Efficient bioproduction of poly(3-hydroxypropionate) homopolymer using engineered Escherichia coli strains.

This study focuses on the development of a scalable method for producing poly(3-hydroxypropionate), a homopolymer with significant physico-mechanical properties, through the use of metabolically-engineered Escherichia coli K12 (MG1655) and externally supplied 3-hydroxypropionate. The polymer synthesis pathway was established and optimized through synthetic biology techniques, including the effects of overexpressing phasin and cell division proteins. The optimized strain achieved unprecedented production titers of 9.5 g/L in flask cultures and 80 g/L in fed-batch bioreactors within 45 h. The analysis of poly(3-hydroxypropionate) polymer properties revealed it possesses excellent elasticity (Young's modulus < 6 MPa) and tensile strength (∼80 MPa), positioning it within the category of elastomers or flexible plastics. These findings suggest a viable path for the sustainable, large-scale production of the poly(3-hydroxypropionate) biopolymer.

Metabolic engineering of Escherichia coli for enhanced production of 1,3-butanediol from glucose.

1,3-Butanediol (1,3-BDO) finds versatile applications in the cosmetic, chemical, and food industries. This study focuses on the metabolic engineering of Escherichia coli K12 to achieve efficient production of 1,3-BDO from glucose via acetoacetyl-CoA, 3-hydroxybutyryl-CoA, and 3-hydroxybutyraldehyde. The accumulation of an intermediary metabolite (pyruvate) and a byproduct (3-hydroxybutyric acid) was reduced by disruption of the negative transcription factor (PdhR) for pyruvate dehydrogenase complex (PDHc) and employing an efficient alcohol dehydrogenase (YjgB), respectively. Additionally, to improve NADPH availability, carbon flux was redirected from the Embden-Meyerhof-Parnas (EMP) pathway to the Entner-Doudoroff (ED) pathway. One resulting strain achieved a record-high titer of 790 mM (∼71.1 g/L) with a yield of 0.65 mol/mol for optically pure (R)-1,3-BDO, with an enantiomeric excess (e.e.) value of 98.5 %. These findings are useful in the commercial production of 1,3-BDO and provide valuable insights into the development of an efficient cell factory for other acetyl-CoA derivatives.

Metabolic engineering of Escherichia coli for biological production of 1, 3-Butanediol.

The production of 1,3-butanediol (1,3-BDO) from glucose was investigated using Escherichia coli as the host organism. A pathway was engineered by overexpressing genes phaA (acetyl-CoA acetyltransferase), phaB (acetoacetyl-CoA reductase), bld (CoA-acylating aldehyde dehydrogenase), and yqhD (alcohol dehydrogenase). The expression levels of these genes were optimized to improve 1,3-BDO production and pathways that compete with 1,3-BDO synthesis were disrupted. Culture conditions were also optimized, including the C: N ratio, aeration, induction time, temperature, and supplementation of amino acids, resulting in a strain that could produce 1,3-BDO at 257 mM in 36 h, with a yield of 0.51 mol/mol in a fed-batch bioreactor experiment. To the best of our knowledge, this is the highest titer of 1,3-BDO production ever reported using biological methods, and our findings provide a promising strategy for the development of microbial cell factories for the sustainable synthesis of other acetyl-CoA-derived chemicals.

Improvement of 3-hydroxypropionic acid tolerance in Klebsiella pneumoniae by novel transporter YohJK.

3-Hydroxypropionic acid (3-HP) is a platform chemical which has potential applications in cosmetic and polymer industries. Microbial production of 3-HP is hampered by its toxic effect when its concentration is high (>300 mM). In this study, the effect of yohJK overexpression (via yieP deletion or episomal overexpression) on 3-HP tolerance was investigated in Klebsiella pneumoniae, Pseudomonas denitrificans and P. asiatica. The deletion of yieP homolog could improve 3-HP tolerance in K. pneumoniae. Transcriptional analysis suggested that, among the two yohJK homologs of K. pneumoniae, expression of yohJK1, not yohJK2, was under the negative control of YieP. Furthermore, deletion of yieP significantly reduced cytoplasmic 3-HP concentration when determined by 3-HP biosensor and enhanced 3-HP tolerance and 3-HP production. This study demonstrates that the YohJK1 functions as 3-HP transporter in K. pneumoniae and their overexpression by the yieP deletion is a good strategy to enhance 3-HP tolerance and its production.

