Vol. VI, No. 11~ EINet News Briefs ~ June 20 , 2003
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In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE
Australia (multistate) — Hepatitis A
According to the Communicable Diseases Network Australia (CDNA), 6 cases from Tasmania, 2 from Victoria, and 2 from Queensland were believed to have been exposed to the liver virus (hepatitis A) while on tour in the Northern Territory from Apr. 24 to Apr. 27, 2003. Hundreds more may have been exposed to the disease, which is spread through persontoperson contact or from water or food that has been inadvertently contaminated by an infected person.
"Tasmania has the largest proportion of cases so far following a visit to the Northern Territory by a large group of people that included 106 from Tasmania," CDNA deputy chair Dr. Vicki Krause said in a statement. "It tends to be a more significant problem if the victim is older, or has an underlying immunity problem or a preexisting liver Condition," Tasmanian public health director Dr. Roscoe Taylor. "The incubation period is usually about a month, but it can range from 15 to 50 days," Dr. Taylor said.
Dr. Taylor had been working with the Northern Territory health authorities
to track the source as well as with authorities in Victoria and Queensland
on identifying other possible cases.
USA — Listeriosis, new prevention regulations
"The rule is tough, it's fair, it's based on science," she said on Jun 4, 2003. Plants that don't comply could be shut down by inspectors, Murano said.
Murano said it took months to finish the rule because the agency was completing studies that would determine the best way to prevent listeria. Advocates complained that the new regulations don't specify how often companies should test surfaces and products. They also said the rule should require companies to warn pregnant women and people with weak immune systems to reheat products before eating them.
"We hope that this regulatory approach, coupled with the scientific strategies employed by meat and poultry companies, will help us achieve our mutual goal: producing readytoeat meat and poultry products that consumers can enjoy with confidence," said J. Patrick Boyle, president of the American Meat Institute.
Because it's an interim rule, the industry and public can comment on the
rule and the government can make changes over the next 18 months. However,
it is scheduled to go into effect in September 2003.
USA — Monkeypox Infections
Interim case definition is available at the following site:
The incubation period from exposure to fever onset is about 12 days. In humans, casefatality ratios in Africa have ranged from 1 to 10 percent. For additional information about monkeypox, visit the following site: www.cdc.gov/ncidod/eid/vol7no3/hutin.htm
Currently, there is no proven, safe treatment for monkeypox. Smallpox vaccine
has been reported to reduce the risk of monkeypox among previously vaccinated
persons in Africa. CDC is recommending that persons investigating monkeypox
outbreaks and involved in caring for infected individuals or animals should
receive a smallpox vaccination to protect against monkeypox. Persons who
have had close or intimate contact with individuals or animals confirmed
to have monkeypox should also be vaccinated. These persons can be vaccinated
up to 14 days after exposure. CDC is not recommending preexposure vaccination
for unexposed veterinarians, veterinary staff, or animal control officers,
unless such persons are involved in field investigations. Interim guidance
for use of small pox vaccination is available at the following site:
In the current outbreak, illness in animals has been reported to include fever, cough, blepharoconjunctivitis, lymphadenopathy, followed by a nodular rash. Some animals have died while others reportedly recovered. The types of animals that may become ill with monkeypox are currently unknown; as a precaution, all mammals should be considered susceptible at this time.
Pet owners who suspect their animal may have an illness compatible with monkeypox should immediately isolate the animal from humans and other animals and contact their state or local health department. In most cases, evaluation by a veterinarian will be recommended. Owners should notify the veterinarian before transporting the animal to the clinic so that appropriate infection control precautions can be implemented prior to arrival.
Further information and the interim guidance for veterinarians and pet owners
are available at the following site:
In Europe, the Standing Committee on the Food Chain and Animal Health (SCFCAH)
agreed unanimously to ban the import of prairie dogs (Cynomys sp.) from the
USA and rodents of non domestic species and squirrels from subSaharan Africa
because of the risks of monkeypox disease. The decision will soon be adopted
by the European Commission.
International Animal Movement: Veterinary Control
"This is a harbinger of things to come," warns Michael Osterholm of the University of Minnesota, who advises the government on infectious diseases, and has long warned that there's too little oversight of the health threats of imported animals.
