IV, No. 19 ~ EINet News Briefs ~ Nov.
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In this edition:
- Infectious disease information
- Journal articles
- How to join the EINet listserve
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a semimonthly summary of AsiaPacific emerging infectious diseases.
According to the Japanese government, the second case of bovine spongiform
encephalopathy (BSE) in the country has been confirmed. The infected
cow was discovered during a nationwide screening of all cows at a meat
inspection center in Hokkaido, northeastern Japan. Japan's first case
of BSE, found in Chiba Prefecture, was confirmed by the Ministry of
Agriculture, Forestry and Fisheries on 22 Sept 2001. Beginning 18 Oct
2001, the Health Ministry began a nationwide screening of all cows for
China (Guangzhou) Pork Poisoning
The biggest porkpoisoning incident of South China's Guangdong Province
took place in Heyuanon on 7 Nov 2001. About 500 people were suspected
to have eaten poisonous pork purchased from local bazaars. Symptoms
of the poisoning included vomiting, headache, and a rapid heartbeat.
The illness is only lifethreatening if hospital treatment is not received
in time. Victims are said to be in stable condition or recovering in
local hospitals and no deaths related to the cases have been reported.
Heyuan government banned sales of pork in the whole city
for three days, set up a task force in order to investigate the cause
of the poisoning, and secured all pork suspected of being poisonous.
On 11 Nov 2001, six suspects who were accused of producing or selling
poisonous pork in Heyuan, China's Guangdong Province, were arrested
and questioned by local police. Three of the suspects were owners of
private pigraising companies and were found to have fed their pigs
with poisonous feedstuff. Farmers used the poisonous feedstuff in order
to increase the percentage pig muscle, but it is dangerous to human
health. Three other suspects were accused of knowingly selling pork
raised on the poisonous feedstuff.
Health Minister Zhang Wenkang has urged for improvements
in the inspection system and pushed for frequent checks on every part
of the food production process, including planting, breeding, production,
processing, storage, transportation and sale.
[Promed 11/17/01, Associated Press 11/09/01]
According to the Department of Health in the Philippines, two separate
incidents of human anthrax involving nine human cases are being monitored
in Barangay Matibag Banna, Ilocos Norte. The National Epidemiology Center
and Research Institute for Tropical Medicine determined that the cases
became ill on 2 Oct 2001 and 7 Nov 2001.
On 2 Oct 2001, six people developed signs consistent with
cutaneous anthrax after a dead carabao was butchered and eaten by townsfolk.
On 7 Nov 2001 three more people developed skin lesions after another
dead carabao was butchered and eaten. A third carabao died on 19 Nov
2001 and was not butchered, but was dehorned. The horns of the third
carabao were tested for anthrax and preliminary test results indicate
the presence of Bacillus anthracis. At the time of investigation, all
nine patients had selfmedicated with various antibiotics and the skin
lesions had healed.
Canada Organic Beans Recall
The Canadian Food Inspection Agency is warning the public not to consume
nine varieties of Green House brand organic bean products due to possible
Clostridium Botulinum contamination. C. Botulinum produces
toxins causing a lifethreatening illness, botulism, in humans. Products
include green lentils, chick peas, white kidney beans, bean salad,
lima beans, pinto beans, red kidney beans, red kidney beans in tomato
sauce, and spicy red kidney beans in tomato sauce. These products,
which are manufactured by Lockwood's, Italy in Concord, Ontario, are
known to have been distributed in Ontario and may have been distributed
throughout Canada. No illnesses associated with the consumption of
these products have been reported.
Canada E. coli Outbreak
As of 26 Nov 2001, 12 cases of Escherichia coli O157:H7 phage
type (PT) 32 have been confirmed in Southern Ontario. Cases include
two people in the MiddlesexLondon area and 10 other cases in Ottawa,
Kingston, Toronto, York Region, Simcoe County, and Windsor. None has
died. The source of the outbreak is unknown, but health officials
say it is unlikely that the infections were caused by contaminated
tap water. The limited number of cases and their wide geographic spread
make sources such as contaminated food and drink seem more likely.
US (Minnesota) Unexplained Deaths
As a precautionary measure, the Minnesota Health Department has asked
all Minnesota hospitals and surgery centers to cease performing any
elective knee operations for a oneweek period so that state health
officials can investigate the deaths of three male surgical patients.
A 23yearold patient had knee surgery at St. Cloud Hospital on 7
Nov 2001 and died on 11 Nov 2001. A 78yearold patient had knee surgery
at the same hospital on 9 Nov 2001 and died on 11 Nov 2001. The third
man, a 60yearold patient, had knee surgery at Douglas County Hospital
in Alexandria on 13 Nov and died on 16 Nov 2001. The three men did
not have the same procedure done. They had previously been healthy
and became ill up to several days after having surgery. According
to the Minnesota Health Department, symptoms of all three cases strongly
suggested an infection.
[Promed 11/22/01; Minnesota Department of Health http://www.health.state.mn.us/news/pressrel/knee.html]
US West Nile Virus
Three cases of human West Nile Virus (WNV) encephalitis or meningitis
have been reported during the period of
7 13 Nov 2001. Two cases occurred in New York and one case
occurred in Louisiana. During 2001, a total of 45 human cases of WNV
encephalitis or meningitis have been reported. During this time period,
WNV infections were also reported in 266 crows, 15 other birds, and
A 44yearold man was the first person in Alabama to die from WNV
infection, state health officials said on Friday 16 Nov 2001. The
man, who was not identified, died on 30 Oct 2001 after becoming infected
in late August. The man is the fifth person in the United States to
die from the mosquitoborne virus this year.
