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Vol. VI, No. 06~ EINet News Briefs ~ March 21 , 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
    Multi Country Outbreak: Severe Acute Respiratory Syndrome (SARS)
    Thailand (Bangkok): Global fund donates US$209 million to Thailand
    China: AIDS Control Pilot Regions
    Mexico: West Nile Virus infected Birds found in Neuvo Laredo
    USA (Northwest): Sprouts may carry salmonella
    Dominican Republic: Detection of West Nile Virus Antibodies in Birds
    USA (Montana): New Tick–borne Disease Suspected
    Netherlands (Hague): Avian influenza infects 31 people
  2. Updates
    USA: CDC Update: West Nile Virus Case Count
  3. Notices
    ASEAN Youth Workshop on HIV/AIDS
  4. How to join the EINet email list

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


Multi Country Outbreak — Severe Acute Respiratory Syndrome (SARS)
SARS was first recognized on Feb. 26, 2003 in Hanoi, Viet Nam. The
causative agent has not to be identified, but physicians in Hong Kong and
in Frankfurt have independent preliminary results suggesting the etiology
of the virus may be a member of the paramyxoviridiae family.

As of March 19 2003, 264 isolated cases of suspected SARS are reported in
the following countries (number of cases): Canada (8), China (suspected),
Germany (1), Hong Kong Special Administrative Region of China (150),
Singapore (31), Slovenia (1), Spain (1), Taiwan (3), Thailand (1), United
Kingdom (1), United States (11), Viet Nam (56). However these numbers are
continuously updated. In addition on March 19 it was noted that 12
patients seen in Hong Kong had been in residence on the same floor of a
hotel, suggesting that contagion may be more serious than previously
presented. It is of note that hotel staff was not sickened in this

In order to see further details, including cumulative number of cases and
deaths, please visit the following URL:

Currently available findings from the outbreak of SARS, continue to
indicate that the overwhelming majority of cases are occurring in
health–care workers, and their families who have had direct contact with
SARS patients. The number of cases without such close contact remains few,
and no data indicate that this number is rapidly increasing.

For the full WHO travel advisory, together with additional information
about this disease, please visit the following URL:

For information from CDC including guidelines and recommendations, please
visit the following URL:

For information from Department of Health Hong Kong SAR, please visit the
following URL:

For information from Singapore Ministry of Health, please visit the
following URL:
(ProMed 3/19/03, WHO Disease Outbreak News (www.who.int/csr/don/en/)
3/19/03, CDC website 3/19/03)

Editor's Note: There have been two independent preliminary identifications
of the agent as a paramyxovirus, and ongoing investigation is underway to
understand the phylogeny of the new agent. In Hong Kong medical personnel
report some tentative success with nebulized antivirals and pulsed
steroids for seriously ill patients. This is to be confirmed.

Thailand (Bangkok) — Global fund donates US$209 million to Thailand
According to the health minister, a global disease prevention fund gave
Thailand US$209.7 million to help treat a rising number of infections of
HIV–AIDS, malaria and tuberculosis caused by an influx of migrant workers.

The donation is the largest–ever given to an Asian country by the Global
Fund to Fight AIDS, Tuberculosis and Malaria, a fund managed by the United
Nations, humanitarian and private sector groups, and country

Public Health Minister Sudarat Keyuraphan said that the donation would
enable the Thai government to distribute anti–viral drugs to HIV–AIDS
patients who are suffering from symptoms and related illnesses such as
tuberculosis, or TB.

A recent influx of migrants into Thailand – particularly illegal workers
from neighboring countries – and drug–resistant strains of malaria and
tuberculosis, have caused infection rates to rise. According to health
ministry statistics, Thailand has about 47,000 cases of malaria annually.
Between 80,000 and100,000 people are infected with tuberculosis every year
and about 25 percent of them are HIV–positive.
(SEA–AIDS 3/12/03)

China — AIDS Control Pilot Regions
According to China Daily, China's Ministry of Health launched a national
project in 51 counties from 11 provinces or regions. Those pilot regions
will provide comprehensive medical services including social and mental
support for HIV carriers and AIDS patients and then search for effective
ways to prevent and control HIV and Aids over the next three years.

The number of pilot counties is expected to be increased from 51 to 100 by
the end of this year. In these counties, a service network will be
established in towns and urban communities to provide medical treatment
and social care.

