Vietnam warns of hand, foot and mouth disease spreading among children

HANOI, Vietnam: Vietnam has warned health officials nationwide to be on the lookout for an infectious disease that has killed 12 children in the country this year, a health official said Friday.

So far, Vietnam has reported about 2,800 cases of hand, foot and mouth disease, a common childhood illness that typically causes little more than a fever and rash, said Nguyen Huy Nga, director of the Preventive Medicine Department, under Vietnam’s Ministry of Health. Nga did not give the number of cases from previous years.

About 400 of those cases have been blamed on enterovirus 71, or EV-71, one of several viruses that cause the illness. EV-71 can result in a more serious form of hand, foot and mouth disease that can lead to paralysis, brain swelling or death.

Neighboring China has been particularly hard hit by the virus this year, with more than 25,000 cases among children and 43 deaths.

In Vietnam, state media quoted Trinh Quan Huan, vice minister of health, as saying the situation is becoming more complicated with the virus spreading in the north of the country.

The disease is usually characterized by ulcers in the mouth, rash and blisters on hands and feet. Since it mostly sickens children and is easily spread, the ministry has ordered that kindergartens should be closed for two weeks if at least two cases are reported.

EV71 virus has caused deaths in Vietnam: health official

5 May 2008

HANOI (AFP) — A virus that causes hand, foot and mouth disease has infected around 400 people in Vietnam this year and led to an unknown number of deaths, a health official in the communist country said Tuesday.

No precise data on cases and fatalities was available because enterovirus 71 or EV71 is not a notifiable disease in Vietnam, said Nguyen Huy Nga, head of the Health Ministry’s Preventive Medicine Department.

A boy suspected of being infected with the deadly enterovirus 71 (EV71)

The intestinal virus, which hits children hardest because of their weaker immune system, has killed at least 26 children in neighbouring China and infected thousands more, raising fears it could spread across the region.

“Vietnam has had about 2,000 cases of hand, food and mouth disease this year, of which about 20 percent were caused by EV71,” Nga told AFP, saying 90 percent of cases were in southern Vietnam, especially Ho Chi Minh City.

“There were some deaths involving the virus but we have no specific figure.”

He said “children under 10 are the group most vulnerable to this disease.”

The senior epidemiologist of the World Health Organisation (WHO) in Vietnam, Dr Sean Tobin, said there was “no obvious association between the cases in China and those in Vietnam.”

“As this is not a notifiable disease, there is no formal collection of data and no clear picture of the numbers in Vietnam,” he said. “But reports from local health officials suggest that the number and severity of cases this year is higher.”

Tobin said “the disease is recognized as an increasing public health problem” in Vietnam and added that local health authorities had asked the WHO for help “to determine options for monitoring and control.”

EV71, which begins with fever, blisters, mouth ulcers and rashes, is highly contagious and spread through direct contact with the mucus, saliva or faeces of an infected person.

Source: AFP

Vietnam battles cholera outbreak, over 130 infected

A woman selling vegetables at a marketHANOI (AFP) — Vietnam, battling a cholera outbreak that has infected over 130 people, this week launches a month-long public hygiene drive while cracking down on dirty food stalls and dredging sewage-choked lakes.

The epidemic of the dangerous bacterial disease — the country’s third major outbreak since October — has spread in recent weeks from its epicentre in Hanoi to southern Ho Chi Minh City and 16 provinces, officials said.

Prime Minister Nguyen Tan Dung, at a weekend crisis meeting, ordered state agencies in the communist country to quickly come to grips with the epidemic, which has also seen over 1,300 people hospitalised with acute diarrhoea.

The disease, spread through unsafe food, “not only affects our people’s health but also socio-economic development, tourism and social security,” he told ministers and provincial chiefs, according to the Tuoi Tre daily.

Cholera is an acute intestinal infection transmitted through water or food contaminated with the bacteria vibrio cholerae. It causes diarrhoea and dehydration and can lead to kidney failure and death if untreated.

Vietnam has so far reported no fatalities from the three outbreaks.

Of 1,335 acute diarrhea cases reported since early March, 136 patients — or about 10 percent — have tested positive for cholera, Deputy Health Minister Trinh Quan Huan said, according to the main government website.

The disease has thrown a spotlight on often poor hygiene conditions in Vietnam’s public spaces, including wet markets and streetside restaurants where ground-level cooking areas are often situated adjacent to toilets.

Many farmers use fresh manure to fertilise vegetables and polluted water to irrigate fields. At tens of thousands of streetside food stalls, dishes and chopsticks are commonly washed using soapy but cold water.

Public health officials say they suspect cholera has spread rapidly along Vietnam’s north-south railway line, where many train carriages have inadequate waste removal services and the toilets can be forbidding places.

