Vol. VI, No. 13~ EINet News Briefs ~ July 18, 2003
****A free service of the APEC Emerging Infections Network*****
The EINet list serve 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 your perspectives and experiences, as your participation directly contributes to the richness of the "electronic discussions" that occur. To respond to the list serve, use the reply function.
In this edition:
1. OVERVIEW OF INFECTIOUSDISEASE
Japan — Outbreaks of Measles at Colleges and High Schools
According to the Infectious Disease Surveillance Center, the National Institute of Infectious Diseases, there have been several measles outbreaks in three colleges and 14 high schools.
In June, 60 freshmen at the medical school in Kagoshima University were infected with measles. All 1500 medical and dental students were tested for serum measles antibody, and negative students were isolated at home until they received vaccination. Dr. Hiromi Yoshida, Dean of the Medical School, stated that medical students were voluntarily isolated at home in order to prevent further spread of measles, especially to hospitalized patients. The school will begin administering the measles antibody test to all admitted students and will give vaccinations beginning next year.
In Kanazawa Technology College, 70 students became infected with measles and 26 were hospitalized from May 8 to June 30. The college reported the outbreak to the regional health center when the number of cases exceeded 20. The college called upon every student and employee to be vaccinated, and 70 percent of them complied.
This is the first time that the Infectious Disease Surveillance Center
has collected information on an intraschool outbreak. High schools in
Tokyo, Miyazaki, and Ishikawa have also experienced outbreaks.
Dr. Kihei Terada, at Kawasaki Medical College said, "All colleges
in the USA demand certification of vaccination upon admission. The same
procedure should be introduced in Japanese colleges to prevent these
outbreaks. Medical schools should be the first to introduce the system
as an example."
Vietnam – 1,300 New HIV Carriers
Thailand — AIDS Conference: Medicine Vowed for All in Need
Prevention efforts, including authorities promoting the use of condoms, will also focus on youths to ensure they have adequate knowledge about the disease, said Health Minister Sudarat Keyuraphan. As part of the prevention campaign, the ministry will ask condom sellers to lower prices at vending machines, from Baht 20 (US 48 cents) for two condoms to about Baht 5 (US 12 cents), added Charan.
Health Ministry Permanent Secretary Wallop Thianua vowed that all HIV/AIDS
patients needing medicines estimated at about 50,000 – would
receive them, but he added that it may be necessary for those who can
afford it to pay a portion of the bill.
USA (Virginia) — Malaria, 2002
"It's not like there were a whole bunch of people infected ... that then infected other residents," said John Barnwell, a senior biological research scientist with the CDC's Division of Parasitic Diseases, who headed the research. "It was a single source and a little outbreak." Scientists and health officials say it's likely that one or more mosquitoes bit a local resident who had returned from a trip to Latin America–or bit an immigrant from that area–and then bit and infected the teenagers, who spent time outdoors near eastern Loudoun's Sugarland Run neighborhood during the same several weeks last summer.
The issues the genetic findings still don't explain exactly are why the
third patient contracted malaria in March, six months after the first two,
why several pools of mosquitoes tested positive for malaria in 2002 in Loudoun
and Montgomery counties, and whether more will be found this summer.
USA (Southeast) — Eastern equine encephalitis
Florida, Georgia, North Carolina, and South Carolina have seen the highest number of horse cases of EEE in years. The disease, which has existed in the United States for decades, kills nearly all unvaccinated horses.
Health officials urge people to use similar precautions against EEE as they would against WNV: wearing protective clothing and using insect repellent while outdoors and getting rid of mosquito habitats, such as standing water, around the home. Horses should be vaccinated against both diseases.
Symptoms in human beings range from mild flulike illness to frank encephalitis,
coma, and death. Horses and emus have long been sentinels because of their
sensitivity to the virus. The disease cannot be acquired from an infected
horse and is not transmitted from horse to horse or horse to human.
