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Vol. IV, No. 21 ~ EINet News Briefs ~ December 29, 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:

  1. Infectious disease information
  2. Updates
  3. Notices
  4. How to join the EINet listserv

Below is a bi–monthly summary of Asia–Pacific emerging infectious diseases.

Thailand – Lymphatic Filariasis
Thailand's Public Health Department recently surveyed migrant workers and found that an unusually high percentage of the cases tested positive for lymphatic filariasis. Filariasis is a mosquito borne disease. Elephantiasis, a filarial clinical entity, can be a disfiguring disease that causes arms, legs, and genital organs to swell several times their normal size. According to Krit Hiranus, chief of the Health Department, 26 (5.05 per cent) of the 515 random blood tests for elephantiasis in workers in Bangkok returned positive results. Although many in Bangkok have tested
positive for the disease, the number of patients being treated is low because symptoms can take as long as five years to manifest themselves and
the majority of infected people are asymptomatic. The workers in the survey who tested positive have been treated.

In 1997 the World Health Organization began an effort to eliminate lymphatic filariasis, a disease caused by the parasitic worms Wuchereria
bancrofti, Brugia malayi, and B. timori. The disease does not often result in death, but is a major cause of morbidity. According to WHO, more than 1.1 billion people live in areas at risk of infection and about 120 million people in tropical and subtropical areas of the world are
infected. For more information about elephantiasis please visit http://www.filariasis.org/index.shtml.
[Promed 12/17/01; World Health Organization]

New Zealand – Sparrow Salmonella Outbreak
According to New Zealand health officials, "Sparrow salmonella" (Salmonella typhimurium type 160) accounted for 47 per cent of all
gastroenteritis cases during the month of November. This strain of bacterial disease was previously recorded in only two humans in New Zealand (during 1998 and 1999), but affected 1,802 people in the year 2000 and 2,275 people during 2001 as of 14 Dec. The strain causes fever,
diarrhea, stomach cramps, nausea, lethargy, and vomiting in humans.

According to Dr. Bob Boyd, the national Health Ministry's chief public health adviser, early results of a study of S. typhimurium type 160 in 117
cases between April and August have reinforced the need to follow food safety and hand hygiene recommendations. Salmonella is enterically
communicable. The study found that cases were four times more likely than the non–infected people to have had contact in the previous month with someone suffering from vomiting or diarrhea. In addition, cases were 30 times more likely than controls to have touched wild birds within three days before their illness. It has been reported that the epidemic of S. typhimurium type 160 in humans has followed the emergence of infections and subsequent deaths among birds and animals in New Zealand.
[Promed 12/22/01]


Cook Islands — Dengue Fever
Three cases of dengue fever have been reported between 26㪴 Nov 2001 in the Cook Islands, an island group in the South Pacific Ocean. According to reports, the three cases contracted the illness in the capital city of Rarotonga. Tupu Araiti, the Secretary of the Ministry of Health, has said disease–carrying mosquitoes on the island has been discovered almost a month after the hospitalization of two tourists with the illness from French Polynesia. This is the second time during 2001 that local cases have been reported after imported cases were discovered. A total of nine cases has been reported to authorities in the Cook Islands during 2001 and five of these have been imported from abroad. Other parts of the Pacific have experienced high levels of the potentially fatal disease this year, but the outbreak in the Cook Islands is considered minor.
[Promed 12/13/01]


Gabon – Ebola Haemorrhagic Fever
According to the World Health Organization (WHO) 27 confirmed cases of Ebola haemorrhagic fever, including 18 deaths, have been reported in Gabon as of 23 Dec 200. In addition, seven suspected cases are under investigation. Fifteen of the 27 cases were detected in Gabon and 12 were detected in neighboring villages of the Republic of the Congo. As of 23 Dec 2001, a total of 203 persons who have had either direct or suspected contact with the blood or other body fluids of a case are being closely monitored for signs or symptoms of Ebola for 21 days. Ninety–four contacts are being followed up in the Republic of Congo and 109 contacts are being followed up in Gabon. An international team is working closely in the field with the teams from the Congolese and Gabonese Ministries of Health on outbreak control interventions. For more information, please visit http://www.who.int/home–page/.
[World Health Organization]

