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Vol. III, No. 15 ~ EINet News Briefs ~ November
21, 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
- Updates from previous bulletins
- Notices
- How to join the EINet listserv
1. OVERVIEW OF INFECTIOUS–DISEASE INFORMATION
Below is a bi–monthly summary of Asia–Pacific emerging infectious diseases.
ASIA
MALAYSIA – DENGUE OUTBREAK
The number of dengue cases in the state of Johor has increased overall
by 56 percent this year, with some districts reporting increases as
high as 533 and 85 percent. This rise in incident cases has been accompanied
by an increase in the mortality rate, which is up 36 percent over last
year. The majority of cases, 85 percent, have occurred in urban areas,
such as the city center in Johor Baru where construction sites have
created breeding grounds for mosquitoes. Blood tests conducted by the
WHO Collaborating Centre for Dengue/DHF revealed the presence of the
type 3 strain, which has been associated with increased virulence and
mortality relative to the Dengue viruses types 1 and 2. The presence
of the type 3 strain suggests that enhanced vector control programs
may be necessary to prevent a potentially severe Dengue virus type 3
season in Malaysia during 2001.
[PROMED 11/7/00, 11/15/00]
CHINA – STDS ON THE RISE
Health officials in China report that increased measures are needed
to control the growing problem of sexually transmitted diseases (STDs).
According to official statistics, the number of cases has increased
approximately 40% this year, and current services to prevent and treat
these infections are inadequate. Illegal roving clinics that provide
poor and questionable services while overcharging patients are still
common. Plans to address these problems include the establishment of
the State Diseases Control Centre under the Ministry of Health to oversee
the management of STDs, increased monitoring of clinics to ensure that
practitioners are qualified to treat STDs, and the elimination of illegal
clinics.
[CHINA DAILY 11/6/00]
VIETNAM – HIV/AIDS SURVEILLANCE AND PREVENTION Vietnam’s
Ministry of Public Health organized a meeting among experts from the
Association of Southeast Asian Nations (ASEAN) to discuss the development
of surveillance measures for HIV/AIDS and their importance in guiding
intervention efforts within member countries. For Vietnam in particular,
the number of reported HIV infections is up 9,203 from last year, and
it is estimated that 140,000 to 165,000 people will be infected by the
end of this year. While Vietnam has shown some success in slowing the
spread of HIV, increased drug use and prostitution are contributing
to its spread. The Vietnam AIDS Committee initiated a month–long information
campaign on the prevention of HIV/AIDS on November 15. The campaign
is targeting men, as they are estimated to account for 80 to 89 percent
of all people infected with HIV in Vietnam.
[VIETNAM NEWS 11/9/00; REUTERS 11/9/00]
AMERICAS
USA (PA) – E. COLI OUTBREAK AT PETTING ZOO
At least 12 children were infected with E. coli in Pennsylvania, presumably
as a result of contact with infected farm animals at a petting zoo.
Eight children were hospitalized, and six developed hemolytic uremic
syndrome, a condition that can lead to kidney damage. State and federal
health inspectors are in the process of examining the water supply and
analyzing fecal samples from the zoo animals in order to identify the
source of the infection. Outbreaks of E. coli have occurred previously
at petting zoos, most recently in Washington state in the spring and
also in Ontario, Canada in 1999. As a result of the outbreak, officials
at the Philadelphia Zoo plan to enhance sanitary measures where children
come into contact with animals.
[THE PHILADELPHIA INQUIRER 11/6/00]
OCEANIA
AUSTRALIA (NSW) – DEATH OF BABY IN PERTUSSIS EPIDEMIC
Health officials in New South Wales reported the first fatal case of pertussis
(whooping cough) in an infant since the outbreak began in mid�. As
of the end of October, 2553 cases had been reported, compared to 1414
during 1999. Pertussis is a highly contagious disease caused by infection
with the bacteria Bordetella pertussis. It is characterized by inflammation
of the respiratory tract and severe attacks of coughing. While a vaccine
exists to prevent the infection in children, it does not provide sufficient
protection for infants until they receive the third shot at six months
of age. The vaccine is not given to children over eight years of age due
to possible side effects, and the protection of the vaccine diminishes
within five to ten years. As a result, outbreaks of pertussis continue
in spite of high vaccine coverage.
[ABC NEWS 11/1/00; PROMED 11/5/00]
2.UPDATES
UGANDA – EBOLA VIRUS
As of November 17, 2000, the WHO reported a total of 329 cases (7 not
laboratory confirmed) and 107 deaths of Ebola virus in the Gulu district.
Four new cases (one confirmed, three suspected), all of whom died, were
reported in the Masindi district just south of Gulu. These cases are believed
to have occurred when a woman who was hospitalized in Gulu returned to
her home in the Masindi district, where she presumably spread the virus
to her husband, daughter, and grandchild. The number of new cases has
dropped substantially, and control measures have helped limit the spread
of the disease outside of the Gulu district. Updated reports are available
at http://www.who.int/disease–outbreak–news/
DATA ON ENTEROVIRUS EPIDEMIC IN TAIWAN
Dr. Hung–Wei Kuo from the Centers for Disease Control in Taiwan has provided
updated data on the enterovirus epidemic that occurred between June 1998
and October 2000. This can be viewed at http://www.apec.org/infectious/surveillance/EV71data.htm.
