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About EINet
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****A free service of the APEC Emerging Infections Network***** "EINet News Briefs" is transmitted over the EINet listserv, which was created to foster discussion, networking, and collaboration in the area of emerging infectious diseases (EIDs) 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 subscribe to the listserv, see the bottom of this page.
In this edition:
Clinically, the illness can be severe and sudden with pulmonary edema, septicemia and cardiac complications. In fact, recent information suggests that the primary mechanism of sudden death is actually bainstem involvement with encephalitis, and a new clinical grading system with attendant supportive fluid management has been helpful in improving clinical outcomes according to studies at Chang Hua Christian Hospital. Further information on this is available from Dr. Lam at email lamsk@medicine.med.um.edu.my. The picture resembles that seen in the Malaysian Sarawak epidemic of 1997 which killed some 30 toddlers. The relationship between the viruses involved is under study according to Dr. Kenneth Lam Sai Kit of Malasyia. Given that the season for enteroviral infection is still in course, neighboring countries should heighten their clinical awareness of this disease. Good clinical guidelines for physicians have been published on the Hong Kong DOH website at http://www.info.gov.hk/dh/new/index.htm (News Bulletin/Information on Enteroviruses for Physicians). Updates on the epidemic can be found at the Taiwan website http://www.dsqs.gov.tw. In Taiwan measures to interrupt the epidemic include cancelling activities which would congregate young children together. It is of note that this virus is probably spread person to person through both respiratory droplets and fecal oral so handwashing is a key strategy to preventing spread. <Agence France Presse 16/06/98>
Similar recall of food products are occurring across the Pacific. In Australia there is an on–going investigation of an outbreak in which 85 cases of _Salmonella oranienburg_ infection have been identified. A case–control study was conducted which showed an increased risk of infection when eating Italian food or eating gelato of the brand, Alba Gelati, which supplies about 600 outlets across the State. Factory samples of the brand of gelato have been examined microbiologically, and _Salmonella oranienburg_ has been isolated from several samples. The manufacturer has undertaken a voluntary recall of gelato products.<Adriana Milazzo, Ingrid Tribe, Peter Brennan and Robert Hall, Communicable Disease Control Branch, South Australian Department of Human Services> Food product recalls are occurring across borders as well. Venetian Meat and Salami Co, a Canadian meat processing company, recently recalled products distributed in the US following an E. coli outbreak in Canada in which 33 people became ill from eating Venetian products. The food products were also distributed in Chicago, New York, New Jersey and northern Pennsylvania. <Nando net, 3㪞㫺> In Hong Kong, nine people fell sick when they ate pig's
lung soup. Subsequent tests found clenbuterol in stocks of
pig offal believed to be imported from the mainland, where
it is outlawed. Farmers use the potentially lethal growth
drug in livestock feed to promote leaner meat at higher
prices. Traders yesterday voluntarily suspended offal sales
after health officials warned people not to eat pig organs.
<South China Morning Post – 4 May> New Tracking System for Foodborne Illness In May, the US government officials unveiled a new computer database tracking system called PulseNet track nationwide that will enable health officials to identify foodborne illness outbreaks five times faster than before. PulseNet, will use the Internet to link the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration, the Agriculture Department, four laboratories and state health departments in all 50 states by 1999. The database will compare and log the DNA "fingerprints" of pathogens from samples of tainted food and make that information available. Washington State is planning to collaborate with CDC and Korea to refine this technologic approach in that country under a New APEC project approved in Chinese Taipei in March. PulseNet will replace CDC's 2–year FoodNet project, which seeks to collect reliable data on how many Americans fall ill from tainted meat, vegetables and other foods. A recently released FoodNet report found that campylobacter was the bacteria most often linked to bad food, followed by Salmonella. Campylobacter, most often found in raw chicken, accounted for nearly half the food–borne illness cases tracked by FoodNet. <FSNET and news media, 25㪝㫺>
Here is our weekly summary of relevant Asia–Pacific EID issues based on 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:
Thailand – Anthrax 28㪝㫺 The Public Health Ministry and the Livestock Department have stepped up measures to control the cross–border movement of cattle in order to prevent the transmission of communicable diseases from animals to humans. Concerned about falling beef sales due to an anthrax scare a few months ago, government organisations have joined hands in an attempt to assure the public that the situation is now under control. Deputy Public Health Minister Sunthorn Vilavan disclosed that illegal immigration to Thailand via the 26 border provinces was one cause of epidemics. Mr Sunthorn said after the outbreak of the disease, the authorities worked hard to put the situation under control by educating beef traders and staff of slaughterhouses on how to screen cattle, taking beef sold in the market for examination, and tightening measures on cattle imports. To curb cattle smuggling, special checkpoints have been erected in many provinces. <Bangkok Post May 28, 1997>
Australia (Western Australia) –
Encephalitis, Undiagnosed 8 to 19㪝㫺 There
have been five deaths in the past three years in Western
Australia from a "mystery" agent, believed by the press to
be a virus that causes an encephalitis–like disease. The
head of the infectious diseases department of Fremantle
Hospital in Perth, Dr. Miles Beaman, said all usual
