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Vol. V, No. 01~ EINet News Briefs ~ Jan. 11 , 2002

****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 listserve

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


Vietnam — Dengue Fever
It has been reported that the number of dengue fever cases in Vietnam in 2001 have increased 62 percent from the previous year. According to reports, the number of people who contracted the viral illness in 2001 is 39,563. Currently there is no cure or vaccine for dengue. Reports have not given reasons for the rise of cases in Vietnam, but stated that the southern Mekong Delta region has the highest rate of the mosquito–borne disease and that the area is an ideal environment for mosquitoes to breed because many farmers in the area use containers to store rain water.

Although there has been an increase in the number of dengue fever cases, there have been fewer cases of malaria reported in Vietnam. According to reports, a total of 242,018 people contracted malaria in 2001 (more than 2 percent less than last year). In addition, the number of deaths from malaria has decreased by 45 percent (76 deaths).
[Promed 12/29/01]

Vietnam — Return of Female Sex Workers from Cambodia
According to Vietnamese officials, an estimated 60,000 female sex workers are expected to return to Vietnam after Cambodian authorities ordered bars, nightclubs, discos, and karaoke clubs to shut down in November 2001. Many of the Vietnamese women worked in these establishments and have a high risk of being exposed to HIV. It has been reported that officials feel that the return of these female sex workers will pose a risk because of possible infections with sexually transmitted diseases (STDs), including HIV.

Although the number of female Vietnamese sex workers living in Cambodia is reported to be around 60,000 by Vietnamese officials, other reports give a much lower estimate. The lack of condom use in brothels and similar settings as well as lack of prevention through education are causing concern about a possible HIV/ADIS epidemic in Vietnam. Vietnamese public health officials warn that the country's AIDS problem is growing at an alarming rate and is rising among injection drug users, tuberculosis patients, and female sex workers. According to a Reuter's report, current HIV prevalence is estimated at 0.22 percent to 0.29 percent. The Vietnamese Ministry of Health (MOH) estimates that the number of citizens currently infected with HIV is 120,000, out of a population of over 76 million.
[Promed 01/05/02; Sea–Aids 01/09/02; Reuters Health 01/02/02]


US — Avian Influenza
Officials have ordered the gassing of 135,000 birds in Pennsylvania due to the contamination of chickens with a strain of avian influenza. The disease can be spread bird to bird and humans can pass the disease to birds. However, most strains do not make humans sick. The virus first appeared in two flocks in Union County at the beginning of December 2001 and then spread to four nearby flocks. Testing in two additional flocks led state agriculture officials to order quarantines at those farms. The original six Union County farms affected remain quarantined. State officials are still advising Pennsylvania's large–scale poultry farmers to limit access to flocks and to disinfect trucks and equipment.

According to the assistant vice president of the Poultry Council, the Union County outbreak is likely connected to a virus found in live bird markets in New York and New Jersey, where some Pennsylvania farmers do business. The state veterinarian has said that the total value of the destroyed chickens is approximately $120,000. Farmers who were ordered to destroy flocks are eligible for reimbursement of up to 66 percent of the value of each bird.
[Promed 01/09/02]


Republic of the Congo and Gabon — Ebola Hemorrhagic Fever
According to the World Health Organization (WHO), 21 confirmed cases of Ebola hemorrhagic fever in Gabon and 13 confirmed cases in villages close to the border between Gabon and the Republic of Congo have been reported, as of
7 Jan 2002. There have been a total of 25 deaths reported by the WHO. An additional 16 suspected cases in Gabon are under investigation. The WHO reports that all persons having direct or suspected contact with blood or other body fluids of an infected person are being closely monitored for 21 days for any sign of Ebola hemorrhagic fever. As of
7 Jan 2002, 231 people in Gabon and 34 in the Republic of the Congo are under active follow–up.

