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RESEARCH

Virology

Six researchers are involved in these surveillance and research activities with approximately 30 persons working in the virology unit. Within each ofthese topics, the virology unit has developed numerous research programmes. Most of these programmes are conducted in collaboration with the IPC’s Epidemiology and Public Health Unit.

RESEARCH

Virology

Six researchers are involved in these surveillance and research activities with approximately 30 persons working in the virology unit. Within each ofthese topics, the virology unit has developed numerous research programmes. Most of these programmes are conducted in collaboration with the IPC’s Epidemiology and Public Health Unit.

The activities of IPC’s virology unit are directed towards biomedical research and the surveillance/monitoring of infectious diseases. They can bedivided into five main components:

      1. arboviruses (ex: dengue, Zika, chikungunya and Japanese encephalitis),
      2. respiratory syndromes (mainly seasonal and avian influenza),
      3. HIV and viral hepatitis,
      4. viral encephalitis (Japanese encephalitis, EV-A71),
      5. zoonotic and emerging pathogens (ex: coronaviruses and Nipah virus).

Projects

Respiratory Viruses

Coordination: Paul Horwood

Partners: MoH & WHO Cambodia (NIC), Arnaud Tarantola and coll., NIPH/US CDC, AFRIMS, WHOCC Melbourne

Objectives

Influenza and other viruses are responsible for respiratory infections that represent an important disease burden in children and adults. The etiology of respiratory infections in tropical countries is not well-known and influenza viruses require constant monitoring to follow their genetic evolution, antigenic shift, and drug resistance patterns. The influence of bacterial and viral co-infections on the severity of respiratory disease has rarely been assessed and described, especially in tropical developing countries.

Core of the project

The Influenza-like illness (ILI) surveillance established in 2006 in collaboration with MoH and WHO allows for the collection of influenza strains and data on seasonality. Based on this information, the National Influenza Centre (NIC) based in the IPC Virology Unit makes annual recommendations to MoH regarding the influenza vaccine strategy and the use of antiviral drugs for the treatment of severe cases. The characteristics of influenza virus circulation and evolution have been described in a recently published report on Cambodian data from 2009-2011 (Horm et al., 2014). The NIC is part of the Global Influenza Surveillance and Response System (GISRS).

Coordination: Paul Horwood, Horm Srey Viseth (Market project)

Partners: Arnaud Tarantola, Ly Sowath and coll. (Epidemiology Unit), MoH, NaVRI-Ministry of Agriculture, WHO, FAO, CDC-USA, NIPH, Kantha Bopha Hospital, NAMRU-2

 

Objectives

To study the evolution and the circulation dynamics of H5N1 virus in Cambodia. In addition, as the treatment of H5N1 poses a great challenge (60% mortality), we decided to study mechanisms associated with resistance to antiviral drugs and to evaluate the neutralizing activity of polyclonal antibodies raised against H5N1 virus. In collaboration with IP Shanghai, we contributed to study the protection obtained with antibodies against conserved epitopes of H5N1 virus. As the transmission of H5N1 to humans is often associated with an exposure to a contaminated environment, we evaluated the virus persistence and the role of the environmental contamination in live bird markets and in farms after outbreaks in poultry. This integrative study of the virus cycle at the human/animal/environment interface allows a better understanding of why the avian influenza virus is still actively circulating since 2003 and thus still posing a pandemic threat.

Previous environmental studies in live poultry markets (LPMs) and human seroprevalence studies in Cambodia have shown that H5N1 virus is circulating in markets, but infection is rare among close contacts of human H5N1 cases. This second integrative study of the virus cycle at the human/animal/environment interface, allows us to evaluate the virus persistence and the role of the environmental contamination in LPMs and also to monitor the exposure of poultry workers (poultry sellers, butchers, middlemen) to influenza viruses in these markets.

