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Vol. III, No. 1~ EINet News Briefs ~ January 3, 2000

****A free service of the APEC Emerging Infections Network*****

The EINet listserv was created to foster discussion, networking, and collaboration in the area of emerging infectious diseases (EID's) among academicians, scientists, and policy makers in the Asia–Pacific region. We strongly encourage you to share their perspectives and experiences, as your participation directly contributes to the richness of the "electronic discussions" that occur. To respond to the listserv, use the reply function.

In this edition:

  1. Infectious disease information from ProMED and other sources
  2. Updates from previous bulletins
  3. Notices
  4. How to join the EINet listserv

Below is a bi–weekly summary of Asia–Pacific EID issues based on postings to the ProMED Electronic Network and other sources. ProMED is the prototype for a communications system that monitors emerging infectious diseases globally, an initiative of the Federation of American Scientists (FAS), and co–sponsored by WHO.


PROMISING NEWS ABOUT AIDS VACCINE A Korean research team from Pohang University of Science and Technology has developed the world's first DNA vaccine for AIDS. In its first trial, the vaccine markedly enhanced antibodies to the virus and activated immune responses to kill HIV–infected cells in monkeys.

Made from a compound of 4 FDA–approved HIV genes, the vaccine aims to activate the production of antibodies in other cells by increasing the amount of the Pol Gene in the body, an HIV gene that works to activate virus–fighting cells. Clinical tests on humans can take place at any time.

A human vaccine could become available within 3 to 5 years, during which time the market could potentially reach $30 billion worldwide.
[POSTECH NEWSLETTER Winter 2000/No. 19 (www.postech.ac.kr/e/postech/newsletter/2.html); KOREA TIMES 12/9/99]

The growing number of prostitutes and drug addicts, coupled with a transient population of 120 million, and an annual budget of 30 million yuan ($3.6 million U.S.), have made China's fight against AIDS and HIV increasingly difficult. The report was presented at a national meeting on prevention and control of AIDS and sexually transmitted diseases (STDs).

The Ministry of Health estimates that over 400,000 persons are infected with HIV, 15,000 of which, are confirmed carriers. Cases include intravenous drug users (70%), sexually active persons (<7%), and those infected through blood transfusions and mother–to–infant transmission.

Prevention and control strategies will focus on stricter policies to fight prostitution, narcotics use, illegal trafficking, and blood sale. The Ministry also intends to establish AIDS and STD supervising stations in areas where infections are more likely to spread.
[CHINA DAILY 12/2/99]

Seventy–four students were struck with Norwalk Virus in November. The outbreak followed an outbreak of the virus in October, during which time 28 students were infected.

Symptoms ranged from vomiting, diarrhea, stomach pain, and fever. Prevention strategies and health education programs have been implemented to control further spread of the easily transmittable illness.
[ProMED 12/1//99]

Results obtained from a study conducted by the Centers for Disease Control and Prevention (CDC) strongly support the premise for human–to–human transmission of avian influenza A virus H5N1 during the flu outbreak in 1997.

The kinetics of the antibody responses of 16 cases of avian H5N1 and their contacts appeared similar to a primary response to a human influenza A virus. However, notable deviations from the kinetics curve were also reported. [REUTERS 12/21/99]

According to a report at the American Society of Tropical Medicine and Hygiene, the drought caused by the El Nino Southern Oscillation (ENSO) was largely responsible for the malaria outbreak in the mountainous regions of Indonesia in 1997�.

The drought fostered malaria infection in a number of ways: an insufficient food supply compromised nutritional status, thereby increasing the susceptibility to infection; fast–moving streams, dried up, creating stagnant pools for mosquitoes to proliferate; and food and water shortages stimulated the descent of the population to lower elevations where endemic malaria was more prevalent. During a 10–week period, the death rate soared from a baseline of 6/wk to over 200/wk, most of which were associated with malaria.

The outbreak remitted after the drought eliminated the pockets of mosquito infestation and the mass distribution of antimalarial drugs to the highland populations
[REUTERS 12/6/99]


Results from a pilot efficacy trial of a vaccine that contains recombinant Plasmodium falciparum proteins offers hope that a malaria vaccine will soon be developed. The study, conducted by PNG Institute of Medical Research (Maprik, Papua New Guinea), involved 120 children between the ages of 5 and 9.

Vaccine or placebo was administered to four groups of children at 0 and 4 weeks, and antimalarial therapy or placebo prior to vaccination. Blood smears were examined biweekly for 18 weeks to determine parasite density. Although antibody titers to the proteins increased in both vaccine groups, parasite density was 62% less in children who didn't receive antimalarial pretreatment than in placebo recipients.
[AP WIRE 12/21/99]


A study conducted in a Tennessee hospital has linked erythromycin, an antibiotic commonly used to treat whooping cough in newborns, to pyloric stenosis, an illness that blocks digestion and causes projectile vomiting. This is the first such association reported.

Erythromycin was prescribed to 200 babies following exposure to a health care worker who tested positive for whooping cough. Seven newborns (<3 weeks) became ill with pyloric stenosis; all recovered shortly thereafter.

