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ASIA
Researchers have identified another enterovirus, Echovirus
7 (echo 7), as contributing to the most recent outbreak of Hand, foot
and mouth disease in Malaysia. Echo 7 was isolated from a fatal case
and has been associated with outbreaks involving central nervous system
disease in the past. While echo 7 is a relatively rare strain, it has
resulted in severe and fatal cases. This is the first time that echo
7 has been identified in Malaysia. Other enterovirsuses isolated during
the recent outbreak include Coxsackie A16, enterovirus 71, Coxsackie
B, and herpes simplex
.[PROMED 10/26/00]
PHILIPPINES – SCHISTOSOMIASIS
Government health officials reported alarming levels of schistosomiasis
among residents of Davao del Sur, located on Mindanao, the southernmost
of the large Philippine islands. The rise in cases has been attributed
to constant flooding and poor sanitation. Health officials plan to destroy
all breeding centers of the parasite and initiate an intensive information
campaign to promote proper sanitation.Schistosomiasis is a tropical
disease caused by the parasitic worm schistosoma. Infection occurs as
a result of contact with contaminated fresh water in which snails that
carry the schistosomes live. Fresh water becomes contaminated by Schistosoma
eggs when infected people urinate or defecate in the water.
[PROMED 10/22/00; www.cdc.gov]
AMERICAS
USA (LOUISIANA) – EIGHT AT RISK FOR CREUTZFELDT–JAKOB DISEASE
Eight patients may have been exposed to Creutzfeldt–Jakob disease
(CJD) after undergoing brain surgery that involved some of the same
instruments used on a person who was later found to have died of
CJD. Normal sterilization protocols reduce, but do not eliminate,
the risk of transmission, as the agent that causes the disease is
resistant to standard sterilization procedures. CJD leads to progressive
dementia and loss of physical functions and inevitably results in
death. The only proven way to contract the disease is through iatrogenic
transmission and an autopsy is required for a positive diagnosis.
Previous cases of CJD have been linked to specific products that
are believed to have increased the risk of transmission. For example
in 1997, the Centers for Disease Control and Prevention said that
at least 61 cases of CJD worldwide were associated with a single
brand of dura mater grafts produced by a German company since 1979.
[The Times–Picayune 10/27/00; MMWR 1997;46:1066㫝 www.cjdfoundation.org]
USA – WEST NILE VIRUS: SUMMARY AND FINDINGS
According to surveillance reports, there were 18 human cases,
including one death, of West Nile virus in the U.S. in New York,
New Jersey, and Connecticut during 2000. The death occurred among
an 82 year–old New Jersey man. The virus has been detected as far
south as North Carolina, where a dead crow was found to be infected.
Below 55 degrees Fahrenheit the virus stops spreading, but it can
resume when mosquitoes become active in the spring and when birds
carry the virus as they migrate.
A recent experiment by the U.S. Geological Survey indicates that
West Nile virus can be transmitted from bird–to–bird in a confined
laboratory setting. In the experiment, infected crows were placed
in the same biocontainment aviary as healthy crows, and nearly all
of the initially healthy birds became infected and died. While mosquito
bites are the primary means of transmission of the virus between
birds and to humans, this experiment reveals that bird–to–bird transmission
can occur.
[PROMED 10/20/00, 10/26/00; REUTERS 10/24/00]
OTHER
RUSSIA – TYPHOID FEVER
Twelve confirmed and seven suspected cases of typhoid fever have
been reported in the Tula region of Russia. This is the first time in
nearly 50 years that typhoid has been reported here. While the source
of the outbreak is not known, typhoid is typically transmitted by contaminated
food and water. Symptoms of typhoid include a sustained fever, weakness,
stomach pains, and occasionally a rash and diarrhea. Without appropriate
antibiotic treatment, typhoid can be fatal.
[PROMED 10/31/00]
ENVIRONMENTAL RISK OF VACCINE–RELATED POLIO
A team of Japanese researchers suggests that an environmental risk
of vaccine–associated paralytic poliomyelitis will persist as long as
live oral poliovirus vaccine is not replaced by inactivated vaccine.
