IV, No. 16 ~ EINet News Briefs ~ October
17 , 2001
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In this edition:
- Infectious disease information
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1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a biweekly summary of AsiaPacific emerging infectious disease
China (Macau, Hong
Kong) Dengue Fever
The Health Services
Bureau reports that the number of confirmed cases of dengue fever in
Macau has escalated to 415 since the first cases were reported on Aug.
30. The 415 confirmed reports occurred between Aug. 30 to Sept. 17.
This has been the first official record of dengue fever in that area.
The Health Services Bureau director, Dr. Koi Kuokieng, has said the
situation is currently under control and that the government has not
released daily updates so as not to "... alarm the population".
Sixtyone people are still being treated at Macau's two hospitals.
As of Aug. 30, no locally contracted case of dengue fever
has been recorded in Hong Kong. The Department of Health has said that
the eight cases reported were all imported. Mosquito breeding grounds
have been targeted in a campaign that will run until Nov. 3.
PhilippinesAcute Flaccid Paralysis
Three cases of Acute Flaccid Paralysis (AFP) associated with circulating
vaccinederived poliovirus (cVDPV) isolates were reported in the Philippines
between March 15 to July 26. The three cases include an 8yearold child
from northern Mindanao Island who had onset of paralysis on March 15;
a 3yearold child from Laguna province who had signs of meningitis
on July 23, but no paralysis; and a 14monthold child from Cavite province
who had onset of paralysis on July 26. None of the children had traveled
outside of their residence since birth. Isolates from the three children
showed Type 1 polioviruses derived from Sabin vaccine strain type 1.
As a result of the AFP cases, the Department of Health
in the Philippines has: begun an active record review for AFP cases
in healthcare facilities in the affected and neighboring provinces;
established surveillance to investigate aseptic meningitis at major
healthcare facilities; collected stools from healthy contacts of cases;
conducted field investigations of grouped AFP cases; and evaluated polio
vaccination coverage in these communities. As of yet there are no unreported
AFP cases. However, some AFP cases are still under investigation. A
mass OPV vaccination campaign is planned in order to disrupt cVDPV circulation.
[PROMED 10/12/01; MMWR 50(40); 874ס]
(Florida, New York, Nevada)Anthrax
of Lantana, Florida died of Anthrax on Friday, Oct. 5 after checking
into Lake Worth Hospital on Tuesday, Oct. 2. The 63yearold man,
a photo editor of The Sun, was the first person in 25 years
to catch a case of the rare inhalation form of anthrax. A coworker,
Ernesto Blanco, was found to have anthrax bacteria in his nasal
passages and traces of anthrax were found on a computer keyboard
in the building.
According to health officials, the coworker was in stable condition
the following Monday at an unidentified MiamiDade County hospital.
David Pecker, chief executive of the tabloid's publisher, American
Media Inc. (AMI), said Ernest Blanco worked in the mailroom. For
this reason, officials believe the anthrax was spread through the
mail. As a preventative measure, public health officials began to
contact the 300 personnel who worked in the building and anyone
who visited the building for more than an hour since Aug. 1, to
test for the bacteria and to provide antibiotics. In addition, the
FBI sealed off the office building and combed it for clues. Results
of the tests on AMI personnel revealed that six employees were exposed
to the anthrax bacterium. On Oct.10 a 35yearold woman tested positive
for anthrax exposure and on Oct.
13 it was announced that five more AMI employees had tested positive
for exposure to anthrax. All employees are in good health, have
begun treatment, and are not expected to develop the disease.
Officials reported on Oct.13 that preliminary tests on letters
mailed to NBC News in New York indicated the presence of anthrax.
The personal assistant to NBC news anchor Tom Brokaw contracted
cutaneous, or "skin," anthrax, which is less dangerous
than inhaled anthrax and rarely fatal if treated. On Sept. 25, the
assistant opened a piece of suspicious mail with powder inside.
