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Vol. IV,
No. 10 ~ EINet News Briefs ~ June 22, 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
- 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 (KUALA
LUMPUR) – DENGUE OUTBREAK
Two women died from brain hemorrhages caused by dengue fever in an outbreak
in northern Malaysia that has infected 24 people. The outbreak occurred
in Perlis state, near the Malaysia–Thai border, where villages are being
fumigated in an attempt to contain the outbreak. The two women who died
were sisters, 44 and 53 years of age. This outbreak is the second in
Malaysia this year. The first occurred in February, when two people
died and 242 others were infected in the central Malaysian state of
Negeri Sembilan.
Dengue fever
is common in tropical regions, and is spread by mosquitoes. It is characterized
by headaches, rashes, cramps, and severe back and muscle pains. The
infection can be fatal if treatment is delayed.
[ASSOCIATED PRESS 6/11/01]
CHINA (HONG
KONG) – vCJD CASE CONFIRMED
A 34–year–old Chinese woman is believed to be suffering from variant
Creutzfeldt –Jakob Disease (vCJD), the human counterpart to bovine spongiform
encephalopathy (BSE), according to Britain’s National Creutzfeldt–Jakob
Disease Surveillance Unit. The woman is currently being treated at the
Prince of Wales Hospital in Hong Kong, but she spent considerable time
in Britain. Dr. Donald Lyon, of the Prince of Wales Hospital, believes
that the woman likely contracted the disease from eating contaminated
beef in Britain, where she lived from 1985 to 1992, and from 1997 until
earlier this year, when she returned to Hong Kong. This is the first
time that vCJD has appeared in Asia.
vCJD was first
detected in Britain in 1996, where over 100 cases have been reported.
People are believed to contract the infection as a result of eating
beef from cattle infected with BSE. Hong Kong has banned imports of
British beef since 1996.
[YAHOO ASIA NEWS 6/9/01, http://asia.dailynews.yahoo.com;
ASSOCIATED PRESS 6/14/01]
CHINA (HONG
KONG) – CHOLERA CLUSTER
The Department of Health of the Hong Kong SAR has diagnosed and confirmed
cholera infection in 6 individuals between mid–May and early June. A
61–year–old woman from Kwai Chung was the first to be diagnosed, and
she indicated that she had not traveled outside Hong Kong during the
incubation period. Vibrio cholerae 01 El Tor Inaba was isolated
from each of the cases. The source of the infection is being investigated.
[PROMED 6/9/01, 6/11/01]
AMERICAS
PERU – YELLOW FEVER
OUTBREAK
Eight cases of yellow fever have been confirmed in the Department
of Loreto, in the Amazon Region of Peru. Two cases have died and
an additional 12 are under investigation. The Pan American Health
Organization (PAHO) has mobilized 400,000 doses of vaccine for a
vaccination campaign.
[WHO Disease Outbreaks Reports; http://www.who.int/disease–outbreak–news]
CANADA (ONTARIO)
– E. COLI EXTENDED SPECTRUM BETA LACTAMASE (ESBL) OUTBREAK
An outbreak of a drug–resistant strain of E. coli has spread
among eight seniors’ homes throughout Greater Toronto, infecting
at least 100 people in the Durham Region and undetermined numbers
in the York Region and Scarborough. This strain of E. coli,
thought to be extended spectrum beta lactamase (ESBL), is a variation
of a common bacterium in the digestive tract that has developed
resistance to antibiotics. The infection is spread through contact
with feces of an infected person. According to the Associate Medical
Officer of health for Durham Region, people with healthy immune
systems can generally fight off the infection, but it can be extremely
serious for frail and elderly individuals. Five elderly people have
died from conditions that may have been exacerbated by the infection.
This outbreak began
in July of 2000 when the infection was identified in several patients
at a Durham hospital. The infection spread to seniors’ homes in
Scarborough when infected seniors moved from Durham to Scarborough.
The origin of the York Region cluster remains unknown. In many of
the 100 Durham cases the bacteria has colonized in patients’ intestines
without any symptoms. Hospital staff are closely monitoring patients
who have tested positive and testing them every two to four weeks.
Officials of the seniors’ facilities have been advised to exercise
strict sanitary precautions when working with infected individuals.
All other residents at the homes are being tested.
[TORONTO STAR, http://www.torontostar.com]
CANADA – TO BEGIN
TESTING IMMIGRANTS FOR HIV
Canada will begin mandatory HIV testing of all immigrants and people
seeking refugee status. According to the Immigration Minister, each
case will be evaluated individually so that a positive test would
not necessarily result in automatic exclusion from Canada. An important
consideration in the decision would focus on the extent to which
the individual’s illness would burden the nation’s health care system.
Currently, immigrants
can be excluded from Canada for leprosy, mental handicaps, and other
conditions, but they are not required to be tested for HIV. The
Health Minister stated that the policy would put Canadian policies
more in line with those of other Western countries. The Canadian
Council for Refugees criticized the policy, claiming that it would
result in increased stigmatization of immigrants.
[ASSOCIATED PRESS 6/13/01]
U.S. – TRANSMISSION
OF DIARRHEAL INFECTIONS IN RECREATIONAL FACILITIES INCREASES
The CDC reports that the transmission of diarrheal infections as
a result of swallowing fecal contaminated water while swimming in
pools and other recreational areas increased during the 1990’s.
Approximately 10,000 cases and 32 outbreaks of waterborne diarrhea
were linked to pools, waterparks, spas, and other facilities in
the U.S. from 1989 to 1998. This increase was attributed in large
part to the fact that many people continue to swim while sick, presumably
because most people do not consider diarrhea a serious illness.