The investigators isolated poliovirus strains from samples of sewage
and river water collected in Japan between 1993 and 1995. They found
that these strains were vaccine–derived and more virulent than the attenuated
virus used in the vaccine as a result of replication in the human gut
and subsequent excretion into the environment.
[The Lancet 2000;356:1461�]
2.UPDATES
UGANDA – EBOLA VIRUS
As of November 6, the Ugandan Ministry of Health reported a total
of 281 cases of Ebola virus, including 91 deaths. The virus has now
spread to the Mbarara district in the southwestern region of the country,
where a soldier previously based in Gulu died of the virus. This was
the first virologically confirmed case outside of Gulu, and two more
have since been reported.
[www.who.int/disease–outbreak–news]
3. NOTICES
ITREID FELLOWSHIP OPPORTUNITIES — UNIVERSITY OF
WASHINGTON
The International Training and Research in Emerging Infectious Diseases
(ITREID) fellowship program at the University of Washington is accepting
applications for fellowship positions starting in September 2001. ITREID
is an interdisciplinary program that seeks to build international research
collaborations in the area of infectious diseases. The objective of
the program is to train exceptional international students who plan
to return to their countries to build successful research programs.
The application deadline is January 1, 2001. For more information, please
visit http://depts.washington.edu/itreid/
or email itreid@u.washington.edu.
COLLABORATIVE RESEARCH GRANTS — TROPICAL DISEASES
The UNDP/World Bank/WHO Special Programme for Research and Training
in Tropical Diseases (TDR) is inviting scientists and research institutions
from least developed disease–endemic countries to submit research proposals
that focus on the following areas:
- Determinants of inequality of access to prevention, therapy, and
information
- Implications of changing economic, social, political and civil
structures for disease persistence, emergence, and resurgence
Grants with budgets normally not to exceed 25,000 US dollars
per year for a period of one to two years will be awarded. The application
deadline is March 23, 2001. Forms and information are available at www.who.int/tdr/grants/workplans/seb.htm.
FAO/WHO MICROBIOLOGICAL RISK ASSESSMENT ACTIVITIES
The FAO and WHO have prepared scientific documents to address the issues
of Salmonella spp in broilers, Salmonella enteritidis in eggs, and Listeria
monocytogenes in ready–to–eat foods. The Codex Committee on Food Hygiene
(CCFH) requested that the FAO and WHO provide scientific advice on these
three areas through expert consultation. The FAO and WHO are asking
for interested parties to contribute to this work in the field of microbiological
risk assessment by reviewing the documents and providing comments along
with any relevant data. Comments must be received by Nov. 15, 2000.
www.fao.org/waicent/faoinfo/economic/esn/pagerisk/riskpage.htm
www.who.int/fsf/mbriskassess/index.htm
www.fao.org/waicent/faoinfo/economic/esn/pagerisk/call.htm
WEB–BASED TB OPERATIONS RESEARCH COURSE
Dr. Hans Rieder of the International Union Against TB and Lung Disease
(IUATLD) has developed a web site that offers a distance learning course
in applied epidemiology for TB operations research. The course is accessible
as a series of .pdf files and includes practical exercises using Epi
Info.
www.tbrieder.org
WORLD MELIOIDOSIS CONGRESS, 2001
The next World Melioidosis Congress will be held in Perth, Australia,
September 26㪵, 2001. Infectious disease specialists, microbiologists,
epidemiologists, veterinarians, soil scientists, environmental health
workers, and civil engineers are invited to attend. Topics of discussion
will include recent developments in epidemiology, cellular and molecular
pathogenesis, diagnosis and treatment, prevention and containment, and
public health implications. For more information and to complete an
expression of interest, please visit www.e–tiology.com.
Melioidosis, also known as Whitmore's disease, is an infectious
disease caused by the bacterium Burkholderia pseudomallei. Melioidosis
is found in the tropics, particularly in Southeast Asia and Northern
Australia. Infection occurs as a result of direct contact with contaminated
soil and surface waters and can result in both acute and chronic infections,
often causing pneumonia–like symptoms with potentially fatal outcomes.
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