In addition, blood samples from three horses in Virginia have recently
tested positive for West Nile Virus (WNV). The United States Department
of Agriculture (USDA) National Veterinary Services Laboratory has
confirmed the results. Six horses have now tested positive for WNV
in Virginia. The first case reported in the state occurred in September
[MMWR http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5045a4.htm; Promed
On 19 Nov 2001 Chilean authorities announced that they had found anthrax
in a letter postmarked from Florida. Although the letter was postmarked
from Florida, it appeared to carry a Swiss postage stamp. The Public
Health Institute confirmed the presence of anthrax spores in the letter
sent to a private office in Santiago. The Health Minister, Michelle
Bachelet, has said that thirteen people who may have been exposed
to the anthrax are taking antibiotics, but that so far no one has
shown signs of infection.
[Promed 11/19/01; Associated Press 11/23/01]
US (Connecticut, Washington D.C.) Anthrax
A 94yearold Connecticut woman, Ottilie Lundgren, died of inhalation
anthrax on 21 Nov 2001, five days after being admitted to hospital.
Officials have not determined how the woman contracted the disease because
she had no known connection to government offices, postal facilities,
or news outlets. Preliminary testing of Lundgren's home in Oxford found
no signs of the bacteria. Investigators from the Center of Disease Control
(CDC) also tested two post offices and the woman's church for anthrax
spores, but found no positive results. The strain of anthrax that killed
the elderly woman was similar to strains found in other recent cases
and, therefore, the Federal Bureau of Investigation (FBI) has begun
a criminal investigation of her death. Investigators have sealed off
the woman's house and are questioning friends and family members in
order to trace her recent movements. She is the fifth anthraxrelated
fatality since several anthraxlaced letters began appearing in the
mail in October.
In addition, a letter laced with anthrax was sent to Vermont Democrat,
Senator Patrick Leahy. The letter was discovered 16 Nov 2001 in a
set of unopened mail sent to Capitol Hill and quarantined since the
discovery of an anthraxcontaminated letter to Senate Majority Leader
Tom Daschle on 15 Oct 2001.
[Promed 11/22/01; Associated Press 11/26/01]
US (CONNECTICUT) Poultry Avian Influenza Correction
It was reported in the previous bulletin that the state agency said
avian influenza virus was found in chickens on a farm raising broilers.
Antibodies to avian influenza were detected in broiler chickens from
a multiage operation in Scotland, Connecticut. However, no influenza
virus was isolated.
WHO Opens Office in Pyongyang
The World Health Organization (WHO) has opened up an office in North Korea's
capital, Pyongyang. A WHO spokesman in Beijing is reported to have said
that North Korea's health care system was near collapse. According to
WHO officials, the mortality rate there has risen by more than 35 % in
recent years because the country suffers from harsh winters, food shortages,
and malnutrition. The WHO has had an emergency liaison office in the North
since 1997, but a representative office, which has better resources and
staffing, will permit the WHO to expand its work as well as focus on longerterm
issues such as technical collaboration and health policy development.
The WHO has previously been involved in emergency programs in North Korea
to aid in reemerging diseases such as tuberculosis, polio and malaria
as well as contribute in training and technical support.
WHO Global Outbreak Response Meeting
The World Health Organization convened its " Global Outbreak and
Response" meeting in Geneva on 29㪶 Nov 2001. The group of international
experts will work towards a common agenda for reinforcing global efforts
at epidemic prevention, surveillance and response. In addition, an evening
sidemeeting focusing on Asia will be held.
4. JOURNAL ARTICLES
Gene May Protect Against CreutzfeldtJakob Disease
According to a paper by John Collinge of Imperial College School of Medicine
in London and his colleagues, people who lack the gene DQ7, which is involved
in immune responses, may be three times more likely to suffer from variant
CreutzfeldtJakob disease (vCJD). vCJD is thought to occur when people
are exposed to misshapen prion proteins from cows with bovine spongiform
encephalopathy (BSE) or 'mad cow disease'. The gene, however, does not
seem to protect against classical CreutzfeldtJakob disease(CJD). Of the
50 British, caucasian patients with vCJD in the study, only 12% have a
gene called DQ7. In contrast, 36 % of the normal British, caucasian population
has the gene. Although the findings do not identify any immediate therapy
for the disease they could be helpful to researchers looking for treatments
and aid in understanding host susceptibility to infection by BSE prions.
However, due to the small sample size of the study, the results are to
be interpreted with caution.
[Jackson GS et al. HLADQ7 antigen and resistance to variant CJD. Nature,
414, 269 270, (2001)]
Hemoglobin C Protects Against Malaria
A recent casecontrol study by David Modiano and colleagues shows that
a mutant form of hemoglobin is associated with a reduction in risk of
clinical malaria. Hemoglobin is the oxygencarrying molecule in redblood
cells. According to the 4,348 subject study, there is a 29 % risk reduction
in HbAC heterozygotes (P = 0.0008) and a 93 % reduction in HbCC homozygotes
(P = 0.0011). Hemoglobin C is common in malarious areas of West Africa
where the Mossi group lives, but is rare outside this ethnic group. Researchers
hope that understanding the effect of Hemoglobin C will lead to treatments
[Modiano D, Luoni G, Sirima BS. et al. Haemoglobin C protects against
clinical Plasmodium falciparum malaria. Nature, 305𤬤, (2001)]
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