Your Vietnam
Melioidosis – the great mimicker
Dr Mattias Larsson*
Thủy is a lively 12-year-old girl. She went on vacation to the countryside in central Việt Nam to help her grandmother on her farm. A few days after coming back home she developed fever, pain, headache, puffy eyelids, tenderness and swelling in the neck.
She was taken to a local clinic that diagnosed parotitis and treated her with an oral antibiotic and paracetamol. She got some temporary relief, but after some days the symptoms got worse.
The high fever persisted, and the neck pain and headache worsened. She also developed torticollis and overall muscle pain. She was unable to open her mouth and mostly lost her appetite. She also developed chest pain and cough.
The increasingly worried parents decided to take Thủy to Family Medical Practice. When examined the paediatrician noted swollen glands near the ears and enlarged lymph nodes in the neck. She was breathing rapidly, and their chest appeared to be sinking inwards. When listened to with a stethoscope, crackling sounds were heard. An ultrasound revealed inflammation in the salivary glands and an abscess in the back of the throat. Blood tests showed signs of a bacterial infection, anemia (low red blood cell count) due to Thalassemia (hereditary small red blood cells). Chest X-rays showed irregular spots and consolidation in the upper part of the lungs.
When asked about exposures, Thủy said that she had helped her grandmother in the rice fields wet soil and got some cuts on her feet and legs. The paediatrician knew that Burkholderia pseudomallei, a bacterium common in southeast Asian soil and surface water, can enter the body through small wounds, spread through the blood and cause Melioidosis (Whitmore’s disease) with abscess.
However, the correct diagnosis of Melioidosis is tricky as it mimics many other conditions, hence also called “the great mimicker.” The diagnosis was confirmed through blood and pus fluid cultures incubated for 48 hours that showed bacterial colonies with metallic shine that was positive for the “Three Antibiotic Disk Test” typical Burkholderia pseudomallei antibiotic resistance pattern.
Thủy was treated with an intensive treatment for two weeks including intravenous antibiotics. Her condition improved and she had no more fever. However, to eradicate the infection she had to use an oral antibiotic for another four months.
Melioidosis spreads through direct contact of contaminated soil dust or water droplets, ingestion of contaminated water, food or through skin abrasions. It is very rare for people to get the disease from another person. Persons with open skin wounds should avoid contact with soil and standing water. Farmers are recommended to wear boots to prevent exposure through the feet and lower legs.
Although healthy people may get melioidosis, underlying medical conditions that may increase the risk include diabetes, liver and kidney disease, cancer, chronic lung disease and, as for Thuy, thalassemia.
There are several types of melioidosis infections, localised abscess, lung and blood infections, each with different symptoms but all including high fever. Children often present with parotitis, an inflammation of the salivary glands located near the ear. The incubation period can range from one day to many years, but generally symptoms appear two to four weeks after exposure.
Children under 16 years of age constitute 5–15 per cent of melioidosis cases and compared to adults have lower mortality rates, are less likely to be associated with underlying diseases and more likely to involve localized disease such as parotitis.
Melioidosis is underdiagnosed as few physicians know about the disease, hence limited number of clinical specimens are sent for bacterial cultures and if sent the 48-hour incubation of agar plates is not always performed correctly. There is a new point of care test, the Active Melioidosis Detect™ (AMD) that hopefully will be available soon. Raising awareness for the disease amongst the public, physicians and laboratory staff as well as introducing a simple laboratory algorithm could increase the detection rate significantly. Family Medical Practice
*Dr Mattias Larsson is a paediatric doctor at Family Medical Practice and associate professor at Karolinska Institutet and has a long experience in research on infectious diseases. He has worked with the Oxford University Clinical Research Unit and the Ministry of Health of Vietnam. He is fluent in English, Swedish, Vietnamese, German and some Spanish.
Visit Family Medical Practice Hanoi 24/7 at 298I P. Kim Mã, Kim Mã, Ba Đình.
To book an appointment, please call us at (024).3843.0784 or via Whatsapp, Viber or Zalo on +84.944.43.1919 or email [email protected].
