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Vol. VI, No. 02~ EINet News Briefs ~ Jan. 24 , 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 listserev, use the reply function.

In this edition:
  1. Infectious disease information
    China (Hong Kong): Avian influenza
    China: Start AIDS Drug Mass–Production in January
    Japan (Wakayama): 6th Case of Mad Cow Disease
    Europe: Influenza B virus
  2. Updates
    USA: CDC Update: West Nile Virus Case Count
  3. <Journal Articles
    PARIS: New Perspectives for Prion Therapeutics Meeting
  4. Notices
    Report of PulseNet Pacific Rim Planning Meeting, Dec.12㪥, 2002
  5. How to join the EINet email list

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


China (Hong Kong) — Avian influenza
Agriculture, Fisheries and Conservation Department (AFCD) quarantined a chicken farm at Pat Heung after they found over 160 dead chickens tested positive for bird flu H5 virus at the farm. Most of the remaining 50,000 chickens on the farm were housed in separate sheds from the ones in which the dead chickens were found. These chickens were under close observation to take appropriate measures to control the spread of the infection. Farms near the one quarantined will be placed under close observation in the coming days.

On Dec. 10, 2002, Penfold Park in the centre of Sha Tin racecourse was closed for a month after 31 ducks and geese died of the H5 virus in 2 weeks. A week later 20 chickens were found dead at a market stall in Mui Wo.

The cull at the Ta Kwu Ling farm was also ordered because more than 1000 chickens died there and tests on 12 chickens from the farm proved positive for the H5 virus.

Two outbreaks of pathogenic avian influenza were reported in broiler farms in the New Territories. The date of initial detection of the incident was Dec. 26, 2002. Total number of bird deaths cases was 5,500 and then 22,500 birds were destroyed. H5N1 avian influenza virus is a causal agent and it is genetically different from HK/1997 (H5N1). In terms of source of agent/origin of infection, infected wild bird involvement is suspected.
(ProMed 1/07/03, 1/20/03 )

China — Start AIDS Drug Mass–Production in January
According to Reuters Health in Taipei, the Chinese Health Minister Zhang Wenkang has reported that mass–production of four drugs (zidovudine, didanosine, stavudine and nevirapine) to treat HIV infection will be started in China in January.

In November, the drug firm, Shanghai Desano Biopharmaceutical Co., said it had been given government approval to sell the first Chinese–made HIV drug combination. A competitor, Northeast China Pharmaceuticals Group Company, has also begun producing drugs.

The mass production would reduce annual treatment expense by 90% and the annual expense for each patient is set to be around 3,000 and 5,000 yuan ($360–$600). AIDS patients at the hospital currently spend between 30,000 and 40,000 yuan ($3,600–$4,800) annually for the treatment using drugs from overseas.

Dr. Zhao Hongxin, in charge of the AIDS center of Beijing Ditan Hospital, told Reuters Health on Monday that the hospital so far had received no official notification about the availability of China–made AIDS drugs from the Ministry of Health.

The State Council approved one of ministry's projects that plans to spend 22 million yuan ($2.64 million) annually from 2002 to 2004 tackling the epidemic in the most seriously effected provinces, such as Henan, Hubei and others in central China, according to Xinhua.

Although China's official record showing the number of AIDS and HIV cases in 2002 was one million, climbing up from 600,000 in 2001, the UN suggests the number is closer to 1.5 million and could hit 10 million by the end of 2010.
(SEA–AIDS 1/06/03)

Japan (Wakayama) — 6th Case of Mad Cow Disease
Japan reported its sixth case of bovine spongiform encephalopathy (BSE) or mad cow disease on Jan. 19, 2003 after it confirmed the brain–wasting illness in a cow in Wakayama Prefecture, the Health, Labor and Welfare Ministry said. The Holstein cow from the town of Shibecha in Hokkaido was found to have been infected with the disease.

The first case of the disease was discovered in Chiba Prefecture in September 2001. Two more cases were discovered in Hokkaido and Gunma prefectures in November 2001, a fourth case again in Hokkaido in May, 2002 and a fifth case in Kanagawa Prefecture in August 2002.

The ministry has carried out BSE tests on all cattle for human consumption since October 2001.
(ProMed 1/19/02)


Europe — Influenza B virus
According to the European Influenza Surveillance Scheme (EISS, http://www.eiss.org/), 11 networks in Europe reported no influenza activity in the week ending Dec. 29, 2002 (week 52). Four networks reported sporadic activity (Belgium, Portugal, Spain, and Switzerland), and one network (France) reported regional activity. A report of no influenza activity indicates that the overall level of clinical activity was at baseline levels. In France, influenza activity was the highest in the Rhone–Alps (southeast), the Midi–Pyrenees (southwest) and the Normandy (northwest) regions. The intensity of clinical activity was medium in Spain and low in all of the other networks.

Out of 3,604 sentinel respiratory specimens for influenza virus since Sept. 30, 2002, 109 (3 %) have tested positive for influenza A (23%) or B (77 %). EISS has received no reports this season of the influenza A(H1N2) virus strain that circulated in Europe last season. Most of the cases of influenza B virus (86 %) reported so far this season, have been reported by Spain, France and Portugal. In France, Influenza B infections are co–circulating with influenza A viruses.