Core of the project

Influenza A/H5N1 was first detected in Cambodian poultry in January 2004 and subsequently the first human case was recorded in January 2005. Since its introduction, human A/H5N1 cases have been detected each year in Cambodia (except 2015). From 2005-2012, human case numbers averaged 1-4 cases per year (maximum of 7 cases in 2011). However, in 2013 there was a dramatic increase in human cases (26 cases) which continued into early 2014 (9 cases in the first 3 months). The sudden increase in cases coincided with the emergence of a new genotype of A/H5N1 which was a reassortant of the previously circulating Clade 1.1.2 genotype Z (HA and NA genes) and a Clade 2.3.2.1 virus (internal genes). The detection of new human cases stopped in March 2014, corresponding with the appearance of a Clade 2.3.2.1 virus which is closely related to the strains circulating in Vietnam. Surveillance for human cases of influenza A/H5N1 is conducted through event based reporting and sampling from Kantha Bopha hospitals (major paediatric hospitals in Phnom Penh and Siem Reap). Although IPC and other Cambodian institutions are continuing surveillance for human A/H5N1 infections, no human cases have been detected since March 2014. In 2015, we have commenced a new market surveillance study.

Prospective

We use advanced genetic sequencing tools and poultry transmission experiments to gain a better understanding of the influenza A/H5N1 viruses circulating in Cambodia, and be able to:

1- Analyse full genome of Cambodian A/H5N1 strains

2- Sequence market environmental samples to investigate the diversity of influenza viruses circulating in Cambodian poultry

3- Conduct experiments to compare the transmissibility of Cambodian influenza A/H5N1 strains

Arboviral Diseases

Coordination: Duong Veasna – Anavaj Sakuntabhai

Partners: Anavaj Sakuntabhai and coll. (IP), Marie Flamant (IP), BioMérieux, Standardia

Objectives

The first part of the project belongs to a larger collaborative programme on dengue that is being established between Biomérieux (BM) and the Institut Pasteur (IP). BM is pursuing two major goals: become involved in the dengue diagnostic field and provide new prognostic markers for predicting a progression evolution towards severe dengue hemorrhagic fever and dengue shock syndrome.

In a second part of this project supported by an industrial partner, we aimed to evaluate the usefulness of saliva and urine for dengue diagnosis and also to identify potential predictive markers of severity that could be easily detected.

Core of the project

The first part of the project belongs to a larger collaborative programme on dengue that is being established between Biomérieux (BM) and the Institut Pasteur (IP). BM is pursuing two major goals: become involved in the dengue diagnostic field and provide new prognostic markers for predicting a progressive evolution towards severe dengue hemorrhagic fever and dengue shock syndrome. In a second part of this project supported by an industrial partner, we aimed to evaluate the usefulness of saliva and urine for dengue diagnosis and also to identify potential predictive markers of severity that could be easily detected.

Prospective

Serial plasma, urine and saliva samples were collected at several time-points between the day of admission to hospital until three months after the onset of fever in children with confirmed dengue disease. Quantitative RT-PCR, NS1 antigen capture and ELISA serology for anti-DENV antibody (IgG, IgM and IgA) detection were performed in parallel on the three body fluids.

Financial support

BioMerieux – Standardia

Coordination: Paul Horwood, Horm Srey Viseth (Market project)

Partners: Arnaud Tarantola, Ly Sowath and coll. (Epidemiology Unit), MoH, NaVRI-Ministry of Agriculture, WHO, FAO, CDC-USA, NIPH, Kantha Bopha Hospital, NAMRU-2

 

Objectives

To study the evolution and the circulation dynamics of H5N1 virus in Cambodia. In addition, as the treatment of H5N1 poses a great challenge (60% mortality), we decided to study mechanisms associated with resistance to antiviral drugs and to evaluate the neutralizing activity of polyclonal antibodies raised against H5N1 virus. In collaboration with IP Shanghai, we contributed to study the protection obtained with antibodies against conserved epitopes of H5N1 virus. As the transmission of H5N1 to humans is often associated with an exposure to a contaminated environment, we evaluated the virus persistence and the role of the environmental contamination in live bird markets and in farms after outbreaks in poultry. This integrative study of the virus cycle at the human/animal/environment interface allows a better understanding of why the avian influenza virus is still actively circulating since 2003 and thus still posing a pandemic threat.

