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Vol. VI, No. 22~ EINet News Briefs ~ November 21, 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 INFORMATION
ASIA Japan—BSE accusations In the last six weeks, Japanese bulls aged 23 and 21 months have tested
positive for BSE. Japan is the only country where tests are not limited
to bovines older than 24 (or 30) months, but include all animals arriving
at slaughterhouses. China—Begins Giving Free HIV/AIDS Drugs to the Poor Henk Bekedam, the World Health Organization (WHO) representative in Beijing, said the free drug program was the latest example of what appears to be a new, more proactive attitude toward AIDS taken by China's leaders. This week Beijing hosted a major international AIDS conference, and an AIDS meeting led by former President Bill Clinton will be held here on Monday. China recently received a $98 million grant, largely to fight AIDS, from the Global Fund. Experts say China has begun manufacturing some antiretroviral drugs,
but only ones no longer under patent. China is negotiating with pharmaceutical
companies to lower the price of newer, patented drugs. The difficult
job of building the necessary health care infrastructure to treat such
a major AIDS problem is the immediate challenge for China, but many experts
believe that SARS, and the lessons the government learned, is one reason
that senior leaders are no longer trying to ignore the country's AIDS
problem. Still, many activists believe that China's top leaders, including
President Hu Jintao and Prime Minister Wen Jiabao, must make highprofile
gestures, as they did during the SARS crisis. China—Reports 840,000 HIV and 80,000 AIDS Cases About 5,000 HIV carriers and AIDS patients in poverty would receive free treatment this year and the free treatment would be available for all poor HIV carriers and AIDS patients next year, Gao announced. In all 124 counties where comprehensive prevention and treatment demonstration zones were established, integrated measures including antiviral treatment, care and life assistance will be adopted. Gao said that HIV/AIDS is a common enemy of humankind and the Chinese
government has attached great importance to prevention and treatment
and treated it as a strategic issue for social stability, economic development,
national prosperity and security. HIV/AIDS in China has not been controlled
and prevention and treatment in China is still faced with arduous tasks,
he said. China would protect the legitimate rights of HIV/AIDS patients
and oppose social discrimination, he added. China (Guangxi)—Rabies Kills 312 People, January to September 2003 A serious, fatal disease that can be transmitted by dogs, cats, livestock
and certain wild animals, rabies infects and kills thousands of people
every year in China. Rabies, called "mad dog disease," has
become the most dangerous infectious killer in the country, easily surpassing
diseases like SARS, pulmonary tuberculosis, AIDS, and anthrax. The ministry's
statistics show that 854 deaths from rabies were reported in 2001, and
the figure rose to 1003 in 2002. Some feared the toll might continue
to rise this year, since rabies outbreaks had ravaged provinces like
Guangdong, Hainan, Hunan, and Jiangsu this summer. China (Hunan, Hubei)—Food poisoning in children In the first case, a farmer from Nanjiang town in Pingjiang county of Hunan allegedly went to Daxing and Simei primary schools in the county and gave poisoned popcorn and citrus to a fifthgrade student and to a secondgrade student and allegedly told them to share the treats with fellow pupils. After they ate the poisonous food, 27 schoolchildren immediately fell sick and were sent to the hospital. Two students died on the way to hospital. The suspect allegedly tried to escape by bus but was stopped by the police; the motives for the poisoning are unknown. In the other food poisoning case in Hubei, a total of 22 students fell
ill on Tuesday night after they had their supper in the dining hall of
the Nigou Central Elementary School in Jingyang. China (Guangzhou)—Staphylococcal outbreak China (Beijing)—Hand, foot and mouth disease on increase Although the mortality rate for patients with hand, foot and mouth disease
is less than one percent, if it leads to meningitis, there is still no
effective medical treatment, China's CDC’s Jin Qi, said. Hand, foot and
mouth disease is a commonly occurring infectious disease caused by an
intestinal virus. Most patients are children under five years of age.
It can lead to fever and rashes and ulcers on the hand, foot, mouth,
and other spots. In exceptional cases it can lead to lifethreatening
complications like myocarditis, acute lung edema, and aseptic meningitis. Thailand—AIDS vaccine tested in Thailand shown to be ineffective The test was carried out in 17 medical centers in the Bangkok area.
The first test on the vaccine, conducted in North America, Puerto Rico
and the Netherlands, also delivered disappointing results. The vaccine
was developed to encourage the immune system to create antibodies which,
in principle, would cling to proteins on the virus and prevent it from
latching onto the cell it wants to invade. Thailand (Prachuap Khiri Khan)—Foot and mouth disease epidemic Russia (Moscow)—Rise in meningitis, meningococcal, type A AMERICA
USA (District of Columbia)—Anthrax scare In October 2001, at least five people died–including two Washington
postal workers–and 17 became seriously ill within weeks of the anthrax
attacks. Letters containing anthrax spores were sent to news media in
New York and Florida, and anthraxlaced letters were sent to the Washington
offices of two senators. Those responsible have not yet been caught.
