Cambodia—Cambodian leader says AIDS more deadly danger than land
mines
Prime Minister Hun Sen said that AIDS is Cambodia's most dangerous scourge
— deadlier than the millions of land mines that still dot the countryside
after decades of war.
"As far as the land–mine problem is concerned, we are working toward zero
casualties," Hun Sen said in a speech at the close of country's second
national conference on HIV and AIDS. "But it (AIDS) is now getting worse
than land mines because it can be spread through the family from husband
to wife and to child." He urged development planners and other concerned
parties "to prevent it (AIDS) from worsening and becoming another killing
field for the Cambodian people," he said. The phrase "killing field"
refers to atrocities carried out by the communist Khmer Rouge, who held
power in the late 1970s, when an estimated 1.7 million Cambodians perished
from execution, overwork, starvation, and disease.
Cambodia has an HIV infection rate of 2.6 percent, the highest in
Southeast Asia, among its 12.5 million people. AIDS has killed about
90,000 people since the country's first case was discovered in 1991, and
160,000 more people are in various stages of the disease. By 2010, the
death toll could reach 230,000𤫪,000, and some 100,000 children will
become orphaned, experts said at the three–day forum. HIV is the virus
that causes AIDS.
(SEA–AIDS 10/07/02)
Korea—HIV infections rise by 20 percent in Korea
According to a study released by the nation's National Institute of
Health, the number of Koreans who are infected with HIV is rising. Between
January and September of this year, 277 people have tested HIV–positive,
increasing the total number of people with HIV to 1,888 as of September.
The rate shows that, on average, one person is infected every day. This is
a 19.7 percent increase compared to the same period last year. Among those
who have tested positive, 73 have contracted AIDS and 59 have died of the
disease. The study also found that, among those who knew how they were
infected, 1,505 (97.2 percent) said they acquired the virus during sexual
intercourse. Among those sexually infected, 360 (23.9 percent) acquired
the virus by contact with foreigners, while 688 (46 percent) acquired it
from Koreans. 457 people (30 percent) were infected by the same sex
partners.
(SEA–AIDS 10/21/02)
China (Beijing)— Provides free drugs to Henan province
China will supply free medicine to thousands of rural villagers with
AIDS,
in the government's first substantial effort to treat patients amid a
growing epidemic.
The central and Henan provincial governments will jointly invest "at
least" $4 million for drugs to treat several thousand people with AIDS in
the central Chinese province, although the final figure is still being
discussed. The medicines will include both domestically made generic
versions of the so–called AIDS cocktail, production of which the
government recently approved, and on–patent versions purchased from
multinational drug companies.
The drugs will be distributed to Henan farm villages where unsanitary
blood–buying operations in the mid�s spread the disease widely.
Only about 100 people in China are now taking the AIDS cocktail, a
combination of drugs that can inhibit the spread of the virus, but it
costs as much as $4,000 for a year's supply and it is out of reach for
most patients.
Surveys have shown that HIV prevalence is rising among intravenous
drug–users and prostitutes. However, the government plan focuses only on
poor farmers who contracted the disease through blood–selling.
The same group is also the focus of the government's application for a $96
million grant from the Geneva–based Global Fund to Fight AIDS,
Tuberculosis and Malaria. The application, a copy of which was obtained by
The Wall Street Journal, says the funds would be devoted to seven central
provinces where illegal blood–buying was most rampant. The money would go
to AIDS prevention, education and treatment, first focusing on 56 of the
worst–hit counties in those provinces.
(SEA–AIDS 10/21/02)
New Zealand—Norwalk–like virus affects staff and visitors at
alpine resort
A virulent virus has infected a large number of people at the Hermitage
Aoraki Mount Cook Alpine Village. Hermitage general manager Denis Callesen
said health officials believed a Norwalk–like virus (i.e., a calicivirus
belonging to the genus Norovirus) had spread to staff and guests at the
hotel after being brought in by a group that arrived.
Mr. Callesen also said it was not unusual for overseas visitors to spread
viruses at this time of year, as some had come from countries where winter
was just starting and new viruses that New Zealand had not experienced yet
were spreading.