Nanocrystalline Cellulose Supported MnO2 Composite Materials for High-Performance Lithium-Ion Batteries.

The rate capability and poor cycling stability of lithium-ion batteries (LIBs) are predominantly caused by the large volume expansion upon cycling and poor electrical conductivity of manganese dioxide (MnO2), which also exhibits the highest theoretical capacity among manganese oxides. In this study, a nanocomposite of nanosized MnO2 and pyrolyzed nanocrystalline cellulose (CNC) was prepared with high electrical conductivity to enhance the electrochemical performance of LIBs. The nanocomposite electrode showed an initial discharge capacity of 1302 mAh g-1 at 100 mA g-1 and exhibited a high discharge capacity of 305 mAh g-1 after 1000 cycles. Moreover, the MnO2-CNC nanocomposite delivered a good rate capability of up to 10 A g-1 and accommodated the large volume change upon repeated cycling tests.

Detection of SARS-CoV-2 Infection in Gargle, Spit, and Sputum Specimens.

The gold standard for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection diagnosis is reverse transcription (RT)-PCR from a nasopharyngeal swab specimen (NPS). Its collection involves close contact between patients and health care workers, requiring a significant amount of workforce and putting them at risk of infection. We evaluated self-collection of alternative specimens and compared their sensitivity and cycle threshold (CT) values to those of NPS. We visited acute coronavirus disease 2019 (COVID-19) outpatients to collect concomitant NPS and gargle specimens and had patients self-collect gargle and either sputum or spit specimens the next morning. We included 40 patients and collected 40 concomitant NPS and gargle specimens, as well as 40 gargle, 22 spit, and 16 sputum specimens the next day (2 patients could not produce sputum). All specimens were as sensitive as NPS. Gargle specimens had a sensitivity of 0.97 (95% confidence interval [CI], 0.92 to 1.00), whether collected concomitantly with NPS or the next morning. Next-morning spit and sputum specimens showed sensitivities of 1.00 (95% CI, 1.00 to 1.00) and 0.94 (95% CI, 0.87 to 1.00]), respectively. The gargle specimens had significantly higher mean CT values of 29.89 (standard deviation [SD], 4.63; P < 0.001) and 29.25 (SD, 3.99; P < 0.001) when collected concomitantly and the next morning, respectively, compared to NPS (22.07 [SD, 4.63]). CT values obtained with spit (23.51 [SD, 4.57]; P = 0.11) and sputum (25.82 [SD, 9.21]; P = 0.28) specimens were close to those of NPS. All alternative specimen collection methods were as sensitive as NPS, but spit collection appeared more promising, with a low CT value and ease of collection. Our findings warrant further investigation. IMPORTANCE Control of the COVID-19 pandemic relies heavily on a test-trace-isolate strategy. The most commonly used specimen for diagnosis of SARS-CoV-2 infection is a nasopharyngeal swab. However, this method is quite uncomfortable for the patient, requires specific equipment (nose swabs and containers), and requires close proximity to health care workers, putting them at risk of infection. Developing alternative sampling strategies could decrease the burden for health care workers, help overcome potential shortages of equipment, and improve acceptability of testing by reducing patient discomfort.

Screening of ZIKA virus infection among dengue-like illness patients with negative RT-PCR for dengue virus in Punjab - Pakistan.

