News Briefs Archive

Chile — Hantavirus
Four new cases of hantavirus pulmonary syndrome in Chile have been confirmed, one of which was fatal. All cases occurred in rural areas of southern and central Chile. The agent causing hantavirus pulmonary syndrome in Chile is likely to be Andes virus. According to Health Minister Michelle Bachelet, hantavirus infection has caused 26 deaths this year in Chile. The number of infection this year, 71, is the highest since the disease first appeared in Chile in 1993. However, the percentage of deaths from infection has fallen from 60 percent in 1997 to 37 percent in 2001.
[Promed 12/11/01]

US (New Jersey) — West Nile Virus
A 75–year–old woman was the eighth state resident confirmed to have been infected with the West Nile virus (WNV) as of 9 Dec 2001. In mid–August the woman, who had a cardiac condition, was admitted to hospital with symptoms including fever, nausea and a headache. She had traveled to the West Coast of the United States and the New Jersey shore just prior to her hospitalization and often spent time outdoors. The Centers for Disease Control and Prevention (CDC) confirmed that the woman became infected this season. She is currently in good health.
[New Jersey Department of Health and Senior Services http://www.state.nj.us/health/index.html 12/05/01; Promed 12/12/01]

RELATED NEWS

Gabon — Ebola
According to Reuters, the World Health Organization (WHO) reported on 8 Dec 2001 that there had been at least one case of Ebola virus in the Central African country of Gabon. There had been previous reports of 10 people who had died of a mystery illness and, according to a WHO officia,l 10 people had died in Gabon from a disease feared to be Ebola. The WHO also received reports of cases of suspected viral hemorrhagic fever, which includes Ebola, in a northeastern province of Gabon, Ogooue Iveindo, and had sent a team to investigate. In 1996 at least 66 people had died from Ebola in the same area of the country. Blood samples of the victims in Gabon have been sent to South Africa for tests.
In addition, another WHO official has reportedly said on 7 Dec 2001 that 28 people had died of hemorrhagic fever in the Democratic Republic of Congo. Doctors also feared that this outbreak might be Ebola. There is neither a known cure nor vaccine available for Ebola.

As of 11 Dec 2001, the World Health Organization (WHO) has received reports of 12 suspected cases of Ebola, including ten deaths from hemorrhagic fever. A laboratory in Gabon, the Centre International de Recherches Medicales de Franceville (CIRMF), has confirmed Ebola virus in one sample from a recovering case in Ogooue Ivindo Province.

The Gabon Ministry of Health has established a national task force for managing a response and an international team from WHO and its partners in the Global Outbreak Alert and Response Network arrived in Gabon on 11 Dec 2001 to assist the Ministry of Health. Assistance includes: coordination of an international response to the outbreak,
employment of disease control measures, identifying and monitoring cases and contacts, as well as supplying protective equipment. For updated information, visit http://www.who.int/disease–outbreak–news/index.html.
[Promed 12/11/01; Reuters 12/08/01; UNWIRE
http://www.unwire.org/unwire/current.asp#22470]

Finland — BSE
On 7 Dec 2001 the first case of BSE in Finland was confirmed by the European Union (EU) reference laboratory. The infected cow had shown clinical signs of disorder and was immediately slaughtered. All bovine animals on the farm of origin, all cohort animals, and the progeny of the positive animal have been destroyed. The 6–year–old cow was born in Finland and the source of infection is not yet known.
[Promed 12/07/01]

