Abstract
The first cases of human melioidosis were described in Vietnam in the 1920s, almost a century ago. It was in Vietnam in the thirties that the saprophytic nature of B. pseudomallei was first recognized. Although a significant number of French and U.S. soldiers acquired the disease during the Vietnam wars, indigenous cases in the Vietnamese population were only sporadically reported over many decades. After reunification in 1975, only two retrospective studies reported relatively small numbers of indigenous cases from single tertiary care hospitals located in the biggest cities in the South and the North, respectively. Studies from provincial hospitals throughout the country were missing until the Research Network on Melioidosis and Burkholderia pseudomallei (RENOMAB) project started in 2014. From then on seminars, workshops, and national scientific conferences on melioidosis have been conducted to raise awareness among physicians and clinical laboratory staff. This led to the recognition of a significant number of cases in at least 36 hospitals in 26 provinces and cities throughout Vietnam. Although a widespread distribution of melioidosis has now been documented, there are still challenges to understand the true epidemiology of the disease. Establishment of national guidelines for diagnosis, management, and reporting of the disease together with more investigations on animal melioidosis, genomic diversity of B. pseudomallei and its environmental distribution are required.
Highlights
Sporadic cases of melioidosis have been reported from Vietnam since the year 1927, the disease has only recently attracted the deserved attention among Vietnamese health care professionals
Serology using indirect hemagglutination (IHA) showed that 8.9% of the sera from the Vietnam veterans had titers of 1:40 or greater [18]. Based on such titers it was estimated by Clayton et al that approximately 250,000 among three million U.S Army personnel got infected with B. pseudomallei when serving in Vietnam [18,19]. These estimates might be interpreted with some cautions considering the limited specificity and sensitivity of the non-standardized IHA test, this study indicated a potential reservoir of latent B. pseudomallei infection among personnel returning from Vietnam
In the context of the Research Network on Melioidosis and Burkholderia pseudomallei (RENOMAB; see below Section 5) that started in 2014, a recent study reported 70 cases detected within seven months at five hospitals in North Central Vietnam
Summary
Sporadic cases of melioidosis have been reported from Vietnam since the year 1927, the disease has only recently attracted the deserved attention among Vietnamese health care professionals. This neglect is remarkable, given the fact that a fundamental characteristic of B. pseudomallei—namely, the environmental reservoir of this pathogen—was demonstrated for the first time in Vietnam [1,2]. We discuss current knowledge on environmental B. pseudomallei in Vietnam, the population structure of Vietnamese B. pseudomallei and its phylogenetic relatedness. We address current and future challenges in prevention and diagnosis of the disease
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