The government of Gabon has restricted access to a province affected by the virus and security and defense authorities helped local officials control movement in and out of Ogooue Ivindo, a northeastern province of Gabon. The border between Gabon and the Republic of Congo has been sealed and only medical specialists involved in the outbreak are able to cross. In addition, officials in the Republic of Congo have blocked off a 125–mile region on their side of the border.

A committee created to deal with the Ebola outbreak reportedly includes ministers of health, defense, transport and the interior and is under the supervision of the Prime Minister. In addition, the Gabonese Red Cross Society is carrying out health education activities in Gabonese villages.
[World Health Organization release 01/07/02, 01/09/02; Promed 01/06/02]


Brazilian Scientists Sequence Bacteria Genome
In early Dec 2001 it was announced that Brazilian scientists have sequenced the complete genome of Chromobacterium violaceum, a gram–negative bacterium found in the soil and water of subtropical regions and abundant in the Brazilian Amazon. A network of 160 researchers in 25 laboratories throughout Brazil worked in collaboration in order to sequence the bacteria's genome. C. violaceum is the first organism sequenced by Ministry of Science and Technology's Brazilian Genome Project (BRGene).

Researchers are interested in utilizing the bacterium and its products through biotechnology. It is thought that genomic information about this bacterium may be helpful in providing new treatments for diseases ranging from cancer to Chagas disease. C. violaceum produces violacein, a purple pigment known to produce antibiotics, antifungicides and a substance that supresses tumors in mice. In addition, a product of the bacterium could be used as an alternative to pesticides because it is highly toxic to insects. For more information please visit http://www.brgene.lncc.br/index.html.
[Associated press 12/19/01]

PAHO Celebrates its 100th Anniversary
On Jan 07 2002, the Pan–American Health Organization (PAHO) launched the celebration of its 100th anniversary, marking a century since its founding in Washington, D.C. in 1902. PAHO serves as the Regional Office of the World Health Organization and is made up of 35 member countries from throughout the Americas. Some of the significant contributions of PAHO in last 100 years to the improvement of health include the eradication of polio in the Western Hemisphere, considerably lowered infant mortality rates, improved life spans, and increased access to basic health care throughout the Americas. Continuing challenges faced by the organization include HIV/AIDS and the health consequences of smoking.
[PAHO http://www.paho.org/English/DPI/100/launch.htm]

APEC Network of Networks Meeting
A meeting of Asia Pacific disease alert and surveillance networks is to be held in Seattle, Washington between
28–30 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 Web site.


The Genetics of Avian Influenza Virus Transmission to Humans
According to a study published in the Jan 2002 issue of Journal of Medical Virology (J Med Virol 2002;66:107𤩢), the ability of avian influenza viruses A H5N1 and H9N2 to cause infection and disease in humans may be due to their shared gene constellations.

In 1997 an outbreak of febrile respiratory illness occurred in Hong Kong involving H5N1, an avian influenza virus, and H9N2, a closely related quail influenza virus. The ability of the avian virus to infect humans was not well understood and it was previously assumed that the major barrier preventing avian strains from infecting humans were the types of sugar molecules on the cell surface that the virus uses to bind to cells.

Dr. Michael Shaw from the US Centers for Disease Control and Prevention (CDC) and colleagues sequenced nine H5N1 and two H9N2 isolates in order to identify molecular changes associated with avian to human transmission of the viruses. The scientists found that the gene sequences of all isolates showed more than 90 percent sequence homology with avian virus sequences available in gene databases and that the viruses were most like the H5N1 and H9N2 viruses isolated in live poultry markets in Hong Kong in 1997. In addition, the scientists discovered three distinct subgroups when analyzing the nucleotide sequences of the 11 isolates. These subgroups appeared to enable the virus to infect human cells even though they had avian virus properties. However, the new genetic trait does not allow the virus to spread from human to human.
[M. Shaw, L. Cooper, X. Xu, et al. Molecular changes associated with the transmission of avian influenza a H5N1 and H9N2 viruses to humans. Journal of Medical Virology 2002;66:107𤩢]

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 apec–ein@u.washington.edu. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious.

Jan. 11, 2002

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