Determinants of dihydro- #artemisinin-piperaquine #treatment #failure in #Plasmodium falciparum #malaria in #Cambodia, #Thailand, and #Vietnam: a prospective clinical, pharmacological, and genetic study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Determinants of dihydroartemisinin-piperaquine treatment failure in Plasmodium falciparum malaria in Cambodia, Thailand, and Vietnam: a prospective clinical, pharmacological, and genetic study

Rob W van der Pluijm, MD, Prof Mallika Imwong, PhD, Nguyen Hoang Chau, MD, Nhu Thi Hoa, MD, Nguyen Thanh Thuy-Nhien, PhD, Ngo Viet Thanh, MD, et al.

Open Access / Published: July 22, 2019 / DOI:




The emergence and spread of resistance in Plasmodium falciparum malaria to artemisinin combination therapies in the Greater Mekong subregion poses a major threat to malaria control and elimination. The current study is part of a multi-country, open-label, randomised clinical trial (TRACII, 2015–18) evaluating the efficacy, safety, and tolerability of triple artemisinin combination therapies. A very high rate of treatment failure after treatment with dihydroartemisinin-piperaquine was observed in Thailand, Cambodia, and Vietnam. The immediate public health importance of our findings prompted us to report the efficacy data on dihydroartemisinin-piperaquine and its determinants ahead of the results of the overall trial, which will be published later this year.


Patients aged between 2 and 65 years presenting with uncomplicated P falciparum or mixed species malaria at seven sites in Thailand, Cambodia, and Vietnam were randomly assigned to receive dihydroartemisinin-piperaquine with or without mefloquine, as part of the TRACII trial. The primary outcome was the PCR-corrected efficacy at day 42. Next-generation sequencing was used to assess the prevalence of molecular markers associated with artemisinin resistance (kelch13 mutations, in particular Cys580Tyr) and piperaquine resistance (plasmepsin-2 and plasmepsin-3amplifications and crt mutations). This study is registered with, number NCT02453308.


Between Sept 28, 2015, and Jan 18, 2018, 539 patients with acute P falciparum malaria were screened for eligibility, 292 were enrolled, and 140 received dihydroartemisinin-piperaquine. The overall Kaplan-Meier estimate of PCR-corrected efficacy of dihydroartemisinin-piperaquine at day 42 was 50·0% (95% CI 41·1–58·3). PCR-corrected efficacies for individual sites were 12·7% (2·2–33·0) in northeastern Thailand, 38·2% (15·9–60·5) in western Cambodia, 73·4% (57·0–84·3) in Ratanakiri (northeastern Cambodia), and 47·1% (33·5–59·6) in Binh Phuoc (southwestern Vietnam). Treatment failure was associated independently with plasmepsin2/3amplification status and four mutations in the crt gene (Thr93Ser, His97Tyr, Phe145Ile, and Ile218Phe). Compared with the results of our previous TRACI trial in 2011–13, the prevalence of molecular markers of artemisinin resistance (kelch13 Cys580Tyr mutations) and piperaquine resistance (plasmepsin2/3 amplifications and crtmutations) has increased substantially in the Greater Mekong subregion in the past decade.


Dihydroartemisinin-piperaquine is not treating malaria effectively across the eastern Greater Mekong subregion. A highly drug-resistant P falciparum co-lineage is evolving, acquiring new resistance mechanisms, and spreading. Accelerated elimination of P falciparum malaria in this region is needed urgently, to prevent further spread and avoid a potential global health emergency.


UK Department for International Development, Wellcome Trust, Bill & Melinda Gates Foundation, Medical Research Council, and National Institutes of Health.

Keywords: Malaria; Plasmodium falciparum; Artemisin; Drugs resistance; Thailand; Cambodia; Laos; Vietnam.


#Evolution and #expansion of #MDR #malaria in southeast #Asia: a #genomic #epidemiology study (Lancet Infect Dis., abstract)

[Source: The Lancet Infectious Diseases, full page: (LINK). Abstract, edited.]

