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Vol. III, No. 8 ~ EINet News Briefs ~ June 9, 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


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

NIPAH VIRUS IDENTIFIED AS A NEW GENUS OF VIRUSES
Researchers at the U.S. Centers for Disease Control (CDC), the University of Malaya Medical Center (Kuala Lumpar, Malaysia), and Australia's Commonwealth Scientific and Industrial Research Organization have identified the Nipah virus as a new viral species capable of infecting animals and humans.

Genetic analysis confirmed a close relationship between the Nipah virus and a virus called the Hendra virus. Tests revealed a strong reaction between the Nipah virus and antiserum for the Hendra virus.

The Nipah virus led to over 100 fatalities in outbreaks in Malaysia and Singapore during 1998 and 1999. The virus may cause severe encephalitis and ultimately, death.
[REUTERS HEALTH 5/26/00; AP WIRE 5/25/00]

SINGAPORE – HIV–INFECTED SPOUSES
Singapore will relax its stance on a law ordering HIV–infected foreign spouses to leave the country by allowing almost a dozen repatriated HIV–infected spouses to return; appeals of similar cases will also be considered. The decision followed media reports about HIV–infected foreigners married to Singaporeans facing expulsion or non–renewal of their visas, and the subsequent calls on government to allow the families to remain together.

Since April 1999, 12 spouses (11 women and 1 man) from Thailand, Indonesia, China, and the Phillipines have been repatriated.
[REUTERS HEALTH 5/31/00; BBC NEWS 5/29/00]


AMERICAS


USA – HEPATITIS C: THE SILENT EPIDEMIC
Almost 4 million people nationwide are infected with Hepatitis C virus; however, only 30% of all existing cases have been diagnosed. Experts believe that Hepatitis C infection has reached epidemic proportions because of a lack of testing years ago when most patients were probably infected, and more effective testing today.

About 80 to 85% of people who come into contact with Hepatitis C become long–term carriers of the virus. Within 10 to 30 years of infection, the virus can grow and replicate in the body, thereby leading to liver inflammation, fibrosis or liver scarring, cirrhosis and liver cancer. Early detection and treatment are considered the best measures to remain complication–free.

Hepatitis C can be transmitted through blood products or other bodily fluids. Approximately 35,000 to 185,000 are infected annually.
[MSNBC 5/23/00]

USA – POSSIBLE E.COLI CONTAMINATION
Kraft Foods has voluntarily recalled 11,000 cases of Breakstone's and Light 'n' Lively cottage cheese after E. coli 0157 was discovered in several product samples. The recalled cottage cheese products were made on the same production line as the contaminated samples.

Containers affected by the recall are stamped with the code "06 JUN 00 W". The products include: 16–oz and 24–oz containers of Breakstone's Free small–curd fat–free cottage cheese, 16–oz and 24–oz containers of Breakstone's 4% milk fat minimum Smooth & Creamy cottage cheese, 24–oz containers of Light 'n' Lively Free fat–free and Light 'n' Lively 1% reduced–fat cottage cheese with calcium.
[REUTERS HEALTH 6/5/00]

CANADA (ONTARIO) – STUDY WARNS ABOUT RISK OF E.COLI INFECTION
A study conducted by Health Canada in 1995 identified neighboring counties in southwestern Ontario, including Walkerton, as 'hot spots' for E. coli infection. Among 3000 cases of E. coli reported in the province between 1990 and 1995, a majority occurred in rural areas between May and July.

A strong and persistent association between E. coli infection and cattle density was discovered, providing support to other studies that identified cattle manure as a chronic source of E. coli contamination of food and water in the United States, Scotland., Argentina, and Canada.
[GLOBE AND MAIL 5/31/00]


OTHER

WARNING ABOUT ANTIBIOTIC TREATMENT FOR E.COLI
A study conducted at the Children's Hospital and Regional Medical Center in Seattle (U.S.A.) has presented strong evidence for an association between antibiotic treatment for E. coli infection and E.coli–related complications.

Among 71 cases (<10 years of age) with diarrhea caused by bacterial infection between 1997 and 1999, 56% (n=9) developed hemolytic uremic syndrome (HUS) after antibiotic treatment, compared to .08% (n=62) who did not receive the medicines.