Japan – Cow Suspected to Have BSE Tests Negative
According to the Japanese Ministry of Health, Labor, and Welfare, the fourth cow suspected to have bovine spongiform encephalopathy (BSE) has tested negative. The three other cases of BSE have been confirmed. Japanis the only non–European country where local cattle have been found infected with BSE.
[Promed 12/17/01]


Chronic Wasting Disease Test
For the first time, a live animal test has been developed to detect chronic wasting disease (CWD) a disease related to bovine spongiform
encephalopathy (BSE). Chronic wasting disease and BSE are thought to be caused by infectious proteins known as prions and infect the brains of
animals, causing them to become thin, display abnormal behavior, lose bodily functions, and die. Currently, there is no test for BSE in live
animals, but a test has been devised recently by the Colorado Division of Wildlife (DOW) to detect chronic wasting disease (CWD) in live and dead deer. The Colorado DOW, working with Colorado State University and the University of Wyoming, began a research project in 2001 to determine if the live test would be accurate and effective. The test for CWD utilizes samples of tonsil tissue from live mule deer and is more sensitive than the current standard test for CWD, which involves examining the brain tissue of animals killed by the illness. This is because prions congregate in the tonsils early in the disease's development.

As there is no cure for either BSE or CWD, the new test provides an important mechanism for preventing the spread and reducing the prevalence
of the disease in wild and captive deer herds. Testing of tonsil tissue is equally effective in both live deer and expired deer, but the test is not
effective for elk due to the differences of disease development in the two species. As of yet, there is still no live test for elk.
[Promed 12/23/01]

APEC Network of Networks Meeting
A meeting of Asia pacific disease alert and surveillance networks is to be held in Seattle, 28㪶 Jan 2002. The meeting will bring together
infectious diseases electronic networks throughout the Asia–pacific region and focus on innovation and collaboration across networks. The meeting is by invitation, but proceedings will be made available through the EINet website.

ICEID 2002
Preliminary program information is now available online for the International Conference on Emerging Infection Disease. The meeting,
hosted in Atlanta by the Centers for Disease Control and Prevention (CDC), will be held in March of 2002 in order to bring together public health professionals to discuss scientific and public health information on global emerging infectious disease issues. For more information, please
visit http://www.cdc.gov/iceid/program.htm.
[CDC http://www.cdc.gov/iceid/index.htm]

Thailand — Asia's First Global HIV/AIDS Forum
On 17 Dec 2001 around 3,000 HIV and AIDS activists, experts, and health officials from around the world met in Chiang Mai, Thailand for Asia's first global HIV/AIDS forum. The Fifth International Conference on Home and Community Care for Persons Living with HIV/AIDS focused on medical treatment and social care for HIV/AIDS patients worldwide. The four–day conference discussed access to medical care in developing countries, clinical treatment, international research and discrimination against people with HIV/AIDS.
[Associated Press 12/17/01]

United States — Anthrax Vaccine
On 20 Dec 2001 the United States Department of Health and Human Services (HHS) reported that around 3,000 people, members of the United States congress and others who may have been exposed to anthrax, will be offered a controversial anthrax vaccine. The vaccine, which was developed for use only by military personnel, will be administered as part of an experimental study.

The study is experimental because the vaccine was developed only to protect people who are immunized before exposure. It is thought that the
vaccine will stimulate the creation of antibodies to provide short–term protection from anthrax. The possible risks of the vaccine will be explained to the individuals and will only be given with full informed consent. Some mild side effects of the vaccine include redness and
swelling at the site of injection. Those receiving the vaccine will be asked to take part in a follow–up study to determine the effectiveness of
the vaccine when given after exposure.

According to the HHS, the vaccine is normally given in a series of six injections over 18 months, but will be given to volunteers in three doses
over a four–week period. The vaccine dosage is based on studies done with monkeys and is thought to be enough to stimulate antibody production. Anyone accepting the vaccine will also be required to take antibiotics for an additional 40 days. The HHS feels the chance of developing anthrax this long after exposure is very low.
[Promed 12/21/01]

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.

Dec.29, 2001

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