Vol. II, No. 01~ EINet News Briefs ~ January 12, 1999
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In this edition:
- Focus on influenza activity
- Overview of infectiousdisease
information from PROMED and other sources
- Updates from previous bulletins
- How to add colleagues to the EINet
1. FOCUS ON INFLUENZA ACTIVITY
Northern China is gradually easing from the effects of an epidemic of
influenza that struck the region in midDecember, 1998. The virus has
been identified as the particularly virulent type A H3N2, that has the
propensity to mutate making preventive measures more difficult to implement.
The strain has been named the Harbin variant reflecting a mutation of
the virus. The SinoJapanese Friendship Hospital in Beijing experienced
a fourfold increase of patients due to the epidemic, and statistics from
hospitals in Tianjin reveal more than 10,000 people who have been affected
by the epidemic. The Ministry of Health has taken preventive measures
to prevent further spread of the epidemic by seeking the cooperation
of health and education departments. Mass vaccinations were given in Beijing
to 20,000 people, mostly children, elderly people and company employees.
The vaccine, imported from France is against the A3 virus strains (Sydney),
and the A1 and B (Beijing) strains. Abnormal weather may have contributed
to the spread of the virus, this being the warmest winter in Beijing in
50 years. One newspaper reports states that more than 1,800 people have
been cremated in Beijing since December 5, 1998, a 40% increase over the
same period in 1997. More than 80% of those dead, were above the age of
60 years with most dying of pneumonia, or respiratory and heart disease.
There are conflicting reports about the actual number of deaths attributed
to influenza, and it may be that the numbers are low considering the severity
Fears that the epidemic will spread further south are said to be groundless,
according to the chief of the National Flu Centre. Health officials in
Hong Kong are monitoring the situation for an increasing trend of the
epidemic, but believe that the people of Hong Kong are at less risk as
they must have at least partial immunity to the virus from previous epidemics.
Reports of influenza activity in Europe have also been noted recently,
though sharp increases have been seen only in England and Wales until
now. The Sydney and Beijing strains of influenza A and influenza B are
circulating in England, but the outbreak has not officially reached epidemic
proportions. An epidemic is declared only when 400 cases per 100,000 of
the population are confirmed to have the disease in a given week. The
Royal College of General Practitioners(RCGP) is monitoring the situation.
According to reports from individual countries and the World Health Organization,
influenza activity has been relatively slow to start this season in Europe.
[Xinhua news agency, Dec. 15, 1998]
[Agence France Presse, Dec. 17, 1998]
[South China Morning Post, Jan. 06, 1999] [
Wenweipo Daily newspaper, Jan. 08, 1999]
[ProMed, Jan. 07, 1999]
[Hong Kong Standard, Jan. 06, 1999]
[China Daily, Dec. 14, 22, & 31, 1998]
[Eurosurveillance Weekly, Jan. 07, 1999]
[BBC, Jan. 08, 1999]
2. OVERVIEW OF INFECTIOUSDISEASE
INFORMATION FROM PROMED Here is our regular summary of
relevant AsiaPacific 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), cosponsored by WHO.
CAMBODIA (PHNOM PENH) SUSPECTED JAPANESE ENCEPHALITIS
600 fatal cases of suspected Japanese Encephalitis have been reported
in Phnom Penh, mostly involving children. Further information will be
available at a later date.
[ProMed, Jan. 05, 1999]
CHINA (HONGKONG)CLOSTRIDIUM PERFRINGENS
Improper food handling has been identified as the cause of an outbreak
of Clostridium perfringens among school children who ate school lunches
last week. 774 children who ate the lunchbox meal were traced by the
Department of Health, and 493 students with symptoms were identified.
The gravy used in the meal had been stored at room temperature for a night
allowing the multiplication of bacteria. Intestinal colic followed by
diarrhea, and nausea are common symptoms associated with the organism.
[South China Morning Post, Dec. 13, 1998]
PHILIPPINES (AKLAN) GASTROENTERITIS EPIDEMIC FEARED
An epidemic of gastroenteritis is feared in the province of Aklan following
a series of flash floods as a result of heavy rains and typhoons last
month. Records at the governmentowned Dr. Rafael S. Tumbokon Memorial
Hospital (DRSTMH) here showed that 423 persons afflicted with the waterborne
disease were admitted from Dec. 1 to 31. Nine deaths have been reported
as of Dec. 28. Health authorities mainly attributed the spread of the
disease to contaminated water sources. Doctors also blame poor sanitation
in Aklan households, improper waste disposal and unsanitary food preparation
as among the factors that contributed to the spread of the disease.
