Vol. V, No. 21~ EINet News Briefs ~ Dec. 6 , 2002
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In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a semimonthly summary of AsiaPacific emerging infectious diseases.
Taiwan — HIV Cases Exceed 4,000 (Official Figures)
HIVpositive 20 and 30yearolds account for 36 percent and 33 percent, respectively, of the cumulative number. Nearly 93 percent of the 4,217 HIVinfected Taiwanese are male. Results of two recent studies by the department indicate the real number of Taiwan's HIV/AIDS cases could be about twice the official statistics, said department Deputy DirectorGeneral Hsumei Hsu.
Obligatory HIV testing in Taiwan includes soldiers, prisoners, blood donors
and pregnant women. In addition, some medical centers offer free, anonymous testing
and counseling. Hsu said there have been more than 20 million testing records
so far. "We estimate five out of 100,000 persons in Taiwan are HIVpositive,
and the infection rate is increasing gradually," Hsu said. Taipei is the
city most heavily affected by HIV/AIDS in Taiwan. Shiowing Wu, of Taipei City
STD Control Center, said that about one in four
A recent survey of 39 sex workers conducted by the Department of Health showed
86 percent were unable to persuade clients to use condoms, Wu said. "The
problem is that they believe they might be lucky," Wu said. In anticipation
of World AIDS Day on Dec. 1, the Department of Health distributed 20,000 condoms
at Taipei gas stations Nov. 25㪵.
Australia (Queensland) — Malaria
Park rangers have used details from visitors’ selfregistration forms during the period of malaria transmission and then the Tropical Public Health Unit in Queensland contacted individuals to inform them of the occurrence of malaria and offer advice.
The individual believed to be the source of the outbreak stayed at the campsite in late September 2002 for four days. He had traveled to Indonesia in 2001, to Africa in 2002, and was diagnosed with Plasmodium vivax malaria the day after he left the campsite. Local mosquitoes may have become infectious from around Oct. 8, 2002. Mosquito trapping revealed a large number of Anopheles farauti, which can transmit malaria in Northern Queensland, breeding in two creeks on either side of the campsite. If, as is assumed, there are no further human cases to act as a reservoir, then it is unlikely that further infectious mosquitoes remain at the campsite, because of their short lifespan. Visitors rarely stay at the campsite for more than two or three nights, and so the presence of a human reservoir is unlikely to be sustained. These considerations may explain why there has not been a larger outbreak.
Australia was declared malariafree in 1981. However, imported cases have occasionally
occurred. A similar outbreak of Pl. vivax involving five cases occurred in the
Cape Tribulation area in 1986; the source was believed to be a man who had arrived
from the Solomon Islands and spent a week in Cape Tribulation before going onto
Brisbane. He was diagnosed with Pl. vivax infection in November 1986.
New Zealand — Hepatitis A and Blueberries
Consumption of raw blueberries was the only significant risk factor (adjusted odds ratio 7.6; 95 percent confidence intervals 2.6㪮.4). Trace back of product through retailers and wholesalers implicated a single commercial orchard. HAV was detected in cases' feces and in blueberries from the orchard. Sanitary audit of the orchard revealed multiple opportunities for fecal contamination of product by pickers and the possibility of contamination by sewagecontaminated groundwater. A child with confirmed hepatitis A was in the orchard during harvest. Speculation that pickers urinated on picked fruit to increase the weight is unfounded.
Extensive food safety improvements in the berry fruit industry are underway.
The report on the investigation has been submitted for publication.
Russia (Siberia) — Trichinellosis
Trichinella spp. are found worldwide in many carnivores and are prevalent in
Russia. Undercooked wild boar is a wellknown source of infection.
USA (Florida) — Norwalklike virus, cruise ship
CDC spokeswoman Susan McClure said the agency has been closely monitoring the ship, but that Holland America voluntarily chose to cancel the Nov. 21 cruise. Historical data show that it takes four days of cleaning, with no passengers on the ship, to significantly reduce the virus amount, she said.
Dr. Gio Baracco, an infectious disease specialist and assistant professor of medicine at the University of Miami, said it is unknown how long the virus remains active on surfaces. But victims of the virus still can be contagious for up to several days after their symptoms have disappeared.
Onboard cruise ships, the virus has become more prevalent since this summer, said David Forney, chief of the CDC's vessel sanitation program. In a contained environment, it spreads quickly, despite warnings to passengers to wash their hands frequently.
The Amsterdam outbreak marks the second time in four months that
hundreds of passengers have contracted the virus on one of Holland America's ships.
The Ryndam, which sailed to Alaska in July 2002, reported 395 cases before being
pulled from service, disinfected and returned to sea.
