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Vol. III, No. 6~ EINet News Briefs ~
May 1, 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:
- Infectious disease information
from ProMED and other sources
- Updates from previous bulletins
- Notices
- How to join the EINet listserv
1. OVERVIEW OF INFECTIOUS–DISEASE
INFORMATION FROM PROMED
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.
ASIA
INDONESIA – MALARIA CARRIERS
Malaria parasites have been isolated in 42 Indonesians and 12 locals
on Penang Island. Health authorities believe the disease was imported
into the state by foreign construction workers. The cases are localized
in a district in Air Itam; the source of the outbreak has not been determined.
The state has enacted preventive measures to stop further spread of
disease. Efforts include a mass blood survey, medication for construction
workers, fogging, and heath education. Control strategies have also
been initiated in high–risk hilly areas, where malaria–causing anopheles
mosquitoes reside.
Until recently, Penang had been malaria–free for 10 years. During 1999,
a total of 25 cases were reported in the state.
[STRAITS TIMES 4/25/00&4/22/00&4/20/00; SARAWAK TRIBUNE 4/20/00]
JAPAN – MALARIA RISE
Since malaria was eliminated in Okinawa Prefecture in 1960, Japan has
been considered a "malaria–free zone". However, in recent years, the
number of malaria cases––including Falciparum malaria, a severe
form of the disease––has risen. The mounting number of imported malaria
cases has been attributed to increased travel activities.
The government, in collaboration with the World Health Organization
(WHO), has proposed that Japanese pharmaceutical companies donate 12,000
samples of potential antimalarial medicines to governmental research
institutes to measure their effectiveness and to develop drugs. A motivation
of the project surrounds the fear that global warming will shift the
malaria belt north, through the high prevalence of malaria–carrying
anopheles mosquito in the northerly latitudes.
Okinawa Prefecture is currently on red alert against the disease.
[THE DAILY YOMIURI 4/18/00]
KOREA – SPREAD OF AIDS
According to the National Institute of Health, 1,122 Koreans were diagnosed
with HIV as the end of March; between January and March, there were
59 newly diagnosed cases of the virus––a 40% increase of cases during
the same period last year.
There are currently 871 AIDS cases nationwide, 752 of
whom are males. Although the number of HIV carriers has grown by just
over 100 cases per year since 1995, government measures to track HIV
carriers, for disease control, and care of AIDS patients, are still
not adequate, due to a limited budget.
[KOREA TIMES 4/17/00]
CHINA – NEW HIV STRAIN
The Ministry of Health has confirmed at least 2 cases of HIVמ infection
in China. Both cases reported past exposure to West Africa, a region
with a high rate of HIVמ infection. Like HIVם, the HIVמ strain can
be contracted through drug injection, use of contaminated blood products,
or unprotected sexual contact; both infections present similar symptoms.
The Ministry aims to increase awareness of the HIVמ virus
this year, and to extend efforts to avoid failure to identify these
cases.
[CHINA DAILY 4/3/00]
OCEANIA
AUSTRALIA – ENCEPHALITIS OUTBREAK
A national alert has been issued after 8 cases, including 2 babies,
were diagnosed with Australian Encephalitis (AE), a potentially fatal
mosquito–borne virus. The outbreak has been attributed to above average
rainfall and flooding in central Australia, thereby leading to large–scale
breeding of mosquitoes that transmit the virus.
AE, a clinical disease spread by mosquitoes, can lead to high fevers,
severe headaches, seizures, delirium, and inflammation of the brain.
Death usually occurs in 20% of cases, and neurological problems, like
memory loss and severe brain damage, result in 30% of those who contract
AE. Infants, young children, and tourists are at high risk for disease.
According to the Communicable Diseases Network Australia New Zealand
(CDNANZ), the current outbreak of AE is the worst recorded since 1974.
[BORNEO BULLETIN 4/19/00; ProMED 4/17/00]
NEW ZEALAND – WHOOPING COUGH EPIDEMIC
One of the worst whooping cough epidemics in years is sweeping through
New Zealand. Over 800 cases were recorded between January and March;
the epidemic was first reported late last year.
To date, only 340 cases have been confirmed by labs; the disease
became a notifiable disease in 1996. [ONE NEWS 4/21/00]
AMERICAS
CANADA – HEPATITIS B OUTBREAK SOURCE
According to a study in the Canadian Medical Association, an outbreak
of hepatitis B at 6 neurology clinics in Toronto has been traced to a
technician. Virus DNA sequencing was used to confirm that the virus isolated
in the technician's blood was identical to virus found in his sickest
patients. The technician treated a total of 18,567 patients. Over 75 cases
were reported after receiving an electroencephalogram (EEG), a diagnostic
test used to detect the source in the brain for behavioral and sleep disorders.