Despite a connection, the Centers for Disease Control and Prevention (CDC) still recommends erythromycin as the treatment of choice for newborns with known exposure to whooping cough.
[SEATTLE TIMES 12/17/99; MMWR 12/17/99 (www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4849a1.htm)]


The Salk vaccine (intramuscular form) has reemerged as the polio vaccine of choice. The American Academy of Pediatrics released a policy statement that routine polio vaccines be administered intramuscularly, rather than orally. The recommendation was first issued 6 months ago by health officials at the Centers for Disease Control and Prevention (CDC).

The vaccine was replaced with the Sabin vaccine (oral form) almost 40 years ago because it only provides immunity to the vaccinated person; as a result, unvaccinated contacts can still be infected. Whereas the oral vaccine, which contains a weakened live virus, enables the vaccinated person to confer some immunity to an unvaccinated person.

Although the risk of the oral vaccine to cause polio is small, health officials strongly support the switch back to the intramuscular form since it holds no such risk.
[NY TIMES 12/16/99; BOSTON GLOBE 12/8/99]

The World Health Organization (WHO), in collaboration with the United Nations Children's Fund and Rotary International, have launched an emergency appeal for increased funding for 700 million polio vaccine doses. According to the WHO, additional vaccination programs scheduled in response to the campaign for worldwide polio eradication will require $50 million. Insufficient funding could greatly threaten campaigns in certain South Asian and Sub–Saharan African countries.

Although worldwide polio eradication is targeted for the end of 2000, careful surveillance will be required during subsequent years. As a result, certification of polio eradication will probably not occur until 2005.

Approximately 5,000 cases of polio were reported this year, a 90% decrease since 1989.
[BOSTON GLOBE 12/16/99; REUTERS 12/7/99]

A study published in the Proceedings of the National Academy of Sciences provides strong support that meat from cattle infected with bovine spongiform encephalopathy (BSE) are linked to cases of Cruetzfeld–Jakob Disease (CJD).

In the study, mice were inoculated with prions extracted from diseased cows. Within 250 days, all test mice developed neurological disease. During the 1990's, more than 175,000 cattle in Britain died of BSE, or mad–cow disease.

At least 48 fatalities in Britain have been attributed to the new form of CJD. The European Union recently lifted a 3–year ban imposed on imported British beef.
[AP WIRE 12/21/99]

A panel of 16 international health experts has recommended that the remaining stocks of smallpox virus be used for research, specifically, to develop a more complete sequence of smallpox DNA, to devise tests to detect smallpox infection in humans, and to develop drugs to treat human smallpox infections. The United States and Russia were among 30 states at the WHO's annual assembly to sponsor further research into antiviral agents and improved vaccines.

The virus stocks, currently held in high–security laboratories at the Centers for Disease Control and Prevention (CDC) and the Russian State Center for Research on Virology and Biotechnology (Novosibirsk, Russia), are scheduled for destruction in 2002, at the latest.
[REUTERS 12/13/99]


In early December, a girl became the first casualty of one of Texas' largest dengue outbreaks. The girl had dengue hemorrhagic fever, a variation of the fever marked by internal bleeding. Health officials believe she contracted the mosquito–borne illness during a visit to Mexico.

The Texas Health Agency has confirmed 51 cases to date.
[NANDOTIMES 12/23/99]


Avorparcin, an antibiotic used as a growth promoter in livestock, will be removed from the market worldwide amid reports about the spread of antibiotic resistance to humans. The similarity between Avoparcin and Vancomycin, an antibiotic used to treat serious illnesses in humans, is the main concern surrounding its use. Between 1994 and 1998, at least 71 cases of Vancomycin–resistant enterococcus (VRE) were reported.

Avoparcin, manufactured by Roche Vitamins, was banned in all European Union member states in 1997. Its use has never been approved in North America.
[ProMED 12/21/99; Emerging Infectious Diseases vol. 5 (3)]

Applications are currently being accepted for the International Conference on Emerging Infectious Diseases (ICEID)(July 16㪫, 2000); the closing date is January 26, 2000.

The program will include plenary sessions and symposia with invited speakers, and presentations on emerging infections. Topics will include current work on surveillance, epidemiology research, communication and training, bioterrorism, and prevention and control of emerging infectious diseases in the U.S., and internationally.

The conference is organized by the Centers for Disease Control and Prevention (CDC), Council of State and Territorial Epidemiologists, American Society for Microbiology, Association of Public Health Laboratories, World Health Organization (WHO), and National Foundation for CDC. Approximately 25,000 are expected to attend.

For more information, contact ICEID management at 202/942/9248, or ICEID@asmusa.org

The Dengue Bulletin, a joint publication of the World Health Organization Regional Offices for South–East Asia (SEARO) and the Western Pacific (WPRO), is soliciting contributions for its March/April 2000 edition. The deadline to submit articles is January 31, 2000.

Research papers must have a direct or indirect bearing on prevention and control strategies of dengue fever (DF)/dengue hemorrhagic fever (DHF). The bulletin disseminates information about the current status of DF/DHF infection in the South–East Asia and Western Pacific regions. It also provides updates about circulating DEN strains, changing epidemiological patterns, new control strategies, and clinical management. For more information, please contact: chusakp@whosea.org or mal_unit@who.org.ph
[ProMED 12/13/99]

The APEC EINet listserv was established to enhance collaboration among academicians and public health professionals in the area of emerging infections surveillance and control. Subscribers are encouraged to share their material with colleagues in the Asia–Pacific Rim. To subscribe (or unsubscribe), please contact nwc@u.washington.edu. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious.

April 21, 1999

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