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Vol. III, No. 7~ EINet News Briefs ~
May 23, 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
POTENTIAL AIDS CRISIS
According to the National Intelligence Council, infectious disease–related
deaths may increase substantially in Asia and the Pacific, as HIV/AIDS
continues to spread throughout southeast Asia. It has been speculated
that the number of HIV–related deaths in this region could surpass Africa's
within the next 10 years.
Contributing factors to the potential AIDS crisis include
the dependence on traditional medicine, the vulnerability of the private
health care system, and the economic situation in Asia.
[AP WIRE 5/3/00]
REEMERGING DISEASES THREAT
Asian health ministers have pledged to collaborate in the battle against
reemerging infectious diseases like tuberculosis and malaria, as well
as AIDS. Non–governmental groups estimate that AIDS cases could reach
as high as 150,000, as prostitution and intravenous drug use continue
to rise. In Thailand, one people are HIV positive; this is the highest
level of HIV infection recorded in the region. The potential of other
disease outbreaks is also strong, due to increased international travel
and the ensuing flow of migrants.
Health ministers aim to address rapid contingency plans
for disease outbreaks, support for comprehensive disease surveillance,
and an accurate monitoring system. Many Asian countries currently participate
in a cross–border agreement to alert neighboring countries about malaria
outbreaks.
[STRAITS TIME 5/1/00]
OCEANIA
AUSTRALIA–LEGIONNAIRES' DISEASE TRACED TO AQUARIUM
The Public Health Division of the Government of Victoria has recorded
91 cases of legionnaires' disease, including 19 hospitalizations and
2 fatalities. The outbreak has been traced to the Melbourne Aquarium,
visited by a majority of the cases between April 11㪱, 2000. Laboratory
tests confirmed the presence of Legionella bacteria in the cooling
towers of the Aquarium.
This is the largest outbreak of legionellosis in Australia since
1987, during which time 10 fatalities were reported.
[XINHUA NEWS AGENCY 5/12/00; WHO/EMC DISEASE OUTBREAKS 5/4/00]
AUSTRALIA–CREUTZFELDT–JAKOB DISEASE
Ten patients were exposed to Cruetzfeldt–Jakob Disease (CJD) during
April 1㪴, 2000 after inadequate sterilization of tools used during
neurosurgery. A dementia patient who may be infected with CJD has
since been treated at Royal Melbourne Hospital (RMH).
CJD is an incurable disease; it is believed to be caused by abnormal
infectious proteins called prions, which are highly resistant to destruction
by usual heating methods. CJD cannot be diagnosed until symptoms are
exhibited.
[NEWS.COM.AU 5/5/00]
NEW ZEALAND–STAPHYLOCOCCUS AUREUS
The number of methicillin–resistant Staphylococcus aureus (MRSA) cases
recorded at Capital Coast Health has increased 50% in the past few
months. Over 100 cases have been reported since June 1999. Four wards
in Wellington Hospital––each with a reported increase of cases––have
been isolated to prevent further spread of the infection. Patients
and relatives have been instructed to wear gloves for any formal patient
contact.
MRSA resists almost all antibiotics. Infection can be life threatening
to immunocompromised patients.
[ONE NEWS 5/15/00]
AMERICAS
USA (CHICAGO)–EOSINOPHILIC MENINGITIS
Five cases of eosinophilic meningitis were reported earlier this month,
after vacationing in Jamaica over spring break. Of the 22 who took the
trip, 7 complained of unremitting headaches, stiff necks, and alternating
numbness and tingling sensations in their limbs within a week upon their
return. The disease was probably contracted from a food–borne parasitic
worm called the rat lungworm, a native of Southeast Asia, but spreading
globally.
A non–contagious form of meningitis, eosinophilic meningitis is transmitted
through the ingestion of raw or insufficiently cooked snails, slugs, or
land planarians–intermediate or transport hosts harboring infective larvae.
Symptoms usually include severe headaches, neck and back stiffness, and
paresthesias. Illness can last between a few days to several months.
[INTERNET TRIBUNE 5/4/00]
USA–IMMIGRATION POLICIES TO ELIMINATE TUBERCULOSIS
According to the Institute of Medicine (IOM), 40% of new tuberculosis
(TB) cases in the U.S. are imported from countries like Asia and Africa,
where over half the population is infected. In an effort to eliminate
TB, the IOM committee on the Elimination of Tuberculosis in the United
States has urged the government to modify immigration policies and increase
funding for TB research. A report issued by the Committee recommends that
changes to the current U.S. immigration policy are tailored to strengthening
the identification of TB cases and treatment of active cases, and improving
screening for latent infections among high–risk groups. Specifically,
immigrants from high–prevalence countries should be required to receive
a tuberculin skin test prior to entry into the country, and documents
granting permanent residency should be withheld until immigrants receive
the necessary screening or treatment upon arrival.