“Fifteen trains a day take 3,000 passengers through 22 provinces,” Huan said according to the Thanh Nien daily. “Only 100 out of 1,000 carriages have sanitary waste collection. This is a huge threat in spreading the germ.”

In Hanoi, where at least 44 cholera cases have been reported, authorities have ordered the dredging of 31 lakes which, although picturesque, are often filled with sewage and are now seen as dangerous disease incubators.

City workers have already dumped over one tonne of chlorine into central Hanoi’s Linh Quang Lake and closed some restaurants and street stalls along its shore after six people living nearby tested positive for cholera.

Two thousand residents have been given cholera vaccines, reports said.

“It is a challenge with a sewerage system that has not kept pace as the population and urban density have increased,” said Sean Tobin, a medical epidemiologist at the World Health Organisation in Vietnam.Tobin said Vietnam was now taking the right steps to fight the outbreak, the source of which remained unclear, but added that there had been “a little bit of a fog of information” on the spread of the disease.

Vietnam’s state-controlled media — after months of focusing on the more benign sounding “acute diarrhoea” — has now started to routinely use the word “cholera,” a shift officials hope will help drive home the health threat.

In its month-long information campaign, the government will stress key public hygiene messages — such as the need to wash hands after using toilets or handling garbage and before touching food, keeping kitchens clean, cooking food well, boiling drinking water, and avoiding unsafe streetside restaurants.

Cholera spreads in Vietnam

Hanoi – A cholera outbreak that began in mid-March has expanded to 16 provinces throughout Vietnam and infected at least 121 people, health officials said Thursday. “The situation is dangerous, and the possibility that the outbreak will further expand to other provinces is very high,” said Nguyen Huy Nga, director of the Ministry of Heath’s Preventive Medicine Department.

Nga said the cause of the outbreak’s spread was contaminated water sources, leading to the contamination of food, especially vegetables.

“Many people don’t have hygienic toilets, and others defecate into rivers or in the fields, resulting in the spread of the bacteria,” Nga said. “It’s more difficult to contain the situation in the countryside, where farmers use human feces to fertilize vegetables.”

Earlier this month, the Ministry of Health sent an urgent message to provinces nationwide, requiring them to take necessary measures to contain the cholera outbreak.

The message urges provinces to tighten food hygiene, ban unhygienic food shops, and closely monitor infected people.

“The best way to contain the outbreak is to urge people to eat cooked food and water and to use hygienic toilets,” said Nguyen Tran Hien, director of the National Institute of Hygiene and Epidemiology.

Late last year, more than 300 people were infected with cholera in an outbreak that expanded to 11 provinces in northern Vietnam, prompting local authorities to ban a popular fermented shrimp paste, which was blamed for half of the cases.

No one reportedly died from the outbreak last year, although health officials warned that dehydration could kill some patients if not treated immediately.

Cholera chiefly spreads through drinking water or eating food contaminated with cholera bacteria.,cholera-spreads-in-vietnam.html

UNICEF Launches Initiative to Provide Assistance to Children With Disabilities in Vietnam

NEW YORK, April 9, 2008 /PRNewswire-USNewswire via COMTEX/ — The U.S. Fund for UNICEF announced today the launch of a fundraising campaign to raise $1 million to bring quality healthcare and education services to all children living with disabilities throughout Vietnam, including many that may be affected by exposure to dioxin left over from the spraying of Agent Orange during the war.

All donations to UNICEF’s program will be matched dollar for dollar by a $1 million grant from the Ford Foundation, which has been funding work that addresses the environmental and health legacy of Agent Orange/dioxin since 2000.

The funds raised will help UNICEF coordinate a community-based pilot intervention program in the south-central city of Da Nang, providing healthcare, nutrition, clean water and sanitation, as well as training to social workers, teachers and welfare workers.

Actress Tea Leoni, who is a U.S. Fund board member and who recently visited Da Nang, said: “As a mother, after seeing the pain of children and their families, I implore others to join this important campaign so that no child lives without the care and assistance so desperately needed.”

“We are thrilled to have developed a partnership with The Ford Foundation to make an impact in the lives of the estimated 1.2 million children with disabilities in Vietnam,” said Caryl Stern, President and CEO of the U.S. Fund for UNICEF. “We are committed to building an environment where top quality services are available to every child in the country.”

UNICEF has a long history of cooperation with the Government in Vietnam and has been implementing successful programs in the country since 1975.

The exact number of children with disabilities in Vietnam is unknown, as many parents have never sought treatment for their children, enrolled them in school or inquired to see if they qualified for social support. As such, in order to have an accurate count of children that require assistance, as well as a clear understanding of their needs, UNICEF and its partners will first work towards identifying all of the disabled children in Da Nang.