FMP’s downtown location in Hồ Chí Minh is in Diamond Plaza, 34 Đ. Lê Duẩn, Bến Nghé, district 1, Thành phố and 95 Đ. Thảo Điền, district 2. Tel. (028) 3822 7848 or email [email protected].
Source: http://ovietnam.vn/life-in-vietnam/melioidosis-the-great-mimicker_349981.html
HẢI PHÒNG — Every weekend the “Free Walking Tour” in Hải Phòng City attracts a large number of tourists due to its unique and captivating experiential value.
The Free Walking Tour is a travel concept offered by Vietravel Company in collaboration with the Hải Phòng Department of Tourism and Hải Phòng Railway Station. It aims to provide visitors with a “slow living” experience, allowing them to observe, feel and immerse themselves in the lives of the local people along each route.
During this tour, participants are guided by locals and provided with insights into the history, culture, architectural landmarks and the people of Hải Phòng. Additionally, they get to indulge in the culinary delights showcased on the Food Tour map.
The tour takes visitors to various attractions, including Tam Bạc Lake, the statue of General Lê Chân, a prominent figure who assisted the Trưng sisters in their resistance against foreign invaders from 40-42 AD, and the revitalised ancient An Biên Village, now known as Hải Phòng City. Other notable stops include the Hải Phòng Opera House, the City Museum and the Post Office.
On weekends, Hải Phòng Railway Station welcomes thousands of tourists. Visitors are provided with complimentary travel publications such as food tour maps, caps, t-shirts and promotional vouchers, enhancing their experience of dining and exploring the city.
In addition to promoting tourism through various digital platforms, the Hải Phòng Department of Tourism has launched a culinary map and a check-in location map to stimulate tourism demand. These initiatives aim to provide visitors with comprehensive tour experiences.
According to the municipal Department of Tourism, these tourism products are continuously evolving to offer tourists increasingly unique experiences during their food tours, thereby fostering a desire to revisit Hải Phòng. VNS
Source: http://ovietnam.vn/life-in-vietnam/tourists-enjoy-free-walking-tour-in-hai-phong_350783.html
HẢI PHÒNG — Hải Phòng City, in its efforts to boost tourism within the country, has established connections with three Central Highlands provinces.
According to Vũ Huy Thưởng, deputy director of Hải Phòng Department of Tourism, the city possesses several advantages in linking tourism with the Central Highlands provinces. This is made possible through the Hải Phòng – Buôn Ma Thuột route, as well as numerous flights connecting various provinces and cities nationwide.
Consequently, the Department of Culture, Sports, and Tourism of the three provinces will collaborate in promoting tourism development, enhancing coordination in showcasing and introducing destinations. Local tourism businesses will conduct research and develop products that capitalise on the unique potential and advantages of each locality. This collective effort aims to support the provinces and cities in accelerating their tourism industry’s sustainable and effective development, ultimately establishing them as alluring destinations on Việt Nam’s tourism map.
Hải Phòng City stands out due to its exceptional eco-tourism and island tourism offerings. Recognising the distinctive features of each location, fostering cooperation and partnerships with other regions becomes crucial in expanding markets and exchanging valuable insights for tourism development.
The Central Highlands, renowned for its abundant resources, boasts breathtaking landscapes and a vibrant indigenous culture. Home to 47 ethnic groups, the region holds significant cultural heritage such as the Central Highlands Gong Cultural Space, recognised as an intangible cultural heritage of humanity. Additionally, it hosts unique traditional festivals like the Elephant Racing Festival and Gongs Festival. VNS
Source: http://ovietnam.vn/life-in-vietnam/hai-phong-connects-tourism-with-three-central-highlands-provinces_350782.html
Trần Khánh An
Valentin Constantinescu, better known by his nickname Chiếc Tây Valentin, regards himself as “a Westerner from Romania with Vietnamese blood.”
The Romanian man does not exaggerate or play on words – after nearly two decades in Việt Nam, he genuinely speaks Vietnamese fluently and profoundly understands this nation like a true Vietnamese.
His story with Việt Nam began in 2004 after graduating from high school, as he got a scholarship to study at the Diplomatic Academy of Việt Nam.