Previous environmental studies in live poultry markets (LPMs) and human seroprevalence studies in Cambodia have shown that H5N1 virus is circulating in markets, but infection is rare among close contacts of human H5N1 cases. This second integrative study of the virus cycle at the human/animal/environment interface, allows us to evaluate the virus persistence and the role of the environmental contamination in LPMs and also to monitor the exposure of poultry workers (poultry sellers, butchers, middlemen) to influenza viruses in these markets.

Core of the project

Influenza A/H5N1 was first detected in Cambodian poultry in January 2004 and subsequently the first human case was recorded in January 2005. Since its introduction, human A/H5N1 cases have been detected each year in Cambodia (except 2015). From 2005-2012, human case numbers averaged 1-4 cases per year (maximum of 7 cases in 2011). However, in 2013 there was a dramatic increase in human cases (26 cases) which continued into early 2014 (9 cases in the first 3 months). The sudden increase in cases coincided with the emergence of a new genotype of A/H5N1 which was a reassortant of the previously circulating Clade 1.1.2 genotype Z (HA and NA genes) and a Clade 2.3.2.1 virus (internal genes). The detection of new human cases stopped in March 2014, corresponding with the appearance of a Clade 2.3.2.1 virus which is closely related to the strains circulating in Vietnam. Surveillance for human cases of influenza A/H5N1 is conducted through event based reporting and sampling from Kantha Bopha hospitals (major paediatric hospitals in Phnom Penh and Siem Reap). Although IPC and other Cambodian institutions are continuing surveillance for human A/H5N1 infections, no human cases have been detected since March 2014. In 2015, we have commenced a new market surveillance study.

Prospective

We use advanced genetic sequencing tools and poultry transmission experiments to gain a better understanding of the influenza A/H5N1 viruses circulating in Cambodia, and be able to:

1- Analyse full genome of Cambodian A/H5N1 strains

2- Sequence market environmental samples to investigate the diversity of influenza viruses circulating in Cambodian poultry

3- Conduct experiments to compare the transmissibility of Cambodian influenza A/H5N1 strains

Coordination: Philippe Dussart – Marco Vignuzzi (IP Paris)

Partners: Arnaud Tarantola, Ly Sowath and coll. (Epidemiology Unit), MoH, WHO

Objectives

To characterise the Chikungunya virus strains detected by our national arbovirus surveillance and encephalitis project for the first time in 2011.

The ability to follow host-specific evolutionary trajectories of viruses is essential to predict, prepare for, and ultimately prevent epidemic emergence events. We hypothesised that performing experimental work in more natural settings, such as during transmission between mosquito and mammalian hosts, will identify strains with epidemic potential well before they emerge in nature.

Core of the project

 

Chikungunya is an arboviral disease caused by an alphavirus (CHIKV) transmitted by the bite of Aedes mosquitoes. In humans, it is mostly a self-limiting illness marked with debilitating joint pains. After first being identified in the 1950s and spreading from Africa in the 1960s, a pandemic strain of Chikungunya virus emerged in East Africa and the Indian Ocean in 2006, progressing to Asia. The Chikungunya circulated in Cambodia in the 1960s and 1970s and was probably related to the Asian genotype.

Recently, CHIKV re-emerged in 2011 and spread in 2012. The strains detected belonged to the East Central South African genotype. We performed experimental mosquito infections of mouse with CHIKV (wild type and mutants) in the BSL3 laboratory of IPC. After generating the cDNA of the viruses, HTS was used in Marco Vignuzzi’s lab (IP) where in vivo and in vitro approaches with high-throughput sequencing to characterise the evolution of chikungunya virus during natural transmission between mosquitoes and mammals were combined. We successfully captured the emergence of a recent epidemic strain of chikungunya and detected two novel E1 glycoprotein mutations, emerging in saliva virus subpopulations of multiple mosquito strains. These new mutations confer fitness advantages in both mosquito and mammalian hosts by altering virion stability and fusogenic activity. These data highlight how evolutionary trajectories of viruses can be predicted and studied in the short-term, before new variants displace the strains currently circulating in nature.

In parallel, a recent study from IPC teams showed a long-lasting immune protection after Chikungunya emergence in a rural community in April 2012. This study demonstrated that being aged above 40 was a significant protective factor for CHIKV infection, reflecting immune protection collectively acquired while Chikungunya circulated in Cambodia in the 1960s and 1970s, prior to the beginning of the Khmer Rouge regime in 1975. These data are the first to support the persistence of CHIKV antibodies over a period of 40 years.