The Committee also called upon the U.S. to increase financial and technical
support to nations where the incidence of the disease is high, to help
bolster research activities, as well as to identify and treat latent infections.
Currently, the National Institute of Health (NIH) and the U.S. Centers
for Disease Control and Prevention (CDC) contribute $60 to $80 million
dollars to TB research.
[REUTERS MEDICAL NEWS 5/5/00]
OTHER
'HUMAN' INFLUENZA B IN SEALS
According to a study published in Science, seals may be the natural reservoir
for influenza B, a virus strain that was once thought to be unique to
humans. The virus, which was first discovered in an 8–month old harbor
seal last spring, closely resembled the strain that circulated among humans
about 5 years ago. The strain had also remained stable since 1995; this
was a significant finding in particular, because influenza strains that
circulate among humans mutate and undergo antigenic drift.
Blood samples of 971 seals from the Netherlands' Seal Rehabilitation
and Research Centre revealed that 2% of the seals that arrived at the
Institute after 1995 had influenza B antibodies, compared to none who
arrived prior to then. It is believed that the seals were infected with
the strain during an outbreak five years ago, and that the virus has since
spread among themselves.
[GLOBE AND MAIL 5/13/00]
SOUTHERN RUSSIA–HEMORRHAGIC FEVER
An outbreak of hemorrhagic fever has surfaced in Stavropol. To date, 10
people have fallen ill, and 2 women have died. Stavropol health officials
believe the outbreak of the fever–which is spread by ticks–is a result
of the unusually warm weather, thereby leading to an increased rate of
ticks multiplying.
According to the ITAR–Tass news agency, there were 3 fatalities from
the disease recorded in Stavropol last year; and no cases had reported
previous to then. Tick control efforts are currently underway.
[ITAR–TASS NEWS AGENCY 5/12/00]
2. UPDATES FROM PREVIOUS BULLETINS
JAPAN–FOOT AND MOUTH DISEASE
There is fear that foot and mouth disease (FMD) has spread to one of Japan's
main cattle regions, after two new suspected cases of FMD were reported
on the northern island of Hokkaido last week. To date, 705 cows at a farm
in Hokkaido have been destroyed. The suspected outbreak was reported shortly
after two prefectures on the southern island of Kyushu declared elimination
of the disease, following an outbreak in March.
There is speculation that the disease may have surfaced in Japan through
straw or hay imported from Taiwan, China, or South or North Korea.
[STRAITS TIME 5/13/00; ProMED 5/13/00]
ROTASHIELD INCREASES RISK OF INTUSSUSCEPTION IN INFANTS
The U.S. Centers for Disease Control and Prevention (CDC) has confirmed
an increased risk of intussusception among infants who receive the rotavirus
vaccine, Rotashield (Wyeth–Ayerst). The conclusion supported the CDC's
recommendation to withdraw Rotashield earlier this year, after 15 infants
developed intussusception upon vaccination. It is believed that the total
number of cases was underreported.
The mortality rate from intussusception is less than 0.5% in the U.S.;
however, in developing countries, the rate is as high as 20%. The need
for a rotavirus vaccine in less developed countries is substantial, particularly,
because medical care is not adequate.
[REUTERS MEDICAL NEWS 5/12/00]
3. NOTICES
NEW LINK ON APEC EINet
"Reports From the Rim" is a newly established link that will
be comprised of reports about infectious diseases in the Pacific Rim.
Submissions by APEC EINet members are strongly encouraged. For more information,
please contact nwc@u.washington.edu.
The Enterovirus Epidemic of Taiwan, 1998�, a report by Dr. Ping–Ing
Lee, MD, PhD (Department of Pediatrics, National Taiwan University Hospital),
can now be accessed through this link.
ASIA–PACIFIC CONGRESS OF MEDICAL VIROLOGY
The 5th Asia–Pacific Congress of Medical Virology will be held in Denpasar–Bali,
Indonesia during June 26㪴, 2000. To register for the Congress, please
contact Dr. Amin at amin0207@rad.net.id
or apcmv@rad.net.id ; a paper must
also be submitted for the Late Breaker's Session.
AIDS DISCUSSION GROUP IN HONG KONG
An e–mail group has been established to discuss issues concerning the
AIDS campaign in Hong Kong, information about the community planning process,
and other relevant news. Organizations and individuals are also welcome
to post information to the e–mail group. To subscribe, please contact
iAIDS@hongkong.com, or visit http://come.to/cppforum/
4. JOIN THE E–LIST AND RECEIVE EINet NEWS BRIEFS
REGULARLY
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.
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