Vol. VI, No. 05~ EINet News Briefs ~ March 7 , 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 AsiaPacific 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. OVERVIEW OF INFECTIOUSDISEASE INFORMATION
Below is a semimonthly summary of AsiaPacific emerging infectious diseases.
China (Hong Kong) – Genetic Characterization of Human Isolate
of H5N1 Influenza Virus
According to Malik Peiris, a microbiologist at the University of Hong Kong who is studying the new virus, the avian influenza virus strain from the 9yearold boy is completely sequenced. The six internal genes of the virus, as well as the neuraminidase gene, are derived from a different genetic lineage from that of the 1997 virus. Only the haemagglutinin derives from the same lineage as 1997. “In addition, we also can establish that the virus has not acquired any human influenza internal genes,” said Pieris.
As of 27 February no further cases of human influenza A(H5N1) have been reported
in Hong Kong SAR. To date the current outbreak of influenza A(H5N1) in Hong Kong
SAR has been limited to two cases, an 9yearold boy and his 33yearold father.
The boy’s 8yearold sister died and the cause of her death is under investigation.
The mother has now recovered from what was thought to have been a parainfluenza
The figures indicate that 700,000 people are HIVpositive in the Eastern Mediterranean region — which includes 18 countries, including Libya, Pakistan and Afghanistan, compared with 220,000 HIVpositive people in the region in 1999. In addition, the proportion of HIVpositive women nearly doubled in 2000 to 32% of the total number of cases from 17% in previous years. An unnamed conference attendee said that the numbers presented were “well below reality” and added that HIV/AIDS is a “real scourge” in some countries, including Libya, Djbouti and Sudan.
Jihane Tawileh, head of the WHO HIV/AIDS program in the region, said that many
of the countries do not have the equipment, staff and facilities to deal with
the increasing number of people affected by the disease. Some conference attendees
said that people in the region do not seek treatment due to the stigma associated
with the disease. Dr. Stewart Flavell, coordinator of the nongovernmental group
People Living with AIDS, said, “There is an aura of shame that prevails
in this region. You cannot fight a disease as long as you deny its existence.”
Indonesia (Java) — Chikungunya Outbreak Spreading in West and
The disease has infected more than 500 people in certain parts of Yogyakarta province and 250 others in the West Java capital of Bandung since last December, 2002, local officials said. It spread last week to Cirebon, West Java, where more than 70 people have been affected since midJanuary, 2003.
However, a local senior health official, Sri Budiartiningsih, said that her
agency had recorded at least 94 cases of chikungunya disease in Cirebon, adding
that the disease was first detected in Bojor Lor village in Klangenan subdistrict
and spread to the adjacent villages of Bojong Wetan and Kreyo. Last year, the
disease also hit the West Javan town of Bekasi and the Central Javan towns of
Purworejo and Klaten.
USA (Massachusetts) — Staph. aureus (MRSA), community
“It's of great concern,” said Dr. Scott Fridkin, a medical epidemiologist at the US Centers for Disease Control and Prevention. “The reports are becoming more frequent, and it appears to be a growing problem.”
Fenway physicians alerted the CDC about the cluster of cases,
and the Massachusetts Department of Public Health has begun an investigation,
hoping to establish whether the cases are linked and, if so, to identify a common
source of infection. The men are all HIVpositive, but neither
USA (California) — Staph. aureus (MRSA), community
Since early last summer, the San Francisco Health Department has identified an increasing number of patients with soft tissue infections among city jail inmates. More recently, Los Angeles health officials also have identified an increase in MRSA among male homosexuals.
In order to control an epidemic, officials need to have some idea
what the incidence is. However, officials can't provide numbers of staph infections
because MRSA is not a reportable disease in California. A San Francisco doctor
estimated the city's cases number between 200 and 300.
Public health officials have declined to release the patient's gender or age, but have said the patient's condition was improving. It was the first known case in California linked to the national drive to vaccinate emergency health workers and military personnel.
In Florida, officials are investigating medical problems among 3 health care workers who became ill after receiving the vaccine. Only one appears to have had a reaction to the inoculation, with the other 2 experiencing symptoms not normally related to the inoculations.
As of last week, 7354 people had been vaccinated in 38 states
and Los Angeles and New York, which are running separate programs. In the military,
where more than 100 000 people have been vaccinated, there have been 5 serious
reactions. All 5 men are in good condition, officials said. In most cases, the
symptoms were not severe.
USA — CDC Update: West Nile Virus Case Count
Fatal Degenerative Neurologic Illnesses in Men Who Participated in
Wild Game Feasts: Wisconsin, 2002
The confirmed case was a Minnesota man aged 55 years with no previous history of a neurologic disease sought evaluation and treatment following a 3month history of progressive difficulty in writing and unsteadiness of gait in May 1999. In June 1999, he was hospitalized following onset of dementia, speech abnormalities, and myoclonic jerking. An EEG indicated lefthemispheric periodic sharp waves and moderate generalized background slowing; CJD was diagnosed clinically. In July 1999, following worsening symptoms and development of right upper extremity dystonia, the patient died. The man was not a hunter but had a history of eating venison once during the mids.
Out of 53 persons who were identified as possibly participating in the wild game feasts, information was obtained for 45 (85 percent); all were male, by direct interview or from family members of decedents. Among those 45 persons, 34 were reported to have attended wild game feasts. 7 of the 34 feast attendees were deceased, including the 3 patients reviewed in this article. None of the 4 other decedents had a cause of death attributed to or associated with a degenerative neurologic disorder. None of the living participants had any signs or symptoms consistent with a degenerative neurologic disorder.
“Although no association between chronic wasting disease (CWD) among deer and elk and CJD was found, continued surveillance of both diseases remains important to assess the possible risk for CWD transmission to humans.”
In order to see the entire article, pleas visit the following URL: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5207a1.htm
International distancelearning outreach: the APEC EINet experience.
METHODS: Distancelearning materials, developed by the University of Washington School of Public Health, were field tested and launched on the site. Publicity was carried out prior to the launch of the materials. Access was tracked prospectively using server counts of page downloads.
RESULTS: Web access increased substantially during the month after the materials were launched, especially among Asia based computers. The effect was isolated to the distancelearning pages, and not general to the site.
CONCLUSIONS: This Web site appears to be responsive to the advertisement and
to the materials. Prospective Website monitoring proved useful.”
2003 PulseNet Update Meeting, April 29 – May 2, 2003 St. Anthony
Hotel, San Antonio, Texas
• Please register by Friday, April 4, 2003.
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 AsiaPacific Rim. To subscribe (or unsubscribe), contact firstname.lastname@example.org. Further information about the APEC Emerging Infections Network is available at http://www.apec.org/infectious.
© 2003, The University of Washington