Norwalk–like viruses (NLV) are a common cause of outbreaks of
gastroenteritis in New Zealand. The hotel outbreak affected some 60 of 150
staff and an unknown number of guests (many had left the hotel before
developing symptoms). Results from fecal specimens are not yet available,
but the picture is consistent with NLV.
The index cases at the hotel were members of a tour party that had been
traveling together for some time. In all, around 25 of its 30 members have
developed symptoms consistent with NLV. The first cases in this party
occurred before they reached New Zealand.
It is common knowledge that illness due to NLV is highly underreported in
many countries.
(ProMed 10/25/02, 10/27/02, 10/29/02)
Japan—New measles strain strikes junior high school students
A group of mainly junior high school pupils have been confirmed as the
first large–scale outbreak of a lethal strain of measles, according to the
National Center for Contagious Diseases. Over 100 people were struck by
the Hם type measles in February and March 2002. It is a rare strain of
the disease that appeared in Hong Kong some three years ago. Compounding
fears about the strain, a large swathe of those afflicted this year had
been immunized against measles, but the vaccination's effects had weakened
over time. The new strain of measles was detected in 109 people aged from
a few months to 62. The large majority of those afflicted, 78, were junior
high school pupils. Among 86 pupils including those only suspected of
having contracted the disease, 61 had been vaccinated for the measles.
Center officials said that Japan is usually afflicted by two types of
measles, the D3 strain and D5 strain. However, they learned the strain
that broke out in Kitaibaraki was of type H1. Measles vaccinations are
usually performed somewhere between 12 and 90 months after birth. However,
center officials said that only about 80 percent of people undergo measles
vaccination.
Recently, vaccinations have also developed a tendency to weaken in effect
over time. Much debate over health issues has been devoted to repeat
immunization. Some pupils affected by the outbreak of the new measles
virus had been vaccinated before, but their symptoms were not as harsh as
those who had not been immunized.
Measles causes fever and rashes to break out, with severe cases leading to
encephalitis or pneumonia. The effects can often be greater if contracted
by an adult. Ministry of Health, Labor and Welfare statistics show that of
the 35,302 reported cases of measles in Japan in 2001, those over 18
accounted for 925 instances. Out of the 21 people who died through measles
in 2001, 10 were 18 or over.
(ProMed 10/30/02)
AMERICAS
USA — A comment on methods of smallpox decontamination and a RFI
Decontamination recommendations in the CDC Smallpox Response Plan and
Guidelines (version 3.0) specify use of 5 percent aqueous solution of
phenolic germicidal detergent for decontamination of inanimate surfaces in
the environment and equipment used to care for a case of smallpox.
Further, choices for terminal decontamination of the room used for such
care include paraformaldehyde vapor (0.3gm/cubic ft.) or fogging with 5
percent phenolic disinfectant.
The following comments on the recommendations have been posted
to ProMed:
These recommendations seem excessive given that variola virus
likely has a
lipid envelope. A phenolic disinfectant is not the sole choice for
disinfection of inanimate surfaces contaminated with variola virus or
other members of the Poxviridae. Lipid–enveloped viruses have marked
susceptibility to a variety of disinfectants including halogens,
aldehydes, quaternary ammonium compounds (QACs), phenolics, alcohols,
proteases, detergents, and hydrogen peroxide.
The early literature consistently stated that the virus was relatively
resistant to phenol at environmental temperatures. The preferred
disinfectants were oxidizing agents (potassium permanganate or ethylene
oxide) and sulphydral–reactive compounds (p–iodo–acetamide).
There doesn't seem to be the rationale for paraformaldehyde vapor
disinfection. While there are studies of use of formaldehyde vapor
disinfection against vaccinia virus, these appear to have used virus
embedded in scabs.
It is suspected that variola virus in fluids would be inactivated
satisfactorily by most germicidal detergents; however, the inactivation of
virus in the crusts shed from patients with the pustular form of smallpox
is more problematic.
(ProMed 10/25/02)
USA — CDC Update: West Nile Virus Case Count
As of Nov. 6, the total reported human cases of West Nile Virus for 2002
are 3,507. Total human fatalities are 206. These numbers have been
reported and verified to CDC/Arbonet. For more information, visit the CDC
WNV Web site: http://www.cdc.gov/ncidod/dvbid/westnile/index.htm
