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Vol. IV, No. 04 ~ EINet News Briefs ~ February 27,
2001
****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
- Notices
- Journal Articles
- 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
SOUTH KOREA – MEASLES OUTBREAK
As of February 9, the World Health Organization (WHO) reported a total
of 39,537 cases of measles nationwide from March 2000 through January
2001, including six deaths. The outbreak initially begin in the eastern
part of the country. The number of incident cases decreased in January,
with 7449, compared to 14,797 cases in December 2000. Children who received
their first vaccine at the age of 12㪧 months but were not vaccinated
a second time between four and six years of age are considered to be
the most vulnerable to infection. In response to the outbreak, the Ministry
of Health and Welfare announced a five–year plan to eradicate measles
that involves the vaccination of about 4.5ע.5 million children and
adolescents between the ages of 8 and 17 who did not receive their second
vaccination.
[WHO http://www.who.int/disease–outbreak–news/;
CHOSUN DAILY NEWS 1/17/01, http://www.chosun.com/english]
AMERICAS
USA (WA) – MEASLES OUTBREAK
A measles outbreak in Seattle and King County, Washington, has resulted
in 11 confirmed cases since January. Four of the cases occurred in
adults in their thirties, and the other seven were in children and
adolescents between the ages of 14 months and 17 years. The cases
have not all been epidemiologically linked, although one had recently
visited South Korea. In Washington State, about 98 percent of school–age
children have been fully vaccinated, but the vaccination rate among
adults is unknown. While a measles immunization is required before
children can enroll in school, exceptions may be granted on the basis
of medical or religious reasons. Health officials are urging individuals
between 30 and 40 years of age to get vaccinated if they are not certain
that they were vaccinated after 1967, as the most effective vaccine
became available in 1968.
[SEATTLE TIMES 2/20/01]
BOLIVIA – DISEASE THREATS FROM FLOODING
Recent floods that spread throughout nine provinces in Bolivia, affecting
about 220,000 people and causing at least 28 deaths, have also led
to an increase in infectious diseases. While there have not been any
reported cases of cholera, the number of incident cases of acute respiratory
infections and gastrointestinal infections have increased about twelve
and ten percent, respectively, compared to last year. Officials are
promoting a safe–water campaign to ensure clean drinking water for
individuals in the affected areas. Flood victims are also at increased
risk of malaria and dengue fever as the heavy rains have created favorable
conditions for the types of mosquitoes responsible for transmitting
these infections. About 1200 new cases of malaria have been reported,
primarily in the northern part of the country, and at least four cases
of dengue fever have been confirmed. As a result of the heavy flooding
and elevated health risks, the government has declared a nationwide
health emergency.
[PROMED 2/12/01]
CHILE – HANTAVIRUS CONCERN
The number of confirmed cases of hantavirus pulmonary syndrome in
Chile for the year 2001 has reached ten, five of which were fatal.
While this is slightly above that confirmed last year at this time,
the Ministry of Health stated that the number of cases of is within
the expected range. The case fatality rate of 50 percent is also consistent
with prior observations of the disease. The hantavirus likely responsible
for these cases, the Andes virus, is spread by the long–tailed pigmy
rice rat, Oligoryzomys longicaudatus. As this species resides
primarily in rural environments, it is unlikely that the infections
occurred in urban areas.
[PROMED 2/21/01]
OTHER
RUSSIA – HEPATITIS A OUTBREAK
Contaminated drinking water is believed to be the cause of a hepatitis
A outbreak in the city of Serpukhov that affected at least 173 individuals
between December 29 and January 22, 2001. The same water supply
serves the city of Protvino, where 55 cases of hepatitis A were
reported between December 25 and January 21, 2001. Subsequent to
the outbreaks, the plumbing and sewer systems were renovated, and
authorities plan to install six germicide plants at the artesian
wells. Health officials from the State Sanitary and Epidemiology
Centers in Serpukhov are conducting epidemiologic investigations.
[PROMED 2/14/01]
2. UPDATES
SOUTH AFRICA – EDUCATIONAL PLAY ABOUT CHOLERA
Health officials in KwaZulu–Natal province have developed a road show
to try to increase the public’s awareness and education about cholera.