Mexico—West Nile Virus Emergency Declared
Among actions to combat West Nile virus infection, Mexican sanitary authorities
have asked horse owners to vaccinate their animals and to report any suspected
cases of West Nile virus infection immediately. The US Agriculture Department
has reported that about one third of the 15,000 horses infected with the
virus in 2002 died.
Brazil — Giving 10 Countries Free HIV/AIDS Drugs
Through the initiative, Brazil aims to help treat HIVinfected people in El Salvador, Guyana, the Dominican Republic, Colombia, Paraguay, Namibia, Burundi, Kenya, Burkina Faso and Mozambique.
Brazil's government will spent $1 million on the project, providing 100 patients in each country with drugs for a year. The 10 countries' governments will pay for the patients' treatment after the year is up.
According to Agencia Brasil, more than 90 percent of the 40 million people who have HIV around the world live in developing countries, and 250,000 people have access to free medication against the disease. Of the latter group, 115,000 are Brazilians.
Seventy orphans with HIV in Nairobi have been receiving free medication from Brazil since 2001, on a reportedly irregular schedule. Beginning next month, they are expected to receive the medication more frequently.
Brazil has been hailed as a model country where HIV/AIDS treatment is concerned.
The country's Health Ministry spends around $175 million per year to provide
free medication to 115,000 infected Brazilians Agencia Brasil/Jornal do Brasil,
Peru — Hepatitis D Virusrelated Deaths of Children in Villa Rica
Villa Rica is a junglelike area, endemic for viral hepatitis B, but there has been no previous report of hepatitis delta virus. Currently, there are no data about the transmission of hepatitis delta virus to the first case. Nevertheless, this boy and his brother may have had contact with migrants from endemic areas for hepatitis B, and probably hepatitis D.
Because hepatitis delta virus (HDV) is dependent on hepatitis B virus (HBV) for replication, HBV/HDV coinfection can be prevented with either pre or postexposure prophylaxis for HBV. HDV infection can be acquired either as a coinfection with HBV or as a superinfection of persons with chronic HBV infection.
The Ministry of Health may declare an epidemiologic emergency for Villa
Rica on Jul. 13. The plan is: education about transmission, vaccination against
hepatitis B virus for all the people living in Cedropampa, and serologic
Europe — Tenth of H.I.V. Cases Are Resistant to Drugs
The biggest study, so far, of resistance to AIDS drugs, presented at an international AIDS conference in Paris, shows that about 10 percent of all newly infected patients in Europe are infected with drugresistant strains.
The study tested 1,633 patients from 17 European countries who had just been diagnosed with the virus that causes AIDS and who had not yet been treated for it. (It is nicknamed the Catch study for "combined analysis of resistance transmission over time of chronically and acute infected H.I.V. patients in Europe.") About 9.6 percent of the patients were resistant to at least one of the three types of antiretroviral drugs that suppress the virus that causes AIDS. Resistance was much higher, at 11.3 percent, among Europeans who had subtype B of the virus that causes AIDS, compared to those with nonB subtypes, in whom it was 3.3 percent. This new study is thought to be the first to give a reliable measure of the phenomenon across a broader population, said Dr. Charles Boucher, the virology professor at Utrecht University who led the new study.
The figure suggested that many AIDS patients who are in treatment go back to engaging in highrisk sex or needlesharing. It also suggested that an "order of battle" approach to prescribing AIDS drugs, like that used for tuberculosis medicines, should be adopted in place of the current freeforall.
Therefore, when the drugs come to Africa, they must be handed out carefully,
with laboratories, doctors and epidemiologists monitoring patients and community
Multi Country Outbreak — Severe Acute Respiratory Syndrome (SARS)
Preparing for the next influenza season in a world altered
Data last probable case reported
In order to see further details, including cumulative number of cases
and deaths, please visit the following URL:
IT in Health Forum, July 30th, Hong Kong Academy of Medicine
Dr. William D. Henriques, Commander of US Public Health Service,
Department of Health and Human Services
Please see more details at the following URL:
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