OBJECTIVE: To detect ZIKV using reverse transcription-polymerase chain reaction (RT-PCR) among clinical samples tested negative for Dengue virus (DENV) by RT-PCR in Punjab, 2016. METHODS: A descriptive cross-sectional study was carried out for duration of two months. Total of 506 samples were collected within seven days from onset of illness from all over hospitals of Punjab, Pakistan of which 350 were selected simply randomly to test for presence of ZIKV by using "Trioplex Real-Time RT-PCR Assay (Trioplex)". Cohen's kappa coefficient (κ) and 95% confidence interval (CI) were used to assess the degree of concordance between DENV positive results of non-structural protein 1 (NS1) and IgM solid-phase enzyme immunoassay (ELISA). RESULTS: No samples were positive for any ZIKV, DENV or Chikungunya virus (CHIKV) by Trioplex. Among the 350 samples, 26 samples were positive concordant and the degree of concordance between NS1- and IgM-ELISA was 13% and κ coefficient was -0.71 (95% CI -0.79, -0.63). CONCLUSION: At study time, no samples were positive for ZIKV. Strengthening laboratory capacity to confirm arboviruses for Punjab's laboratories is warranted. Trioplex RT-PCR has 100% sensitivity so there are nominal chances of false negative results. Establishing syndromic surveillance for Zika and conducting a sero-surveillance survey for Zika in areas with high human and Aedes mosquito density are recommended in Punjab.

Mosquito Net Ownership, Utilization, and Preferences among Mobile and Migrant Populations Sleeping in Forests and Farms in Central Vietnam: A Cross-Sectional Study.

Strengthening vector control measures among mobile and migrant populations (MMPs) is crucial to malaria elimination, particularly in areas with multidrug-resistant malaria. Although a global priority, providing access and ensuring high coverage of available tools such as long-lasting insecticidal nets (LLINs) among these vulnerable groups remains a significant challenge. We assessed mosquito net ownership, utilization, and preference among individuals who slept in a forest and/or on a farm against those residing only in village "home" settings in a priority malaria elimination area of Vietnam. Proportions of respondents owning bed nets were similar among forest, farm, and home sleeping sites, ranging between 96% and 98%. The proportion of respondents owning hammock nets was higher for the forest group (92%), whereas ownership of hammocks in general was significantly lower for the home group (55%). Most respondents (97%) preferred to bring hammock nets to their remote sleeping site, whereas a smaller proportion (25%) also considered bed nets as an option. Respondent preferences included thick hammock nets with zippers (53%), hammocks with a flip cover (17%), and thin hammock nets with zippers (15%), with none choosing polyethylene (hard) LLINs. Although there is high coverage and access to nets for this high-priority MMP group, there was a noted gap between coverage and net use, potentially undermining the effectiveness of net-related interventions that could impact malaria prevention and elimination efforts in Vietnam. The design and material of nets are important factors for user preferences that appear to drive net use.

Results from a malaria indicator survey highlight the importance of routine data capture in high-risk forest and farm transmission sites in Vietnam to tailor location-specific malaria elimination interventions.

In-line with the World Health Organization's (WHO) Global Technical Strategy for Malaria (2016-2030), Vietnam is striving to eliminate malaria by 2030. Targeting appropriate interventions in high-risk populations such as forest and forest-fringe communities is a critical component of malaria elimination efforts in Vietnam. In 2016, a household-level malaria indicator survey was conducted in Phu Yen Province, Vietnam with the aim of assessing the knowledge, behaviors and associated risks of malaria infection among priority mobile and migrant populations (MMPs) working and sleeping in forests and on farms. A total of 4211 people were included in the survey, comprised of 1074 heads of households and 3137 associated household members. Of the 1074 head-of-household respondents, 472 slept in a forest, 92 slept on a farm, 132 slept in both forests and farms, and 378 slept at their villages within the last 12 months. Age, literacy, and occupation were significantly different among those who slept in a forest versus on a farm. Of 301 respondents who answered questions about malaria risk factors at sleeping sites, 35% were somewhat aware of malaria prevention practices, but only 4% could recall at least four malaria prevention messages. Among the same group of 301 respondents, only 29% used nets and only 11% used treated nets. Ownership and use of nets among forest-goers was significantly lower than those who slept on a farm or in their village. Huts without walls were significantly prominent forest sleeping site locations (POR = 10.3; 95% CI 4.67-22.7). All respondents who slept in a forest requested standby malaria drugs and one-third of them self-treated without blood testing. Results from this study highlight the importance of capturing relevant location-specific data among priority populations such as remote forest and farm going mobile and migrant populations in Vietnam. Data regarding behavioral practices, knowledge, preventative measures, and intervention coverage at remote-area transmission sites must be routinely captured to effectively monitor progress and refine targeted intervention strategies accordingly.

