Vol. V, No. 08~ EINet News Briefs ~ April 19 , 2002
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In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a semimonthly summary of AsiaPacific emerging infectious diseases.
Malaysia (Selangor, Melakar) Hand, Foot and Mouth Disease
In Malacca, Malaysia 10 cases of suspected HFMD have been reported
in children less than seven years of age, as of 09 April 2002. According
to the State Human Resource, Health, and Consumer Affairs Committee,
cases were admitted to private and government hospitals for one to
two days for observation before being discharged. The state is closely
monitoring all suspected cases.
Japan Newcastle Disease
Australia (Tasmania) Ross River Virus Infection
Australia (Melbourne) Influenza A Outbreaks
The first outbreak occurred in January 2002 in a hostel where 23 cases were identified by means of laboratory confirmation and two cases were suspected. Nineteen (45%) of the hostel residents and six (21%) of the staff members were identified as cases. A total of 10 residents were hospitalized and there were no deaths. Thirtyeight (90%) of the residents and two (7%) of the staff members had been vaccinated.
The second outbreak occurred in March 2002 in a nursing home in which 16 cases were laboratoryconfirmed and 12 cases were suspected. Fifteen (47%) of the residents and 10 (36%) of the staff members were identified as cases. A total of three staff members and seven residents were hospitalized, one of whom died due to influenza infection. Vaccination histories had been collected on 20 residents and all staff. Eighteen (90%) of the residents with a known history and three (10%) of the staff members had been vaccinated.
The World Health Organization (WHO) Collaborating Center for Reference
and Research on Influenza in Melbourne, Australia performed analyses
and determined that both outbreaks were due to influenza A(H3N2) strains
that were antigenically related to the current and 2001 A/Moscow/10/99
(H3N2)like vaccine component as well as genetically similar to the
recent strains circulating worldwide. According to analyses, the two
outbreaks did not have a common source.
New Zealand Hepatitis A
Symptoms of this most common form of viral hepatitis include nausea,
vomiting, fever, stomach ache, loss of appetite, and jaundice. Foodborne
transmission of hepatitis A virus often occurs due to preparation
of uncooked foods or harvesting of produce by an infected individual.
The majority of hepatitis A transmissions occur by the fecaloral
United States (Virginia, North Carolina) Avian Influenza
The United States Department of Agriculture (USDA) has confirmed the presence of a low pathogenic H7N2 avian influenza virus in turkey breeder flocks and meat turkey flocks in Virginia and North Carolina. Neither Virginia nor North Carolina has had a "highly pathogenic" strain of the virus. The virus, which is not an OIE List A disease, was first detected in midMarch 2002 and has been detected in 19 turkey flocks and one flock of broiler chickens. As of 03 April 2002, a total of 61,000 birds have been destroyed and health officials plan to destroy another 235,000 birds. Both states have decided to depopulate the flocks.
The USDA, Animal and Plant Health Inspection Service (APHIS), Veterinary
Services (SV) has been assisting Virginia and North Carolina with
tracing the source of infection for the outbreak, aiding in final
laboratory diagnostic typing of virus isolates, and handling of international
trade consequences of the outbreak. Currently, the source of the virus
is not known, but it is thought that the virus did not come from wild
birds. Sequence analysis has shown that the isolates are most similar,
but not identical, to H7N2 viruses that have been isolated in the
United States (Texas) Yellow Fever
United States Transmissible Spongiform Encephalopathy
According to the USDA's Animal and Plant Health Inspection Service,
none of the confiscated sheep had entered the animal or human food
supply. According to reports, as part of USDA's scrapie control efforts
the sheep, which were imported from Belgium and the Netherlands in
1996, were placed under federal restrictions when they entered the
United States. In 1998, the USDA discovered that it was likely the
sheep from Europe had been exposed to feed contaminated with bovine
spongiform encephalopathy (BSE). At that time, the state of Vermont
imposed a quarantine that prohibited slaughter or sale for breeding
purposes on these flocks.
It has been reported that on 11 April 2002 an official from the Japanese Agriculture, Forestry, and Fisheries Ministry estimated the damage to farming and related industries due to bovine spongiform encephalopathy (BSE) to be more than 365 billion yen (USD 2.73 billion). The estimate approximates the damage caused between Sept 2001, when BSE was first confirmed in Japan, and February 2002. During that time period revenues at farms are thought to have declined by 131 billion yen (USD 992 million) from a year before and sales by meatselling industries are estimated to have declined by 160 billion yen (USD 1.21 billion). In addition, sales of beef barbecue restaurants have declined by approximately 74 to 90 billion yen (USD 560 to 681 million).
