Community event-based surveillance aims to enhance the early detection of emerging public health threats and thus build health security. The Ministry of Health of Vietnam launched a community event-based surveillance pilot program in 6 provinces to improve the early warning functions of the existing surveillance system. An evaluation of the pilot program took place in 2017 and 2018. Data from this evaluation were analyzed to determine which factors were associated with increased detection and reporting. Results show that a number of small, local events were detected and reported through community event-based surveillance, supporting the notion that it would also facilitate the rapid detection and reporting of potentially larger events or outbreaks. The study showed the value of supportive supervision and monitoring to sustain community health worker reporting and the importance of conducting evaluations for community event-based surveillance programs to identify barriers to effective implementation.

Background: One hundred days after SARS-CoV-2 was first reported in Vietnam on January 23 ^rd , 270 cases have been confirmed, with no deaths. We describe the control measures used by the Government and their relationship with imported and domestically-acquired case numbers, with the aim of identifying the measures associated with successful SARS-CoV-2 control. Methods: Clinical and demographic data on the first 270 SARS-CoV-2 infected cases and the timing and nature of Government control measures, including numbers of tests and quarantined individuals, were captured by Vietnam’s National Steering Committee for COVID-19 response. Apple and Google mobility data provided proxies for population movement. Serial intervals were calculated from 33 infector-infectee pairs and used to estimate the proportion of pre-symptomatic transmission events and time-varying reproduction numbers. Findings: After the first confirmed case on January 23 ^rd , the Vietnamese Government initiated mass communications measures, case-contact tracing, mandatory 14-day quarantine, school and university closures, and progressive flight restrictions. A national lockdown was implemented between April 1 ^st and 22 ^nd . Around 200 000 people were quarantined and 266 122 RT-PCR tests conducted. Population mobility decreased progressively before lockdown. 60% (163/270) of cases were imported; 43% (89/208) of resolved infections remained asymptomatic for the duration of infection. 21 developed severe disease, with no deaths. The serial interval was 3.24 days, and 27.5% (95% confidence interval, 15.7%-40.0%) of transmissions occurred pre-symptomatically. Limited transmission amounted to a maximum reproduction number of 1.15 (95% confidence interval, 0.37-2.36). No community transmission has been detected since April 15 ^th . Interpretation: Vietnam has controlled SARS-CoV-2 spread through the early introduction of mass communication, meticulous contact-tracing with strict quarantine, and international travel restrictions. The value of these interventions is supported by the high proportion of asymptomatic and imported cases, and evidence for substantial pre-symptomatic transmission. Funding: The Vietnam Ministry of Health and Wellcome Trust, UK. Research in context: Evidence before this study: Vietnam was one of the first countries outside of China to detect imported and human-to-human transmitted SARS-CoV-2 within its borders. Yet, as of May 1 ^st , a total of only 270 cases have been confirmed, no deaths have occurred, and no community transmission has been detected since April 15 ^th despite intensive screening, tracing and testing. We did a PubMed database search to identify studies investigating COVID-19 response in Vietnam using the terms “Vietnam”, “COVID-19”, and “SARS-CoV-2”. All relevant articles were evaluated. Studies describe cases of COVID-19 and their management, aspects of the government response from newspapers and online government sources, but there are no previous reports using national data to describe and investigate the national epidemic and the impact of control measures cases over time. Added value of this study: We used data from the National Steering Committee for COVID-19 response to give a comprehensive account of the first 100 days of the SARS-CoV-2 epidemic in Vietnam, including case numbers and their symptomatology, the estimated reproductive number by week, and their relation to the multiple control measures instituted by the Vietnam Government over time. We show two distinctive features of Vietnam’s response. First, the Government took rapid actions to restrict international flights, closed schools and universities, and instituted meticulous case-contact tracing and quarantining from late January, well before these measures were advised by WHO. Second, they placed mass communication, education, and the identification, serial testing, and 14-day quarantine of all direct contacts of cases, regardless of symptom development, at the heart of the response. The value of strict contact-tracing and quarantine is supported by the high proportion of asymptomatic cases (43%) and imported cases (60%), and evidence for substantial pre-symptomatic transmission. Implications of all the available evidence: Vietnam has had remarkable success in controlling the emergence of SARS-CoV-2. Our report provides a complete picture of the control of SARS-CoV-2 in Vietnam, with lessons for other Governments seeking to extend national SARS-CoV-2 control or prevent future epidemics. Our findings shows the importance of acting early, before the virus becomes established in the community, and before the case numbers overwhelm systems of case-contact tracing and mass quarantine. They also demonstrate the value of effective mass communication in rapidly educating the public in infection prevention measures and providing real-time information on the state of the epidemic.

