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EINet
News Briefs Archive
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About EINet
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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:
The WHO reports that as of 12 December, 1997, three
suspected cases of influenza A(H5N1) are now under
investigation. Influenza Type A(H5N1), which was known
previously to infect only birds, was first isolated from a 3
year old boy in Hong Kong in May 1997, who died of Reyes
syndrome during an acute respiratory illness. According to
"Outbreak," there have been 4 confirmed cases, 2 deaths, and
9 additional suspected cases. Influenza surveillance now
includes all hospitals and 63 public health clinics. So far
no case of person–to–person transmission has been
identified, but further tests of blood specimens are
required to ascertain the origin of the infection with
greater precision. In the absence of human–to–human
transmission and of any documented outbreak, WHO does not
recommend the development of a specific H5N1 vaccine.
However, the WHO Collaborating Centres for Influenza are
working with various H5 strains to prepare high growth
reassortants which could be used for vaccine production, in
case of need. In the meantime, the WHO Collaborating Centre
at CDC has prepared a kit of reagents which will be
despatched shortly to all National Influenza Centres for
diagnosis of H5N1 (adapted from http://www.who.org/programmes/emc/news.htm).
Dr Hur from the CDC, Minstry of Health and Welfare,
Korea, reports that Korean surveillance reported the
separation of influenza virus type A (subtype now under
investigation) on Nov 25 for the first time this season. He
also noted that there was "4.1% of ILI (influenza like
illness) which showed a little bit rapid increase during
recent 2 weeks." Dr. Hur notes that the CDC is now
constructing an "Infection Information system" website for
reporting acute illness information with GIS technology
which is supposed to be finished by the end of next year.
Thank you for sharing this information with us; we look
forward to link APEC EINet on to this new site.
Caroline Akehurst reported in Eurosurveillance Weekly, of
the identification of a strain of influenza virus
(A/Sydney/05/97, like (H3N2)) similar to but
antigenically distinguishable from the H3N2 strain
incorporated in the influenza vaccine recommended for
1997/98. The outbreak occurred among passengers and crew on
consecutive voyages on the same cruise ship between New York
and Montreal (1). This (A/Sydney/05/97–like (H3N2) )
antigenic variant has not yet been detected in Africa,
Europe, South America, or the continental United States (US)
and represents an antigenic drift of the virus. It is
antigenically distinguishable from A/Nanchang/993/95, which
is the A(H3N2) component of the 1997/98 influenza vaccine
currently in use in the US. The A/Nanchang/993/95 strain is
very similar to the A/Wuhan/359/95(H3N2)–like strain which
the World Health Organization recommended should be a
component of trivalent vaccines for the 1997/98 season in
Europe (2).
The efficacy of the 1997/98 vaccines against this variant
is unknown but the protection of this year's vaccine could
be reduced if this variant circulates widely.
Here is our weekly summary of relevant Asia–Pacific
postings to the ProMED Electronic Network, which is a
prototype for a communications system to monitor emerging
infectious diseases globally as an initiative of the
Federation of American Scientists (FAS) and co–sponsored by
WHO. More information about PROMED can be acquired
contacting the moderator. Please contact the moderator if
you would like more any of the reports below:
3㪤㫹
CJD & DURA MATER TRANSPLANTS – THAILAND Dr.
Hemachudha from Chulalongkorn University reports of a CJD
patient from iatrogenic transmission, dura mater graft. The
43–year–old patient was initially was admitted to Department
of Psychiatry, Chulalongkorn University Hospital for the
management of depression and anxiety. She subsequently
demonstrated dystonic movement of the arms and legs and
became mute within the following month. In 1990, she had a
spinal cord surgery, removal of astrocytoma, and a dura
mater graft, lyophilized product from a German company. Dr.
Hemachudha advise the hospital to use disposable
neurosurgical instruments for lumbar puncture, an idea also
supported by WHO.
6㪤㫹
INFLUENZA, AVIAN, H5 SEROTYPE – ITALY A highly pathogenic
strain (H5) of avian influenza has been identified
in outbreaks in Italy; the diagnosis was made by the
Experimental Animal Disease Co farm. – DP.)
Other developments reported by the South China Morning
Post:
12,000 tablets of amantadine (Symmetrel) are being flown
in on an emergency basis, after there was a "run on the drug
in the past two days and private practitioners are unable to
buy supplies from the limited stocks of manufacturers." This
shipment, enough to treat 1200 persons, will not arrive
until next week.