[Philippine Daily Inquirer, Jan. 05, 1999]
Cases of leptospirosis are on the rise in Singapore following an increase
in the population of rats that carry the disease. 14 cases were reported
in the first eight months of this year, while an average of only 9 cases
a year were reported between 1993 and 1997. Normally, only 5% of market
and food centers were found to have a problem with rats, but this was
not the case last year where 50% of the places surveyed had rats. In the
first nine months of this year, rats were found 16 per cent of the time
(35 out of 211 places).
[The Straits Times Interactive, Dec. 7, 1998]
VIETNAM HIV CARRIERS DETECTED IN ALL PROVINCES OF VIETNAM
HIV carriers have been reported in all 61 provinces of Vietnam resulting
in a total number of 11,301, 2,071 of whom account for AIDS patients.
The National AIDS Committee met in Hanoi to work out a plan to accelerate
dissemination of information on HIV/AIDS in 1999.
[NHANDAN Newspaper, Dec. 31, 1999]
AUSTRALIA ROSS RIVER VIRUS INFECTION
While the total number of reported cases of Ross River virus infection
has remained significantly lower than in 1997, the number of cases (198)during
November and December of 1998 were higher than the corresponding period
in 1997 (67).
[The Australian, Jan. 01, 1998]
AUSTRALIA OUTBREAK OF SHIGELLA
An outbreak of shigellosis at a funeral lunch in Adelaide has been attributed
to contamination of ham served at the lunch by a food handler on the previous
night. This person had recently recovered from a diarrheal illness, the
cause of which was unknown. The attack rate for those who ate the ham
was 62% (8 out of 13). Person to person transmission has also been considered
a possibility following the use of a single hand towel in the bathroom
that had become sodden from hand wiping. A total of 13 people became ill
with diarrhea, and Shigella sonnei biotype G was grown from three of the
cases. Shigella dysenteriae type 2 was also cultured from one individual
who had acquired the infection before attending the funeral from elsewhere.
S. sonnei biotype G has been the commonest Shigella identified during
1997 and 1998, in contrast to S. dysenteriae type 2 which was last notified
only in 1990.
[FSNET & Communicable Diseases Australia Vol. 22; No.13, Dec. 31, 1998]
PAPUA NEW GUINEA TYPHOID
600 cases of typhoid and 40 deaths were reported in the Western Highlands
Province during the past year. Typhoid was listed as the number one cause
for admissions in Mount Hagen Hospital. Unhygienic food and contaminated
water were cited as causes for the rise in incidence. An outbreak of typhoid
in New Ireland Province in November 1998 affected more than 30 people
and is on the decline now.
[ProMed, Jan. 11, 1999]
USA LISTERIOSIS, MULTIFOCAL
Contamination with Listeria monocytogenes has accounted for 50 cases of
listeriosis and 8 deaths in 11 states since early August 1998. Hot dogs
produced by Sara Lee Corporation's Bil Mar Foods unit in Zeeland, Michigan,
were the source of contamination, and specific production lots of hot
dogs and other meat products were recalled on Dec. 22, 1998. The establishment
numbers are EST P261 and EST 6911. LM isolates from the hot dogs and cases
belonged to serotype 4b and shared an unusual DNA pattern called Pattern
E. More details are available on MMWR at http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/00056024.htm
[Nando net, Dec. 18, 1998]
[FSNET, Dec. 22 & 24, 1998]
[MMWR, Dec. 23, 1998]
[CNN Custom News, Jan. 08, 1998]
USA (NEW MEXICO)UNDIAGNOSED FEVER
Researchers in New Mexico are trying to find the cause of an unknown illness
since 1993 characterized by fever, chills,, nausea, vomiting, abdominal
pain, diarrhea, and loss of appetite. The most prominent symptom is severe
muscle pain. Low platelet and white blood cell counts are other features
of the illness. While all patients have recovered, the diagnosis remains
unknown inspite of aggressive investigations conducted by five labs from
around the country. 80 unsolved cases have collected since 1993, and similar
cases have been detected in Colorado, Texas, Arizona, and Utah. The illness
appears to be related to rural areas, and peaks in August.
