by Dr Brian McNaull*
Influenza spreads in two main ways and it is worth noting that children are much more infectious than adults.
1. Droplet spread: an infected person sneezes or coughs disseminating the virus through droplets of mucus which enter directly into the eyes, nose or mouth of another person present within 1–2m. A sneeze or cough releases more than half a million viral particles.
2. Contact: Hand-to-eye/to-nose/to-mouth transmission, from contaminated surfaces or from direct personal contact.
Morbidity and mortality
Influenza spreads globally annually and symptoms may be mild to severe. This disease annually causes three to five million cases of severe illness and 290,000–650,000 deaths. Complications include viral pneumonia, secondary bacterial pneumonia, sinusitis, and the exacerbation of extant health problems such as asthma or heart failure. Death is commonest in the high risk groups: the young, the old, pregnant women and those with health problems including the immuno-compromised, transplant recipients, and individuals with severe chronic diseases. Smoking is another risk factor, as is air pollution. Common symptoms such as fever, headaches and fatigue are the result of the release of proinflammatory cytokines and chemokines that are produced by influenza-infected cells, In the United States it has been estimated that influenza annually causes approximately 36,000 deaths and more than 200,000 hospitalisations. The country’s average annual economic cost is over US$11billion
Mutation necessitates annual vaccination
Due to influenza’s high mutation rate, any particular vaccine usually confers protection for no more than a few years. Indeed, vaccine effectiveness is annually estimated at 25–60 per cent. For this reason, each year, the World Health Organisation predicts which influenza strains are likeliest to circulate in the next year hence allowing pharmaceutical companies to produce targeted vaccines. The vaccine does not include all active strains in any particular season, and it is thus occasionally possible for a new or overlooked and therefore non-included strain to become prevalent and widespread. The vaccine induces immunity after about two weeks. Seasonal influenza vaccination is cost-effective, especially in children and the elderly.
Influenza and flu vaccination in the COVID-19 era
Infection with one pathogen does not preclude co-infection with a second or more pathogens. This winter, in the likely absence of an effective COVID-19 vaccine, it is almost certain that influenza strains will circulate in conjunction with COVID-19. Thus far, it appears that with the current strains of these two viruses, the clinical outcome is not significantly worse than infection with COVID-19 alone. However it is now known that these two virus can co-infect the same patient. Very early experience shows co-infected patients did not fare worse compared to patients just infected with COVID-19. But the argument in favour of universal influenza vaccination would imply decreasing hospital stays due to complications and therefore alleviating the hospital and other health systems from the significant pressure of dealing with both COVID and influenza in the same period.
This year we will be facing a bigger challenge: seasonal influenza that is still not fully preventable, confounded by the COVID-19 pandemic. Children are susceptible to both, may become co-infected and can transmit both respiratory viruses to others. We still do not have full understanding of the immune response to these viruses. Immune dysregulation is one of the features observed in individuals presenting with severe COVID-19 disease and is likely the explanation for the inflammatory syndromes incorporating a spectrum of manifestations classically seen in Kawasaki disease and Toxic Shock syndrome re-ported in children. Presently, data on the clinical manifestations and severity of disease with influenza A and SARS-CoV-2 co-infection are very limited. Bacterial superinfection is one of the deadliest complications of influenza. Vaccination against influenza and pneumococcal disease will be important to mitigate these infections. This is especially important for children who are known to play an important role in the transmission of influenza and the pneumo-coccus to the elderly.
Lower COVID mortality following flu vaccination
A new study (retrospective cohort) involving over 92,000 patients with COVID-19 in Brazil shows that the odds of severe disease, ventilatory support requirement, and death are reduced with a recent trivalent flu vaccine. This seems to indicate that these vaccines should be used as widely as possible to reduce the risk of severe COVID-19, especially among high-risk groups. The researchers then looked at rates of death among vaccinated and non-vaccinated patients in the same facility. They found that the odds of dying of COVID-19 was lowered by 18 per cent in the flu-vaccinated group.
