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About EINet
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Vol. V, No. 16~ EINet News Briefs ~ Sept. 27, 2002
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. OVERVIEW OF INFECTIOUS–DISEASE INFORMATION Below is a semi–monthly summary of Asia–Pacific emerging infectious diseases. ASIA Japan—BSE origins baffle Japan The source of BSE infection in Japan, where five cases have been diagnosed since September 2001, remains debatable. Since the first four infected dairy cows, from different farms, were of the similar age group and said to have been fed during their first months with a calf milk–replacer (CMR) from a common source, earlier commentaries raised the possibility that CMRs might have played a role in the epidemiology. Reportedly, the fifth cow was “probably” fed the same substitute. A Japanese delegation visited The Netherlands in June 2002 to discuss the matter, since the Japanese CMR’s were said to have contained Dutch animal fats; however, the results of this visit remained inconclusive. The Scientific Steering Committee of the EU (SSC) has been working
on an updated quantitative assessment of the possible residual BSE
risk in bovine–derived products such as tallow, gelatin, and dicalcium
phosphate (DCP). A specialized working group is preparing a report
containing proposals for the basic assumptions and input data to be
used in the risk assessment. The final report is expected before the
end of the year. Taiwan—Dengue Fever Cases Reach Highest Total Since
1988 Officials from the Environmental Protection Administration (EPA)
said that there were signs that the number of mosquitoes was on the
decline in some areas of Kaohsiung, and that the cleanup and inspection
efforts were working. The EPA said they were more concerned about
an epidemic next year, explaining that a more serious dengue epidemic
usually occurs in the year following a year like this one if prevention
work is not carried out thoroughly. As a consequence, the EPA is planning
to start its mosquito cleanup effort next year in February rather
than May. Singapore—Rise in Dengue Fever Cases The World Health Organization estimates there may be 50 million cases
of dengue infection each year, with 2.5 billion people, a fifth of
the world's population, at risk. Malaysia—Dengue Alert in Federal Territory and Four
States There were 17, 341 cases reported by the end of last month with 16,
258 being dengue fever and the rest dengue hemorrhagic fever cases.
There were 34 deaths during the period. State health department officials
attributed the increase in cases to a stretch of wet weather followed
by a short dry spell recently. China (Nanjing)—Fatal Food Poisoning Hundreds of people, including many children, fell ill after eating food laced with rat poison at a snack shop, selling fried dough, sesame cakes, and rice in the Chinese city of Nanjing. Several of the victims were reported to have collapsed, some coughing up blood, just minutes after eating at the restaurant. The China Daily said 500 medical personnel have been mobilized to deal with the case. The product that caused the poisonings has been identified as a popular
tetramine rat poison marketed as “Du Shu Qiang,” an official
at the Nanjing Military Region General Hospital said. Production of
Du Shu Qiang is banned in China, but the poison is widely used in
rural areas because of its low cost and high effectiveness, according
to a report in the Shanghai Daily on Tuesday Sept. 17, 2002. As little
as five milligrams of the poison is enough to kill someone, a local
doctor told the newspaper. The active ingredient is Tetramine; Tetramethylene
Disulfotetramine. Mongolia—Plague
AMERICAS
USA (Wisconsin)—Chronic wasting disease
in captive deer The infected deer was killed by a hunter on a preserve Sept. 4. Officials said the buck was believed the first captive deer to test positive for the disease in the nation. Previously only captive elk had tested positive for chronic wasting disease. The game farm has been quarantined, along with another game farm in Walworth County. It has not yet been determined whether all the animals will be destroyed. No cases of chronic wasting disease have been found in Wisconsin 's wild deer population. Like mad cow disease in cattle and scrapie in sheep,
chronic wasting disease is caused by abnormal proteins that attack
the brain and nervous system, causing weight loss and behavioral changes.
Researchers have not yet determined how chronic wasting disease is
spread or whether it is transmittable to humans.
USA (multi–states)—Listeriosis Although DNA testing has shown that the bacteria in the cases in New York City was the same strain as that in the Pennsylvania cases, laboratory tests have not determined whether those deaths in New Jersey are tied to the Pennsylvania cases. Listeriosis is caused by Listeria monocytogenes, a species of bacteria sometimes found in raw foods, including uncooked meat and unpasteurized milk. Although the bacteria should be killed during processing by food manufacturers, it has been found to survive in some ready–to–eat meats. In New York City, recent outbreaks have been linked to hot dogs, turkey meat, and refrigerated pate. Eating listeria–contaminated food results in flu–like symptoms, which may not show up for 10 weeks, including fever, muscle aches, and diarrhea in otherwise healthy people. Pregnant women are at particular risk; they are 20 times more likely to contract listeriosis. The people who died had weakened immune systems, which
placed them at high risk. New York City Health Department officials
said 20 percent of those who have compromised immune systems typically
die if they contract listeriosis. USA—West Nile Virus Transfusion Transmission The recent MMWR summarizes two investigations of recipients of organs and blood products, four investigations of transfusion recipients, and one investigation of a WNV–seronegative person with fever and encephalopathy who received a potentially contaminated unit of blood. The initial investigation demonstrated transmission from a WNV–viremic organ donor to four recipients of those organs. In another investigation, the isolation of live WNV from a unit of Fresh Frozen Plasma (FFP) indicates that the virus can survive in some blood components and probably can be transmitted by transfusion. Although this case is highly suspicious for transfusion–associated transmission, this patient lived in an area where WNV was active, and the exact means of WNV acquisition cannot be determined. In contrast, the preliminary results of another case investigation indicate that not all recipients of potentially WNV–contaminated units (i.e., those that are positive for WNV by TaqMan) will become infected with WNV. Approximately 4.5 million persons receive blood or blood
products annually. Although persons needing blood transfusions or
organ transplants should be aware of the risk for WNV infection, the
benefits of receiving needed transfusions or transplants outweigh
the potential risk for WNV infection. In addition, blood donation
poses no risk to the donor for acquiring WNV, and PHS encourages blood
donation. USA—Mass Smallpox Vaccination Clinic Guide
Now Posted on CDC Web site This document describes the operational and logistical
considerations associated with implementing a large–scale voluntary
vaccination program in response to a confirmed smallpox outbreak. EID Side Meeting: APEC Industrial Science and
Technology Working Group (ISTWG)
Accumulation of Prion Protein in Tonsil and Appendix:
Review of Tissue Samples In their study, one appendix showing the lymphoreticular accumulation of prion protein, the infectious agent responsible for variant Creutzfeldt–Jakob disease (vCJD), out of 8,318 samples tested gives an estimated detectable prevalence of prion protein accumulation of 120 per million (95 percent confidence interval, 0.5 to 900) among people aged 10㫊 between 1995 and 1999. "It offers some limited reassurance, the findings could have been a lot worse than this," said Professor Peter Smith, chairman of the Spongiform Encephalopathy Advisory Committee that advises the government on vCJD. "This is the first time that anybody has been able to get any sort of handle on the level of exposure. But it is a small sample and what is needed now is larger–scale studies," Smith added in an interview. In the seven years since vCJD appeared, 115 people have
died and 12 patients have the disease. The number of deaths during the
first eight months of this year was 11, compared with 20 in 2001 and 28
in 2000.
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