Prospective

The vector of the ECSA genotype of the virus has not yet been identified in Cambodia. Following the detection of new cases, entomological investigations are conducted to collect Aedes mosquitoes to attempt to identify the virus in those vectors. This re-emerging disease is considered as a public health concern by national authorities.

New experiments exploring the evolution of CHIKV Caribbean strains in Asian Aedes aegypti and Aedes albopictus mosquitoes are scheduled in 2016. The objective is to identify emerging adaptive mutations that are shared, or specific, to each mosquito population (PTR CHIKAlert). We will collaborate with colleagues from Paris through a project that aims to generate a comprehensive world map of chikungunya virus quasispecies in humans. The objective is to analyse individual patient samples from Cambodia (from ECSA genotype). Other Institut Pasteur from the Network where CHIKV circulated or is settled (French Guiana, Senegal, Laos and New Caledonia) are involved under the coordination of Marco Vignuzzi’s lab in Paris.

Finally, findings from previous studies on CHIKV immune protection need to be further explored in the laboratory through the study of immunity against 1960s CHIKV strains (from Asian genotype) among Cambodian people with immunity acquired in 2012. The confirmation of previous results remains important to understand the immunity against Chikungunya and to predict or control future epidemics and public health needs.

Financial support

WHO – Institut Pasteur, Paris

Zoonoses

Coordination: Duong Veasna

 

 

Partners: Wildlife Conservation Society, University California Davis, Ministry of Agriculture Laos, National Veterinary Research Institute (NaVRI)

Background

Anthropogenic activities, such as wildlife trade and land conversion for agriculture, are recognized as drivers of zoonotic disease emergence. Cambodia is a key source, conduit, and consumer of wildlife. In the past decade, the country has seen economic development accompanied by large scale land-use change and increasing human-wildlife-domestic animal contact, which may increase opportunities for pathogen spillover from animals to people.

Objectives

Emerging infectious diseases pose a significant burden on human and animal health and global economies. Conventional approaches to epidemic control have most often been reactive. However, explosive human population growth, dramatic changes in land use, and increased global trade and travel require a shift toward a proactive, predictive approach. The PREDICT project aims to prevent, detect, and rapidly respond to the spillover of novel infectious pathogens from wildlife to humans. The goal of the PREDICT project in Cambodia was to build local capacity to conduct surveillance and diagnostics for zoonotic pathogens in wildlife.

Core of the project

Anthropogenic activities, such as wildlife trade and land conversion for agriculture, are recognised as drivers of zoonotic disease emergence. Cambodia is a key source, conduit, and consumer of wildlife. In the past decade, the country has seen economic development accompanied by large scale land-use change and increasing human-wildlife-domestic animal contact. The PREDICT project aims to prevent, detect, and rapidly respond to the spillover of novel infectious pathogens from wildlife to humans. The goal of the PREDICT project in Cambodia was to build local capacity to conduct surveillance and diagnostics for zoonotic pathogens in wildlife.

In PREDICT 1, a total of 3,887 animals were sampled (300 nonhuman primates, 552 rodents, and 2,503 bats). Polymerase Chain Reaction (PCR) screening for 16 viral families and additional pathogens of regional concern was conducted at IPC. The following viral families were targeted for testing: arenaviruses, alphaviruses, astroviruses, bocaviruses, bunyaviruses, coronaviruses, enteroviruses, filoviruses, flaviviruses, influenza viruses, hantaviruses, henipaviruses, herpesviruses, orthopoxviruses, paramyxoviruses, rhabdoviruses, lyssaviruses, retroviruses (Lentivirus genus), simian foamy viruses, and seadornaviruses.