Health Canada Orders Withdrawal of Dura Mater Grafts
On 11 March 2002 the Canadian Health Ministry suspended the license for Tutoplast Dura, the last dura mater graft on the market. The use of these grafts, which are made from human corpses, has been banned by Health Canada because of concern that they may spread CreutzfeldtJakob Disease (CJD). In addition, the government has requested that physicians place any supplies they may have in a secure place. The graft is used to repair the brain's dura mater as well as for other operations such as shoulder surgery and bladder lifts. It has been associated with at least one CJD death in the United States, prompting a Canadian review of the product.
Recently the Canadian Neurosurgical Society estimated that surgeons
used the Germanmade dura mater grafts for about 200 patients a year.
Lyodura, another brand of these grafts that had its license revoked
in 1987, has been linked to approximately 115 CJD deaths worldwide,
including four deaths in Canada. Production methods of the Lyodura
grafts associated with these deaths differed from that of other dura
mater graft producers.
Chinese Estimates of HIV Carriers
Needlesharing among intravenous drug users accounted for 68% of
confirmed HIV cases, while illegal blood transfusions accounted for
9.7% and unsafe sex 7.2%. Beijing went public with its fight against
AIDS last year after state media exposed the spread of the virus in
rural Henan province, where farmers sold their blood to purchasing
stations. In the village of Wenlou in the central province of Henan,
43% of people who sold blood are infected, according to a statement
by the Deputy Health Minister in August 2001. China held its first
AIDS conference in November 2001, and a stateowned pharmaceutical
company announced plans to produce lowcost antiAIDS drugs. Despite
increased openness by health officials at the national level, many
local leaders are accused of suppressing information about the disease
for fear of acknowledging prostitution or drug trafficking in their
Certain Cosmetics Banned in China Due to Fear of BSE
The Chinese ban comes one month after the European Union (EU) blocked
imports of Chinese meat and seafood products because they contained
what were considered harmful antibiotics. As of 04 April 2002, Beijing
customs authorities have seized 177 items of cosmetics from Japan
and Europe that were produced in France, Britain, Italy and Japan.
While many department stores in Beijing have discontinued the sale
of restricted products, others in smaller markets are reportedly continuing
until they receive a list of specified imports to pull. According
to reports, a ministry official said that the list would not be distributed
until after 20 April 2002. The estimated sale of cosmetics from the
affected countries is more than one million US dollars a year, according
to Chinese officials.
AIDS Vaccine Combo Enters Second Human Testing Phase
The survival of three million children each year has been attributed
to vaccination programs. However, according to the UN's Children's
Fund (UNICEF) an additional three million children die because they
cannot receive the needed vaccines. In addition, 10 of 14 vaccine
manufacturers partially or totally stopped production of children's
vaccines between 1998 and 2001. According to UNICEF, this is because
vaccine manufacturers want a commitment long in advance of delivery
date, but some countries cannot make such a commitment because funding
is often set on an annual basis. Vaccine shortages threaten the success
of the worldwide campaign to eradicate polio by 2005, according to
a UNICEF spokeswoman.
Ban on Import of Thai Prawn Fry in Malaysia
XIV International AIDS Conference 2002
Oral Cholera Vaccine Effective in Human Tests
A study in the April issue of Infection and Immunity by Dr. Cohen and colleagues of Children's Hospital Center in Ohio, United States tested a new oral vaccine against cholera called Peru㪧 in 59 healthy volunteers. The existing vaccine available for preventing cholera is given by injection, and protects about half of people who receive it and produces adverse reactions at the injection site and throughout the body. In the study volunteers received either the vaccine, made from live, weakened Vibrio cholerae bacteria, or an inactive placebo shot. Approximately three months later 36 volunteers were exposed to live V. cholerae bacteria.
Headache and abdominal cramps were reported more often with the Peru㪧
vaccine than with the placebo, but the occurrence of abdominal cramps
was not statistically significant. All but one person who received the
vaccine (97%) showed at least a fourfold increase in the amount of anticholera
antibodies in their blood. When exposed to the cholera germ, five (42%)
individuals in the placebo group and none of the 24 individuals in the
vaccine group developed moderate or severe cholera. Seven placebo recipients
(58%) and one (4%) person recipient of the vaccine reported any diarrhea.
According to Reuters Health, investigators plan on conducting a larger,
multicenter challenge study to replicate the results obtained using a
production lot of the vaccine. The length of time that the new vaccine
protects against Cholera has yet to be determined.
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© 2002, The University of Washington