Added Ms Leoni: “The situation for children with disabilities is extremely difficult. With few care options, many are confined to their beds with little or no prospects for their future. Families without assistance are relegated to their homes to care for their children — depriving them of the opportunity to work, earn a living or interact with their communities. Caring for children with disabilities is literally a 24-hour-a-day job.”

The community-based pilot program will provide a comprehensive package of services specifically designed to be inclusive of children with disabilities. This program will, include: training health workers and caregivers to properly monitor the health and nutrition status of children living with disabilities, developing water and sanitation facilities in schools that specifically focus on meeting the needs of disabled children, training social and welfare workers to better understand how to assist families caring for disabled children and supporting respite centers by providing rehabilitative aids such as wheelchairs, prosthetic limbs and more.

“Although there are already two respite centers in Da Nang, they serve just a fraction of the people living with disabilities in the area because many families are unaware of the services or find traveling to and from the centers too difficult a journey,” said Stern. “It is therefore essential to the program’s success that we educate the community about the resources that are available to them so that they can take advantage of these services.”

UNICEF will also work closely with the government to improve legal policies and standards that promote the inclusion of the rights and specific needs of children with disabilities. Where possible, the program will work to leverage existing structures, such as the Vietnam’s Women’s Union, in order to help prevent the exclusion of disabled people from the country’s national policies.

Vietnam is home to a disproportionately large number of people with disabilities (approximately 7% of the entire population), including many affected by exposure to dioxin. The majority of these are children, who are unable to care for themselves and therefore live with their families indefinitely. One-third of families with disabled children have never sought treatment for their disabilities while only one-fifth of disabled children use the proper rehabilitative aids such as wheel chairs, prosthetic limbs, or hearing aids. Only a small number of children access the social assistance to which they are entitled and the vast majority of disabled children in Vietnam do not finish primary school.


For more than 60 years, UNICEF has been the world’s leading international children’s organization, working in over 150 countries to address the ongoing issues that affect why kids are dying. UNICEF provides lifesaving nutrition, clean water, education, protection and emergency response saving more young lives than any other humanitarian organization in the world. While millions of children die every year of preventable causes like dehydration, upper respiratory infections and measles, UNICEF, with the support of partnering organizations and donors alike, has the global experience, resources and reach to give children the best hope of survival. For more information about UNICEF, please visit

About The Ford Foundation

The Ford Foundation is an independent, nonprofit grant-making organization. For more than half a century it has been a resource for innovative people and institutions worldwide, guided by its goals of strengthening democratic values, reducing poverty and injustice, promoting international cooperation and advancing human achievement. With headquarters in New York, the foundation has offices in Africa, the Middle East, Asia, Latin America, and Russia.


Acute diarrhea epidemic ravages northern Vietnam

Acute diarrhea outbreaks have occurred in 10 northern localities, with Hanoi being the hardest-hit area, a local health agency reported.

Preventive Health Department Head Nguyen Huy Nga said on Wednesday that 85 patients had tested positive for cholera, with 44 cases reported in Hanoi alone.

Tran Thi Phuong Thuy, a doctor from the Hanoi-based National Institute for Tropical and Infectious Diseases, said 103 patients with acute diarrhea are currently being treated on site.

Three other Hanoi general hospitals – Xanh Pon, Bach Mai and Dong Da – also admitted a total of 110 cases of acute diarrhea.

Recent tests conducted by the institute revealed the presence of the bacterium Vibrio cholerae, which causes the cholera disease, in water from canals and lakes in Hanoi and other northern provinces.

Warmer temperatures associated with the changing of the season heighten the bacterium resistance and increase the potential for the disease to proliferate.

Nga said water sterilization measures have been implemented at infected canals and lakes.

Last December, the Ministry of Health announced a 40-day acute diarrhea epidemic in 13 northern localities had been controlled.

That outbreak totaled 1,991 reported cases, of which 295 tested positive for cholera.

San Francisco vision doctor helps out in Vietnam

Medical technology is saving more premature babies in Vietnam, but that same technology puts the children at risk for a disorder that could leave them blind. See how one Bay Area(San Francisco) doctor is making a difference half a world away.

Three-year-old Nguyen was born premature in Ho Chi Minh City. The high amounts of oxygen used to keep him alive also damaged the blood vessels in his eyes, resulting in blindness.

“In the 1950’s in the United States, up to 25,000 babies would go blind a year because of retinopathy of prematurity. Now, in Vietnam, that same thing is happening all over again.” says pediatric ophthalmologist Douglas Fredrick M.D.

Today, doctor’s can treat retinopathy of prematurity (ROP) with a laser if it’s detected early. That’s Why Dr. Douglas Fredrick at Lucile Packard Children’s Hospital is a mentor to doctor’s from Vietnam.

