|
About EINet
News
Briefs
Emerging
Infections Course
Data
Library
search
More
information
APEC
ISTWG
EINet
home
|
Vol. IV, No. 05 ~ EINet News Briefs ~ March 15,
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
SINGAPORE – HFMD UPDATE
An eleven–month–old child who was infected with enterovirus 71 (EV71),
one of the viruses that can cause hand, foot, and mouth disease (HFMD),
died on February 28 at the KK Women’s and Children’s Hospital in Singapore.
The child’s twin brother, who was also admitted, has since recovered,
and the twins’ older sisters have shown no signs of infection. During
the week of February 24, 141 cases of HFMD were reported, compared with
an average of 110 cases for the previous five weeks. According to the
HFMD taskforce, these cases do not suggest an outbreak. During the peak
of the last outbreak in October 2000, there were approximately 1140
cases per week. While several enteroviruses can cause HFMD, EV71 appears
to be associated with severe cases in the very young.
[SG MINISTRY OF THE ENVIRONMENT NEWS RELEASE 2/24/01, 2/28/01; PROMED
2/26/01]
MALAYSIA – UNDIAGNOSED ENCEPHALITIS
Previous concerns about a possible re–emergence of the Nipah virus,
a paramyxovirus that was responsible for an outbreak of severe encephalitis
in Malaysia in late 1998 to 1999, have abated. The death of a 22–year–old
livestock worker from Bukit Pelanduk from a form of encephalitis had
raised fears of the re–emergence of the virus, but health officials
claim that his death was likely a consequence of a prior exposure. Reports
indicate that the victim, who was likely exposed to the Nipah virus
while participating in the culling of pigs during the last outbreak,
exhibited symptoms of Nipah virus infection at that time. Laboratory
tests are currently underway to accurately identify the virus, which
is presumed to be Nipah virus. Health authorities are advising those
who were previously infected with either the Japanese Encephalitis virus
or Nipah virus to have a check–up at state hospitals.
[PROMED 3/9/01, 2/28/01]
OCEANIA
AUSTRALIA (VICTORIA) – MEASLES
Since January 31, 47 cases of measles have been identified in Victoria,
of which 43 are laboratory confirmed, two are epidemiologically linked
to confirmed cases, and two are clinically compatible but have no
established epidemiological link to other cases. The primary case
was a 19 year–old with no documented history of vaccination who returned
from India 16 days prior to the onset of rash. Direct links have been
established between 23 of the cases. Young adults born between 1970
and 1983 are considered the most vulnerable to infection, as they
are unlikely to have been infected with the wild measles virus or
to have been adequately immunized. Measles vaccines were first available
in Australia in 1968, but the more effective two–dose MMR (Measles–Mumps–Rubella)
vaccine was not introduced until 1994. In this outbreak, all but five
cases are between the ages of 15 and 34 years. Victoria is currently
in the third wave of transmission, and additional cases are anticipated.
[PROMED 2/16/01; PERS. COMM. 3/3/01]
OTHER
INDIA – UNDIAGNOSED INFECTION
An undiagnosed infection has infected at least 62 people, including
39 deaths, in the town of Siliguri and adjoining areas in north
Bengal since the infection first appeared on February 5, 2001. The
infection, which is presumed to be airborne, is characterized by
high fevers, headaches, body pains, and in some cases, convulsions
and respiratory problems. Blood samples and cerebrospinal fluid
from patients were sent to the National Institute of Communicable
Diseases (NICD) and the National Institute of Virology for analysis.
According to the Times of India, the Indian Council for Medical
Research (ICMR) released preliminary findings, identifying the infection
as “mutating measles virus.” The Health Minister stated that usual
precautions against communicable diseases should be followed.
[TIMES OF INDIA 2/28/01, 3/1/01, 3/6/01]
2. UPDATES
AUSTRALIA –MURRAY VALLEY ENCEPHALITIS
One documented and two suspected cases of Murray Valley encephalitis (MVE)
have been reported in Northern Australia, where ongoing elevated mosquito
activity has raised concerns over the risk of acquiring the infection.
The risk of infection extends across much of northern Australia, although
the regions of Victoria River, Barkly, and Alice Springs are considered
most at risk. While only a few cases have been reported, the sentinel
chicken program has detected MVE virus infection in various regions of
the Northern Territory, alerting health officials to the increased potential
for infection. Continuing rains and climatic conditions suggest that the
elevated risk will persist for at least two months. Residents are urged
to take precautionary measures against mosquito bites.
[PROMED 3/5/01]
3. NOTICES
20th APEC ISTWG MEETING – VIETNAM
The 20th meeting of the APEC Industrial Science and Technology Working
Group (ISTWG) scheduled for April 23rd–27th in Hanoi, Vietnam will include
a side meeting on Health/Emerging Infections on Tuesday, April 24 at the
Melia Hanoi Hotel. Interested persons should contact their APEC delegation
for further information.
UPDATED APEC WEBSITE
We have updated our website, http://www.apec.org/infectious.
Now it is easier to subscribe to our bi–monthly newsletter, and to view
updated information about important emerging infections through our link
to “other sites” at http://apec.org/infectious/othersites/index.html.
UGANDA OUTBREAK OFFICIALLY OVER
The WHO issued a press release on February 28, 2001, stating that the
Uganda Ebola outbreak that began in October 2000 is officially over. According
to the report, the last person to be infected recovered over 42 days ago,
which is twice the maximum incubation period for the virus. The international
response and the mobilization of the local community in Gulu are credited
with having helped curb further spread of the virus, which ultimately
killed 224 individuals in Uganda. The WHO is working towards raising awareness
of the global importance of infectious diseases and aims to further strengthen
the epidemic response of the international community. The press release
can be viewed at the following URL: http://www.who.int/disease–outbreak–news/n2001/index.html.
