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Vol. VI, No. 01~ EINet News Briefs ~ Jan. 10 , 2003

****A free service of the APEC Emerging Infections Network*****

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. Infectious disease information
    China (Hong Kong): Officials Find New Case of Bird Flu
    China (Hong Kong): Vaccinations against Bird Flu
    China (Hong Kong): Chickens Killed amid Growing Bird Flu Fears
    Philippines (Caraga): Unexplained Deaths
    Thailand: Rate of HIV Infection Grows Among Thai Teenagers
    Australia (Victoria): Paralytic Shellfish Poisoning: Alert
    Chile (Easter Island): Yellow Fever Vaccination Required For Travel to and from Easter Island
    Canada (Alberta): New Cases of Hantavirus Infection Reported
    USA (Ohio): Salmonellosis, Raw Milk
  2. Updates
    USA: CDC update: West Nile Virus case count
    USA: Canada: Viral Gastroenteritis
  3. Journal Articles
    China Makes Its First Antiretroviral Drugs for Treating AIDS

Below is a semi–monthly summary of Asia–Pacific emerging infectious diseases.


China (Hong Kong) — Officials Find New Case of Bird Flu
Health officials said samples from several chickens found dead in a poultry shop on Dec. 18 tested positive for avian flu in the second outbreak of the viral disease this month. A further investigation will be conducted to determine whether more than 20 chickens from the retail outlet on Hong Kong's rural Lantau Island had the same strain of virus that once killed 6 people here. As a precaution, 60 other birds from the shop were immediately slaughtered, the Food and Environment Hygiene Department said in a statement. Officials also ordered the shop closed Dec. 19 for disinfecting. The H5N1 virus crossed over from birds to humans in 1997 and provoked officials to slaughter all 1.4 million chickens in Hong Kong. Since then officials have held mass poultry slaughters and imposed stricter hygiene standards on the industry.
(ProMed 12/18/02)

China (Hong Kong) — Vaccinations against Bird Flu
The government is stepping up its program of vaccination against H5 avian influenza. The expanded vaccination effort will cover all chicken farms, 80 farms, within 5 km of Pak Sha in the eastern New Territories. The Agriculture, Fisheries and Conservation Department says this will give it access to more data to evaluate the effectiveness of vaccine under local conditions.
(ProMed 12/27/02)

China (Hong Kong) — Chickens Killed amid Growing Bird Flu Fears
Health inspectors have destroyed more than 50 chickens at a fresh food shop here after some of the birds were stricken with avian flu. According to the Food and Environmental Hygiene Department, the birds were killed after 13 dead chickens were found in the shop on Dec. 30, 2002. The shop was ordered closed so that it could be disinfected by health workers.

The government slaughtered more than 16,000 chickens on a farm on Dec. 28, 2002, after a number of dead birds were found there. To prevent the spread of the avian flu, the government also closed Hong Kong's wholesale poultry market for cleansing on Monday. Two weeks ago, 20 dead chickens found in Mui Wo market on Lantau island had the bird flu.

The avian virus detected so far is not of the same strain [H5N1] that crossed over into humans in 1997.
(ProMed 01/04/03)

Philippines (Caraga) — Unexplained Deaths
Twelve persons have died since Dec. 23, 2002, from what the health department in Caraga Region described as suspected "measles outbreak" in five tribal barangays here, Mamanwa tribal leaders said on Dec. 28. Blood samples of the affected patients were already sent to the Research Institute of Tropical Medicine in Mandaluyong to determine the “virus” that cause the suspected “outbreak”.

According to the Philippine Department of Health Statistics, in 2001 measles was the 8th leading cause of morbidity for children 0נ years of age, and the 4th leading cause of death for this age group.
(ProMed 12/29/02)

Thailand — Rate of HIV Infection Grows Among Thai Teenagers
Thailand's Health Ministry announced that the rate of HIV infection among teenagers has risen over the past year from 11 to 17 percent, and it vowed to make condoms more freely available to the young because less than 50 percent of teenagers use condoms.

Although the ministry plans to buy 26 million condoms to distribute at health offices this year, adding that more condom vending machines would be installed in public places, Thailand's National AIDS Prevention and Control Commission complained recently about authorities removing vending machines, or refusing to install them, fearing they promote promiscuity.
(SEA–AIDS 01/05/03)

Australia (Victoria) — Paralytic Shellfish Poisoning Alert
Victorian health authorities have issued a warning that anyone eating shellfish taken from the waters off inner city Melbourne could be fatally poisoned.

Victoria's Chief Health Officer, Dr Robert Hall, said “The symptoms of PSP ranged from slight tingling and numbness about the lips to, in the most severe cases, complete paralysis and death from respiratory failure,” and “People should note that cooking shellfish does not destroy the toxin.”
(ProMed 12/26/02)


Chile (Easter Island) — Yellow Fever Vaccination Required For Travel to and from Easter Island
As of November 8, 2002, the Government of Chile requires obligatory vaccination against yellow fever for all persons from areas where the disease is endemic. The government also requires yellow fever vaccination for all persons returning from or traveling by any means to Easter Island. Although there have been cases of dengue fever, with the Aedes aegypti mosquito being the vector of both dengue fever virus and yellow fever virus in Easter Island, there have been no cases of yellow fever reported in the island.
(ProMed 12/11/02)

Canada (Alberta) — New Cases of Hantavirus Infection Reported
People in Alberta are cautioned to avoid mouse droppings or urine after two cases of hantavirus infection were reported to provincial officials last week. Four cases of the disease were confirmed in the province in 2002. Since 1989, there have been 27 confirmed cases of the disease in Alberta, with eight deaths reported.