Since the attacks, the Postal Service has spent millions of dollars to
test and install equipment to sterilize the post. USA (Pennsylvania)—Restaurantrelated hepatitis A outbreak toll reaches
500 As of 15 Nov 2003, 510 cases of hepatitis A have been confirmed in the outbreak, said Richard McGarvey, a spokesman for the Pennsylvania Health Department. He said more infections were expected because people who contract hepatitis A typically do not exhibit its early flulike symptoms for 30 days. The state started offering antibody inoculations on 5 Nov 2003 to anyone who ate at the restaurant after 22 Oct 2003. The antibody reduces the risk of hepatitis A developing, but it must be given within two weeks of exposure. In severe cases, the virus can lead to liver failure. About 8500 people have received the shots because of the outbreak linked to a ChiChi's at the Beaver Valley Mall, about 25 miles northwest of Pittsburgh. The Beaver Valley branch is closed until 2 Jan 2004. Health investigators said they still did not know the source of the
virus. They are looking at foods, including green onions, which are difficult
to clean and have been linked to smaller outbreaks in other states. ChiChi's
has removed green onions from all of its restaurants as a precaution. Please see Hepatitis A Outbreak Associated with Green Onions at a RestaurantMonaca, Pennsylvania, 2003 in the Articles Section below. USA (Virginia)—First human death associated with raccoon rabies Emergency medicine physicians, infectiousdisease consultants, and state
and national public health officials can provide advice on rabies prophylaxis
for complicated or unusual exposure scenarios to prevent this fatal disease
and aid in its diagnosis. In order to see the article by CDC, please visit the following site:http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5245a4.htm USA (Washington)—Death of Student from Hantavirus pulmonary
syndrome County health department investigators hope to identify where the individual
may have been exposed to the virus. Because the disease cannot be spread
through human contact, local residents should not become alarmed, Browning
said. Migrant workers and people who work around barns where deer mice
could be present are among those most at risk for contracting the virus.Hantavirus
pulmonary syndrome is characterized by fever, chills, and severe muscle
aches, followed by difficulty in breathing and shortness
of breath. Deer mice are the main carriers of the deadly virus, which
kills 40 percent of people infected. To prevent the disease, wear gloves
and a dust mask when cleaning a rodentinfested area or a shed or cabin
that has been closed up. Soak mouse nests and droppings with a solution
that is one cup bleach to 10 cups water. Don't stir up any dust; use
mops or rags soaked in the bleach solution. USA (Idaho)—First probable human case of West Nile virus infection The man, in his 40s, has completely recovered from the infection and poses no health threat to other Idaho residents. Lab tests conducted at the Idaho Department of Health and Welfare's Bureau of Laboratories were positive for West Nile virus. About 20 per cent of people who are infected with West Nile virus have
symptoms of the infection, which can include headaches, body aches, and
mild fever. Less than one per cent of people infected develop a serious
illness from the viral infection. "We have known for some time that
West Nile was coming," said Dr. Christine Hahn, state epidemiologist
with the Idaho Department of Health and Welfare. "Counting Idaho,
the virus has been found in 46 states now, including our neighboring
states of Montana, Wyoming, Utah, and Nevada. And, we can expect that
it will reappear in Idaho next year." USA (Alaska)—Salmonella confirmed at Kodiak school Although health and school officials believe they have pinpointed the event at which the salmonella spread (an International Day potluck lunch) they do not know the direct source of the bacteria. The bacteria could already have been in a food or contaminated by handling, and there were few items at the lunch that are typically associated with salmonella. There was no dish with eggs, except sugar cookies, which appeared properly baked. Salmonella bacteria cause an infection of the intestines. Infections
can be caused by eating raw or undercooked foods such as meat, poultry,
or eggs or by eating food or drinks contaminated by an infected person.
Nations prepare for return of SARS Dogs, cats, rabbits, badgers and other animals are sold to be eaten as delicacies in markets in southern China, where scientists think the SARS virus jumped from animals to humans, possibly from a wild civet cat. At the height of the SARS epidemic last spring, the Chinese government banned the sale of wild animals in the markets, but lifted the ban in August. In China and Hong Kong–hardesthit by SARS–authorities are already taking
precautions in case of a reemergence. Last month Beijing unveiled a
new antiSARS task force aimed at preventing any further outbreaks, and
officials said hospitals and specialist clinics began intensive training
for preventing and handling the disease. In Hong Kong, Dr. Tong Chakkwan
said they are ready at Princess Margaret Hospital, which handled more
than a third of all Hong Kong's SARS cases. USA—West Nile virus surveillance Please visit the following URL for more details: Canada—West Nile virus surveillance Hepatitis A Outbreak Associated with Green Onions at a Restaurant—Monaca,
Pennsylvania, 2003 In order to see the entire article, please visit the following site: WHO steps up action against substandard and counterfeit medicines Counterfeit and substandard medicines are frequently detected in Cambodia, China, the Lao People’s Democratic Republic, Myanmar, Thailand and Viet Nam and the problem seems to be increasing. Products most commonly counterfeited in this region include antibiotics and those used in the treatment of tuberculosis, malaria and HIV/AIDS. The use of poor quality or counterfeit medicines has little or no therapeutic effect and in poor settings often leads to death. “Combating low quality or illegal medicines is now more important than ever. Expanding access to safe, effective treatment for AIDS and other illnesses is no longer an option, it is an imperative,” says Dr Lee Jongwook, WHO DirectorGeneral.” In order to see the entire article, please visit the following site: The APEC EINet listserv was established to enhance
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