* Living in Hà Nội since 2006, Dr Brian is presently Medical Director of Family Medical Practice Hà Nội. Graduated in the UK, he practised medicine principally in Canada (1981-2005) before coming to Việt Nam. Postgraduate medical training includes Cambridge University (Chronic Disease Epidemiology and Biostatistics), University College London (Tropical and Infectious Disease) and University of Toronto Hospitals (Hospital for Sick Children – Hematology and Bone Marrow Transplant) and Mt Sinai Hospital (Hepatology – Clinical trials experimental liver/virology unit 1997-2006). He has conducted medical research, worked and lectured in various countries on infectious disease topics, epidemiology and liver disease (Canada, Việt Nam, Cambodia, Philippines). He is also the weekly co-host of Radio the Voice of Việt Nam’s (VOV5) ‘Doctor at Home’.
Family Medical Practice was the first foreign-owned primary healthcare provider in Việt Nam, and has consistently remained at the forefront of international-standard medicine since 1995. It offers extensive healthcare and emergency medical services nationwide to Vietnamese, expatriate and corporate customers.
For more advice on any medical topics, visit Family Medical Practice (FMP) Hà Nội at: 298 I Kim Mã St, Ba Đình Dist. Tel: (024) 3843 0748. Email: [email protected]
FMP’s downtown Hồ Chí Minh City location is: Diamond Plaza, 34 Lê Duẩn St, District 1; 95 Thảo Điền St, Distrist 2. Tel: (028) 38227848. Email: [email protected]
FMP Đà Nẵng is located at 96-98 Nguyễn Văn Linh St, Hải Châu Dist, Đà Nẵng. Tel: (0236) 3582 699. Email: [email protected]
Lives of Cong ethnic people in Dien Bien
La Cha Village in the northern mountainous province of Dien Bien’s Nam Po District is home to a Cong ethnic community, one of the five ethnic minority communities in the province with 79 households and nearly 400 inhabitants.
|La Cha Village in Nam Po District, one of the few villages in the northern mountain province of Dien Bien where the ethnic Cong people live.|
The living conditions of the Cong people in the village have improved in the past few years due to support from the Government and local authorities.
Investment projects on infrastructure construction, agricultural production, and cultural preservation in the district have helped change the lives of local people.
|Cong children in La Cha Village have fun during their extracurricular school hours. VNA/VNS Photos Xuan Tien|
The village is now connected with the electricity network, while roads, schools, and bridges have been built, creating convenient conditions for people to develop all aspects of life.
|A traditional dance featuring the manual farming works of Cong ethnic people in La Cha Village, Dien Bien Province.|
|An old woman of the Cong ethnic group doing some manual cultivation work in the garden.|
|Some festivals, cultural rituals and spiritual beliefs of families and clans in the village are performed by a shaman. VNA/VNS Photos Xuan Tien|
In the past, Cong people had very difficult lives as they depended a lot on self-sufficiency and migration.
They earned their living just by manual cultivation on slash-and-burn fields, so crop productivity was very low. VNS
UAE forecasts strong growth in trade with VN
On December 2, 2020, the UAE celebrates the 49th anniversary of the founding of the federation under the slogan “Spirit of the Union”. Dr Ezzat Abdulwahed Sayed, political and economic analyst from the UAE Embassy in Hà Nội, writes for Việt Nam News.
On this day in 1971, the UAE started its first journey towards progress and development to achieve its pioneering ambition in all fields as the embodiment of the “UAE Vision 2021” which aims to make the precious UAE one of the best countries in the world on the 50th anniversary of its establishment.
Every year in which Emiratis celebrate their National Day, they touch on the great development achievements of the country during the previous year, and what they aspire to achieve during the next year. This is all within the framework of a comprehensive development vision that does not satisfy only the forefront but is concerned with the present and the future, and is in the midst of competition in the field of development with confidence, based on proper planning and production of knowledge, and looking at national human cadres as the most important wealth of the nation and its real investment.