All of the influenza viruses detected/isolated so far this season by EISS have been closely related to the 2002㪛 influenza vaccine strains.

EISS aims to contribute to a reduction in morbidity and mortality associated with influenza in Europe. Their Weekly Electronic Bulletin describes the epidemiological and virological spread of influenza in the 19 countries (22 surveillance networks). During the current influenza season, EISS includes 28 national reference laboratories, at least 10,600 sentinel physicians and covers a total population of 441 million inhabitants.
(ProMed 1/10/02)


USA — CDC Update: West Nile Virus Case Count
As of Jan. 15, the total reported human case cases of West Nile Virus for 2002 reached 3,949. There have been 254 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


PARIS — New Perspectives for Prion Therapeutics Meeting
More than 200 researchers met at a Left Bank hotel in December for the first international conference dedicated exclusively to therapeutics for prion diseases.

Since 1995, vCJD has killed more than 120 people in Europe and no one knows how many harbor latent vCJD infections from having eaten tainted beef during the height of the “mad cow disease” epidemic in the late 1980s and early 1990s.

Masashi Nakajima, a neurologist reported dramatic improvements in patients with Creutzfeldt–Jakob disease (CJD) who had been treated with the drug quinacrine. However, the gains were short–lived and both patients returned to their previous states within weeks of starting treatment.

Jean–Philippe Brandel, a neurologist in Paris, also reported disappointing results. In a non–blinded study of the same drug, researchers detected neither "clinical improvement in the CJD patients nor an increase in their length of survival.

Quinacrine is one of many compounds capable of stopping the spread of prions in cultured neuroblast cells or in infected lab animals. No one knows why quinacrine shows modest, early success in some patients but fails to halt the disease.
(Science 2003 299: 191𤪰)


PulseNet Pacific Rim Planning Meeting
December 12㪥, 2002

Organizers: Centers for Disease Control and Prevention (CDC), Atlanta, GA
The Association of Public Health Laboratories (APHL), Washington, D.C.
Dr. Kai Man Kam, Public Health Laboratory Centre, Department of Health, Hong Kong

Overview and Purpose
PulseNet is a highly successful laboratory–based surveillance system for foodborne bacterial diseases in North America. Over the past four years, PulseNet USA has developed a close working relationship and partnership with Health Canada in the formation of PulseNet Canada. This has facilitated early interventions in foodborne outbreaks in terms of investigative procedures and public health prevention strategies, thus preventing additional illnesses and possibly saving lives. CDC is now in the process of facilitating the replication of the PulseNet concept internationally. A consortium of European scientists headed by Dr. Peter Gerner–Smidt of the Statens Serum Institut, Copenhagen, Denmark, is working towards the establishment of PulseNet Europe.

A meeting was held in Honolulu, HI on Dec. 12㪥, 2002 to explore the possibility of setting up PulseNet Pacific Rim. The purpose of the Honolulu meeting was to discuss issues involved in the standardization of methods, data generation, and terms for data sharing and collaboration. Through interactive brainstorming sessions, the benefits and challenges of forming PulseNet Pacific Rim were discussed, an action plan for the establishment of PulseNet Pacific Rim was developed, and a steering committee for this network was formed at this meeting.

The moderators for this meeting included speakers from CDC, APEC–EINet (University of Washington), WHO, EnterNet, and the Washington State Department of Public Health. Invited participants in this planning meeting included representatives from 12 Pacific Rim countries/areas. Each country/area presented their current level of foodborne surveillance testing, as well as an outline of their capabilities for future participation in molecular–based laboratory surveillance. The participants agreed that a network for foodborne surveillance in the region should be formed, and that this network would benefit by functioning as a part of the global PulseNet network. Also, the participants decided that the PulseNet Asia Pacific would be a more appropriate name for the network, particularly with the inclusion of the Centre for Health and Population Research, Dacca, Bangladesh as one of the participating institutions in the network.

Therefore, the Steering Committee for PulseNet Asia Pacific was formed as follows:

1. Kai Man KAM, Hong Kong (chairman/ coordinator)
2. Diane LIGHTFOOT, Australia (secretary)
3. Haruo WATANABE, Japan
4. Yasin MD ROHANI, Malaysia
5. Celia CARLOS, Philippines
6. Jian–Guo XU, People’s Republic of China
7. G. Balakrish NAIR, Bangladesh
8. Chien–Shun CHIOU, Taiwan

Additional invited participants from the Asia Pacific region were:

9. Cindy LUEY, Hong Kong
10. Bok Kwan LEE, Korea
11. Kwai–Lin THONG, Malaysia
12. Brent J. GILPIN, New Zealand
13. Orn–Anong RATCHTRACHENCHAI, Thailand
14. Binh Minh NGUYEN, Vietnam

Reported by:

Bala Swaminathan, Centers for Disease Control and Prevention
Sharon Rolando, Association of Public Health Laboratories


The APEC EINet listserv was established to enhance collaboration among academicians and public health professionals in the area of emerging infections surveillance and control. Subscribers are encouraged to share their material with colleagues in the Asia–Pacific Rim. To subscribe (or unsubscribe), contact apec–ein@u.washington.edu. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious.


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