[Albuquerque Journal, Dec. 13, 1998]
USA EPIDEMIC OF SEXUALLY TRANSMITTED DISEASE
Latest figures reveal that the incidence and prevalence of sexually transmitted
diseases in the United States are among the highest in the industrialised
world. The United States had 15.3 million new cases of sexually transmitted
disease in 1996 and more than 68 million Americans now have an incurable
sexually transmitted disease such as herpes, human papillomavirus infection,
hepatitis B, or HIV infection. Teenagers and young adults are most affected
by sexually transmitted diseases. By the age of 24, one in three sexually
active people in the United States has had a sexually transmitted disease.
While the CDC estimated 12 million cases a decade ago, the latest figure
of 15.3 million may also reflect more sensitive tests and screening procedures.
Sexually transmitted infections now cost the US economy $8.4 billion (5.25
billion) each year for medical treatment.
[BMJ, Dec. 12, 1998;317:1616]
TUBERCULOSIS ADVISORY, AIR TRAVEL WHO
The World Health Organization has issued an advisory about the risk of
acquiring TB by air travel from fellow air passengers on long flights.
The risk, though small, is real and cases have been documented where passengers
have been infected with the bacterium. Poor ventilation, flights over
8 hours long, and crowding on airplanes facilitate the spread of the bacterium.
WHO estimates that a third of the world's population carries the bacterium.
The organization has issued guidelines to airlines to help limit exposure
by barring those with known disease from air travel. While WHO admitted
that it would be difficult to have complete airline records, it recommended
airlines trace and inform passengers and crew who were on a flight of
more than eight hours with an infectious person.
[ProMed, Dec. 17, 1998]
USA LYME DISEASE VACCINE PROGRESS
The first vaccine against Lyme disease has been approved by the Food and
Drug Administration. It is indicated for people between the ages of 15
and 70, and is given in three doses over a oneyear period. Since it is
not 100% effective, the FDA recommends alternate methods of protection
from ticks while spending time outdoors. Safety and efficacy were shown
when the vaccine doses were given between January and April, shortly before
the peak tick season in the northeast US. The duration of protection,
and safety data on the use of the vaccine in pregnancy or in patients
with chronic joint and neurological disease is limited. The vaccine contains
a genetically engineered protein from the surface of Borrelia burgdorferi
bacteria, which causes Lyme disease. For this reason, the vaccine is effective
only against B. burgdorferi s.s., and not against other variants that
are found outside the U.S.
[ProMed, Dec. 22 & 23, 1998]
3. UPDATES FROM PREVIOUS BULLETINS
AUSTRALIA (MELBOURNE) LEGIONELLOSIS
Three cooling towers in Thomastown have been identified as possible sources
of the Legionella outbeak in October. DNA testing of samples from infected
patients and the cooling towers were supportive of this conclusion.
[Herald Sun, Dec. 24, 1998]
MALAYSIA JAPANESE ENCEPHALITIS VACCINATION
The outbreak of Japanese Encephalitis in the state of Perak has been contained
following effective vaccination and education of residents in pig farm
areas, and fogging residences and pig farms. No new cases have been reported
since 30 Nov. 1998, and the final count is 11 cases, including 4 deaths.
70, 000 people living near pig farms in seven states are considered to
be at risk, and the Ministry of Health has decided to ask the Federation
of Livestock Farmer's Association to pay for vaccination of this population.
Highrisk groups living outside these areas will fall under the responsibility
of the Ministry. Free vaccinations are currently being given to residents
in the affected areas, targeting a total of 6,864 people. The Ministry
has also requested the Veterinary Research Institute to produce a cheaper
local vaccine for pigs, since the vaccine currently used is imported from
Japan and costly. Mandatory vaccinations are being given to 10,000 residents
in the town of Shah Alam, 25 km west of Kuala Lumpur, a highrisk area
due to the number of pig farms.
[The Straits Times, Dec. 18, 1998]
[Bernama The Malaysian National News Agency, Dec. 17, 1998]
[Borneo Bulletin, Dec. 29, 1998]
The 2nd Australasian Conference on Hepatitis C: HCV the Evolving Epidemic
will be held from 17㪫 August 1999 at Christchurch, New Zealand. This
conference is intended to provide a forum for all those involved with
hepatitis C to present and discuss their perspectives on the evolution
of this global epidemic and their responses to it. The programme will
include keynote addresses as well as concurrent streams on basic sciences,
clinical sciences, epidemiology and social research, community support
and self management, and prevention and public health. Abstracts are invited
for presentation in all streams and the abstract deadline is 1 March 1999.
For more information email: email@example.com Or visit their website
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