In 2011–2012, Northern Vietnam experienced its first large scale hand foot and mouth disease (HFMD) epidemic. In 2011, a major HFMD epidemic was also reported in South Vietnam with fatal cases. This 2011–2012 outbreak was the first one to occur in North Vietnam providing grounds to study the etiology, origin and dynamic of the disease. We report here the analysis of the VP1 gene of strains isolated throughout North Vietnam during the 2011–2012 outbreak and before. The VP1 gene of 106 EV-A71 isolates from North Vietnam and 2 from Central Vietnam were sequenced. Sequence alignments were analyzed at the nucleic acid and protein level. Gene polymorphism was also analyzed. A Factorial Correspondence Analysis was performed to correlate amino acid mutations with clinical parameters. The sequences were distributed into four phylogenetic clusters. Three clusters corresponded to the subgenogroup C4 and the last one corresponded to the subgenogroup C5. Each cluster displayed different polymorphism characteristics. Proteins were highly conserved but three sites bearing only Isoleucine (I) or Valine (V) were characterized. The isoleucine/valine variability matched the clusters. Spatiotemporal analysis of the I/V variants showed that all variants which emerged in 2011 and then in 2012 were not the same but were all present in the region prior to the 2011–2012 outbreak. Some correlation was found between certain I/V variants and ethnicity and severity. The 2011–2012 outbreak was not caused by an exogenous strain coming from South Vietnam or elsewhere but by strains already present and circulating at low level in North Vietnam. However, what triggered the outbreak remains unclear. A selective pressure is applied on I/V variants which matches the genetic clusters. I/V variants were shown on other viruses to correlate with pathogenicity. This should be investigated in EV-A71. I/V variants are an easy and efficient way to survey and identify circulating EV-A71 strains.

Objectives: Online misinformation has reached unprecedented levels during the coronavirus disease 2019 (COVID-19) pandemic. This study analyzed the magnitude and sentiment dynamics of misinformation and unverified information about public health interventions during a COVID-19 outbreak in Da Nang, Vietnam, between July and September 2020.Methods: We analyzed user-generated online information about five public health interventions during the Da Nang outbreak. We compared the volume, source, sentiment polarity, and engagements of online posts before, during, and after the outbreak using negative binomial and logistic regression, and assessed the content validity of the 500 most influential posts.Results: Most of the 54,528 online posts included were generated during the outbreak (n = 46,035; 84.42%) and by online newspapers (n = 32,034; 58.75%). Among the 500 most influential posts, 316 (63.20%) contained genuine information, 10 (2.00%) contained misinformation, 152 (30.40%) were non-factual opinions, and 22 (4.40%) contained unverifiable information. All misinformation posts were made during the outbreak, mostly on social media, and were predominantly negative. Higher levels of engagement were observed for information that was unverifiable (incidence relative risk [IRR] = 2.83; 95% confidence interval [CI], 1.33–0.62), posted during the outbreak (before: IRR = 0.15; 95% CI, 0.07–0.35; after: IRR = 0.46; 95% CI, 0.34-0.63), and with negative sentiment (IRR = 1.84; 95% CI, 1.23–2.75). Negatively toned posts were more likely to be misinformation (odds ratio [OR] = 9.59; 95% CI, 1.20–76.70) or unverified (OR = 5.03; 95% CI, 1.66–15.24).Conclusions: Misinformation and unverified information during the outbreak showed clustering, with social media being particularly affected. This indepth assessment demonstrates the value of analyzing online “infodemics” to inform public health responses.

From 2011 to 2012, Northern Vietnam suffered its first large-scale hand, foot, and mouth disease (HFMD) epidemic. Two sets of official guidelines were issued during the outbreak to handle the HFMD crisis. The city of Hai Phong was used as a model to analyze the impact of the released guidelines. A total of 9621 HFMD cases were reported in Hai Phong city from April 2011 to December 2012. Three distinct waves of HFMD occurred. Enterovirus A71 and Coxsackievirus A16 were successively associated with the epidemics. Two periods, before and after the guidelines’ release, could be distinguished and characterized by different patient patterns. The time to admission and severity changed notably. Guideline publications help the health system refocus on the 0.5–3 years age group with the highest incidence of the disease. The three waves showed different special distribution, but the main routes of infection were rivers and local secondary roads, most likely through local trade and occupational movements of people.