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Vol. V, No. 02~ EINet News Briefs ~ Jan.25, 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. Journal Articles
  5. How to join the EINet listserve

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


Indonesia — Malaria
According to health officials, malaria has occurred in 13 provinces, 16 districts, and 106
villages throughout Indonesia and has struck 15 million Indonesians since 1998. The
number of malaria cases in the country has been increasing since 1998. For example, the
number of acute malaria outbreaks went up from 18 to 48 in the Bali–Java region since
1998. The increase in outbreaks is attributed to bad management of shrimp ponds, illegal
sand exploration, illegal mangrove logging, population mobility, and climate change.
Authorities have pledged to carry out mosquito abatement in some affected areas later in
[Promed 01/20/02; Associated Press 01/19/02]

Indonesia (Sulawesi) —Dengue Fever
As of 10 Jan 2002, 25 people, including 22 children, were hospitalized for dengue fever
in North Sulawesi, Indonesia. First reports of the disease occurred on 1 Jan 2002 in
Manado, Bitung, and Minahasa. According to the provincial health office there had been
no fatalities as of 10 Jan 201. The provincial health office did not consider the spread of
dengue fever in North Sulawesi unusual. However, the spokesman for the hospital at
which all dengue patients in Manado are being treated said that the spread of the disease
had been classified as significant and that the hospital had established a team to fight the
[Promed 01/15/02]

China (Macao) — Dengue Fever
According to the Chinese Health Service Bureau, as of 30 Sept 2001, more than 1,000
local residents of Macao, China have been confirmed as infected with dengue fever. The
disease is believed to have been brought to Macao by travelers returning from Southeast
Asian countries. Preventing the spread of the disease will be a priority on the 2002
agenda of health service departments in China's Macao Special Administrative Region
(SAR). Efforts by the Health Service Bureau will include improvement of mosquito
eradication, the use of more accurate apparatus to treat dengue fever, and closer
cooperate with counterparts in neighboring countries and regions.
[Promed 01/22/02]

Japan — Psittacosis
It has been reported that four bird keepers and one visitor of the Matsue Vogel Park in
Shimane prefecture, western Honshu Island, were confirmed to have psittacosis. The
visitor was at the park on 12 Dec 2001 and was diagnosed with psittacosis on 12 Jan
2002. Five bird keepers had fevers between 8 and 20 Dec 2001 and four of the cases were
confirmed. The clinical conditions of these patients have not been reported.

Two scarlet macaws, Ara macao, and two Moluccan cockatoos, Cacatua moluccensis,
have been suspected as being the source of infection. The birds had been transferred on
30 Oct 2001 from a closed zoo in the Chiba Prefecture. Although park policy is to isolate
imported birds for at least three months upon arrival to the park, these particular birds
were not isolated because they originated within Japan. The aviary in the park was closed
on 14 Jan 2002 and the city task force notified approximately 95,000 people who have
visited the park since October 2001.
[Promed 01/20/02]

Australia — Measles
Due to a recent outbreak, health authorities in Western Australia's southwest have
advised people aged 18 to 30 to ensure that they are immunized against measles.
According to the Health Department’s communicable disease control, nine cases of
measles had been confirmed since 9 Dec 2001 and four of the cases were hospitalized.
The outbreak had been connected to a 25–year–old woman who acquired the disease
while in Bali, Indonesia.

The area had been free of locally circulating measles virus for three years and most
people older than 30 and younger than 18 have immunity. However, blood surveys show
that around 15 percent of people between ages 18 and 30 are not immune.
[Promed 01/13/02]


Canada (British Columbia) — Necrotizing fasciitis
As of 14 Jan 2002, four cases of invasive group A streptococcus infection (iGAS), an
infection that can cause flesh–eating disease or necrotizing fasciitis (NF), have occurred
in British Columbia. According to The British Columbia Centre for Disease Control, a
total of 97 laboratory–confirmed cases of iGAS infection were reported in British
Columbia during 2001. Most of the reports (81 percent) were from seven of the 15 health
service delivery areas throughout the province, including Vancouver, South Fraser,
Capital, Simon Fraser, Thompson, and Northern Interior. Five deaths associated with
iGAS infection and 21 cases of NF were reported during 2001. A number of other
bacteria can cause necrotizing fasciitis as well. The overall increase in incidence of NF in
British Columbia is attributed to an increase in cases of iGAS in Vancouver Island. It is
thought that the increase in cases in Vancouver Island is due to a widespread circulation
of group A streptococci in this population at this time. For more information, please visit
[BC Centre for Disease Control 01/15/02]

United States (Texas) — Bayou Virus
According to Houston health officials, in Dec 2001 a 30–year–old man became ill with
Bayou virus, a hantavirus carried by rice rats. Hantavirus pulmonary syndrome is a
potentially fatal disease contracted by inhaling airborne particles of dried urine or
droppings from an infected rodent. The man, who was hospitalized for nine days, has
recovered. According to health officials, he most likely was exposed to the disease while
duck hunting in Louisiana or in the Texas county of Brazoria. The Houston Department
of Health and Human Services said that the man's house was well kept with no crawl
space underneath, making contact with infected rodents there doubtful. The Texas
Department of Health and the state of Louisiana are conducting investigations to
determine the source of the Houston man's exposure.
[Promed 01/15/02]