The show is scheduled to run through March 17, and is intended to educate
individuals about the waterborne disease, and how to prevent and treat
it. According to the director of environmental health for the province,
the play represents the department’s efforts to diversify their strategies
in order to reach out to more people. The WHO reports that as of February
14, 48,647 cases of cholera were reported, including 108 deaths. [ASSOCIATED
PRESS 2/9/01; http://www.who.int/disease–outbreak–news/]
3. NOTICES
20TH ISTWG MEETING – VIETNAM
This is a reminder that the 20th meeting of the APEC Industrial Science
and Technology Working Group (ISTWG) is scheduled for April 23rd–27th
in Hanoi, Vietnam. The side meeting on health will be held on April 24th.
Enhancement of the APEC–EINet will be among the issues to be discussed
at the health side meeting.
DISTANCE LEARNING TOOLS
We always want to remind everyone about the updated distance learning
materials on emerging infections that are available at http://www.hscer.washington.edu/em_inf/index.html.
The information on this website is drawn from a course taught at the University
of Washington, and includes lectures and audiovisual materials produced
by international experts.
WHO REPORT – EBOLA HEMORRHAGIC FEVER IN UGANDA
The WHO has published a report entitled “Outbreak of Ebola hemorrhagic
fever, Uganda, August 2000–January 2001” in their February 9 issue of
the Weekly Epidemiological Record. The report describes the epidemic response,
surveillance efforts, case profiles, and the epidemiology of the outbreak.
A map of the outbreak sites and a graphic plot displaying the date of
onset and confirmation of diagnosis are also included. The full report
can be accessed at: http://www.who.int/disease–outbreak–news/n2001/february/9afebruary2001.html
US – 8TH ANNUAL CONFERENCE ON RETROVIRUSES AND OPPORTUNISTIC INFECTIONS
Nearly 3500 scientists, clinicians, and representatives from the pharmaceutical
industry and patient advocacy groups gathered in Chicago, IL from Feb.
4 – 8, 2001 for the 8th Conference on Retroviruses and Opportunistic Infections.
The conference focused primarily on major developments in the pathogenesis,
prevention, and treatment of HIV disease. General themes pertained to
the increasing infection rates of at–risk groups in the developed world,
the growing HIV epidemic in developing countries, disappointment at the
lack of a viable candidate vaccine, the implications of drug resistant
strains, and mounting concern about the toxicities of available antiretroviral
therapies. For example, one study conducted by Dr. Susan J. Little and
a multicenter team noted that approximately 14 percent of 394 recently
infected, treatment–naďve patients were infected with a viral strain that
exhibited reduced susceptibility to at least one antiretroviral drug.
This degree of reduced susceptibility was estimated to be about 3.5 percent
between 1995 and 1998. Abstracts from the symposia, slide sessions, and
poster presentations can be viewed at the conference’s website at http://www.retroconference.org/2001/.
[MEDSCAPE, http://www.medscape.com]
7TH INTERNATIONAL DENGUE COURSE
The seventh International Course on Dengue, entitled “Dengue, a Challenge
of the Third Millenium,” will be held from August 13㪰, 2001 in Havana,
Cuba. Co–sponsored by the Pan–American Health Organization (PAHO) and
the Special Program of Research and Training for Tropical Diseases (TDR/WHO),
this course will provide a multidisciplinary approach comprised of theoretical
and practical sessions, and will involve Cuban and foreign experts in
the field. The course is intended for physicians, microbiologists, infectologists,
biochemists, epidemiologists, entomologists, and technologists involved
in the prevention and control of dengue fever.
All presentations will be conducted in Spanish. Applications should be
sent via fax or e–mail before July 1st, 2001 and should include: Name
and postal address, telephone, telex, fax, e–mail address, a short Curriculum
Vitae and practical session of interest. Send to:
Professor Maria G. Guzman
Instituto “Pedro Kouri”
Tel:53ף� 53ף�
Fax:53ף�
Email: lupe@ipk.sld.cu lupe@ipk.sld.cu
For more information on the course, including a list of the practical
sessions, please visit the website at http://www.paho.org/English/HCP/HCT/HCT–Cuba�.htm.