The illnesses are believed to be caused by a “Norwalklike virus”, one of the most common gastrointestinal viruses. (The virus is named for an outbreak in Norwalk, Ohio, 30 years ago). The Centers for Disease Control and Prevention in Atlanta was conducting tests to identify the virus, spokeswoman Bernadette Burden said. Results were expected later this week.
The CDC said on Nov. 23 that it did not suspect that the outbreaks
on the Magic and Amsterdam were intentional or related in any way. "These
are two separate incidents," spokeswoman Bernadette Burden said. "There
are no direct links."
Canada (Toronto) — Viral gastroenteritis, hospital
“We haven't determined what the infection is yet. We suspect it to be a case of something called “winter vomiting disease,” hospital spokesman Craig DuHamel said. “Obviously we have to be very vigilant to ensure this is contained in our emergency department.” The emergency department was expected to be closed until the afternoon of Wednesday, Nov. 27 at least, DuHamel said.
Patients walking into emergency were told about the situation
upon arrival and, if their condition was stable, asked to go to another hospital.
Those who were unable to go to another facility would be treated, the hospital
said in a news release. Winter vomiting disease is an infection caused by a virus
commonly transmitted from persontoperson in cold weather, when people are indoors
more often and in closer contact. Symptoms include severe nausea and vomiting
that can last between 24 and 48 hours. DuHamel said the virus is not lifethreatening
and is similar to the Norwalk virus.
New BSE cases — Switzerland, Italy, Denmark, Netherlands,
In Italy, three additional cases have recently been identified; the total number of BSE cases for this year is 33 to date. During 2001, fifty BSE cases were recorded in Italy. Italy has carried out more than a million tests for BSE since it began a BSE testing program in January 2001 in compliance with the European Union regulations. All cows over 24monthsold now have to undergo such testing prior to slaughter. The number of confirmed cases of BSE has risen to 80.
A government task force was set up and BSE control measures were
introduced last February after the discovery of the first suspected case of the
human form of the brainwasting disease, variant CreutzfeldtJacob Disease (vCJD),
in a young Sicilian woman. The case of vCJD was confirmed last month.
In Denmark, the tenth case of mad cow disease was confirmed. According
to the Danish Veterinary and Food Administration said that two tests were done
on a 4yearold milking cow that was found dead in early November, adding that
both tests were positive. Out of the 10 cases of BSE, 9 were in Danishborn cows
and one in a cow imported from Scotland in 1992.
In the Netherlands, 51 cases of BSE have been recorded since 1997,
including 23 during 2002.
In Ireland, the Department of Agriculture has discovered five
new cases of BSE this week, bringing the total number of cases so far this year
USA—CDC Update: West Nile Virus Case Count
On Nov. 2, the company recalled 200,000 pounds of poultry, after its products were linked to an outbreak in the Northeast that has killed seven people. USDA said the strain found in both incidents were “indistinguishable.” Despite the government's findings, the company said “to our knowledge, no one has become ill as a result of consuming these products.”
Pilgrim's Pride, the No. 3 poultry producer based in Pittsburg, Texas, was also linked to the listeriosis outbreak. It recalled 27.4 million pounds of its Wampler brand turkey and chicken. Despite USDA test results finding the listeria outbreak strain at its plant, Pilgrim's Pride also has said its products were not to blame for the illnesses.
Despite the expanded recall, the USDA said the plant remained open because the Nov.14 sample that tested positive for listeria was actually produced on Aug. 30. “The plant is still open because all the (USDA) action took place at the Nov. 2, 2002 recall,” said Steve Cohen, spokesman for USDA's Food Safety and Inspection Service. “The complete plant was cleaned up.”
About 1,500 meat plants that either do not test for listeria or
choose not to share their results with USDA were subject to USDA's directive,
the U.S. Department of Agriculture said on Nov. 18. The directive
U.N. Releases Latest Global Assessment Before World AIDS Day
The HIV/AIDS pandemic is rapidly spreading in some parts of the world and is worsening the effects of a lingering southern African famine, according to a new World Health OrganizationJoint U.N. Program on HIV/AIDS report released prior to the Dec. 1 commemoration of World AIDS Day.
“The face of the epidemic is changing,” and the disease has changed from being a “gay white man's disease” to an epidemic that is greatly affecting women in southern Africa, UNAIDS Executive Director Peter Piot told reporters today. The epidemic has also begun to rapidly emerge in other areas outside of Africa and the developed world, particularly in the former Soviet Union, India and China.
Subtitles of the report are:
• With 42 Million Now Infected, Epidemic Emerging In New Areas
• Not All Bad News, Epidemic Stabilizing In Some Countries
• HIV/AIDS "Potent" Factor In Southern Africa Food Crisis And Vice Versa
• HIV/AIDS In Conflict Situations
• Effective Prevention Efforts Will Require Up To $15 Billion Annually
The entire report is available at:
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© 2002, The University of Washington