USA (Midwest) – E. coli O157, Ground
At least 56 Midwesterners have become ill in the latest suspected contamination
of ground beef with E. coli O157 bacteria. As of Sept. 27, symptoms among 52 people
in Wisconsin, three in Minnesota, and one in Illinois have been linked to the
contamination. Nineteen in Wisconsin were admitted to hospital. "The suspected
vehicle for transmission of E. coli 0157:H7 in these outbreaks is ground beef,"
the Wisconsin health agency said. A Wisconsin meat packing company said that it
is recalling, for a precaution, about 400,000 pounds of ground beef that may be
connected to E. coli outbreaks in three states. In May 2002, the company recalled
471,000 pounds of ground beef because of possible contamination with E. coli.
The USDA's recent declaration of war on the deadly strain of E. coli called for
random testing of all US meat processing plants as a precaution. Companies also
were ordered to review their food safety measures and adopt stricter ones to reduce
the risk of contamination. Congressional investigators with the General Accounting
Office said USDA food safety inspectors were not reliable in identifying or documenting
companies that failed to meet federal standards.
USA (Michigan) – West Nile Virus Infection and Breastfeeding
Based on a recent case in Michigan, it appears that West Nile virus (WNV) can
be transmitted through breast milk. A new mother in Michigan contracted WNV from
a blood transfusion shortly after giving birth. A sample of the mother's breast
milk obtained 16 days after delivery tested positive for WNVspecific IgM. She
breastfed her infant, and three weeks later, her baby's blood tested positive
for WNV. Because of the infant's minimal outdoor exposure, it is unlikely that
infection was acquired from a mosquito. The infant was most likely infected through
breast milk. The child is healthy, and does not have symptoms of WNV.
The case does not mean that current recommendations in favor of
breastfeeding should change, according to the Centers for Disease Control and
Prevention, because the health benefits of breastfeeding are well established,
and the risk for WNV transmission through breastfeeding is unknown. The American
Academy of Pediatricians and the American Academy of Family Physicians recommend
that infants be breastfed for a full year of life. Lactating women who are ill
or who are having difficulty breastfeeding for any reason, as always, should consult
According to Dr. Lyle Petersen, a West Nile expert at CDC, two
other viruses in the same family as West Nile had been transmitted to people from
drinking milk from cows or goats. Neither of those viruses has been found in North
America. One is from India and the other from Eastern Europe and parts of Asia.
There is no information about whether those viruses pass into human breast milk.
There were just two viral infections in which women are told not
to breastfeed, HIV and a very rare illness, human Tcell leukemia virus type
1. With other viral illnesses like colds and flu, women are generally told to
continue nursing because the illnesses are not severe enough to justify stopping.
Although mosquitoes are by far the most important source of infection,
Dr. Petersen said, the illness in two transfusion recipients was further evidence
that the virus could spread through blood and blood products. Transmission via
blood is thought to have occurred in three other transfusion recipients. Officials
theorize that four people, including one who died, contracted the disease from
There is no screening test to detect WNV in the blood supply.
Dr. Jesse Goodman of the Food and Drug Administration said his agency was "urgently
working with manufacturers and others with potential blood screening tests to
try to facilitate their availability."
(ProMed 09/29/02, NY Times 09/30/02, MMWR 10/04/02)
USA (Washington) — West Nile Virus, Bird
WNV has been detected in a dead raven collected near Newport, Washington. Testing
at the National Wildlife Health Center Laboratory in Madison, Wisconsin confirmed
the virus. This is the first WNV detection in Washington, according to the state
Department of Health. No human or horse cases of WNV infection have been reported
in Washington. Nationwide, 43 states have detected the virus.
Canada — West Nile Virus
As of Sept. 30, Health Canada has reported a total number of 38 human
cases of WNV infection: 28 suspected cases, 10 confirmed cases, including one
death. Three suspected cases and one confirmed case are resident in the province
of Quebec, while the other 25 suspected cases and nine confirmed cases are resident
in the province of Ontario (see previous report). One confirmed case likely acquired
infection while traveling in the U.S. whereas all other cases acquired their infection
within their home province. More information is available at Health
(WHO WER 10/01/02)
Canada (Nova Scotia) — Lyme Disease
Health officials have confirmed the first case of Lyme disease in Nova
Scotia. The provincial health department said on Friday that a person living on
the province's South Shore contracted the disease, which is caused by tick bites.