The pilot counties have been selected for the project because they have a
large proportion of high–risk people who have been infected through
illegal blood transfusions in rural areas and by drug abuse and
prostitution in the cities.
(SEA–AIDS 3/19/03)


Mexico — West Nile Virus infected Birds found in Neuvo Laredo
State health authorities of Monteree have confirmed the presence of West
Nile virus in Nuevo Leon, Mexico, after samples from three birds in a
ranch in the municipality of Lampazos yielded positive results.
(ProMed 3/15/03)

USA (Northwest) — Sprouts may carry salmonella
A local sprout producer, Harmony Farms, issued recall of alfalfa sprouts
yesterday after 9 people in Oregon and southwest Washington were sickened
by bacteria in the sprouts. According to the company, the products are
distributed to stores, restaurants, schools, and institutions in
Washington, Oregon, Alaska, and Idaho.
(ProMed 3/16/03)

Dominican Republic — Detection of West Nile Virus Antibodies in Birds
The Ministry of Health issued an epidemiologic alert yesterday for febrile
illnesses in humans after finding antibodies against West Nile virus (WNV)
in birds in the Los Haitises National Park, which is the first confirmed
cases of the virus in the Caribbean.

According to the research team of University of Kansas, United States,
they confirmed that five blood specimens collected in November from birds
in the Los Haitises National Park had specific antibodies against WNV.
This finding demonstrates that WNV has been transmitted locally to birds
resident in the country.
(ProMed 3/15/03, University of Kansas News Release 3/12/03)

USA (Montana) — New Tick–borne Disease Suspected
Scientists in Montana, United States, believe an undiscovered, Lyme
disease–like illness is being transmitted by wood ticks in Montana,
particularly in the Yellowstone River area from Livingston downstream to

"In recent years during the spring and early summer we have received
reports from physicians of human illness with rashes similar to Lyme
disease at the site of a tick bite — but it's not Lyme disease," according
to Dr. Todd Damrow, Montana state epidemiologist for the Department of
Public Health and Human Services. "We aren't sure what it is, but we plan
to find out."

The cases have been clustered in the Yellowstone River drainage, but
reports have also come in from both Helena and Missoula. In each instance,
Lyme disease has been ruled out, as has Rocky Mountain Spotted Fever.

Although the microorganism that causes Lyme disease — Borrelia burgdorferi
— was named after a Montana scientist, Willy Burgdorfer, Montana is the
only state in the nation where a case of the disease has not been
confirmed. The species of tick that carries Lyme disease also has never
been found in Montana.

In order to see more details, please visit the following URLs:

(Montana Department of Public Health and Human Services 3/03/03, Billings
Gazette 3/03/03


Netherlands (Hague) — Avian influenza infects 31 people
As of Mar. 17, the number of people infected by the avian influenza virus
has risen to 31 although it was 19 last Friday. Those people suffer from

Out off the first 22 sampled patients with conjunctivitis, influenza
A/H7N7 and A/H3N2 have been confirmed in 19 and 2 patients respectively.
In addition, influenza A/H7N7 virus was isolated from a sample of a
household contact (daughter) of one of the patients. This girl had no
chicken contact.

Preliminary data show that 75 out of 1100 exposed persons have had eye
complaints during the course of the epizootic, suggesting an attack rate
of 7 percent.

The Dutch Ministry of Agriculture announced on Mar. 17, 2003 that the
total number of poultry plants affected by highly pathogenic avian
influenza (HPAI) has risen to 87, of which 52 are regarded "definitely
infected" and 35 "seriously suspected".

The export of poultry from the Netherlands was prohibited by the Dutch
authorities as of Mar. 1, 2003. Consequently, export of live poultry and
hatching eggs was banned by EU's Commission Decision 2003/153/EC of Mar.
3, 2003, relating to EU member countries and to "third countries". The
decision has been repeatedly extended since that time. The EU ban did not
include poultry meat, since "there is no evidence that poultry for
slaughter has been affected".

Saudi Arabia has imposed a temporary ban on the import of any chicken
products from the European Union after the discovery of suspected cases of
bird flu in Europe. Saudi Arabia imports around 120,000 tons of chicken
products annually from the EU valued at 133 million USD.
(ProMed 3/18/03, 3/16/03)


USA — CDC Update: West Nile Virus Case Count
As of Mar. 12, the total reported human case cases of West Nile Virus from
2002 reached 4,161. There have been 277 human fatalities. These numbers
have been reported and verified to CDC/Arbonet. For more information,
visit the CDC WNV Web site:


ASEAN Youth Workshop on HIV/AIDS
The World Youth Foundation in cooperation with UNAIDS, Ministry of Youth &
Sports Malaysia, WAY, Malaysian AIDS Council and the Ministry of Health
Malaysia will be organizing the ASEAN Regional Workshop on HIV/AIDS:
"Addressing Stigma and Discrimination" from the 25㪳th April 2003 in
Melaka, Malaysia.

Among the topics that will be discussed during the workshop includes:
Stigma and Discrimination; Young Women Priorities and HIV/AIDS; Involving
Men to Make a Difference; Information, Education and Networking for Safe
Behaviour etc.

For information, please contact Ms Varsha at wyf@po.jaring.my


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