The success of PREDICT 1 has led to further funding from USAID for the PREDICT 2 project (5 years) where IPC has the lead role in carrying out the project in Cambodia. While PREDICT 1 studied only wildlife at the interface with humans (hunting, restaurant, wildlife market, etc), phase 2 of PREDICT will focus at the interface of wildlife, livestock and humans. The project started in October 2014 and focused on surveillance and interventions at the source of pathogen emergence, amplification, and spread in human populations and to forecast risk from viruses before they emerge, through: (1) expanded characterisation of pathogens of known epidemic and unknown pandemic potential and their dynamics among hosts; (2) documenting pathogen sharing between wildlife, domestic animals, and people at high-risk interfaces for disease emergence; (3) target surveillance at high-risk pathways for disease emergence, spillover, and spread in order to identify social and ecological drivers of (i.e. factors influencing) pathogen emergence and transmission and determine appropriate targets for intervention; (4) build on global One Health initiatives for effective collaboration across disciplines and geographic borders.

Three sites presenting interface between human, wildlife and livestock were identified: 1) bat farming site for guano, 2) cross border rodents trade for consumption to Vietnam and 3) land concession area with different landscape changes due to deforestation. Molecular assays will be used to screen for 10 virus families.

Prospective

HTS sequencing is being conducted on selected CoV positive samples from PREDICT 1 in Cambodia. The whole genome sequences generated by HTS will help us characterise the genome of these different CoV in bats and study their host specificity in transmission. Further characterisation of different viruses detected in PREDICT1 are being explored.

Financial support : USAID

Coordination: Philippe Dussart – Paul Horwood

Partners: Wildlife Conservation Society, the Cambodian National Veterinary Research Institute (NaVRI), the Lao P.D.R. National Animal Health Laboratory, the Lao-Oxford-Mahosot-Hospital-Wellcome Trust Research Unit.

Objectives

To bring together partners in the human health, wildlife health and animal health sectors to create capacity to survey, diagnose and understand the drivers of disease at human-animal-environmental interfaces.

Core of the project

The LACANET project intends to build capacity for surveillance and field investigation for zoonotic diseases, enhance laboratory capacity to detect zoonotic diseases, improve national and regional cross-sectorial collaborations by establishing a One Health surveillance and laboratory network and conduct strategic research on two important drivers of disease emergence – wildlife trade and land-use change.

Prospective

The LACANET partners have initiated a programme to strengthen the capacity to conduct field investigations and detect zoonotic disease outbreaks and events in Cambodia and Lao P.D.R. To achieve these goals, four integrated project activities were designed, and the implementation of these activities was commenced in Year 1 of the project. In both countries, the partners have consulted and gained the support of national health, veterinary and wildlife officials through regular meetings and national-level workshops (in each country). We have made efforts to improve the participation of wildlife health partners in the One Health system in both countries through promoting participation in technical working group meetings and inclusion of the wildlife health sector in zoonotic disease preparedness and response plans. Wildlife disease and mortality surveillance has been initiated, for the first time, in each country. Rangers and veterinary staff are actively engaging with the project partners to collect samples and report wildlife disease events. Through LACANET we have commenced research projects to investigate the role of two important drivers of zoonotic disease emergence, land-use change and wildlife trade. These projects will be used as a ‘vehicle’ to initiate improved collaboration and communication between the three One Health sectors in each country.

Financial support : European Union

Neurotropic Infections

Coordination: Philippe Dussart, Chris Gorman (Regional Coordinator)

Partners: Kantha Bopha Hospitals – SEAe consortium: Epidemiology Unit (Arnaud Tarantola), IMMI, Institut Pasteur (Marc Lecuit, Olivier Lortholary, Marc Eloit), NIHE Hanoi, IRD (Xavier de Lamballerie), Oxford University Clinical Research Unit Laos (Paul Newton), CIRAD (Julien Cappelle, Véronique Chevalier)

Objectives

To reduce the morbidity and mortality associated with infectious encephalitis in Southeast Asia by improving diagnosis and medical care for patients. To describe the etiologies of acute encephalitis in Cambodia, Laos, Vietnam and Myanmar, with the prospect to extend the study to Thailand, Indonesia, Malaysia and Philippines. To improve laboratory diagnosis of encephalitis caused by known pathogens through developing new diagnostic capacities at hospitals in Cambodia, Laos, Vietnam and Myanmar. To develop a harmonized diagnostic strategy that provides diagnostic information to clinicians in a timely-manner. To implement a quality assurance program and biobanking facility, to detect non-traditional or unusual pathogens in samples that test negative to current diagnostic procedures, to improve diagnostic tools and to discover novel pathogens.