Systems evaluation reveals novel transporter YohJK renders 3-hydroxypropionate tolerance in Escherichia coli.

Previously, we have reported that 3-hydroxypropionate (3-HP) tolerance in Escherichia coli W is improved by deletion of yieP, a less-studied transcription factor. Here, through systems analyses along with physiological and functional studies, we suggest that the yieP deletion improves 3-HP tolerance by upregulation of yohJK, encoding putative 3-HP transporter(s). The tolerance improvement by yieP deletion was highly specific to 3-HP, among various C2-C4 organic acids. Mapping of YieP binding sites (ChIP-exo) coupled with transcriptomic profiling (RNA-seq) advocated seven potential genes/operons for further functional analysis. Among them, the yohJK operon, encoding for novel transmembrane proteins, was the most responsible for the improved 3-HP tolerance; deletion of yohJK reduced 3-HP tolerance regardless of yieP deletion, and their subsequent complementation fully restored the tolerance in both the wild-type and yieP deletion mutant. When determined by 3-HP-responsive biosensor, a drastic reduction of intracellular 3-HP was observed upon yieP deletion or yohJK overexpression, suggesting that yohJK encodes for novel 3-HP exporter(s).

Targeting high risk forest goers for malaria elimination: a novel approach for investigating forest malaria to inform program intervention in Vietnam.

BACKGROUND: Individuals that work and sleep in remote forest and farm locations in the Greater Mekong Subregion continue to remain at high risk of both acquiring and transmitting malaria. These difficult-to-access population groups largely fall outside the reach of traditional village-centered interventions, presenting operational challenges for malaria programs. In Vietnam, over 60% of malaria cases are thought to be individuals who sleep in forests or on farms. New malaria elimination strategies are needed in countries where mobile and migrant workers frequently sleep outside of their homes. The aim of this study was to apply targeted surveillance-response based investigative approaches to gather location-specific data on confirmed malaria cases, with an objective to identify associated malaria prevention, treatment and risk behaviors of individuals sleeping in remote forest and farms sites in Vietnam. METHODS: A cross-sectional study using novel targeted reactive investigative approaches at remote area sleeping sites was conducted in three mountainous communes in Phu Yen province in 2016. Index cases were defined as individuals routinely sleeping in forests or farms who had tested positive for malaria. Index cases and non-infected neighbors from forest and farm huts within 500 m of the established sleeping locations of index cases were interviewed at their remote-area sleeping sites. RESULTS: A total of 307 participants, 110 index cases and 197 neighbors, were enrolled. Among 93 participants who slept in the forest, index cases were more likely to make > 5 trips to the forest per year (prevalence odds ratio (POR) 7.41, 95% confidence interval (CI) 2.66-20.63), sleep in huts without walls (POR 44.00, 95% CI 13.05-148.33), sleep without mosquito nets (POR 2.95, 95% CI 1.26-6.92), and work after dark (POR 5.48, 95% CI 1.84-16.35). Of the 204 farm-based respondents, a significantly higher proportion of index cases were involved in non-farming activities (logging) (POR 2.74, 95% CI 1.27-5.91). CONCLUSION: Investigative approaches employed in this study allowed for the effective recruitment and characterization of high-priority individuals frequently sleeping in remote forest and farm locations, providing relevant population and site-specific data that decision makers can use to design and implement targeted interventions to support malaria elimination.

GeTe-TiC-C Composite Anodes for Li-Ion Storage.