Between 1990 and 1996, at least 1000 patients who attended the clinics
tested positive for hepatitis B, unrelated to an EEG.
The study concluded that the outbreak occurred because the technician,
who received multiple blood transfusions in the early 1970s, was unaware
of his hepatitis B status; also, the clinics had less than adequate infection
control measures.
[THE GLOBE AND MAIL 4/19/00]
USA – CITRUS JUICE RECALL
California Day Fresh Foods has voluntarily recalled their unpasteurized
citrus juices, due to potential salmonella–related contamination. The
products, with a "best if used by" date on or before May 4, were sold
under the brand names Naked Juice, Ferraro's, Von's, and Trader Joe's
The recall covers products sold in California, Arizona, Nevada, Colorado,
Washington, and Oregon.
Isolated salmonellosis cases have been reported in Southern California,
Colorado, and Nevada. However, salmonella has not been found in any of
the company's products.
[ProMED 4/20/00]
USA – SALMONELLIS OUTBREAK
Consumers have been warned not to eat Pacific Coast Sprout Farms' (Sacramento,
CA) raw mung bean sprouts purchased before April 18th because of potential
contamination with Salmonella. The bean sprouts, distributed in 12 and
16 ounce bags to restaurants and grocery stores in Northern California
and Reno areas, have been voluntarily recalled. Over 40 cases of the food–borne
illness, Salmonella Enteritidis, have been confirmed in Sacramento,
and neighboring counties, Placer, and Yolo, since March 26th. Most of
the cases have reported diarrhea and cramping; a couple of patients were
hospitalized with bloodstream infections.
The U.S. Food and Drug Administration (FDA) has issued guidelines for
the sprout industry about sprout production practices designed to reduce
the risk of bacterial contamination. Raw sprouts present food safety issues
because the conditions for growth are ideal for rapid development of bacteria;
in addition, harmful bacteria are not always eliminated through washing.
This is the first reported outbreak associated with raw mung bean sprouts.
[CALIFORNIA DEPT. OF HEALTH SERVICES NEWS RELEASE 4/19/00]
USA – E. COLI 0111:H8 OUTBREAK
The first community outbreak of Shiga toxin–producing E. coli infection
(STEC) was recorded by the Tarrant County Health Department in June 1999.
According to the Texas Department of Health (TDH), a group of teenagers
attending cheerleader camp during June 9㪣 became ill with STEC, and
presented symptoms of nausea, vomiting, severe abdominal cramps, and diarrhea.
Two cases were hospitalized, and two others received an appendectomy.
The investigation conducted by laboratories at the U.S. Centers for Disease
Control (CDC) and TDH have suggested a point–source outbreak. The original
source of contamination and the mode of transmission have not been determined.
STEC infection can cause illness in otherwise healthy persons; it is
considered the second most common non– 0157 STEC infection, after E. coli
026. Most STEC outbreaks have led to E. coli 0157 infection.
There is currently a commercial kit available to screen stool specimens
for Shiga toxin and potential STEC. States have been advised to add STEC
to their notifiable disease lists.
[MMWR vol. 49, no. 15; 4/21/2000]
OTHER
HEALTH AND ECONOMIC DEVELOPMENT
The Commission on Macroeconomics and Health (CMH) will advise the World
Health Organization (WHO) and the global community about issues concerning
health macroeconomics and development. The Commission, which was launched
in January, will recommend measures to maximize poverty reduction and
economic development of health sector investment. The group will also
address policies to stimulate the development of drugs and vaccines for
the poor, mobilization of resources, and linkages between health and the
international economy.
CMH aims to produce a series of studies on the role of health interventions
on economic growth and reduced inequity in developing countries over the
next two years. The preliminary findings will be presented at the 53rd
World Health Assembly next month.
[REUTERS MEDICAL NEWS 4/19/00]
TUBERCULOSIS THREAT ON ASIAN ECONOMIES
According to the United Nations Children's Fund, tuberculosis (TB) poses
a serious threat to Asia's sustained socioeconomic development. Asia accounts
for about 70% of TB cases worldwide. The threat of TB on development is
illustrated by the increasing number of cases between 15 and 54 years
of age, society's most economically active sector; furthermore, 40% of
HIV/AIDS cases go on to develop the disease.
Effective treatments, sufficient policies, and social partnerships between
government, business, the private sector, institutions, non–governmental
organizations, the community, and family, are necessary to battle TB.
