What's going on in Ho Chi Minh City?

It is hard to know what to make of the report out of Ho Chi Minh City (neé Saigon) that thousands of children are filling two pediatric hospitals with respiratory and digestive illnesses "due to hot weather." The implication is that heat or its attendant dehydration are responsible. Abnormal respiration is seen frequently in dehydrated children but it is usually rapid and deep and not usually described as a "respiratory illness." Thus much hangs on the meaning of "respiratory problems" in this case. There seems to be no other source of information beyond the story in Tranh Nien (the same daily that broke the story about 195 with flu-like illness in Quang Binh, where we still await follow-up information).

The hot season seems wrong for Respiratory Syncytial Virus, a frequent cause of lower respiratory infection in infants and upper respiratory infections and bronchiolitis in older children. The next most common cause would be one of the parainfluenza viruses, but again, the hottest months don't seem right for this (usually winter-spring or fall events). Influenza A and B would also seem to be in the differential here, and if it is influenza A, one would have to worry about H5N1.

Niman at Recombinomics has made a note of this event, and rightly so. From this vantage point the possibilities range from minimal risk to extremely serious. We hope authorities will clarify soon. As always, Hope Springs Eternal.