infective causes have been ruled out. The patients, all of
whom died within 10 weeks after seeking medical help,
suffered headaches, cognitive distortion and fever before
lapsing into a coma. None of the patients had traveled
abroad just prior to becoming sick, and three of the cases
came from an area south of Perth. While the cases come from
a broad geographical area and are not necessarily connected
to each other, Dr. Beaman explained that it is unusual for a
cluster of unexplained cases to occur over such a reasonably
short time. Doctors have only recently put them together and
are now seeking assistance from the US Centre for Disease
Control to find a cause. <Australian Associated Press – 8
May 1998> Australia – Mosquito Viruses on the Increase Arboviruses (mosquito borne) are spreading and becoming established in new areas, which is of growing concern, according to the latest edition of the Communicable Diseases Intelligence (CDI), the official journal of the Communicable Diseases Network Australia New Zealand (CDNANZ). In a special edition of the CDI which reviews arboviruses in the Australian region from 1990 to 1998, communicable diseases experts express concern that the flaviviruses, Murray Valley encephalitis, Kunjin, Japanese encephalitis and dengue virus types 1, 2 and 3 and the alphaviruses, Ross River and Barmah Forest, are causing significant human disease in Australia. The CDI can be accessed on the internet on the Communicable Diseases Australia homepage: http://www.health.gov.au/pubhlth/cdi/cdihtml.htm <Dr. Bronwen Harvey, Editor, Communicable Diseases Intelligence, National Centre for Disease Control (MDP 6), Australian Department of Health and Family Services> Papua New Guinea – Typhoid
18㪝㫺 A recent study conducted by the Papua
New Guinea Institute of Medical Research in Goroka found
that 10 out of every 1000 in Papua New Guinea is exposed to
typhoid. Dr Megan Passey, who was one of the doctors who
conducted the study, said the disease could only be
eradicated if measures were taken to improve hygiene and
sanitation in the community. The doctor said typhoid was
most common in the highlands, Port Moresby and Lae and
admissions to hospitals in these areas had soared in the
past 10 years to alarming proportions lately. Typhoid is a relatively new problem in Papua New Guinea. From very few cases in the 1960s, the incidence has gradually increased to a situation where it was now endemic in the Highlands and some larger coastal towns. Because typhoid symptoms are confused with pneumonia and malaria and because malaria drugs were readily available, this is the first line of treatment received by typhoid patients. The results from the study also indicated that prevention would be difficult and it would require a long–term integrated approach, involving improvements in hygiene and sanitation. <Pasifik Nius is an e–mail service provided by the South Pacific University in Papua New Guinea. Mina Vilayleck <MinaV@SPC.ORG.NC> Via: Pacific Public Health Surveillance Network <PACNET@LISTSERV.SPC.ORG.NC>
TB GENOME MAPPED In an article in Nature, scientists at the Pasteur Institute in Paris and at Britain–s Sanger Centre report they have decoded and analyzed the 4,000–gene sequence, or genome, of a well–known strain of TB called H37Rv. The genome contains more than 4.4 million base pairs of genes, the scientists report. By identifying all the genes and predicting what many of them do, the scientists have made it easier and safer for other researchers in the field to advance their work, says Carl Nathan, professor of medicine at Weill College of Medicine, Cornell University, Ithaca, N.Y. Knowing which genes are active in disease–causing mechanisms gives drug and vaccine researchers something to shoot at, he says. <Genetic code for TB cracked Next: Disabling a killer, Anita Manning, USA TODAY 11㪞㫺> Australia: 270 cases of dengue fever have been reported – compared to 188 last year. Dengue fever is restricted to northern Queensland, where the carrying mosquito can be found. The mosquito (vector) has now spread towards the Northern Territory and New South Wales borders. <Radio Australia – World News, 18㪞㫺> Brazil: Biological Insecticide Developed Researchers at the Oswaldo Cruz Institute in Brazil have developed a biological insecticide that can kill the larva of the mosquito Aedes aegypti more efficiently than the products the Ministry of Health currently use. According to Leon Rabinovitch, head of the Dept of Bacteriology of the Institute, the new insecticide is made from the active portion of the bacteria Bacilus thuringiensis sorovar israelensis, which produces a toxin that is ingested by the Aedes larva and dissolved in the intestine, where toxic fragments become fixed on the intestine walls, killing the host. Rabinovitch notes that the insecticide targets only Aedes aegypti larva, without affecting other insect species, so that its action does not affect the fauna equilibrium. There was no mention in the article of the relative effectiveness of this insecticide compared to others in the market. <O Globo, 16/5/98 & Jornal da Ciencia, 18㪝㫺> Singapore: Heavier Fines for Mosquito Breeders Stiffer fines are in store for those hauled to court for having mosquito breeding sites on their premises. Under a new Bill tabled in Parliament on Monday, offenders face a fine of up to $5,000 –– five times more than the current $1,000. <Strait Times: 3㪞㫺>
Global Conference on Lung
Health ======================================================================
PROTOTYPE WEB PAGE ON TB CROSS
CULTURAL ISSUES Dear Colleagues: I would
like to ask for your help in improving a web page devoted to
cross–cultural issues in tuberculosis. The web page is part
of EthnoMed, a website at the University of Washington
devoted to disseminating medical and cultural information
pertinent to the health care of refugees in the United
States. The TB web page is under construction and no doubt
contains many errors. Some of the links do not work.
However, at this early stage in its development I would
appreciate your comments about its structure and
organization, and suggestions on how to improve it. The URL
for the prototype page is: http://weber.u.washington.edu/~kwangett/tb/tb.html
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