The only confirmed carrier of Hantavirus is the deer mouse, but it's possible that other rodents could carry the virus. The disease usually appears in one or two weeks after the infection, but it can take up to six weeks to appear. Symptoms resemble severe influenza, with a high fever, body aches, chills and troubled breathing. Anyone who develops difficulty breathing with the history being in an area contaminated by rodents should see a doctor immediately.
(ProMed 12/24/02)

USA (Ohio) — Salmonellosis, Raw Milk
On Jan. 2, 2003, local health officials said that the salmonella outbreak linked to a local dairy didn't begin there. Since December 2002, 47 people have been confirmed with cases of the food–borne illness. Test results pointed to non–pasteurized milk as the cause, but analysis of bacterial strains statewide show the salmonella connected to the dairy is the same as one found in Ross County in south–central Ohio in October 2002 and in Columbiana County, Ohio near Pennsylvania in the summer of 2002.

“It did not originate at the dairy,” said Charles Patterson, Clark County's health commissioner. “We're trying to find some epidemiological link between (the dairy) and where it came from.” But finding that link may be difficult, he said.

A Columbiana County person with salmonella in September 2002 still carried the bacteria as late as last month, Patterson said. Salmonella is usually contracted from eating such things as raw eggs or uncooked meat or from improper hygiene, such as not washing hands.
(ProMed 01/05/03)


USA — CDC Update: West Nile Virus Case Count
As of Dec. 31, the total reported human case cases of West Nile Virus for 2002 reached 3,873. There have been 246 human fatalities. 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

USA, Canada – Viral Gastroenteritis
There are many outbreaks of viral gastroenteritis due to suspected norovirus reported from the United States and Canada. In Michigan, USA, Norwalk virus or a similar norovirus has sickened more than 100
nursing home residents and staffers. At the Sparrow Dimondale Nursing Center, about 80 of the 170 residents have been suffering from diarrhea, stomach pain, and vomiting this past week. Also, 67 out of 245 staffers were affected.

In British Columbia, Canada, norovirus–like virus infection has affected four Vancouver assisted living centers since before Thanksgiving. The Health District has reported 328 cases of suspected norovirus illness at the four centers since the first sick call.

On board the aircraft carrier USS Theodore Roosevelt, hundreds of sailors have contracted viral gastroenteritis during exercises in the Atlantic, U.S. Navy officials said. When the virus infection peaked, it affected at least 300 of the more than 5000 crew members stationed aboard the ship.

At Long Island Hospitals, New York, USA, several wards at Nassau University Medical Center (NUMC) and St. Charles Hospital have been closed off to new patients to prevent the spread of what may be a norovirus infection. “Just like the cruise ship where people came to the cruise ship with the virus, we believe the same situation is occurring here,” said registered nurse Maria Ninivaggi, director of NUMC's infection control division.

In Minnesota, USA, state health officials said an unprecedented 25 outbreaks of illness afflicting as many as 1000 people have been attributed to norovirus infection since Nov. 1, 2002.

In Alaska, USA, as of Dec. 19, 2002, at least 225 people living near Ketchikan have come down with symptoms typical of Norwalk–like virus.

In New Hampshire, USA, an epidemic of what is believed to be norovirus infection has caused nearly 50 residents and workers at a local nursing home to become ill. The home is not taking any admissions because of the epidemic.

In Ontario, Canada, there are currently 11 hospitals with confirmed cases of the virus and 42 more with suspected cases, according to the health ministry.

According to the Centers for Disease Control and Prevention, each year, norovirus infection affects 23 million people, requiring hospitalizations for 50 000 of them. Although most of the time there are no long–term health consequences, there are 310 deaths annually.
(ProMed 12/18, 19/02)


China Makes Its First Antiretroviral Drugs for Treating AIDS
The first domestically produced combination drug treatment for AIDS in China will be sold by the end of 2002. The manufacturer, Shanghai Desano Biopharmaceuticals Company, based in Shanghai, recently got government approval for the production of didanosine, stavudine, and nevirapine. The company expects to get approval for manufacture of zidovudine by the end of 2002 as well. Then all the drugs can be made by Desano without infringing patents in China.

“Our production capacity will be sufficient to treat 500000 people a year, but we expect that by the end of 2003 we will have sold treatments for 20000 people,” said Ms Carras, spokeswoman for Desano's marketing department. UN estimates1.5 million HIV positive people in China at the end of 2001.

Even though the company estimates that the cost of the cocktail will be a tenth of that of imported drugs, the price will not still be affordable for many rural people infected with HIV or with AIDS without the government’s subsidy.

In order to see the entire article, please visit the following URL:
(Jane Parry, Hong Kong , BMJ(bmj.com website), November 30, 2002)


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