The letter, postmarked Sept.18 from Trenton, New Jersey, has tested
positive for anthrax. In addition, on Oct. 14 the Mayor of New York,
Rudolph Giuliani, stated that anthrax spores were found on a police
officer and two lab technicians involved in detecting the case of
anthrax at NBC. All of those who are known to have been exposed
are being treated with antibiotics and are in good health.
In Nevada, state officials said that tests have shown that pictures
contained in a letter sent to a Microsoft office in Reno from Malaysia
were contaminated with anthrax. As of yet, no one has tested positive
U.S. Attorney General John Ashcroft has said that the FBI has started
a criminal investigation, but does not yet know if the anthrax is
related to the Sept.11 terrorist attacks.
[[PROMED 10/04/01 10/08/01 10/09/01
10/14/01; REUTERS 10/10/01; NEW YORK
US (Hawai'i)Dengue Fever Outbreak
The dengue fever outbreak in Hawai'i is the first in 50 years. As
of Oct. 12, the U.S. Center for Disease Control and Prevention has
confirmed cases of dengue fever in 45 Maui residents, two Kauai
residents, and one Oahu resident. In addition to the confirmed cases,
20 suspected cases have tested positive on preliminary screening
tests and another 222 reports of illness are under investigation.
The state Health Director Bruce Anderson has stated that the problem
is largely confined to East Maui and a few areas on other islands.
In another statement Anderson has said that the virus has most likely
been introduced from American Samoa, Tahiti, and other parts of
Polynesia, where the disease is epidemic. The Department of Health
in Hawai'i and the Center for Disease Control have jointly implemented
an extensive, statewide mosquito control program. All islands are
involved in the aggressive mosquito control measures with intensive
activity focused on the island of Maui. In addition, the state is
urging residents to help by using insect repellent and eliminating
breeding grounds for mosquitoes.
[PROMED 10/06/01; ASSOCIATED PRESS 10/09/01; HAWAI'I DEPARTMENT
OF HEALTH 10/09/01 http://www.state.hi.us/health/dengue/press.html]
US (North Carolina)A Possible Case of West Nile Infection
In early September a 66yearold Florida man traveling with his
wife through North Carolina in a recreational vehicle (RV) was treated
for a possible West Nile virus infection. It is not certain where
the man may have contracted the virus, but the man noticed a dead
bird under his RV and noticed many mosquitoes when he stayed several
nights in Greenville. Tests performed by a private laboratory indicate
that the man may have contracted the virus, but the State Public
Health Laboratory will conduct further tests to confirm the preliminary
On Oct. 9 the North Carolina Public Health Laboratory reported
that five new cases of West Nile virus have been found in animals.
The cases include three crows and two horses found in four of the
state's counties. West Nile virus was first detected in the state
a year ago on Sept.17. The virus is transmitted to humans when a
mosquito bites an infected bird and then bites a human. It is not
known to pass directly from birds to humans or from human to human.
[PROMED 10/03/01 10/09/01 NORTH CAROLINA DEPARTMENT OF HEALTH
ChileGirl Dies of Hantavirus Infection
A 4yearold girl from Llico Bajo, Chile died of hantavirus infection
after being admitted to the local hospital on Sept. 18 with a severe
fever. The following Thursday a team from the Department of Environmental
Programs visited the area in which the girl resided in order to
collect samples and establish a possible zone of contagion.
VietnamDengue Hemorrhagic Fever
According to the Vietnamese
Ministry of Health, the number of reported cases of dengue hemorrhagic
fever (DHF) has increased considerably. As of midAugust over 18,700 people
have been infected and 44 persons have died from the disease. Health officials
have said that this is a 57 percent increase from the same time period
last year. Most of the reported cases are from southern Vietnam, but the
disease has spread to the central and northern provinces of Quang Binh
and Nghe An. There have been 12 deaths of 2300 reported cases in An Giang
province, 2200 cases reported in Binh Thuan province and 2170 cases reported
in Phu Yen province. There is no vaccine or cure for dengue fever and
the high death toll among reported cases is most likely due to the delay
in seeking medical treatment.