United States — Botulism Food Contamination
The American Food and Drug Administration (FDA) has warned of food contamination
in cans of chopped clams produced by Cape May Foods of Cape May, New Jersey. The
company is recalling the 6.5–ounce cans because they may be contaminated with
Clostridium botulinum, a gram–positive and anaerobic bacterium that can cause life–
threatening illness or death. Botulism is caused by the consumption of contaminated
products containing the bacteria or spores. Spores produce toxin when they germinate in
the product or in the digestive tract. Botulism can cause general weakness, dizziness,
abdominal swelling, and constipation as well as difficulty speaking, swallowing, and

The LaMonica Brand chopped clams were distributed primarily to states in the northeast
United States and are labeled with the can code C271C. The FDA has warned that people
should not eat the clams even if they don't look or smell spoiled and that they may be
returned to the place of purchase for refunds. The contamination was discovered after the
manufacturer received consumer complaints about swollen cans. The FDA cautioned that
bulging cans may be a warning sign of botulism, but that clams can be contaminated even
when cans appear normal.
[FDA News 01/10/02; Promed 01/12/02]


Brazil (Paraná) — Toxoplasmosis
The largest outbreak of toxoplasmosis ever recorded in Brazil took place in the
northwestern part of Paraná state. Reports state that 290 individuals were affected and
132 cases were confirmed by laboratory examination. Three infected women were known
to be pregnant and one woman miscarried due to infection. Toxoplasmosis in pregnancy
may lead to neurological problems and abortion. According to reports, no more cases
have occurred as of 15 Jan 2002.

The source of the epidemic has not been found, but a contaminated underground reservoir
that supplies the town of Santa Isabel do Ivai is suspected. Toxoplasmosis is caused by
the single–celled parasite, Toxoplasma gondii and can be transmitted by ingestion of
oocysts of Toxoplamsa gondii in soil or contaminated sources such as meat, cats, or
water. According to reports, the reservoir is to be shut down.
[Promed 01/12/02, 01/15/02]


Republic of the Congo and Gabon — Ebola Hemorrhagic Fever
According to the World Health Organization (WHO) 24 confirmed cases of Ebola
hemorrhagic fever in Gabon and 15 confirmed cases in villages in the Republic of the
Congo have been reported as of 17 Jan 2002. There have been a total of 30 deaths
reported by WHO. The international team working to contain the epidemic is operational
in Libreville, Makokou and the Republic of the Congo. The WHO is discussing the return
of the team to Mekambo with provincial and national authorities. It is hoped that the team
will go back at the earliest possible date to aid in containing the outbreak in collaboration
with local authorities.
[World Health Organization Update 15]


Conference on TB, HIV, and the Media, Tb.net 2002
A Conference entitled “Tb.net 2002: Communicate before it’s too late” will be held in
Kathmandu, Nepal during 22㪰 Feb 2002. The conference will cover such topics as
communication between TB and HIV workers; the role of the media in communication;
and techniques and modes for communication. The conference is limited to 150
participants. Information on registration and scholarships are available at http://www.tb.net.np.

Second International Conference on Sexual Health and Care
An international conference organized by Siam Care will be held in Bangkok, Thailand
during 23㪴 Feb 2002. The conference will cover topics such as adolescent sexual
health; sexual health promotion, prevention, and networking; and community and home
based care.

APEC Network of Networks Meeting
A meeting of Asia Pacific disease alert and surveillance networks is to be held in Seattle,
Washington, USA 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.


11th Influenza Virus Protein May Play Role in Virulence
An article in a Dec 2001 issue of Nature Medicine (Nat Med 2001;7:1306㪤) reports the
discovery of a new protein, PB1–F2, which may influence the pathogenicity of Influenza
A virus (IAV). The international team of authors includes researchers from the National
Institute of Allergy and Infectious Diseases in Maryland, USA; the Heinrich Pette
Institute of Experimental Virology and Immunology in Hamburg, Germany; the Mount
Sinai School of Medicine in New York, USA; and the Institute of Biochemistry at
Humboldt University in Berlin, Germany.

Previous studies suggested that the influenza virus is comprised of eight genes that can
combine to produce 10 proteins. The new discovery of the PB1–F2 protein, which is
made by translation from an alternate reading frame, suggests that perhaps more are yet
to be discovered. This new virus protein works by damaging mitochondria, the cell’s
energy producer, and is proficient at killing immune system cells that protect the body
against a viral infection.

According to the authors, the gene probably came from a bird virus. This may explain the
dangerous influenza outbreak in Hong Kong in 1997 that was caused by a virus
transmitted directly from chickens. The discovery may also contribute to the
understanding of worldwide influenza pandemics and other lethal influenza outbreaks
caused by direct bird to human transmission.
[Chen W, Calvo PA, Malide D, Gibbs J, Schubert U, Bacik I, et al. A novel influenza A
virus mitochondrial protein that induces cell death. Nature Medicine 2001; 7:

Cattle Carrying Influenza Strains
An article published in Nature’s Science Update entitled “Cows could foster flu
pandemics” (9 Jan, 2002) suggests that cattle could act as a breeding ground for future flu
outbreaks. Ian Brown and colleagues at the Veterinary laboratories Agency in the United
Kingdom have found influenza genes in cattle for the first time. It is not known whether
or not the virus can spread from cow to cow or where the cattle virus originated.

Influenza viruses originate in wild birds and are thought to become lethal when they cross
into poultry or pigs. In cells infected with another flu variety, the viruses pick up genes
that enable them to infect humans. Of concern is the possibility that dormant cattle
viruses could emerge in more virulent forms to infect humans.
[Nature 01/09/02 http://www.nature.com/nsu/020107/020107נ.html]

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.

Feb. 4, 2002

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© 2002, The University of Washington