HUS, a rare complication in children, usually destroys red blood cells and causes kidney failure. According to the U.S. Centers for Disease Control and Prevention (CDC), HUS occurs in 2ף% of E. coli 0157:H7 cases.
[NEW ENGLAND JOURNAL OF MEDICINE, PRE–PUBLICATION RELEASE 5/23/00;
NOTE: FINAL VERSION TO BE PUBLISHED 6/29/00]

WATER BORNE DISEASES REEMERGING ON CRUISE SHIPS
Three recent outbreaks that led to over 1300 cases of gasteroenteritis (collectively) on cruise ships have been linked to E.coli infection. Health officials believe that E.coli contaminated water was taken aboard the ship in foreign ports. The outbreaks were associated with consumption of iced beverages; unbottled water was an additional cause of 2 outbreaks. It is suspected that the water treatment systems failed briefly on at least two of the ships.

In addition to standards set by the U.S. Centers for Disease Control and Prevention (CDC) for treatment of drinking water on cruise ships that dock in U.S. ports, improved water–handling practices on cruise ships and careful monitoring of water quality have been advised.
[REUTERS HEALTH 6/5/00; J INFECT DIS 2000; 181:1491�]

RUSSIA (MOSCOW) – MALARIA
Public Health and epidemic monitoring authorities are concerned about a mass outbreak of malaria in Moscow. Since the beginning of the year, over 14 cases have been treated in isolation hospitals. It is feared that the situation may worsen if the municipal disinfecting station does not effectively treat stagnant ponds where larvae of malaria mosquitoes (anopheles) have been found.

In 1999, anopheles mosquitoes were exterminated manually by scattering bacterial insecticides on all the local areas of water. To date, funding for mosquito control has not been provided this year.
[BBC MONITORING 5/23/00]


2. UPDATES FROM PREVIOUS BULLETINS

RUSSIA – HEMORRHAGIC FEVER
Since April, the number of suspected cases of Congo–Crimean Hemorrhagic fever (CCHF) virus has increased three–fold to 22 in the Stavropol region. Fever cases reported in May have been registered in 9 additional districts.

Patient medical examinations have confirmed ticks as the primary source of infection; ticks have become increasingly active lately, due to current weather conditions in the Stavropol region.
[ITAR–TASS NEWS AGENCY 5/23/00]

USA – ADDITIONAL FUNDING TO PREVENT WEST NILE VIRUS
The Clinton administration will provide an additional $5 million for states and local communities to expand surveillance activities for West Nile Virus (WNV). The funding will be used to enhance the capacity of state and local health departments to detect WNV activity, meet increasing requests for technical assistance and training from state and local health departments, and expand the capacity to perform reference lab work and conduct data analyses.

Earlier this year, $2.7 million was granted for prevention efforts in New York City, the District of Columbia, and 17 states along the Atlantic and Gulf coasts that were affected by last year's outbreak, or are at higher risk for WNV spread this year due to bird migratory patterns.
[www.hhs.gov; www.cdc.gov]


3. NOTICES

WORLD FEDERATION OF PUBLIC HEALTH ASSOCIATION'S 9TH INTERNATIONAL CONGRESS (BEIJING, CHINA)
"Challenges for Public Health at the Dawn of the 21st Century (September 2ע, 2000) will include a range of speakers, plenaries, symposia, workshops, and poster sessions on many important global health issues. Topics will range from the role of public and private sectors and the environment, the economy, and high tech communications. Among the speakers invited are Pan American Health Organization (PAHO) Director, Dr. George Alleyne; International Red Cross President, Dr. Kollenberger; U.S. Surgeon General Dr. David Satcher; and former United States president Jimmy Carter.

Further information and registration for the Congress is available at www.apha.org/wfpha, or contact Brooke Lundquist, program planning assistant, at brooke.lundquist@apha.org
[www.apha.org/wfpha]

HEALTH INTERNETWORK
The WebMD Foundation, in collaboration with the United Nations and the World Health Organization (WHO), has proposed the development of an international internet infrastructure to address global health issues. The specific objectives of the Health Internetwork are to disseminate health and medical information to developing countries, and to facilitate the flow of surveillance and health data.

The network will enhance public health and improve population health status and outcomes in developing countries through routine and sustainable access to state–of–the–art medical and health care information.
[ProMED 6/4/00]


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.

Revised:
April 21, 1999

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