An epidemiologist from the CDC’s National Center for Infectious
Diseases stated that one person with diarrhea could contaminate
an entire swimming pool for several days.
The majority of the outbreaks associated with swimming pools were
caused by Cryptosporidium, a parasite that is highly resistant
to chlorine.
The CDC has issued recommendations
to reduce the transmission of pool–related diarrhea, including enhanced
awareness and education for both the public and pool operators as
to the risks of fecal transmission in pools, creating bathroom breaks
for kids, and separate filtration systems for “kiddie” pools. Most
importantly, the CDC suggested that sick individuals should refrain
from swimming while ill and until two weeks after the diarrhea has
stopped, as Cryptosporidium can be excreted several weeks
after diarrhea has ceased.
[MMWR 2001;50:406𤮊, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5020a3.htm;
PROMED 5/28/01]
2.
UPDATES
SUMMARY – APEC 20th
ISTWG SIDE MEETING ON EMERGING INFECTIOUS DISEASES
A summary of the side meeting on emerging infectious diseases that
was held on April 24, 2001, at the 20th APEC Industrial Science
and Technology Working Group (ISTWG) is now posted on the APEC Science
and Technology website for registered users at http://www.apecst.org/site/index.cfm.
Twenty–eight representatives from 10 APEC economies, including Canada,
Hong Kong, China, Japan, Korea, Malaysia, Chinese Taipei, Thailand,
United States, and Vietnam, met to discuss ongoing projects, new
project proposals, and strategies for APEC to address HIV/AIDS and
emerging infectious diseases. New project proposals that received
endorsement included the Molecular Epidemiology of Dengue Viruses,
Preventing Emerging Infections in the Asia Pacific: Creating a Network
of Networks, Emerging Infections Outbreak Response Training, and
The Impact of HIV/AIDS on the Business Sector in the Asia Pacific
Region – Policy Forum on Developing a Regional Business Response.
3. NOTICES
PLEASE HELP!! NOMINATE
ASIA PACIFIC–BASED DISEASE SURVEILLANCE NETWORKS!
APEC is committed to a network of networks strategy to enhance disease
alert and surveillance activity in our region. PLEASE HELP! Nominate by
July 15th any regional or national Asia Pacific–based networks for disease
alert or surveillance that you have found helpful in your work. These
include electronic networks other than EINet that you use to obtain disease
alert and surveillance information, such as those related to HIV/AIDS
or microbial resistance, etc. Please send this information, including
the names of principal contacts, to apecein@u.washington.edu.
Your help is greatly appreciated.
CALL FOR INFORMATION ON
DRUG USE AND HIV VULNERABILITY IN ASIA
The Centre for Harm Reduction (CHR) and the Asian Harm Reduction Network
(AHRN) are undertaking a Rapid Situation Assessment of drug use and HIV/AIDS
vulnerability in Asia. The project is collecting all available information
on illicit drug use and on HIV infection among illicit drug users in 22
Asian countries, from Mongolia to Iran, and is to be completed within
the next 12 weeks.
The CHR is requesting any
material from APEC–EINet subscribers relating to aspects of the twin themes
of illicit drug use and HIV infection in the Asian region. This may include
published or unpublished material, reports, articles, books, websites,
or videos, as well as the names of organizations active in these areas.
The first Regional Situation
Assessment, entitled The Hidden Epidemic, was conducted in 1997 and was
influential in raising the profile of HIV epidemics among injecting drug
users and their families in the Asian region. This report is available
at the AHRN website at http://www.ahrn.net,
under publications. The new assessment will monitor changes that have
occurred since then, and examine countries previously not investigated.
Please direct all information
and questions to Gary Reid at the Centre for Harm Reduction in Australia
at reid@burnet.edu.au.
OVER 10 MILLION YOUTH INFECTED
WITH HIV
The United Nations Children’s Fund (UNICEF) announced that 10.3 million
youth aged 15 to 24 are living with HIV/AIDS worldwide, with the majority
in sub–Saharan Africa. According to their report, many sexually active
youth exhibit low levels of HIV knowledge, even for those in countries
with high infection rates. For example in Mozambique, almost 74% of girls
and 62% of boys aged 15 to 19 are unaware of prevention measures. Likewise,
an estimated 16 million girls aged 15 to 19 in sub–Saharan Africa do not
realize that individuals who appear healthy may be infected with HIV.
UNICEF proposes enhancing “youth friendly” health services to provide
youth access to HIV testing, counseling, and information. The UN General
Assembly will be hosting a special session on HIV/AIDS on June 25㪳.
[UN WIRE 6/13/01,
http://www.unfoundation.org/unwire/2001/06/13/index.asp#15246]
WHO, FAO, OIE–SPONSORED
CONFERENCE ON BSE, JUNE 11㪧
The UN Food and Agriculture Organization (FAO), the World Health Organization
(WHO), and the World Organization for Animal Health (OIE) sponsored a
four–day conference in Paris for international veterinarians, food safety
experts, and health officials to develop methods of combating the spread
of bovine spongiform encephalopathy (BSE). The organizations, along with
over 150 conference attendees, called on governments worldwide to ban
the feeding of meat and bone meal to ruminants and increase surveillance
of the disease. They also issued 13 recommendations to prevent BSE, such
as urging countries to assess trade and possible risk factors for potential
exposure, highlighting the need for more specific guidance for conducting
risk assessments, and emphasizing that risk management must be based on
science, among others. To view the recommendations, visit the following
URL: http://www.who.int/inf–pr�/en/pr2001㪴.html.
[WHO PRESS RELEASE 6/14/01]
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 contactmailto:nwc@u.washington.edu. Further
information about the APEC Emerging Infections Network is available at
http://www.apec.org/infectious.
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