Valentin shared with Việt Nam News that he remembers vividly the heat and humidity of the ambience, as well as numerous motorcycles along the road to the student dormitory on the first day he set foot in Hà Nội.
Valentin was impressed by Hà Nội’s blend of tradition and modernity, which he described as “even more convenient than some developed countries.”
“I can go and stop anywhere, anytime on a motorbike with ease. Even shopping and dining are within easy reach,” he said.
“Even now, the payment system in Việt Nam is impressive,” Valentin added. “As bank transfers and QR code payments are more common, all you truly need to carry is a phone.”
“Vietnamese people are also friendly and hospitable. After the first week in Hà Nội, I decided I would never leave Việt Nam again.”
The 38-year-old now works as an English teacher and a content creator, producing content about Vietnamese culture and his experiences as an expat living in Việt Nam. This role earns him more than half a million followers on all social platforms.
He has also participated in numerous gameshows and television programmes, winning over Vietnamese audiences with his sharp wit, conversational charm and profound knowledge of Việt Nam.
Valentin is also a chàng rể Hà Nội (Hà Nội’s son-in-law) — a term to describe a man marrying a Hà Nội’s woman. After he met his wife in 2016, Cupid immediately shot an arrow to match the couple up, and they married in 2018.
Valentin admitted that adjusting to his role as Hà Nội’s son-in-law was a bit challenging.
“My wife and I can have a loose timetable while we live together. When we visit our wife’s parents, however, we live in a more ordered manner,” he shared.
“However, I believe that regularity and discipline in lifestyle are also unique characteristics of the Hà Nội people.”
Valentin’s seven-year multicultural marriage has given him a nuanced viewpoint of Eastern and Western traditions.
“I realise that both Eastern and Western culture are somehow constraining women,” he said.
In Việt Nam, unlike Western countries, it is not a custom that the wife must acquire her husband’s surname after marriage. However, it is a widely held belief here that when a woman marries, she is expected to care for her husband’s family more, as if her parents had lost a daughter.
“When my wife kept her Vietnamese last name, Phạm, I highly supported my wife’s decision and was so happy for her,” he recalled.
“I also frequently encourage my wife to visit and take care of her family so that her parents do not feel like losing their daughter,” he added.
“If I were a father, I would be happy if my daughter marries a wonderful spouse and has a happy life, rather than suffering with the pain of losing my child.”
Due to the work change, Valentin and his wife moved to HCM City in 2018, and they miss Hà Nội weather and cuisine terribly. Hà Nội truly has cast him under its spell.
“The cold in Hà Nội and the sensation of being bundled up in layers of warm clothing, which also reminds me of Romania, is what I miss most,” Valentin recalled.
“Southern food is a little bit sweet for me, whereas food in Hà Nội is perfect. While some may consider Hà Nội’s delicacies to be bland, the unique aspect of Hà Nội cuisine is that it empowers diners to season and customise their dishes with spices,” he added.
Valentin and his wife both love cooking and share equal footing in the kitchen. She taught him how to prepare Vietnamese dishes, and now he could cook for their family and friends.
He prefers rolls because they are simple to prepare, as well as bordelaise sauce, which is not only a Hà Nội speciality but also reminds him of his time in Europe.
Valentin also hinted to Việt Nam News about his biggest project yet – he plans to travel across Việt Nam and spend at least a few months in each province to explore and introduce the people, culture, and cuisine.
“I want to visit all provinces and cities across the country. I have only lived in two major cities; even when I travel, I have not completely immersed myself and lived as a native resident,” he revealed the reason behind his upcoming project.
As an expat who has lived in Việt Nam for nearly two decades, he is also confident that his unique viewpoint and extensive knowledge of his content can enrich the visitors’ experience compared to other foreign travelling vloggers – who may spend just a few weeks in Việt Nam.
“I hope my videos will offer the audience valuable insights into local customs, culture, and cuisine, proving that Việt Nam is a place worth living.” VNS
Source: http://ovietnam.vn/life-in-vietnam/valentin-constantinescu-a-romanianwith-vietnamese-blood_350744.html
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