Evolution and expansion of multidrug-resistant malaria in southeast Asia: a genomic epidemiology study

William L Hamilton, PhD †, Roberto Amato, PhD †, Rob W van der Pluijm, MD, Christopher G Jacob, PhD, Huynh Hong Quang, PhD, Nguyen Thanh Thuy-Nhien, PhD, et al.

Open Access / Published: July 22, 2019 / DOI:




A multidrug-resistant co-lineage of Plasmodium falciparum malaria, named KEL1/PLA1, spread across Cambodia in 2008–13, causing high rates of treatment failure with the frontline combination therapy dihydroartemisinin-piperaquine. Here, we report on the evolution and spread of KEL1/PLA1 in subsequent years.


For this genomic epidemiology study, we analysed whole genome sequencing data from P falciparum clinical samples collected from patients with malaria between 2007 and 2018 from Cambodia, Laos, northeastern Thailand, and Vietnam, through the MalariaGEN P falciparum Community Project. Previously unpublished samples were provided by two large-scale multisite projects: the Tracking Artemisinin Resistance Collaboration II (TRAC2) and the Genetic Reconnaissance in the Greater Mekong Subregion (GenRe-Mekong) project. By investigating genome-wide relatedness between parasites, we inferred patterns of shared ancestry in the KEL1/PLA1 population.


We analysed 1673 whole genome sequences that passed quality filters, and determined KEL1/PLA1 status in 1615. Before 2009, KEL1/PLA1 was only found in western Cambodia; by 2016–17 its prevalence had risen to higher than 50% in all of the surveyed countries except for Laos. In northeastern Thailand and Vietnam, KEL1/PLA1 exceeded 80% of the most recent P falciparum parasites. KEL1/PLA1 parasites maintained high genetic relatedness and low diversity, reflecting a recent common origin. Several subgroups of highly related parasites have recently emerged within this co-lineage, with diverse geographical distributions. The three largest of these subgroups (n=84, n=79, and n=47) mostly emerged since 2016 and were all present in Cambodia, Laos, and Vietnam. These expanding subgroups carried new mutations in the crt gene, which arose on a specific genetic background comprising multiple genomic regions. Four newly emerging crt mutations were rare in the early period and became more prevalent by 2016–17 (Thr93Ser, rising to 19·8%; His97Tyr to 11·2%; Phe145Ile to 5·5%; and Ile218Phe to 11·1%).


After emerging and circulating for several years within Cambodia, the P falciparum KEL1/PLA1 co-lineage diversified into multiple subgroups and acquired new genetic features, including novel crt mutations. These subgroups have rapidly spread into neighbouring countries, suggesting enhanced fitness. These findings highlight the urgent need for elimination of this increasingly drug-resistant parasite co-lineage, and the importance of genetic surveillance in accelerating malaria elimination efforts.


Wellcome Trust, Bill & Melinda Gates Foundation, UK Medical Research Council, and UK Department for International Development.

Keywords: Malaria; Plasmodium falciparum; Drugs resistance; Artemisin; Cambodia; Laos; Thailand; Vietnam.


#Molecular characterization of #carbapenem-resistant #Escherichia coli and #Acinetobacter baumannii in the #Lao People’s Democratic Republic (J Antimicrob Chemother., summary)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

Molecular characterization of carbapenem-resistant Escherichia coli and Acinetobacter baumannii in the Lao People’s Democratic Republic

Tomas-Paul Cusack, Vilayouth Phimolsarnnousith, Khuanta Duangmala, Phonelavanh Phoumin, Jane Turton, Katie L Hopkins, Neil Woodford, Nandini Shetty, Nicole Stoesser, Hang T T Phan, David A B Dance

Journal of Antimicrobial Chemotherapy, dkz234,

Published: 05 June 2019



Global dissemination of carbapenemases among Gram-negative bacteria is a growing public health concern. Therapeutic options for these organisms are often limited, with alternative agents such as tigecycline and colistin having potentially less favourable efficacy and toxicity profiles.1,2 Furthermore, these agents are expensive and not readily available in resource-constrained settings. In the Lao People’s Democratic Republic (Laos), carbapenems are not yet on the national list of essential drugs, although in Vientiane the high prevalence of ESBL-producing Enterobacterales3,4 has driven more widespread use of carbapenems imported by individual pharmacies from neighbouring countries. However, while carbapenem-resistant Enterobacterales (CRE) and carbapenem-resistant Acinetobacter baumannii(CRAB) have been described in neighbouring Thailand and Vietnam,5 little is known about carbapenem resistance in Laos, where few laboratories perform antimicrobial susceptibility testing (AST) and surveillance networks are not well established.




The Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU) is core funded by Wellcome (grant number 106698/Z/14/Z). The funding body had no role in: the design of the study; collection, analysis and interpretation of data; and writing of the manuscript. Study-related work at the other sites was supported by internal funding.

Transparency declarations

None to declare.

Keywords: Antibiotics; Drugs Resistance; Carbapenem; Acinetobacter baumannii; E. Coli; Laos.


#Zika virus in #Vietnam, #Laos, and #Cambodia: are there #health #risks for #travelers? (Eur J Clin Microbiol Infect Dis., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Eur J Clin Microbiol Infect Dis. 2019 May 2. doi: 10.1007/s10096-019-03563-6. [Epub ahead of print]

Zika virus in Vietnam, Laos, and Cambodia: are there health risks for travelers?

Dinh TC1, Bac ND2, Minh LB3, Ngoc VTN4, Pham VH5, Vo HL6, Tien NLB7, Van Thanh V7, Tao Y8, Show PL9, Chu DT10,11.

Author information: 1 Institute for Research and Development, Duy Tan University, 03 QuangTrung, Danang, Vietnam. 2 Vietnam Military Medical University, Hanoi, Vietnam. 3 NTT Hi-tech Institute, Nguyen Tat Thanh University, 300A Nguyen Tat Thanh St., Ward 13, District 4, Ho Chi Minh City, Vietnam. 4 School of Odonto Stomatology, Hanoi Medical University, Hanoi, Vietnam. 5 AI Lab, Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh City, Vietnam. 6 Institute for Preventive Medicine & Public Health, Hanoi Medical University, Hanoi, Vietnam. 7 Institute of Orthopaedics and Trauma Surgery, Viet Duc Hospital, Hanoi, Vietnam. 8 College of Food Science and Technology, Nanjing Agricultural University, Nanjing 8, 210095, China. 9 Department of Chemical and Environmental Engineering, Faculty of Engineering, University of Nottingham Malaysia Campus, JalanBroga, 43500, Semenyih, Selangor Darul Ehsan, Malaysia. 10 School of Odonto Stomatology, Hanoi Medical University, Hanoi, Vietnam. 11 Faculty of Biology, Hanoi National University of Education, Hanoi, Vietnam.



Vietnam, Laos, and Cambodia have reported first cases of Zika virus (ZIKV) infection since 2010 (Cambodia) and 2016 (Vietnam and Laos). One case of ZIKV-related microcephaly was recognized among a hundred infected cases in these areas, raising a great concern about the health risk related to this virus infection. At least 5 cases of ZIKV infection among travelers to Vietnam, Laos, and Cambodia were recorded. It is noticeable that ZIKV in these areas can cause birth defects. This work aims to discuss the current epidemics of ZIKV in Vietnam, Laos, and Cambodia and update the infection risk of ZIKV for travelers to these areas.

KEYWORDS: Cambodia; Laos; Travelers; Vietnam; Zika virus infection; Zika virus–infected travelers

PMID: 31044332 DOI: 10.1007/s10096-019-03563-6

Keywords: Zika Virus; Vietnam; Laos; Cambodia.


A random #survey of the #prevalence of #falsified and substandard #antibiotics in the #Lao PDR (J Antimicrob Chemother., abstract)

[Source: Journal of Antimicrobial Chemotherapy, full page: (LINK). Abstract, edited.]