Core of the project

Infectious encephalitis is a world-wide public health issue, and this issue is further amplified in Southeast Asia due to the high level of endemic and emerging infectious diseases, particularly in resource limited settings. Defining an etiology for encephalitis has proven to be difficult due to the wide spectrum of encephalitic pathogens circulating in the environment, and traditionally, a laboratory diagnosis has been difficult to establish. Previous meningo-encephalitis studies by IPC identified JEV, DENV, TB and scrub typhus as key encephalitis causing pathogens, however ~50% of patients lacked a laboratory confirmed diagnosis. The SEAe Project has expanded on previous studies by including a large array of tests and a more comprehensive range of patient samples. Each patient recruited into the project is tested for ~80 pathogens, pathogens that are known to be endemic or where treatment is available are prioritised, and the results are delivered to the physician within 24 hours. To ensure that the testing strategy is comparable across the region, all laboratory tests are standardised between countries and these results are coupled with clinical and epidemiological data. Considering the countries selected for this project are resource-limited, capacity building in hospitals has strengthened their abilities to test for a larger range of pathogens and to provide a system in which samples can be stored for additional studies. The diagnosis of encephalitis in the hospitals is supported by the national centers, by implementing a quality control program and providing an expansive range of further testing that is applicable to both laboratory diagnosis and discovery of new or unusual pathogens.

Prospective

Pediatric and adult patients are currently being recruited in Cambodia, Laos and Vietnam (Myanmar to follow in early 2016), and a total of 1,500 patients are expected to be included over the next two years. Testing of these cases are on-going and include molecular, culture and serological state-of-the-art techniques. Prospective and retrospective testing of CSF, bloods, urine, swabs and skin samples will continue to be performed, and in cases where no infectious agent is identified, the patient’s samples will be submitted for high through-put sequencing to identify previously unknown pathogens. Training and support is continually provided to the hospital sites by the national centres, and all the information is stored in dedicated databases that are processed through the quality assurance programme which is monitored and evaluated by an international consortium of experts. This project is funded until the end of 2016. Additional financial support should be found to extend the programme to 2017 and beyond.

Financial support: Pathoquest – Total Fundation – Institut Pasteur – AVIESAN Sud – INSERM – IRD

Coordination: Paul Horwood

Partners: Epidemiology Unit (Arnaud Tarantola, Yoann Crabol)

 

 

Background

Human enterovirus 71 (EV71) is an important pathogen associated with hand, foot and mouth disease (HFMD) in children. Although most children infected with EV71develop a mild, self-limiting disease, a small proportion of patients develop severe and potentially fatal neurological and systemic manifestations. In Cambodia during 2012, a disease outbreak characterized by severe encephalitis with pulmonary oedema (SEP – severe encephalitis with pulmonary oedema) resulted in at least 52 fatalities in young children. EV71 serotype C4 was identified as the causative organism. This was the first time that EV71 had been recorded in Cambodia and the severity of illness and the large number of severe cases was a concern for national and international health authorities.

Objectives

The MOH, through the Department of Communicable Disease Control (CDCD) and the 2nd Health Sector Support Program (HSSP2) has engaged the Institut Pasteur du Cambodge (IPC) to undertake a seroprevalence study in 2015 to measure and describe the extent of a Hand Foot and Mouth Disease (HFMD) outbreak in Cambodia (Apr-Sep 2012) ascribed to Enterovirus 71 (EV71), persistence in 2015 and to test risk associations of susceptibility. Secondary objectives of this study are: (i) conduct field and laboratory investigations to elucidate the risk factors associated with severe cases of EV71; (ii) describe clinical presentation and associated risk factors for severe HFMD cases compared with non-cases or mild cases, including testing risk associations of cases and non-cases for heightened susceptibilities; (iii) elaborate the pattern of EV71 circulation during outbreaks and assess point prevalence in communities to compute future vaccine needs.