Annually, 8 million TB cases are reported, and an estimated 2 million
die of the disease. Among women, 750,000 die of the disease each year––more
than any other infectious disease.
[AP WIRE 3/23/00]
2. UPDATES FROM PREVIOUS BULLETINS
ASIA (SOUTH KOREA) – FOOT AND MOUTH DISEASE
The National Veterinary Quarantine Service has reported another outbreak
of foot and mouth disease (FMD) on a farm in Hongsong, 60 miles south
of Seoul. To date, over 500 cows on the farm and other nearby farms have
been slaughtered. Outbreaks of the disease have been confirmed in cattle
on 15 farms since mid–March; cattle, pigs, and goats within a 6 mile radius
of infected farms have been inoculated, and almost 2000 cattle and pigs
have been slaughtered preventively.
Cattle ranchers and pig farmers have requested of the government to destroy
all livestock within a 2–mile radius of the outbreaks amid fears that
the government's offer to release meat bought on export markets will cause
domestic meat prices to fall. According to the Agricultural Ministry,
it is unlikely that tens of thousands of healthy cattle and pigs will
be slaughtered, due to the potential of other FMD outbreaks. So far, over
2000 animals at or near FMD outbreaks have been destroyed.
The disease scare has suspended the potential $400 million pork export
industry.
[ProMED 4/20/00; NY TIMES 4/16/00]
USA – ANTIBIOTIC APPROVED
The U.S. Food and Drug Administration (FDA) has approved Zyvox (Pharmacia
Corp.), the first new treatment for methicillin–resistant staphylococcus
in 40 years. A drug in a new class of antibiotics, Zyvox is unique because
it stops bacteria from multiplying by interrupting the production of proteins
vital to growth early in the life cycle; other antibiotics, like recently
approved Synercid (Aventis SA), stop germ spread later in process.
Zyvox will be marketed for treatment, in both intravenous and oral forms,
for pneumonia, skin infections, and resistant superbugs.
[REUTERS MEDICAL NEWS 4/19/00]
USA – WEST NILE VIRUS
Health officials at the U.S. Centers for Disease Control (CDC) believe
that the West Nile Virus (WNV) strain that struck the New York area last
summer is related to a virus that has been prevalent in Israel since 1997.
Control measures and monitoring efforts have been initiated to reduce
the threat of another outbreak situation. Nine fatalities and 54 illnesses
were reported from the virus last year; between 5,000㪢,000 crows died.
There is speculation that the migratory patterns of birds will cause
the virus to spread to states along the Atlantic and Gulf coasts.
[ProMED 4/26/00]
USA (NEW YORK) – MOSQUITO CONTROL
The city intends to prevent another outbreak of West Nile Virus (WNV)
through routine testing for the virus in mosquito and sentinel chickens,
the release of larvicide into the city's storm drains, and the use of
larvae–eating "mosquito fish" in the city's waste water treatment plans.
A public education campaign has also been made available in pamphlet form
in 11 languages.
The use of malathion, the pesticide sprayed during the outbreak last
year, will not be considered until the Environmental Protection Agency
(EPA) completes its review (of the pesticide) later this summer. Despite
assurance of its safety, malathion was blamed for rashes, flare ups, and
respiratory illnesses.
According to city officials, pesticides will only be applied as a last
resort.
[ABC NEWS 4/14/00]
3. NOTICES
INTERNATIONAL CONFERENCE ON EMERGING INFECTIOUS DISEASES (ICEID)
ICEID 2000––a meeting of plenary sessions, symposia, and presentations
on emerging infection activities––will take place during July 16㪫, 2000
(Atlanta, GA, USA). Topics will encompass surveillance, epidemiology,
research, communication training, bioterrorism, and emerging infectious
disease control. Other activities planned include a coincident coordinating
meeting for the new APEC Initiative on Emerging Infections (details will
follow shortly).
Abstracts may be submitted on–line until June 9 at the American Society
for Microbiology web site (www.asm.org).
ICEID 2000 is organized by the U.S. Centers for Disease Control (CDC),
Council of State and Territorial Epidemiologists, American Society of
Microbiology (ASM), Association of Public Health Laboratories, World Health
Organization (WHO), and the National Foundation for CDC.
For more information, please call ICEID Management at 202/942�, or
e–mail ICEID@asmusa.org
[www.cdc.gov/ncidod/iceid/index.htm]
4. JOIN THE E–LIST AND RECEIVE EINet NEWS BRIEFS
REGULARLY
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surveillance and control. Subscribers are encouraged to share their material
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please contact nwc@u.washington.edu.
Further information about the APEC Emerging Infections Network is available
at http://www.apec.org/infectious.
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