A random survey of the prevalence of falsified and substandard antibiotics in the Lao PDR

Patricia Tabernero, Isabel Swamidoss, Mayfong Mayxay, Maniphone Khanthavong, Chindaphone Phonlavong, Chanthala Vilayhong, Sengchanh Yeuchaixiong, Chanvilay Sichanh, Sivong Sengaloundeth, Michael D Green, Paul N Newton

Journal of Antimicrobial Chemotherapy, dkz164,

Published: 02 May 2019




In 2012, a stratified random survey, using mystery shoppers, was conducted to investigate the availability and quality of antibiotics sold to patients in the private sector in five southern provinces of the Lao People’s Democratic Republic (Laos).


A total of 147 outlets were sampled in 10 districts. The active pharmaceutical ingredient (API) content measurements for 909 samples, including nine APIs (amoxicillin, ampicillin, ceftriaxone, ciprofloxacin, doxycycline, ofloxacin, sulfamethoxazole, tetracycline and trimethoprim), were determined using HPLC.


All the analysed samples contained the stated API and we found no evidence for falsification. All except one sample had all the units tested with %API values between 75% and 125% of the content stated on the label. However, we identified the presence of substandard antibiotics: 19.6% (201/1025) of samples had their units outside the 90%–110% content of the label claim and 60.2% (617/1025) of the samples had units outside of the International Pharmacopoeia uniformity of content limit range. Amoxicillin had a high number of samples [67.1% (151)] with units above the limit range, followed by ciprofloxacin [58.8% (10)] and ofloxacin [57.4% (39)]. Ceftriaxone, trimethoprim and sulfamethoxazole had the highest number of samples with low API content: 57.1% (4), 51.6% (64) and 34.7% (43), respectively. Significant differences in %API were found between stated countries of manufacture and stated manufacturers.


With the global threat of antimicrobial resistance to patient outcomes, greater understanding of the role of poor-quality antibiotics is needed. Substandard antibiotics will have reduced therapeutic efficacy, impacting public health and control of bacterial infections.


Keywords: Antibiotics; Drugs Resistance; Laos.


Low #Zika Virus #Seroprevalence in Vientiane, #Laos, 2003-2015 (Am J Trop Med Hyg., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Am J Trop Med Hyg. 2019 Jan 28. doi: 10.4269/ajtmh.18-0439. [Epub ahead of print]

Low Zika Virus Seroprevalence in Vientiane, Laos, 2003-2015.

Pastorino B1, Sengvilaipaseuth O2, Chanthongthip A2, Vongsouvath M2, Souksakhone C3, Mayxay M4,5,2, Thirion L1, Newton PN4,2, de Lamballerie X1, Dubot-Pérès A2,1,4.

Author information: 1 Unité des Virus Émergents (UVE: Aix-Marseille Univ-IRD 190-Inserm 1207-IHU Méditerranée Infection), Marseille, France. 2 Lao-Oxford-Mahosot Hospital-Wellcome Trust Research Unit (LOMWRU), Microbiology Laboratory, Mahosot Hospital, Vientiane, Lao PDR. 3 National Blood Transfusion Centre, Lao Red Cross, Vientiane, Lao PDR. 4 Nuffield Department of Clinical Medicine, Centre for Tropical Medicine and Global Health, Churchill Hospital, University of Oxford, Oxford, United Kingdom. 5 Institute of Research and Education Development, University of Health Sciences, Vientiane, Lao PDR.



Zika virus (ZIKV) has been presumed to be endemic in Southeast Asia (SEA), with a low rate of human infections. Although the first ZIKV evidence was obtained in the 1950s through serosurveys, the first laboratory-confirmed case was only detected in 2010 in Cambodia. The epidemiology of ZIKV in SEA remains uncertain because of the scarcity of available data. From 2016, subsequent to the large outbreaks in the Pacific and Latin America, several Asian countries started reporting increasing numbers of confirmed ZIKV patients, but no global epidemiological assessment is available to date. Here, with the aim of providing information on ZIKV circulation and population immunity, we conducted a seroprevalence study among blood donors in Vientiane, Laos. Sera from 359 asymptomatic consenting adult donors in 2003-2004 and 687 in 2015 were screened for anti-ZIKV IgG using NS1 ELISA assay (Euroimmun, Germany). Positive and equivocal samples were confirmed for anti-ZIKV-neutralizing antibodies by virus neutralization tests. Our findings suggest that ZIKV has been circulating in Vientiane over at least the last decade. Zika virus seroprevalence observed in the studied blood donors was low, 4.5% in 2003-2004 with an increase in 2015 to 9.9% (P = 0.002), possibly reflecting the increase of ZIKV incident cases reported over this period. We did not observe any significant difference in seroprevalence according to gender. With a low herd immunity in the Vientiane population, ZIKV represents a risk for future large-scale outbreaks. Implementation of a nationwide ZIKV surveillance network and epidemiological studies throughout the country is needed.