Since its establishment in 1971, the foreign policy of the UAE has been characterised by wisdom, moderation, balance, and advocacy of truth and justice, based on the foundations of dialogue and understanding between brothers and friends, respect for international conventions, adherence to the United Nations Charter, respect for the rules of good neighbourliness, sovereignty and territorial integrity, non-interference in internal affairs and resolving disputes by peaceful means.
The UAE has witnessed a wide openness to the outside world, which has resulted in the establishment of strategic political, economic, commercial, cultural, scientific, educational and health partnerships with many countries in various continents, thus enhancing the prestigious position it occupies in the international community.
The UAE economy has made an exceptional performance thanks to the country’s long-standing desire to adopt a development policy based on diversifying sources of income and supporting non-oil sectors. The country’s economy is characterised by the infrastructure of stable and balanced performance despite all its surrounding regional and international challenges.
As a responsible, committed member of the international community, the UAE strongly condemns terrorism and extremism in all forms, and demonstrates its commitment to confront, degrade and eradicate terrorism and extremism across the region and worldwide.
The UAE is also considered one of the leading countries in the field of humanitarian giving through its successive initiatives in all fields and arenas of charitable and humanitarian work at local and international levels. The leadership of the Emirates believes that humanitarian work is a moral responsibility and a duty that embodies solidarity and synergy between peoples and nations.
The UAE has always been proactive in carrying messages of peace and co-operation initiatives to the whole world, and for this it has been keen on building friendly, high-level relations with various countries around the world.
Since the UAE and Việt Nam officially established diplomatic relations in 1993, significant achievements have been recorded in diplomatic, economic and other aspects of the relationship, and after more than 25 years of diplomatic relations, the UAE and Việt Nam are considered key economic partners in Southeast Asia and the Middle East thanks to their open economic policies.
Bilateral trade and investment have developed rapidly, with the two countries becoming mutual strategic partners in trade and economy. The non-oil trade balance reached more than US$8.2 billion in 2018, which represents 34 per cent of the total non-oil trade between the UAE and ASEAN countries. The UAE is considered Việt Nam’s top trading partner in the Middle East region, including the GCC and Africa.
Over the past two decades, the UAE has also been acknowledged as one of the leading foreign investors in Việt Nam, and we are confident that this trade and investment relationship will continue to grow stronger.
UAE businesses have been investing in infrastructure, real estate, sea ports, oil and gas, tourism and services in Việt Nam, while Vietnamese businesses have been investing in wholesale and retail trade, motor vehicle repair and real estate.
The UAE is a gateway for Việt Nam to penetrate the Middle East, Europe and Africa. Meanwhile, Việt Nam is an important gateway for the UAE to Southeast Asia and the Far East. The two countries have much potential to boost co-operation in the fields of renewable energy, metallurgy, ship repair, petro-chemistry, chemicals, mechanics and manufacturing
For its part, the UAE attaches great importance to relations between the two countries and hopes to enhance trade relations between the two countries and raise them to higher levels in line with the level of bilateral relations and the aspirations of the leaderships, raising trade to $20 billion by 2025. VNS
Art events infused with innovative technology at Arcan
HCM CITY — Double+, a series of art events infused with innovative technologies such as audio/visual and motion-sensor systems, and an interactive wall, is opening at Arcan until Friday.
The event features American artist Mike Hodges and Vietnamese artist Trần Nguyễn Ưu Đàm. They have showcased their artworks by integrating video mapping with audio/visual effects to create a high-tech, immersive and aesthetic interaction with the viewers.
The artists have also offered decorative artwork performances and a talk show at the event.
The event is open from 7-10 pm at 236/29/2H Điện Biên Phủ Street in Bình Thạnh District. Tickets at VNĐ300,000 can be purchased at www.ticketbox.vn. — VNS
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