Germanium boasts a high charge capacity, but it has detrimental effects on battery cycling life, owing to the significant volume expansion that it incurs after repeated recharging. Therefore, the fabrication of Ge composites including other elements is essential to overcome this hurdle. Herein, highly conductive Te is employed to prepare an alloy of germanium telluride (GeTe) with the addition of a highly conductive matrix comprising titanium carbide (TiC) and carbon (C) via high-energy ball milling (HEBM). The final alloy composite, GeTe-TiC-C, is used as a potential anode for lithium-ion cells. The GeTe-TiC-C composites having different combinations of TiC are characterized by electron microscopies and X-ray powder diffraction for structural and morphological analyses, which indicate that GeTe and TiC are evenly spread out in the carbon matrix. The GeTe electrode exhibits an unstable cycling life; however, the addition of higher amounts of TiC in GeTe offers much better electrochemical performance. Specifically, the GeTe-TiC (20%)-C and GeTe-TiC (30%)-C electrodes exhibited excellent reversible cyclability equivalent to 847 and 614 mAh g-1 after 400 cycles, respectively. Moreover, at 10 A g-1, stable capacity retentions of 78% for GeTe-TiC (20%)-C and 82% for GeTe-TiC (30%)-C were demonstrated. This proves that the developed GeTe-TiC-C anodes are promising for potential applications as anode candidates for high-performance lithium-ion batteries.

Enhanced infection control interventions reduced catheter-related bloodstream infections in the neonatal department of Hung Vuong Hospital, Vietnam, 2011-2012: a pre- and post-intervention study.

Background: Catheter-related bloodstream infections (CR-BSI) cause high neonatal mortality and are related to inadequate aseptic technique during the care and maintenance of a catheter. The incidence of CR-BSI among neonates in Hung Vuong Hospital was higher than that of other neonatal care centres in Vietnam. Methods: An 18-month pre- and post-intervention study was conducted over three 6-month periods to evaluate the effectiveness of the intervention for CR-BSI and to identify risk factors associated with CR-BSI. During the intervention period, we trained all nurses in the Department of Neonatology on BSI preventive practices, provided auditing and feedback about aseptic technique during catheter care and maintenance, and reorganised preparation of total parenteral nutrition. All neonates with intravenous catheter insertion ≥48 h in the pre- and post-intervention period were enrolled. A standardised questionnaire was used to collect data. Blood samples were collected for cultures. We used Poisson regression to calculate rate ratio (RR) and 95% confidence interval (CI) for CR-BSI incidence rates and logistic regression to identify risk factors associated with CR-BSI. Results: Of 2225 neonates enrolled, 1027 were enrolled in the pre-intervention period, of which 53 CR-BSI cases occurred in 8399 catheter-days, and 1198 were enrolled in the post-intervention period, of which 32 CR-BSI cases occurred in 8324 catheter-days. Incidence rates of CR-BSI significantly decreased after the intervention (RR = 0.61, 95% CI 0.39-0.94). Days of hospitalisation, episodes of non-catheter-related hospital-acquired infections, and the proportion of deaths significantly decreased after the intervention (p < 0.01). The CR-BSI was associated with days of intravenous catheter (odds ratio [OR] = 1.05, 95% CI 1.03-1.08), use of endotracheal intubation (OR = 2.27, 95% CI 1.27-4.06), and intravenous injection (OR = 8.50, 95% CI 1.14-63.4). Conclusions: The interventions significantly decreased the incidence rate of CR-BSI. Regular refresher training and auditing and feedback about aseptic technique during care and maintenance of catheters are critical to reducing CR-BSI.

Risk factor assessment for clinical malaria among forest-goers in a pre-elimination setting in Phu Yen Province, Vietnam.

BACKGROUND: The transition from malaria control to elimination requires understanding and targeting interventions among high-risk populations. In Vietnam, forest-goers are often difficult to test, treat and follow-up for malaria because they are highly mobile. If undiagnosed, forest-goers can maintain parasite reservoirs and contribute to ongoing malaria transmission. METHODS: A case-control study was conducted to identify malaria risk factors associated with forest-goers in three communes in Phu Yen Province, Vietnam. Cases (n = 81) were residents from the study area diagnosed with malaria and known to frequent forest areas. Controls (n = 94) were randomly selected forest-going residents from within the study area with no identified malaria infection. Participants were interviewed face-to-face using a standard questionnaire to identify malaria risk factors. Logistic regression was used to calculate odds ratios (ORs) and 95% CI for risk factors after adjusting for socio-demographic characteristics. RESULTS: Among the cases, malaria infection varied by species: 66.7% were positive for Plasmodium falciparum, 29.6% for Plasmodium vivax, and 3.7% were diagnosed as mixed infection. Cases were less likely than controls to use treated nets (aOR = 0.31; 95% CI 0.12-0.80), work after dark (aOR = 2.93; 95% CI 1.35, 6.34), bath in a stream after dark (aOR = 2.44; 95% CI 1.02-5.88), and collect water after dark (aOR = 1.99; 95% CI 1.02-3.90). CONCLUSIONS: As Vietnam moves toward malaria elimination, these findings can inform behaviour change communication and malaria prevention strategies, incorporating the risk of after-dark and water-related activities, in this priority and difficult-to-access population group.