PMID: 30693859 DOI: 10.4269/ajtmh.18-0439

Keywords: Zika Virus; Seroprevalence; Laos.


#Antiviral Drug– #Resistant #Influenza B Viruses Carrying H134N Substitution in #Neuraminidase, #Laos, February 2016 (@CDC_EIDjournal, abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 23, Number 4—April 2017 / Dispatch

Antiviral Drug–Resistant Influenza B Viruses Carrying H134N Substitution in Neuraminidase, Laos, February 2016

Tatiana Baranovich, Phengta Vongphrachanh, Pakapak Ketmayoon, Thongchanh Sisouk, Khampheng Chomlasack, Viengphone Khanthamaly, Ha Thuy Nguyen, Vasiliy P. Mishin, Henju Marjuki, John R. Barnes, Rebecca J. Garten, James Stevens, David E. Wentworth, and Larisa V. Gubareva

Author affiliations: Carter Consulting, Inc., Atlanta, Georgia, USA (T. Baranovich); World Health Organization Collaborating Center for Surveillance, Epidemiology and Control of Influenza, Atlanta (T. Baranovich, V. Khanthamaly, H.T. Nguyen, V.P. Mishin, H. Marjuki, J.R. Barnes, R.J. Garten, J. Stevens, D.E. Wentworth, L.V. Gubareva); Centers for Disease Control and Prevention, Atlanta (T. Baranovich, V. Khanthamaly, H.T. Nguyen, V.P. Mishin, H. Marjuki, J.R. Barnes, R.J. Garten, J. Stevens, D.E. Wentworth, L.V. Gubareva); National Center for Laboratory and Epidemiology, Vientiane, Laos (P. Vongphrachanh, P. Ketmayoon, T. Sisouk, K. Chomlasack); World Health Organization Emerging Disease Surveillance and Response Unit, Vientiane, Laos (P. Ketmayoon); Battelle Memorial Institute, Atlanta (H.T. Nguyen)



In February 2016, three influenza B/Victoria/2/87 lineage viruses exhibiting 4- to 158-fold reduced inhibition by neuraminidase inhibitors were detected in Laos. These viruses had an H134N substitution in the neuraminidase and replicated efficiently in vitro and in ferrets. Current antiviral drugs may be ineffective in controlling infections caused by viruses harboring this mutation.

Keywords: Seasonal Influenza; Influenza B, Antivirals; Drugs Resistance; Laos; Oseltamivir.


#Genetic #diversity of #coronaviruses in #bats in #Lao PDR and #Cambodia (Infect Genet Evol., abstract)

[Source: Science Direct, full page: (LINK). Abstract, edited.]

Infection, Genetics and Evolution / Available online 6 December 2016 / In Press, Accepted Manuscript / Research paper

Genetic diversity of coronaviruses in bats in Lao PDR and Cambodia

Audrey Lacroix a, Veasna Duong a, Vibol Hul a, Sorn San b, Hull Davun b, Keo Omaliss c, Sokha Chea d, Alexandre Hassanin e, Watthana Theppangna f, Soubanh Silithammavong g, h, Kongsy Khammavong g, Sinpakone Singhalath g, Zoe Greatorex g, Amanda E. Fine i, Tracey Goldstein j, Sarah Olson k, Damien O. Joly k, l, Lucy Keatts d, Philippe Dussart a, Aneta Afelt m, Roger Frutos n, o, Philippe Buchy a, p