NEW PUBLICATION FROM UNDP AND SOUTHEAST ASIA HIV AND DEVELOPMENT PROJECT
The United Nations Development Project and the Southeast Asia HIV and
Development Project have published a new document, “Assessing Population
Movement and HIV Vulnerability: Brunei–Indonesia–Malaysia–Philippines
Linkages in the East Asean Growth Area.” In this document the links between
population movement and susceptibility to HIV infection are examined among
the diverse groups who move between these areas. The study focused primarily
on the Philippines–Malaysia linkages and examined the following:
- Characteristics and dynamics of population movement between these
two areas;
- Impacts of cross–border movements on migrants and their families in
the communities of origin and communities of destination;
- Migration policies and health policies in the areas of origin and
destination; and
- Factors that promote vulnerability and resilience to HIV.
The full report can be downloaded at http://www.hivundp.apdip.net/se/mailing/BIMP.htm
.
TB–EDUCATE LISTSERV
The Division of Tuberculosis Elimination (DTBE) of the Centers for Disease
Control and Prevention (CDC) and the CDC National Prevention Information
Network (CDC NPIN) have formed TB–Educate, an education and training e–mail
listserv. TB–Educate allows subscribers to ask questions, share comments,
and exchange information about tuberculosis education and training issues.
The listserv is open to anyone with an interest in these topics. To subscribe
to TB–Educate with immediate delivery of each message, send a blank message
to tb–educate–subscribe@cdcnpin.org.
To subscribe to the TB– Educate digest, send a blank message to tb–educate–digest–subscribe@cdcnpin.org.
IUATLD INTERNATIONAL TB COURSE RESOURCES
Materials offered in the International Union Against TB and Lung Disease
(IUATLD) International Tuberculosis Courses are now available on their
updated website, at http://www.tbrieder.org.
The information is organized according to the five modules in the IUATLD
courses, and covers bacteriology, clinical diagnosis, epidemiology, interventions,
and principles of control. The web–site is currently a work–in–progress,
but will ultimately contain publications, a slide show, and at least one
course for each module.
4. JOURNAL ARTICLES
UNDERDIAGNOSIS OF DENGUE – TEXAS, 1999
In the February 2 issue of the MMWR, the CDC reports on how the
recognition and diagnosis of dengue in border populations can be improved
through enhanced surveillance, education of the public and medical communities,
and prompt reporting of cases by health–care providers. In the border
city of Laredo, TX, for example, no cases of dengue were reported during
1987 through July 1999, while approximately 300𤬵 cases were reported
during January through July 1999 in a city across the Rio Grande River
from Laredo. A review of medical records from health facilities in Laredo
found that 50 percent of suspected dengue case–patients who had visited
these facilities between July 23 and August 20, 1999 had undiagnosed dengue
infections. Subsequent to the identification of these cases, the Laredo
Health Department implemented mosquito reduction activities, alerted health
care providers, and distributed mosquito reduction and personal protection
information to the public to improve recognition and surveillance of dengue
infection. From mid–August to December 1999, 161 suspected dengue cases
were reported, of which 18 tested positive.
[MMWR 50;2001:57㫓, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5004a2.htm]
E. COLI 0157:H7 GENOME DECIPHERED
A team of primarily University of Wisconsin researchers, led by Fred Blattner
and Nicole Perna, have decoded the genome of the lethal E. coli strain,
0157:H7. This strain affects nearly 75,000 individuals annually in the
United States and can have potentially fatal consequences. The genetic
information should facilitate efforts to develop an effective vaccine
for cattle and other animals that would ultimately reduce the risk of
human infection. Blattner and Perna had previously sequenced the genome
of the benign strain EDL933, and found distinct differences between the
two. Most notably, while the two strains share about 3500 genes, the 0157:H7
strain has 1387 additional genes that are not present in the harmless
strain. The 0157:H7 strain also frequently picks up genetic material from
other bacteria and viruses that may make the development of an effective
vaccine difficult.
[NATURE 409;2001:529𤰅, http://www.nature.com;
ASSOCIATED PRESS 1/24/01]
5. 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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