On Sept. 13, the Veterinary Laboratories Agency (VLA), located in the
United Kingdom, confirmed the National Institute of Animal Health (NIAH)
diagnosis of bovine spongiform encephalopathy (BSE) in a dairy cow in
Shiroi City, Chiba Prefecture. The source of infection is under investigation
and the dairy farm where the case of BSE was found has been placed under
supervision by Chiba Livestock Hygiene Service Center. Investigators are
tracing animals kept with the infected cow and examining the feed used
on the farm. Officials are also visiting feed mills and cattle farms in
Japan to investigate practices in feed preparation and to examine other
cattle for clinical signs of BSE infection.
AustraliaEchovirus Types 9, 13, and 30
The virus isolation laboratory at Westmead Hospital in Sydney, Australia
reports an increase of echovirus types 9, 13, and 30. The lab has detected
echovirus type 13 in 12 samples in the first seven months of 2001 when,
previously, the virus was rarely isolated. Within the first six months
of 2001, the lab has received 168 nonpolio isolates, of which Echovirus
type 9 was identified most frequently (32 percent of the isolates). In
comparison, the highest number of isolations within a calendar year was
258. Additionally, but to a lesser extent, echovirus type 30 has increased
CambodiaIncrease in Suicide
Among Young Aids Patients
According to the Cambodian
Aids Authority, approximately 170,000 people in Cambodia are infected
with HIV. Government officials in Phnom Penh reported that the suicide
rate among young AIDS patients has risen during the last three years such
that the number of suicides during the first half of this year nearly
match the total number of recorded suicides for 1999. This year 105 HIV
positive men and women have committed suicide. Officials with the Cambodian
Aids Authority have begun a public appeal to HIV infected persons in order
to stop the suicides.
UKPlague Bacterium Genes Mapped
Scientists at Britains Wellcome Trust Sanger Center in Cambridge
have mapped the 4,012 genes of the plague bacterium, Yersinia pestis strain
CO92. Y. pestis has been responsible for three human pandemics and still
poses a threat to human health due to drug resistant strains and its potential
use as a biological weapon. In addition, up to 3,000 cases of bubonic
plague are reported each year to the World Health Organization.
The researchers mapped a strain isolated from a US veterinarian who died
of pneumonic plague when he contracted the bacterium from an infected
cat in 1992. Julian Parkhill, the head of the research team, said in a
telephone interview with Reuters that, Having this data will without
a doubt accelerate and facilitate subsequent research of the organism
in terms of new drugs or vaccines. The sequence of Y. pestis CO92
determined with collaboration from the London School of Hygiene and Tropical
Medicine, The Imperial College, the London School of Medicine and Dentistry,
and the Defense Science and Technology Laboratory in Porton Down.
[NATURE 2001;413:523𤯿 http://www.sanger.ac.uk/Projects/Y_pestis/;
2002 APEC Emerging Infections Network Meeting
A meeting organized by the APEC Emerging Infections Network will be held
by invitation in winter, 2002 in Seattle. The meeting will bring disease
alert and surveillance networks from the APEC community together to discuss
possible cooperation among networks. Details on the meeting will appear
in following bulletins.
2002 CDC Conference on Emerging Infectious Disease
The Center for Disease Control and Prevention (CDC) is hosting the International
Conference on Emerging Infectious Diseases (ICEID) March 2427, 2002
in Atlanta, Georgia. At the conference 2,500 public health professionals
will come together to exchange scientific and public health information
on global emerging infectious disease issues. The program will include
plenary sessions and symposia with invited speakers,
presentations on emerging infections, and oral poster presentations. Featured
topics include: surveillance, epidemiology, research, communication and
training, bioterrorism, and prevention and control of emerging infectious
diseases, both in the United States and abroad.
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Further information about emerging infections and the APEC Emerging Infections
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