a Institut Pasteur du Cambodge, Virology Unit, Phnom Penh, Cambodia; b National Veterinary Research Institute, Ministry of Agriculture Forestry and Fisheries, Cambodia; c Forest Administration, Ministry of Agriculture Forestry and Fisheries, Cambodia; d Wildlife Conservation Society, Cambodia; e Muséum national d’Histoire naturelle, Institut de Systématique, Evolution, Biodiversité (ISYEB), UMR 7205 MNHN CNRS UPMC, France; f National Animal Health Laboratory, Ministry of Agriculture Forestry and Fisheries, Lao Democratic People’s Republic; g Wildlife Conservation Society, Lao Democratic People’s Republic; h Metabiota Inc., Vientiane, Lao Democratic People’s Republic; i Wildlife Conservation Society, Vietnam Program, Hanoi, Vietnam; j One Health Institute, School of Veterinary Medicine, University of California, Davis, USA; k Wildlife Conservation Society, Wildlife Health Program, Bronx, New York, USA; l Metabiota Inc., Nanaimo, British Columbia, Canada; m Institute of Physical Geography, Faculty of Geography and Regional Studies, University of Warsaw, Warsaw, Poland; n Cirad, UMR 17, Cirad-Ird, TA-A17/G, Montpellier, France; o Université de Montpellier, IES, UMR 5214, CNRS-UM, Montpellier, France; p GSK Vaccines R&D, 150 Beach road, # 22-00, 189720, Singapore

Received 1 August 2016, Revised 26 November 2016, Accepted 26 November 2016, Available online 6 December 2016



  • Coronaviruses detected in bats from Lao PDR and Cambodia.
  • High diversity of αCoVs and βCoVs circulating in bats in Cambodia and Lao PDR.
  • One strain of βCoV, a new member of the MERS-CoV sister-clade, detected from Pipistrellus coromandra.
  • A αCoV strain genetically related to PEDV-CoV, detected from Myotis horsfieldii.
  • CoVs detected for the first time in diverse bats species and genus, i.e. Megaerops niphanae, Myotis horsfieldii and Macroglossus sp.



South-East Asia is a hot spot for emerging zoonotic diseases, and bats have been recognized as hosts for a large number of zoonotic viruses such as Severe Acute Respiratory Syndrome (SARS), responsible for acute respiratory syndrome outbreaks. Thus, it is important to expand our knowledge of the presence of viruses in bats which could represent a risk to humans. Coronaviruses (CoVs) have been reported in bat species from Thailand, China, Indonesia, Taiwan and the Philippines. However no such work was conducted in Cambodia or Lao PDR. Between 2010 and 2013, 1965 bats were therefore sampled at interfaces with human populations in these two countries. They were tested for the presence of coronavirus by consensus reverse transcription-PCR assay. A total of 93 samples (4.7%) from 17 genera of bats tested positive. Sequence analysis revealed the presence of potentially 37 and 56 coronavirus belonging to alpha-coronavirus (αCoV) and beta-CoV (βCoV), respectively. The βCoVs group is known to include some coronaviruses highly pathogenic to human, such as SARS-CoV and MERS-CoV. All coronavirus sequences generated from frugivorous bats (family Pteropodidae) (n = 55) clustered with other bat βCoVs of lineage D, whereas one coronavirus from Pipistrellus coromandra fell in the lineage C of βCoVs which also includes the MERS-CoV. αCoVs were all detected in various genera of insectivorous bats and clustered with diverse bat αCoV sequences previously published. A closely related strain of PEDV, responsible for severe diarrhea in pigs (PEDV-CoV), was detected in 2 Myotis bats. We highlighted the presence and the high diversity of coronaviruses circulating in bats from Cambodia and Lao PDR. Three new bat genera and species were newly identified as host of coronaviruses, namely Macroglossus sp., Megaerops niphanae and Myotis horsfieldii

Keywords: Bats; Coronavirus; Betacoronavirus; Alphacononavirus; Laos; Cambodia; SARS; MERS-CoV.


Novel #Reassortant #H5N6 #Influenza A Virus from the #Lao People’s Democratic Republic Is Highly Pathogenic in #Chickens (PLoS One, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

PLoS One. 2016 Sep 15;11(9):e0162375. doi: 10.1371/journal.pone.0162375.