NEW STD PUBLICATIONS FROM WHO, WPRO
The WHO, Western Pacific Regional Office (WPRO) has published two new
documents:
- Sexually Transmitted Infections: Briefing Kit for Teachers; and
- Promoting Condoms in Clinics for Sexually Transmitted Infections:
A Practical Guide for Programme Planners and Managers
These publications are the last of a set of seven “STI – HIV” reference
publications developed in the past three years. Hard copies can be obtained
free of charge on request at HIS@wpro.who.int,
or the publications can be accessed on the web at http://www.wpro.who.int/themes_focuses/theme1/focus4/pub_doc.asp.
WORLD CONFERENCE ON LUNG HEALTH
The 32nd IUATLD (International Union Against Tuberculosis and Lung Disease)
World Conference on Lung Health will be held November 1נ, 2001 in Paris,
France. Main topics for the scientific program include TB, tobacco prevention
and control, child lung health, bacteriology and immunology, respiratory
disease, TB in animals, and advocacy in lung health. The deadline for
submission of abstracts is May 15, 2001. For more information, and to
download registration and abstract forms, visit the IUATLD website at
http://www.iuatld.org.
7th ANNUAL BASIC ASPECTS OF VACCINES SYMPOSIUM
The purpose of this symposium is to provide a broadly based interactive
forum for discussion of some of the most important current issues in basic
immunology and vaccinology. The conference, sponsored by the Walter Reed
Army Institute of Research, will be held from May 2נ, 2001, at the Uniformed
Services University of the Health Sciences in Bethesda, MD. For further
information, please email symposium@na.amedd.army.mil
or visit their website at http://wrair–www.army.mil/symposia/dmbsym.htm.
INTERNATIONAL WORKSHOP ON CAMPYLOBACTER, HELICOBACTER AND RELATED
ORGANISMS (CHRO 2001)
CHRO 2001 aims to promote interdisciplinary exchange and collaborative
research, particularly between medical microbiologists, infectious disease
specialists, veterinarians, food microbiologists, public health experts,
and epidemiologists. The program will cover new developments and research
in molecular microbiology, epidemiology, public health surveillance, animal
health, and food safety, with plenary sessions on bacterial secretory
machines, functional genome analysis, carcinogenesis, virulence factors,
and new vaccination strategies. The congress will be held from September
2ס, 2001 in Freiburg, Germany. The deadline for abstract submissions
is May 15, 2001. For further information, visit the CHRO2001 website at
http://www.chro2001.de or contact
Prof. Manfred Kist at kistman@uk1.uni–freiburg.de.
INDIA – BLOOD BANKS REQUIRED TO TEST FOR HCV
In India the government issued amendments to the Drugs and Cosmetics Rules
that will require the country’s blood banks to test all blood products
for hepatitis C virus (HCV) beginning June 1, 2001. Currently, blood banks
are required to test for the hepatitis B surface antigen, HIV, malaria,
and syphilis.
[MEDSCAPE 2/23/01; http://www.medscape.com]
4. JOURNAL ARTICLES
MARKER MAY ALLOW EARLY DIAGNOSIS OF TSE’s
Scottish investigators led by Dr. Michael Clinton have identified a molecular
marker that may play an important role in the early diagnosis of transmissible
spongiform encephalopathies (TSE), which are fatal neurogenerative diseases
such as bovine spongiform encephalopathy (BSE) and variant Creutzfeldt–Jakob
disease. The researchers observed that the expression of one erythroid
differentiation–related factor (EDRF) was markedly reduced in the splenic
tissue of infected mice compared with uninfected mice. Further studies
in cattle, sheep, and humans support this association. These results demonstrate
that changes in gene expression caused by TSE infection can occur outside
of the central nervous system. As this change in EDRF levels is easily
measured in readily accessible tissues, this finding has important implications
for diagnostic and therapeutic strategies. Additional questions that remain
include the normal EDRF expression levels in humans, the amount of variation
present in healthy individuals, and whether EDRF downregulation is prion–specific.
[NATURE MEDICINE 2001;7:361𤭜 MEDSCAPE: http://www.medscape.com]
EV 71 INFECTIONS IN CHILDREN MAY BE RELATED TO ALTERED CELLULAR REACTIONS
The severity of enterovirus 71 (EV 71) infections, which have been associated
with high case fatality rates of hand, foot and mouth disease (HFMD) in
Malaysia and Taiwan, may be related to differences in cellular immune
responses among infected children. Dr. Kuender D. Yang and others investigated
the immune reactions in 78 children in Taiwan with and without EV 71 meningoencephalitis
to examine whether host factors played a role in the pathogenesis of EV
71 meningoencephalitis. Of the 31 children with complications, 81% had
HFMD. The researchers found that younger age was significantly associated
with the occurrence of meningoencephalitis and other complications. Children
with meningoencephalitis also exhibited reduced CD40–ligand (L) expression
on the CD4 T cells, which has been associated with increased susceptibility
to other enteroviruses. The investigators also looked at cytotoxic T lymphocyte
antigenנ (CLTAנ) polymorphism at position 49 because of its role as
an important negative regulator of T cell cytotoxicity, and because the
A or G phenotype of exon 1 is related to some autoimmune disorders. Children
with meningoencephalitis had significantly more G/G genotype of CTLAנ
polymorphism than did patients without meningoencephalitis and healthy
controls. The authors suggest that a younger age, because of its association
with a retarded CD40–L response, and certain genetic polymorphisms may
predispose children to complicated EV 71 meningoencephalitis.
[JOURNAL OF INFECTIOUS DISEASES 2001;183:850ע]
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.
|