The patient is recovering and did not require hospital admission like most Lyme
Dr. Richard Gould, a provincial health officer said the discovery
of the disease in Nova Scotia was not unexpected because it has been present in
the eastern United States (USA) for years, and the tick most closely associated
with the disease are present in the province.
USA (Virginia) Malaria Parasites Identified in Loudoun
Health authorities say they have discovered malariacarrying mosquitoes
in two Loudoun County neighborhoods, several miles from where two teenagers became
ill with the disease in a rare outbreak over the summer. The finding marks the
first time in at least 20 years that mosquitoes carrying the parasite have been
identified in a U.S. community where humans were also infected with malaria, according
to Richard W. Steketee, chief of the malaria epidemiology branch of the federal
Centers for Disease Control and Prevention in Atlanta. On Oct. 4, mosquitoes trapped
in Montgomery County, Maryland, near the Virginia state line tested negative for
malaria, offering the first results from a series of followup tests being performed
in Maryland. The tests were conducted for Montgomery by military malaria experts
from the Uniformed Services University of the Health Sciences.
(ProMed 09/28/02, 10/06/02)
Switzerland Concerns over Harmful Nitrofuran Found in
According to the Swiss Federal Office of Public Health, traces of the
antibiotic nitrofuran above the safelimit, which is thought to cause cancer,
have been found in 43 of 121 tested samples of poultry and shrimp imported from
Asia and South America.
USA — CDC Update: West Nile Virus Case Count
As of Oct. 4, the total human case cases for 2002 are 2703. Total human
fatalities are 146. These numbers have been reported and verified to CDC/Arbonet.
More information is available at CDC
USA — Smallpox Vaccination Strategies
On Oct. 5, the USA' top public health officials, which included Dr. Julie
L. Gerberding, director of CDC, said that they favored offering smallpox vaccine
to the public, even in absence of a bioterror attack, but only after up to 10
million health care workers are immunized, and after a vaccine is licensed for
general use, which is not likely until 2004. It was the first time federal officials
have said that the public should have access to the vaccine, which carries significant
risk of serious side effects. However, the final decision rests with President
Bush, and a White House spokesman said the issue was still under review.
(ProMed 10/06/02, NY Times 10/05/02)
USA (multistate) – Listeriosis, Deli Meat Suspected
Forty people in seven the northeastern U. S. (Pennsylvania, New York, New Jersey,
Delaware, Maryland, Connecticut, Michigan) have become sick, and 40 have died
from infection with the foodborne listeria bacteria, according to officials at
CDC in Atlanta, Georgia. "Analysis of data collected to date indicate that
the leading suspect food in this outbreak is sliced turkey deli meat," say
CDC experts. They say health officials are working hard to track down the exact
brand of meat responsible for the outbreak. More information on listeria is available
Industrial Science and Technology Working Group Side Meeting
on Emerging Infections, Taipei
The United States and Canada cochaired a side meeting on infectious
disease and health on Sept. 24, the day before the formal 23rd ISTWG began. Key
recommendations, all subsequently endorsed at the ISTWG, included: (1) Change
name of Subgroup to "Health and Sustainable Development"; (2) identify
one Health Sector contact person from each economy, for subsequent networking
to include all economies; and (3) develop or explore new project proposals in
selected priority areas. Priority areas of interest to the group for which an
economy committed to developing a proposal included: pandemic influenza planning
(Canada); national health databases online (Philippines); water, agriculture and
health (Mexico). Other priority areas of particular interest were: climate change
and vectorborne disease; malaria; and antimicrobial resistance.
Reevaluation Results of Network of Networks Meeting,
With cooperation of the meeting participants, we have conducted the survey
of the reevaluation of the APEC Network of Networks Meeting in Seattle, USA,
in January 2002. The evaluation was aimed to follow the impact of the meeting
in participants’ current work at six months after the meeting. All participants
were asked to fill out an anonymous Webbased survey form or to send a MSWord
survey form back to us. We have received responses from 12 of 14 economies that
attended the meeting, All responders rated the meeting good to excellent as whole
even six months after its conclusion. More than 90 percent of those also reported
that we achieved the meeting goals. Survey