Novel Reassortant H5N6 Influenza A Virus from the Lao People’s Democratic Republic Is Highly Pathogenic in Chickens.

Butler J1, Stewart CR1, Layton DS1, Phommachanh P2, Harper J1, Payne J1, Evans RM1, Valdeter S1, Walker S1, Harvey G1, Shan S1, Bruce MP1, Rootes CL1, Gough TJ1, Rohringer A1, Peck GR1, Fardy SJ1, Karpala AJ1, Johnson D1, Wang J1, Douangngeun B2, Morrissy C1, Wong FY1, Bean AG1, Bingham J1, Williams DT1.

Author information: 1CSIRO Australian Animal Health Laboratory, Geelong, Victoria, Australia. 2National Animal Health Laboratory, Vientiane, Lao People’s Democratic Republic.



Avian influenza viruses of H5 subtype can cause highly pathogenic disease in poultry. In March 2014, a new reassortant H5N6 subtype highly pathogenic avian influenza virus emerged in Lao People’s Democratic Republic. We have assessed the pathogenicity, pathobiology and immunological responses associated with this virus in chickens. Infection caused moderate to advanced disease in 6 of 6 chickens within 48 h of mucosal inoculation. High virus titers were observed in blood and tissues (kidney, spleen, liver, duodenum, heart, brain and lung) taken at euthanasia. Viral antigen was detected in endothelium, neurons, myocardium, lymphoid tissues and other cell types. Pro-inflammatory cytokines were elevated compared to non-infected birds. Our study confirmed that this new H5N6 reassortant is highly pathogenic, causing disease in chickens similar to that of Asian H5N1 viruses, and demonstrated the ability of such clade 2.3.4-origin H5 viruses to reassort with non-N1 subtype viruses while maintaining a fit and infectious phenotype. Recent detection of influenza H5N6 poultry infections in Lao PDR, China and Viet Nam, as well as six fatal human infections in China, demonstrate that these emergent highly pathogenic H5N6 viruses may be widely established in several countries and represent an emerging threat to poultry and human populations.

PMID: 27631618 DOI: 10.1371/journal.pone.0162375

[PubMed – as supplied by publisher]

Keywords: Research; Abstracts; Avian Influenza; H5N6; Poultry; Laos; Reassortant Strain.


#Plasmid-mediated #mcr1 #gene in #colistin-resistant clinical isolates of #Klebsiella pneumoniae in #France and #Laos (AAC, abstract)

[Source: Antimicrobial Agents and Chemotherapy, full page: (LINK). Abstract, edited.]

Plasmid-mediated mcr-1 gene in colistin-resistant clinical isolates of Klebsiella pneumoniae in France and Laos.

Jean-Marc Rolain1*, Marie Kempf2, Thongpan Leangapichart1, Selma Chabou1, Abiola Olumuyiwa Olaitan1, Stéphanie Le Page1, Serge Morand3 and Didier Raoult1

Author Affiliations: 1Aix-Marseille Université, URMITE, 27 Bd Jean Moulin, 13385 Marseille Cedex 5, France. 2Laboratoire de Bactériologie, Institut de Biologie en santé – PBH, CHU, Angers, France. 3Institut des Sciences de l’Évolution, CNRS-IRD-UM2, CC065, Université Montpellier 2, 34095 Montpellier Cedex 05, France; CNRS-CIRAD, Centre d’Infectiologie Christophe Mérieux du Laos, Vientiane, Lao Democratic People’s Republic.



Recently Yi-Yun Liu et al reported the emergence of plasmid-mediated colistin resistance involving mcr-1 gene from Escherichia coli and Klebsiella pneumoniae isolated from animals, food and humans in China (1).…



*Corresponding author Phone: (33) 4 91 32 43 75. Fax: (33) 4 91 38 77 72 Email:

Copyright © 2016, American Society for Microbiology. All Rights Reserved.

Keywords: Research; Abstracts; Antibiotics; Drugs Resistance; Colistin; Klebsiella Pneumoniae; Laos; France; MCR1.