Vol. V, No. 18~ EINet News Briefs ~ Oct. 25 , 2002
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In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a semimonthly summary of AsiaPacific emerging infectious diseases.
China (Hong Kong) — Possible Transmission of Dengue Virus by
This appears to be the first report of the transmission of dengue virus infection by transfusion of viruscontaminated blood.
Hong Kong health officials warned Australia of a shipment of dengue fever viruscontaminated blood from Hong Kong to Australia after those two cases. Therapeutic Goods Administration spokeswoman Kay McNiece said no blood from Hong Kong was used in the Australian supply. "Australia is selfsufficient with blood," she said. "There is no suggestion that blood from Hong Kong or anywhere else would get into the Australian blood supply."
"Australia does provide a service to Hong Kong, which is done by CSL laboratories,
to import blood from Hong Kong to screen and make blood products, and then export
those products back to Hong Kong," she said. "This process is totally
segregated from the production of Australia's blood supply. In addition, the Red
Cross Blood Service tests some blood for Hong
Hong Kong has reported 36 cases of dengue fever since an outbreak began in
September 2002. The blood sent to Australia may be linked to that outbreak.
Australia (Queensland) — Listeria in Meat Factory Forces Recall
The products have been on sale in stores in only two towns in the Cairns region
of northern Queensland since 10 Jul 2002, with no associated cases of human disease
reported. According to the "Control of Communicable Diseases Manual 2000,"
the maximum recorded incubation period for listeriosis is 70 days.
Vietnam (Hanoi) — HIV/AIDS Could Erode Vietnam's Economic Development
"IDUs (injecting drug users) play a critical role in the dynamics of the epidemic," said Andrew Ball, a WHO expert on HIV/AIDS. "If we don't address it, it will be very difficult to control the epidemic in these four countries and elsewhere in the region."
"There needs to be a separation of HIV/AIDS from social evils. HIV/AIDS is not an evil, it is a virus," Ryan said. "Social evils" is the term used by the Vietnamese government to refer to drug addicts and prostitutes. Health experts have long criticized the government for focusing on AIDS as an affliction of these two groups, rather than raising awareness about the epidemic among the wider population.
"Harm reduction programs should be introduced if we want the epidemic not to spread quickly," said Pascale Brudon, the World Health Organization’s representative to Vietnam. "We have more and more good evidence coming from the rest of the world that things need to change here."
That transformation is underway, Ryan said. "The mindset of the government is beginning to change. Awareness is coming home to roost, but now the focus has to be on implementation."
While Vietnam acknowledges 54,640 HIV cases, the real number is at least 200,000,
UNAIDS AIDS Epidemic in Asia May Become the Largest in the World
"HIV has already spread to more than six million people across Asia," Dr. Piot said. "By not tackling it now while it is still manageable, the epidemic will have farreaching effects, destabilizing societies and damaging productivity." Dr. Piot was speaking at the World Economic Forum's (WEF) East Asia Economic Summit, which he cochairs.
"It is a question of good economic sense," Dr. Piot also said. "By protecting their employees from HIV and caring for those who are infected, businesses minimize the loss of skilled workers and managers, and boost their longterm productivity."
"Governments cannot go it alone, and businesses can play a pivotal role in the response in Asia. Taking action on AIDS goes beyond a matter of corporate responsibility — it is about making a good investment now to save paying vast costs later," he added.
A document package* released at the summit outlines examples and options for businesses committed to working on AIDS and shows that providing treatment and care to employees is often cheaper than the overall cost of AIDS to businesses.
Key to supporting workers is protecting them from discrimination, Dr. Piot said. Protecting rights is essential to fighting the fear and denial that surround HIV/AIDS.
* The document package, prepared by WEF, the Asian Business
Coalition on AIDS, the International Labour Organization and UNAIDS, is available
USA: Recall of Poultry, Listeriosis
Although this contamination was discovered in the search for the origin of the multistate outbreak of listeriosis in the northeastern US, no products have been linked to that outbreak and the genetic strain that caused the outbreak is different from the strain found at the plant. Deli meats are always a significant concern in the spread of listeriosis since they are ready to eat. The size of this recall reemphasizes the potential for foodborne llnesses in the global marketplace.
The largest previous meat recall in US history was in 1997, when
Hudson Foods recalled 25 million pounds of ground beef after 15 people in Colorado
fell ill from E. coli after eating hamburger from its plant in Columbus, Neb.
Based on this experience, Dr. Kells suspects that containers and trailers may play a far more important role for easttowest movement of WNV. Container movement of oviposition sites has the potential to translocate not just one or two adults, but hundreds to thousands of mosquitoes. Considering the potential, with a daily movement of 3,000 or more 20footequivalent containers through any one of five or more major ports, the potential for mosquito movement is impressive, both between and within countries.
The origin of the aberrant case of West Nile virus in California, in the absence of any evidence of bird or horse infection, could well have been infected mosquitoes escaping from a container coming from east of the Rocky Mountains, as previously suggested.
Apart from mosquito movement, Dr. Kells also thinks that container
shipment is an important factor when considering any disease with the potential
to vertically transmit to the progeny from the parent vector. Containers brought
vector mosquitoes from East Timor to Australia during a dengue outbreak in 2000.
USA — CDC Update: West Nile Virus Case Count
USA (Florida) Probable Variant CreutzfeldtJakob Disease
in a U.S. Resident
The patient was born in the United Kingdom in 1979 and moved to Florida in 1992. It is likely that this patient was exposed to the Bovine Spongiform Encephalopathy (BSE) agent one or more times during 1980 before moving to the U.S. and that the interval between the patient's exposure to BSE and onset of illness was 9㪭 years. Such an incubation period would be consistent with known incubation periods for other similar diseases in humans, such as kuru and CJD related to exposures to pituitaryderived human growth hormone.
The patient never had donated or received blood, plasma, or organs and never had received human growth hormone. There was no family history of CJD. In October 2001, before the onset of the illness, the patient's wisdom teeth were extracted, but there was no history of major surgery. The patient is unlikely to have transmitted the disease to others.
As of late September 2002, the patient had become bedridden, experienced considerable weight loss requiring surgical insertion of a feeding tube, and was no longer communicating with family members. On the basis of a case definition developed in the United Kingdom, the patient's illness met criteria for a probable case of vCJD.
The report in MMWR documents the investigation of this case and
underscores the importance of physicians increasing their suspicion for vCJD in
patients presenting with clinical features described in the report who have spent
time in areas in which (BSE) is endemic.
© 2002, The University of Washington