani, an Italian doctor, who was the first to report the disease to the World Health Organization. Urbani ordered a number of preventive steps to be taken, but ended up dying of the disease. On March 15, the WHO issued a worldwide alert for a new diseases, which it called SARS.

Dr Urbani, the WHO’s representative in Hanoi, was one of the first specialists to raise the alarm on SARS. He fell ill on a flight to Bangkok, and died in the city. Dr Christiane Dolocek, a researcher in Saigon, told the Times of London: “Carlo persuaded the hospital in Bangkok to close and he stayed in it and died. He had three little kids and was a lovely guy....When you’re dealing with an unknown agent and you don’t know whether it’s going to be like SARS, where a high proportion of healthcare workers came down with it, and you don’t know if you’ve got a treatment for it, it’s very scary. [Source: Anjana Ahuja, The Times, October 30, 2006]

See SARS Under Diseases in Southeast Asia

Bird Flu in Vietnam

See Website article, Southeast Asia

Image Sources:

Text Sources: New York Times, Washington Post, Los Angeles Times, Times of London, Lonely Planet Guides, Library of Congress, Vietnamtourism. com, Vietnam National Administration of Tourism, CIA World Factbook, Compton’s Encyclopedia, The Guardian, National Geographic, Smithsonian magazine, The New Yorker, Time, Newsweek, Reuters, AP, AFP, Wall Street Journal, The Atlantic Monthly, The Economist, Global Viewpoint (Christian Science Monitor), Foreign Policy, Wikipedia, BBC, CNN, Fox News and various websites, books and other publications identified in the text.

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© 2008 Jeffrey Hays

Last updated May 2014

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