Development of 3-hydroxypropionic-acid-tolerant strain of Escherichia coli W and role of minor global regulator yieP.

3-Hydroxypropionic acid (3-HP) is an important platform chemical, but its toxic effect at high concentrations (> 200 mM) is a serious challenge for commercial production. In this study, a highly 3-HP-tolerant strain of Escherichia coli W (tolerance concentration: 400 mM in M9 minimal medium and 800 mM when yeast extract was added) was developed by adaptive laboratory evolution (ALE) with glycerol as the carbon source. Genome analysis of the adapted strain (designated as E. coli WA) indicated the presence of mutations in 13 genes, including glpK (glycerol kinase) and yieP (a less-studied global regulator). The mutant GlpK (K67T) exhibited a higher activity than the wild-type enzyme, but it was not beneficial for 3-HP production due to its causing carbon overflow metabolism. Interestingly, among the other 12 genes, the mutation in yieP alone was almost fully responsible for the improved tolerance to 3-HP. When the mutant yieP was substituted with the wild-type counterpart, the adapted E. coli WA strain completely lost its tolerance to 3-HP, showing a tolerance similar to the wild-type W strain. Deletion of yieP conferred 3-HP tolerance to several other E. coli strains including K-12 W3110, K-12 MG1655, and B except BL21 (DE3). The E. coli WA with wild-type glpK showed, as compared with its parental strain, better 3-HP production, indicating that improved tolerance is beneficial for 3-HP production.

Analysis and characterization of coenzyme B12 biosynthetic gene clusters and improvement of B12 biosynthesis in Pseudomonas denitrificans ATCC 13867.

Coenzyme B12 is an essential cofactor for many enzymes such as glycerol dehydratase, methionine synthase and methylmalonyl-CoA mutase. Herein, we revisited the B12 biosynthetic gene clusters (I and II) in Pseudomonas denitrificans, a well-known industrial producer of the coenzyme B12, to understand the regulation of gene expression and improve the production of coenzyme B12. There were eight operons, seven in cluster I and one in cluster II, and four operons were regulated by B12-responsive riboswitches with a switch-off concentration at ∼5 nM coenzyme B12. DNA sequences of the four riboswitches were partially removed, individually or in combination, to destroy the structures of riboswitches, but no improvement was observed. However, when the whole length of riboswitches in cluster I were completely removed and promoters regulated by the riboswitches were replaced with strong constitutive ones, B12 biosynthesis was improved by up to 2-fold. Interestingly, modification of the promoter region for cluster II, where many (>10) late genes of B12 biosynthesis belong, always resulted in a significant, greater than 6-fold reduction in B12 biosynthesis.

An Outbreak of Norovirus Infections Among Lunch Customers at a Restaurant, Tampere, Finland, 2015.

On January 29, 2015, the city of Tampere environmental health officers were informed of a possible foodborne outbreak among customers who had eaten lunch in restaurant X. Employees of electric companies A and B had a sudden onset of gastrointestinal symptoms. We conducted a retrospective cohort study to identify the vehicle, source, and causative agent of the outbreak. A case was defined as an employee of companies A or B with diarrhea and/or vomiting who ate lunch at Restaurant X on January 26, 2015. All employees of the companies attending the implicated lunch were invited to participate in the cohort study. Environmental investigation was conducted. Twenty-one responders were included in statistical analysis, of which 11 met with the case definition. Of the 15 food items consumed by participants, four food items were associated with gastroenteritis. Of four kitchen staff, three tested positive for norovirus GIP7, the strain was found earlier in the community. No patient samples were obtained. Level of hygiene in the kitchen was inadequate. Infected kitchen staff probably transmitted norovirus by inadequate hygiene practices. No new cases associated with Restaurant X were reported after the hygiene practices were improved.