Core of the project

Human enterovirus 71 (EV71) is an important pathogen associated with hand, foot and mouth disease (HFMD) in children. Although most children infected with EV71develop a mild, self-limiting disease, a small proportion of patients develop severe and potentially fatal neurological and systemic manifestations. In Cambodia during 2012, a disease outbreak characterised by severe encephalitis with pulmonary oedema (SEP) resulted in at least 52 fatalities in young children. EV71 serotype C4 was identified as the main causative organism followed by genotype B5 and other non-EV71 strains. This was the first time that EV71 had been recorded in Cambodia. The severity of illness and the large number of severe cases was a concern for national and international health authorities.

Prospective

A new grant from Institut Pasteur and Total Fondation has been obtained in 2015 (PI: Institut Pasteur in Shanghaï). Thanks to this grant and through our collaboration with Kantha Bopha Hospital we will continue to monitor encephalitis cases and confirm suspected EV71 infections in 2016-2017. We will continue to monitor the circulation of the virus and amend our community point prevalence studies accordingly. We will also investigate the genetic variation in enterovirus strains to determine the role of viral pathogenesis in disease severity, and the involvement of the host’s immunological factors as a contributor to disease severity.

Financial support : 

      • Institut Pasteur
      • Cambodian MoH 
      • Asian Development Bank
      • WHO

Support to National Authorities

The following summarizes key support to Cambodian National Authorities during 2019 as part of our ongoing programs and projects.

National dengue surveillance in Cambodia

As part of a collaboration with the WHO and Cambodia’s National Dengue Control Program (NDCP) and within the framework of a national programme on outbreak missions, the virology unit’s laboratory received, over 2019, samples from six provincial hospitals and the National Pediatric Hospital in Phnom Penh and from clinical laboratory from IPC. These surveillance sites in Cambodian provinces are located within high risk areas of dengue haemorrhagic fever (high population density, presence of the vector, history of dengue in the region). Results from the monitoring of haemorrhagic syndromes are reported weekly to the various monitoring programme participants (Director of the NDCP, hospital physicians, etc.).

DENV-1 was the main dengue serotype detected from 2011 to 2015, and 2016 was marked by an increased detection of DENV-2 in Cambodia. In 2017, we continued to detect mainly DENV-2, while DENV-1 was still present in the country with a low circulation of dengue viruses. The recrudescence of dengue in 2018 was much higher compared to previous years, and 2019 was marked by a dengue outbreak with more than 68,000 hospitalized cases and 48 deaths reported countrywide. For comparison, in 2018, 24,684 cases and 23deaths were reported. DENV-1 was the main serotype detected in 2019 (67%) then DENV-2 (29%), while DENV-4 was sporadically detected (4%). The previous huge dengue outbreak occurred in 2007 with around 40,000 hospitalized cases and was caused by DENV-3serotype.

Teaching & Training

One of IPC’s main missions is to contribute to teaching and training activities. The virology unit has been proactive in the training oflaboratory technicians from partner institutions in the fields of surveillance and research, conducted at the national and regional levels.

In 2019, the virology unit received one foreign student (Resident in medical biology from Agence de Santé -île   de France, as well as seven Cambodian students (one bachelor of pharmacy and six lab technician students). Moreover, two staff from National Health Laboratory from Yangon, Myanmar (one microbiologist and one lab technician) were trained to improve their laboratory capacities in rabies diagnosis.

Additionally, two virology staff were trained at Institut Pasteur in Paris in bio-informatics/bio-statistics (mathematical modelling of infectious diseases) and NGS data analysis (C3BI: The Center of Bioinformatics, Biostatistics and Integrative Biology) for seven and five weeks, respectively. Also, one virology staff in PhD program in the field of virology at Aix Marseille University spent 4 months in Xavier de Lamballerie Lab (first year of his PhD).

Team

Dr DUONG Veasna, MD, PhD

Head of Unit & BSL3 Platform

Dr Erik KARLSSON, PhD

Deputy Head of unit

Dr HORM Srey Viseth, MD, PhD

Senior Scientist & BSL3 Platform

Ms. Y Phalla

Respiratory Viruses & Sequencing Platform

Ms. CHEA Kim Lay
Respiratory Viruses

Main National and International Partners

OPEN HOURS