8㪤㫹
INFLUENZA, HUMAN, H5N1 – CHINA (HONG KONG)
Two new cases of H5N1 in HK. Dr. Paul Saw, DOH Deputy
Director stated that the increased surveillance the first
case in August may have resulted in the detection of the 3
subsequent cases.
At least 7 hospital staff members who had contact with
the man who died and the young woman who is in critical
condition have developed flu–like–symptoms and have been
asked to go on leave.
9㪤㫹
INFLUENZA, AVIAN, H7 SEROTYPE – AUSTRALIA (02) There's
been a second outbreak of avian influenza, on another
poultry farm near Tamworth in northern New South Wales. A
further 30,000 layer hens will be destroyed and buried in
the next few days, taking the total to 150,000 birds
destroyed on two separate farms in the Tamworth district
after Australia's fifth–ever outbreak of the disease was
discovered earlier this week. In addition more than one
million eggs from the chickens involved in the latest
outbreak have also been destroyed at two hatcheries in
Sydney.
INFLUENZA, BIRD–TO–MAN – CHINA (HONG KONG) (12) A major
wire service today provided information on an outbreak of
H5N1 in poultry that was originally published in the Hong
Kong Standard on 22 August of this year.
There was an outbreak of the virus in chickens in
Guangdong province in February and March, killing
approximately 1.7 million birds. In April, there was another
outbreak, according to the newspaper, killing 4500 chickens
on 3 farms in Lau Fau Shan, Hong Kong province. According to
official statements of the Agriculture and Fisheries
Department (AFD) in late August, the virus was believed to
have burned itself out, because there were no further
reports from farmers. After the first human case of H5N1,
the department's Castle Peak laboratory took 80 blood
samples from 5 farms to test for viral activity. Laboratory
results, supposed to be ready within 4 weeks (i.e., late
Sept.), were not made public.
10㪤㫹
INFLUENZA, AVIAN, H7 SEROTYPE – AUSTRALIA (03) Update on
incursion of highly pathogenic avian influenza in New South
Wales, Australia from Australia's latest advice to the
Office International des Epizooties on avian influenza in
New South Wales indicates that the isolated virus has an
Intravenous Pathogenicity Index (IVPI) of 2.54. Studies of
the haemagglutinin (H) and neuraminidase (N) antigens have
subtyped the virus as H7N4.
INFLUENZA, BIRD–TO–MAN – CHINA (HONG KONG) (13)
Investigations of the 4 H5N1 influenza cases observed to
date show that the initial clinical presentation is not
different from ordinary influenza cases. However,
respiratory distress syndrome and renal failure set in
rapidly in three cases. Hence, doctors taking care of
influenza patients are advised to watch for symptoms and
signs of complications, and early hospitalization is advised
once the clinical conditions warrant. Doctors are also
advised to not wait for the laboratory diagnosis of H5N1
infection before they start appropriate treatment. It is
prudent to note that treatment for H5N1 infection is
essentially the same as for other influenza viruses.
Appropriate treatment, including the use of amantadine,
should be guided by the clinical assessment and should be
started immediately once influenza with complications is
clinically diagnosed.
INFLUENZA, BIRD–TO–MAN – CHINA (HONG KONG) (14) Deputy
Health Director Dr. Paul Saw Thian–aun announced that the 2
children infected by H5N1 (1 fatality, 1 recovery)
"caught it through direct contact with birds." This
statement was based on tests done at CDC in Atlanta. Dr. Saw
reported, however, that the families of the 2 children are
"adamant" that they did not ever have close contact with
birds.
According to this report, the 54–year–old man who died
from H5N1 was a dentist who treated patients during the week
before his death. Complicating the attempt by health
authorities to trace the patients is the fact that the
dentist was practicing illegally. In addition, 12,000
tablets of amantadine (Symmetrel) are being flown in on an
emergency basis (source: South China Morning Post).
Provisional legislator Edward Leong Che–hung called for
the administration of a new blood test to a random sample of
1מ thousand people in HK to see if, or how many, others may
have contracted the virus. But, according to Dr. P.Y. Lam,
another director in the Hong Kong Health Department, this is
not yet feasible because the test has not yet been released
for use and probably would not be ready for "some time". Dr.
Lam will be passing on the legislator's suggestion to CDC
specialists, three more of whom are scheduled to arrive.
(source: The Hong Kong Standard)
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 own material with their
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To subscribe or unsubscribe, please contact Nedra Floyd Pautler at pautler@u.washington.edu.
Further information about the APEC Emerging Infections Network is available at
http://www.apec.org/infectious. |
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© 1998, The University of Washington |
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