Exploiting Language Models to Classify Events from Twitter.

Classifying events is challenging in Twitter because tweets texts have a large amount of temporal data with a lot of noise and various kinds of topics. In this paper, we propose a method to classify events from Twitter. We firstly find the distinguishing terms between tweets in events and measure their similarities with learning language models such as ConceptNet and a latent Dirichlet allocation method for selectional preferences (LDA-SP), which have been widely studied based on large text corpora within computational linguistic relations. The relationship of term words in tweets will be discovered by checking them under each model. We then proposed a method to compute the similarity between tweets based on tweets' features including common term words and relationships among their distinguishing term words. It will be explicit and convenient for applying to k-nearest neighbor techniques for classification. We carefully applied experiments on the Edinburgh Twitter Corpus to show that our method achieves competitive results for classifying events.

Applying standard epidemiological methods for investigating foodborne disease outbreak in resource-poor settings: lessons from Vietnam.

An outbreak of gastroenteritis occurred among workers of company X after eating lunch prepared by a catering service. Of 430 workers attending the meal, 56 were hospitalized with abdominal pain, diarrhea, vomiting, and nausea, according to the initial report. We conducted an investigation to identify the extent, vehicle, and source of the outbreak. In our case-control study, a case was a worker who attended the meal and who was hospitalized with acute gastroenteritis; controls were randomly selected from non-ill workers. Cases and controls were interviewed using a standard questionnaire. We used logistic regression to calculate adjusted odds ratios for the consumption of food items. Catering service facilities and food handlers working for the service were inspected. Food samples from the catering service were tested at reference laboratories. Of hospitalized cases, 54 fulfilled the case definition, but no stool specimens were collected for laboratory testing. Of four food items served during lunch, only "squash and pork soup" was significantly associated with gastroenteritis, with an adjusted odds ratio of 9.5 (95 % CI 3.2, 27.7). The caterer did not separate cooked from raw foods but used the same counter for both. Cooked foods were kept at room temperature for about 4 h before serving. Four of 14 food handlers were not trained on basic food safety principles and did not have health certificates. Although no microbiological confirmation was obtained, our epidemiological investigation suggested that squash and pork soup caused the outbreak. Hospitals should be instructed to obtain stool specimens from patients with gastroenteritis. Food catering services should be educated in basic food safety measures.

An outbreak of food-borne salmonellosis linked to a bread takeaway shop in Ben Tre City, Vietnam.

OBJECTIVES: To identify the vehicle, source, and causative agent of a community-wide food-borne outbreak of gastroenteritis. METHODS: We conducted a case-control study. Cases were city residents diagnosed with gastroenteritis and hospitalized in Ben Tre City from 22 to 25 May 2013; 41 cases were selected randomly from a list of hospitalized patients. Controls were age- and gender-matched healthy neighbours of cases. Participants were interviewed using a standard questionnaire. Samples from patients and food were tested at reference laboratories. We used conditional logistic regression to calculate matched odds ratios (mORs) for the association of gastroenteritis with food items consumed. RESULTS: Of the 41 cases enrolled in the study, 61% were males and the median age was 33 years; cases resided in 12 wards of the City. Of 13 food items consumed by the cases, only stuffed bread was significantly associated with gastroenteritis (mOR 21.3, 95% confidence interval 6.3-71.8). Among the 29 cases who ate stuffed bread, the median time to illness onset was 9h. Patient stool samples and bread samples were positive for Salmonella species. CONCLUSIONS: Stuffed bread was the likely vehicle of the outbreak. The laboratory testing capacity for serotypes of Salmonella should be strengthened in Vietnam. Food-handler training in basic food safety measures should be improved.