Vietnam: Partnering to Strengthen Laboratory and Surveillance Capacity

Global health security has become a priority for many countries and public health agencies worldwide due to recent international disease outbreaks. In February 2014, Vietnam joined the Global Health Security Agenda (GHSA) and was designated a priority country by CDC because of the potential for outbreaks of severe acute respiratory infections (SARIs). As part of the GHSA partnership, CDC is collaborating with the Vietnam MoH to strengthen their outbreak preparedness, emergency outbreak response, laboratory networks, disease surveillance, and the public health workforce. While their work focuses on a variety of diseases such as influenza, this story focuses on their work on diarrheal diseases like norovirus and rotavirus, and viral respiratory diseases like MERS.

Welcoming global health security partners at CDC

As part of this joint effort on global health security, CDC welcomed delegates from the Vietnam MoH to the agency’s Atlanta headquarters on June 16, 2016. The focus of the visit was to learn about how public health infrastructure is organized in the U.S., including how CDC works with state and local health departments to optimize disease tracking, testing, and reporting. The delegation also met with gastroenteritis and respiratory virus team members Dr. Dean Erdman, Dr. Baoming Jiang, Dr. Azaibi Tamin, and Dr. Brett Whitaker. They also took a tour, led by Dr. Whitaker and Dr. Tamin, of the gastroenteritis and respiratory virus laboratories.

“To have more effective implementation of public health activities, we want to learn about the relationship between the different levels here like the relationship between CDC at the federal level and the state level. In Vietnam we have the national level and then the provincial level, so we want to see the linkage between those levels,” says Dr. Trần Đắc Phu, Director General of the Department of Preventive Medicine in Vietnam’s MoH.

Stopping outbreaks through surveillance

One component of linking the national and the provincial levels is implementing SARI surveillance, including having the capability to detect and test for influenza and emerging respiratory threats. Because avian influenza poses a high risk for human outbreaks in Vietnam, it is important to collect and analyze data related to this virus, since it can cause severe illness and can spread quickly across countries. The SARI surveillance system will improve capacity for detecting and preventing outbreaks.

“For the southern region in particular, we see that SARI surveillance can benefit us a lot. Ho Chi Minh City is a hub for travelers, particularly every year we see more than 3 million travelers from the U.S. so there’s a lot of exchange and movement in this region. In the southern region there’s a great chance for animal and human interaction. In the same household, you can see humans and pigs and other animals live in the same habitats so it can really affect mutations. We hope that with this SARI surveillance platform, it can help us detect those mutations or maybe early detection of an outbreak caused by these novel strains,” says Dr. Phan Trọng Lân, Director of the Pasteur Institute in Ho Chi Minh City.

Utilizing laboratory technologies

CDC laboratory teams have also partnered with the Vietnam MoH to make improvements to the country’s disease surveillance and outbreak response infrastructure. This collaboration has included participation in ongoing discussions as well as site visits in Vietnam. On the delegates’ visit to CDC headquarters, Dr. Erdman, Dr. Jiang, and Dr. Whitaker shared the history of the surveillance and laboratory protocols for MERS, norovirus, and rotavirus. They discussed technologies such as next-generation genomic sequencing and bioinformatics as part of advanced molecular detection, and gave the delegates a tour of CDC’s laboratories so they could see the protocols in action.

Dr. Đặng Đức Anh, Director of the National Institute of Hygiene and Epidemiology, said “the labs in different groups are very impressive. They try to develop the testing platforms to help the labs in the U.S. and also labs in other countries in case of an epidemic. I think it’s very useful. I think we need support from the CDC to develop this bioinformatics system in our labs.”

Dr. Arunmozhi Balajee, CDC’s Associate Director of Global Health Systems in the Division of Viral Diseases, stresses the importance of the work in Vietnam and the delegate visit. “Early Warning and Response (EWAR) systems enable countries to detect outbreaks early and intervene quickly. Laboratories are central to the response to outbreaks. CDC’s Division of Viral Diseases and CDC Vietnam are working closely to strengthen laboratories systems in Vietnam, specifically building capacity in order to test for gastrointestinal and respiratory viruses. Having this delegation at CDC headquarters visiting with disease-specific subject matter experts allowed the Ministry to understand the crucial role of laboratories in EWAR systems.”