The effort is sponsored through a global non profit organization called Orbis International. Fed Ex is the corporate sponsor that provides financial and logistical support.

“They spend two months with me learning about retinopathy of prematurity, learning how to diagnose the condition and treat the condition,” says Fredrick.

Dr. Nguyen Thanh Chi is the eighth doctor in five years to shadow Dr. Fredrick. Dr. Chi returns to Da Nang Eye Hospital next month. She’s eager to practice what she’s learned here and share her new skills with other doctors. Just as she has been empowered, the student will soon be the teacher.

“First of all, I will teach others in order to improve knowledge about pediatrics,” says Chi.

Dr. Fredrick estimates some 500 children in Vietnam have had their vision saved as a result of the mentoring program.

“I can’t think of anything more significant than taking a child who has every opportunity to see clearly for the rest of their lies and preserving that vision so they have a chance to see normally.”

Dr. Chi says more laser equipment is needed for rural hospitals in Vietnam, but at least now, more doctors have a clear vision of how to diagnose a problem and change a life.

Hidden Tragedy Of Under-reported Neonatal Mortality In Northern Vietnam

ScienceDaily (Mar. 31, 2008) — In Northern Vietnam, neonatal mortality is almost four times higher than the official figure according to a report published today in the open access journal BMC International Health and Human Rights. This under-reporting could mean neonatal healthcare in the country is massively under-funded.

Lars-Ake Persson, Mats Målqvist and colleagues at Uppsala University, along with researchers at Karolinska University Hospital, Stockholm, Sweden, are working with the Uong Bi General Hospital, in Quang Ninh, and the Vietnamese Ministry of Health, in Hanoi, on the question of unreported births and neonatal deaths.

The researchers explain that in order to reduce infant mortality in low-income countries, such as Vietnam, there is an urgent need to have valid health statistics. Such data would highlight the need for national and international health initiatives and for the provision of sufficient funds to implement them. Without valid statistics many children could be dying unnecessarily at birth.

Information on all births and neonatal deaths in Quang Ninh province in Northern Vietnam during 2005 was collected through questionnaire surveys and group interviews with healthcare staff at 187 Community Health Centers and 18 hospitals, as well as with 1372 village health workers. Information was also gathered from health facility records. The team then compared these results with official statistics from the Provincial Health Bureau.

The researchers found that the neonatal mortality rate was 16 deaths in 1000 births. The official figure is just 4 in 1000. This discrepancy is attributed to a dysfunctional registration system that relies on grieving families, and not the health system, to report a death. This has severe consequences because at the national and international level a low mortality rate does not necessitate urgent healthcare investment.

“Such faulty health information systems are not unique to Vietnam”, say the researchers. “Improving reporting systems on births and neonatal deaths is a matter of human rights and a prerequisite for reducing neonatal mortality,” the researchers add.

Journal reference: Unreported births and deaths, a severe obstacle for improved neonatal survival in low-income countries; a population based study. Mats Malqvist, Leif Eriksson, Nguyen T Nga, Linn I Fagerland, Dinh P Hoa, Lars Wallin, Uwe Ewald and Lars-Ake Persson. BMC International Health and Human Rights (in press)

Over 20,000 people annually die of tuberculosis in Vietnam

Vietnam has some 100,000 tuberculosis infections and 20,000 deaths caused by the disease each year, according to local newspaper Vietnam News on Tuesday.

Vietnam now ranks the 13th among 22 countries having the highest numbers of tuberculosis infections.

To curb the disease, Vietnam is intensifying vaccination, urging local people to keep hygienic and have healthy lifestyles, encouraging them to go to see doctors when having signs of tuberculosis infection, and strengthening diagnosis and treatment systems nationwide.

The country with a population of over 86 million has aimed to halve the annual new tuberculosis infections by 2015.

Vietnam contains acute diarrhea outbreaks

HANOI, Nov. 27 (Xinhua) — Vietnam has basically contained an acute diarrhea after it has hit the country for over one month, local newspaper Labor on Tuesday quoted Vietnamese Deputy Health Minister Trinh Quan Huan as saying.

    The number of new infection cases admitted to hospitals sharply decreased last weekend. Only 12 patients, including a cholera one, were admitted to the Tropical Disease Hospital and four to the Bach Mai hospital in capital Hanoi.

    To eliminate the disease, Vietnam has taken drastic measures, including monitoring food safety, ensuring environmental hygiene and intensifying publicity on acute diarrhea, especially in food-hit localities.

    Acute diarrhea has affected over 1,800 people in Vietnam since Oct. 23. Of the patients, 267 have been tested positive to cholera virus, according to the ministry.