European Union — Hepatitis A Vaccine Recall
Aventis Pasteur MSD, the European vaccines joint venture set up by Merck and Aventis, announced the recall of all stocks of VAQTA hepatitis A vaccine due to concerns that it might not be potent enough. According to a spokesman for the joint venture, only some of the syringes are not sufficiently potent. However, difficulty in identifying affected syringes led to the decision to recall every batch. The firm is withdrawing all pre–filled syringes of VAQTA vaccine for adults and VAQTA K for children. According to Dr. Pat Troop, the deputy chief medical officer of the Department of Health in the United Kingdom (UK), the VAQTA vaccine products are not being recalled for reasons of safety. It is possible that patients who have received these vaccines since their introduction to the market in 1997 and 1998, respectively, may not have adequate and continuing protection against infection with hepatitis A. The Commercial director of Aventis Pasteur MSD's German unit, Ralf Ehret, reportedly said that 532,000 doses of the vaccine were sold in Europe in 2000. As a precautionary measure, the UK Department of health has advised for anyone at continuing risk of hepatitis A who has been immunized with VAQTA products should be immunized with another hepatitis A product.
[Promed 12/09/01; UK Department of Health Chief Medical Officer's urgent communication http://www.doh.gov.uk/cmo/cmo01_16.htm]

2. UPDATES

US (Minnesota) — Unexplained Deaths
Three unexplained deaths after knee surgery were reported on 7, 11, and 16 Nov 2001. Blood cultures obtained from one of the patients before his death grew a clostridial species that was identified by biochemical and molecular typing at the Minnesota Department of Health (MDH) and the Center for Disease Control and Prevention (CDC) as Clostridium sordellii. Blood cultures from the other two patients did not yield growth of any bacteria and no Clostridium species was identified in their autopsy tissues. The cause of death in these two patients remains unknown.

No cases of C. sordellii infection associated with severe hemodynamic collapse or death in patients recently undergoing knee or large joint surgery have been identified. Because infection associated with contaminated graft tissue is a known but uncommon complication of allograft surgery, MDH, CDC, and the Food and Drug Administration (FDA) began an investigation to determine whether the allograft might have been the source for the C. sordellii found in the patient. The CDC conducted preliminary cultures of non–implanted knee tissue from the same donor source as the allograft used in the deceased patient, but have not found growth of Clostridium species. Reports of other allograft recipients infected with clostridial species have been received at CDC and are being investigated. As a result of the investigation the MDH lifted a moratorium on elective knee surgery on 25 Nov 2001.

US — Anthrax
As of 5 Dec 2001, a total of 22 cases of anthrax have been identified. Eleven were confirmed as inhalation anthrax and seven were confirmed as cutaneous. There have been four suspected cases of cutaneous anthrax. A 54–year–old man who worked at a postal facility in New Jersey (NJ) previously had been classified as having a suspected case of cutaneous anthrax, but the illness no longer meets the CDC surveillance case definition for anthrax.

Prospective and retrospective surveillance in Connecticut has not identified any additional cases of anthrax and the direct source of exposure for the case of inhalation anthrax in the 94–year–old Connecticut woman remains unknown. However, through environmental sampling, B. anthracis spores were identified in three high–speed mail sorters in the postal processing and distribution center in Wallingford, CT. This center serves Oxford, the town where the 94–year–old woman resided, and receives mail from several postal distribution facilities known to have been contaminated by B. anthracis spores.
[Promed 12/06/01; MMWR 2001 50(48); 1077ץ (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5048a1.htm)]
Japan — BSE
According to the Health, Labor and Welfare Ministry, a Holstein dairy cow born in Gunma prefecture and slaughtered in a different prefecture was found infected with BSE on 30 Nov 2001. On 2 Dec 2001 a ministry's panel of experts confirmed the third case of Bovine Spongiform Encephalopathy (BSE). The three BSE infected cows were born between March and April 1996 and were fed the same kind of powdered milk produced at the same Gunma prefecture factory.

Japanese officials found a fourth suspected case of mad cow disease on 11 Dec 2001. According to officials, a 40–month–old Holstein cow slaughtered at a meat processing center in Tsuyama tested positive in an initial examination. Further tests were planned at the Kobe Quarantine office in western Japan and an agricultural and veterinary university in Hokkaido. Japan is the only Asian country where herds have been affected by BSE.
[Promed 12/02/01; 12/12/01]