"There are some of us who feel like lone voices in the night" in calling for better scrutiny, adds Peter Jahrling, a scientist at the U.S. Army Medical Research Institute of Infectious Diseases (USAMRID). "Perhaps incidents like this might bring some muchneeded reexaminations."
SARS, the respiratory epidemic, is thought to have come from civet cats bred as an exotic meat in Chinese markets where bats, snakes, badgers, and other animals live in sidebyside cages until they become someone's dinner.
Japan recently banned the importation of prairie dogs because they can carry plague. The rodents had been wildly popular as pets in that country.
Just last summer, a group of prairie dogs caught in South Dakota was discovered to have tularemia, a dangerous infection typically spread by the bites of infected ticks, deerflies, and such or through ingesting contaminated material. The disease was detected only after the animals were shipped to 10 other states and 5 other countries.
Then there's salmonella, which iguanas and other reptiles, as well as birds, routinely shed in their feces. The CDC counts a stunning 90,000 people a year believed to have caught salmonella from some form of contact with a reptile, either touching it or touching a surface where the reptile had tracked the bacteria.
There is little federal scrutiny of most imported animals for potential
human health risk, and rules on owning and selling exotic animals vary by
state and city.
Canada (Quebec) — West Nile Virusinfected Crow
John Carsley, head of the infectious diseases unit of the Montreal regional public health department, said the convergence of such factors as the presence of some contaminated birds and pools of contaminated mosquitoes in the same sector could lead to intervention through corrective measures, such as mosquito larvicide treatments.
There were 16 cases of humans infected with West Nile across the province
last year, 2 of which resulted in deaths.
Multicountry Outbreak — Severe Acute Respiratory Syndrome (SARS)
Experts expand criteria for diagnosing SARS
According to the findings researchers in Hong Kong presented at a conference organized jointly by the World Health Organization and the Hong Kong government on June 13, about one in 4 elderly people suffering from SARS show no signs of fever during their illness and the incubation period for typical patients can range well beyond the standard of 10 days to as much as 16 days. Dr. S.Y. Au of Tuen Mun Hospital suggested that the absence of high temperature readings could be due to certain medications being taken by elderly patients that mask fevers, and said doctors should search carefully for atypical symptoms and whether the person had recently been hospitalized. Another researcher, Professor Joseph Sung from the University of Hong Kong, added that about 50 percent of the cases seen in Hong Kong were not typical. These patients often had diarrhea and liver problems. Researchers quickly agreed that the original WHO guidelines for diagnosing SARS were outdated and said they'd had to incorporate the latest findings early on in Hong Kong's outbreak last March, 2003.
Situation in China
Chinese officials expressed deep concern about the country's capacity to deal with the next influenza season against a background of possible SARS cases. The presence of influenza could greatly complicate the detection and accurate diagnosis of SARS cases, while also considerably increasing the caseload of suspect cases.
In an earlier report, a WHO assessment team reached the following conclusion: "If SARS is not brought under control in China, there will be no chance of controlling the global threat of SARS. Achieving control of SARS is a major challenge especially in a country as large and diverse as China. Effective disease control and reporting are the cornerstones of any strategy to do this."
In order to see further details, including cumulative number of cases and
deaths, please visit the following URL:
As of June 19, the areas to which travelers to consider postponing all but
essential travel are as follows: China (Beijing)
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
For information from Singapore Ministry of Health, please visit the following
Bovine Spongiform Encephalopathy in Canada
About 2700 cattle in total have been destroyed. Rapid diagnostic testing has been completed and all results are negative. The traditional tests are partially completed and all are negative to date, meaning that the incidence of BSE in Canada remains confined to one cow.
Regarding the feed component of the investigation, quarantine has now been lifted on all three farms in this line of inquiry. All tests have come back negative. Any required feed cleanup has been completed.
As part of the extended
traceout investigation, it was found that 5 bulls had been exported to the
United States of America (USA) in early 1997 from
one of the herds that had been quarantined. Identification of these animals
was provided to the importing country.
WHO first Global Conference on Severe Acute Respiratory Syndrome
(SARS), June 17 –18, 2003, Kuala Lampur, Malaysia. Rocky Mountain Spotted Fever: A Clinician's Dilemma
WHO first Global Conference on Severe Acute Respiratory Syndrome
(SARS), June 17 –18, 2003, Kuala Lampur, Malaysia.
Rocky Mountain Spotted Fever: A Clinician's Dilemma
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