3. NOTICES
PROGRESS IN POLIO ERADICATION
On October 29, 2000, international health experts certified the WHO Western
Pacific Region as polio–free. The Commission on Poliomyelitis Eradication
confirmed that vigorous surveillance efforts in the region did not detect
any new cases of indigenous polio in the last three years. This region
is now the second in the world to be certified as polio–free, following
the WHO Region of the Americas in 1994. The Western Pacific Region will
continue to perform certification–standard surveillance procedures and
work towards accomplishing secure containment of laboratory stocks of
the wild poliovirus.
The Global Polio Eradication initiative, established in 1988, is a global
effort led by WHO, Rotary International, UNICEF, and the Centers for Disease
Control to certify the world polio–free by 2005. Since its beginning in
1988, the number of polio cases has decreased by 95 percent. Polio transmission
is likely to continue in areas such as Central and West Africa and parts
of Asia. On November 20, the UN launched a house–to–house polio vaccination
campaign in Central and West Africa, with hopes of immunizing 70 million
children in 19 countries. It is estimated that about 10 percent more children
will be vaccinated this year than in previous years as a result of a more
comprehensive approach that includes reaching nomadic settlements and
refugee camps.
[WHO PRESS RELEASE 10/29/00; ASSOCIATED PRESS 11/16/00]
WHO WESTERN PACIFIC REGION– HIV/AIDS–RELATED PUBLICATIONS
The WHO Regional Office for the Western Pacific has released several publications
on its website that contribute to the field of HIV/AIDS:
WORLD BANK REPORT – CONFRONTING AIDS IN THAILAND
The World Bank issued a report, “Thailand’s Response to AIDS: Building
on Success, Confronting the Future” to discuss how Thailand can respond
to its evolving AIDS epidemic. The report notes Thailand’s success in
slowing the spread of HIV, particularly among commercial sex workers,
while also underscoring the need for additional efforts that reach out
to different groups in society. New infections are increasing among women
and children, and the prevalence of HIV among injection drug users is
also on the rise. The top three recommended objectives for the government
include the following: 1. Sustaining and expanding condom use beyond commercial
sex; 2. Developing a new initiative to prevent transmission by injecting
drug use; and 3. Ensuring access for people with HIV/AIDS to cost–effective
prevention and treatment of opportunistic infections. The report is available
on the web at http://www.worldbank.or.th/social/index.html.
UPDATED DISTANCE LEARNING WEBSITE ON EMERGING INFECTIONS OF INTERNATIONAL
PUBLIC HEALTH IMPORTANCE
An updated version of the distance learning materials on Emerging Infections
of International Public Health Importance will be available at http://cer.hs.washington.edu/em_inf/
on December 1, 2000. The information on this site is drawn from a course
at the University of Washington. The materials provided will include recent
lectures and audiovisual materials by international experts, and are being
made available by the APEC EINET project. We welcome any comments you
may have, and an evaluation form is provided on the website. This distance
learning course can also be accessed from our homepage.
KISSING MAY SPREAD HERPES VIRUS 8
Research conducted at the University of Washington by Dr. John Pauk and
others suggests that the herpes virus 8, a virus that can cause a skin
cancer called Kaposi’s sarcoma, can spread through kissing. Tests of gay
men infected with herpes virus 8 revealed that the virus was more commonly
present in saliva samples and in greater concentrations than in anal and
genital samples. While infected individuals with healthy immune systems
often do not develop Kaposi’s sarcoma, those with weakened defense mechanisms
are more likely to acquire the disease. About 30 to 50 percent of people
infected with HIV and the herpes 8 virus will eventually develop Kaposi’s
sarcoma. While these findings have important public health implications,
further research is needed before exact prevention messages can be established.
[ASSOCIATED PRESS 11/8/00]
ISID HIV/AIDS FELLOWSHIP PROGRAM
The International Society for Infectious Diseases (ISID) has announced
the HIV/AIDS International Fellowship Programs for the spring of 2001.
This program aims to acquaint both community– and academic–based infectious
disease specialists from around the world with state–of–the–art epidemiological,
clinical, therapeutic, and public health issues relevant to the field
of HIV/AIDS. Participants will spend 2ן weeks at one of four training
sites in the U.S. Selection will be based on geographic considerations
and how the applicant plans to care for people with HIV disease in his
or her community. A stipend will be provided to those accepted into the
program. Applications must be submitted by December 1, 2000. For further
information on how to apply, please visit the ISID website at http://www.isid.org/programs/hiv.html
or email Melanie Carrow.
POSSIBLE MAD COW DISEASE LINK WITH AUSTRALIAN VACCINES
Recent findings revealed that Australian polio vaccines are produced using
British calf serum. While this suggests a theoretical risk of infection
with variant Creutzfeldt Jakob Disease (vCJD, the human form of mad cow
disease), Australia’s Chief Medical Officer contends that the risk is
minute and that use of the vaccine will continue. Although calf serum
is used in the early stages of viral growth, the bovine matter is essentially
washed away during the manufacturing process. The Chief Medical Officer
also cited that the overwhelming benefits of immunizing children outweighed
the theoretical and remote risk of transmitting vCJD.
[THE SYDNEY MORNING HERALD 11/2/00]
GUIDE TO FACILITATING SUSTAINABLE BEHAVIOR CHANGE
The United Nations Development Programme, in collaboration with the Macfarlane
Burnet Centre for Medical Research and the Sydney Myer Fund, published
a guide that discusses important issues relevant to the design of programs
that promote behavior change. The guidebook reviews theories from various
disciplines and provides context–relevant program and evaluation components.
For those interested in obtaining a copy of this guide, please email Benjamin
Brown or Angeline Ackermans.
4. JOIN THE E–LIST AND RECEIVE EINet NEWS
BRIEFS REGULARLY
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academicians and public health professionals in the area of emerging infections
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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