Vol. II, No. 07 ~ EINet News Briefs ~ April 06, 1999
****A free service of the APEC Emerging
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In this edition:
- Update on Japanese Encephalitis/hendralike
- Overview of infectiousdisease
information from PROMED and other sources
- Updates from previous bulletins
- How to add colleagues to the EINet
ON JAPANESE ENCEPHALITIS/HENDRALIKE VIRUS
The newly discovered hendralike virus has been claimed to be the major
cause of the viral encephalitis outbreak currently raging in Malaysia.
AS of April 2, 84 people have died since October 1998, and a total of
221 people have been affected by the outbreak. So far, only 18 deaths
have been confirmed to be caused as a result of infection with the Japanese
Encephalitis virus. While experts from the US, Australia, and Taiwan are
working with Malaysian authorities on controlling the epidemic, very little
is known about the hendralike virus that was discovered two weeks ago.
The only preventive measures recommended until now with regard to the
new virus are, hand washing with soap or detergent, and protective clothing
and gear for pig farm workers. The CDC has confirmed that this virus is
killed by soap and detergent. CDC personnel have established a highlevel
biohazard laboratory at the University of Malaysia to handle specimens,
identify isolates of the paramyxovirus, and conduct studies to determine
the mode of transmission of this virus to humans. Transmissibility of
the disease is thought to be low for those not associated with pig farming.
The illness apparently begins with fever, followed by drowsiness and coma.
Fluctuating blood pressure and body temperature occur in the late stages.
Ribavirin appears to be effective when given in the early stages of illness.
Malaysian authorities have expanded the pig culling campaign to the neighbouring
state of Perak, and five buffer zones have been set up to contain the
outbreak of the virus. Movement of human beings and livestock will be
prevented in these zones by establishment of roadblocks. All pigs in the
buffer zones will be slaughtered. Investigations are being conducted to
identify the role of intermediary hosts in the transmission of the virus.
Malaysia's pork industry, in the meantime has suffered a 70% drop in sales.
The Philippine government has imposed a total ban on import of pigs and
pork from Malaysia for the next 21 months. Indonesia has tightened control
over the inflow of livestock from Malaysia in border areas in Sumatra
and Kalimantan. Increased monitoring of the health conditions of the country's
livestock, particularly pigs is also in effect in Indonesia. Thailand
has also tightened border control along the southern provinces in an effort
to prevent the spread of the virus. While there are no official recommendations
for travelers to Malaysia other than being aware of the disease, Thailand
seems to have benefited from the outbreak. Hotels have reported brisk
business, and a larger than usual flood of tourists mostly diverted from
Malaysia and Indonesia. While the diversion from Indonesia is due to the
prevailing ethnic violence, tourists to Malaysia have been deterred by
the viral outbreak.
US experts from the CDC have confirmed that 11 out of 15 blood samples
sent to them contained IgM antibodies to the Hendralike virus. The samples
belonged to eight abattoir workers in Singapore. No new cases have been
identified, and authorities in Singapore are confident that the situation
has stabilized following a ban on import of live pigs from Malaysia.
[ProMed, Mar. 25 April 5, 1999]
[Reuters, April 02, 1999]
[Bangkok Post, Mar. 29, 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.
CHINA SCHISTOSOMIASIS ALERT
Health departments in China, especially along the Yangtze River and around
Dongting and Poyang lakes have been advised to be on alert for the occurrence
of snail fever, otherwise known as schistosomiasis. In spite of last summer's
devastating flooding, only 1,888 cases of snail fever were reported throughout
[Xinhua, Mar. 30, 1999]
CHINESE TAIPEILAGGING BEHIND IN ANTITB CAMPAIGN
The Director General of the Department of Health has stated that Taiwan
has a much higher TB rate than the United States (71/100,000 vs. 7.4/100,0000,
and lags behind developed countries in its campaign to eradicate the disease.
Taiwan had 14,000 TB cases in 1997, accounting for more than 80% of all
infectious disease cases, with 1,600 of them fatal, accounting for half
of all deaths from infectious diseases. TB is more prevalent in the mountainous
areas of eastern Taiwan where its incidence rate is five times more than
that of other areas. The mortality rate is also 3.4 times higher than
the rest of the island. Only 80% of Taiwan's TB patients are ever fully
cured, while 10% succumb to the disease, and 10% are not accounted for,
posing a risk to the general public.
[China News Agency, Mar. 24, 1999]
HONG KONG AVIAN FLU VIRUS DETECTED IN WATER FOWL
Officials have isolated a strain of the H5N1 bird flu virus for the first
time from Guangdong geese at a local wholesale market in Hong Kong. While
this virus is similar to the 1996 virus that killed 6 people, further
tests are needed to confirm the relationship. Worldrenowned virologist,
Professor Robert Webster, has stated that there is no cause for alarm
as the chances of human infection from the virus were very small. Poultry
workers at the market showed no evidence of infection, and the Agriculture
and Fisheries Department will stop importing poultry from contaminated
farms on the mainland. It is believed that the emergence of the virus
could be related to migrant birds, which are natural carriers of the influenza
[South China Morning Post, Mar. 29, 1999]
[The Straits Times Interactive, Mar. 27, 1999]
HONG KONG HIV RISK FROM MAINLAND
Dr. David Ho DaI, an AIDS specialist in Hong Kong has warned of the risk
of HIV in Hong Kong as a result of growing numbers of mainlanders who
are HIVpositive. While the scenario did look grim with the rising volume
of traffic in and out of border posts, he believed that Hong Kong was
fortunate as it had ample resources to address the problem.
[Seaaids, Mar. 31, 1999]
INDONESIA TB INCIDENCE
The incidence of TB in Indonesia is estimated to be 450,000 cases annually,
making it the third biggest killer after heart and respiratory ailments.
While the government is making an effort to combat the disease, especially
with the implementation of DOTS strategy, poor compliance and high cost
of treatment are factors that have proven to be an impediment.
[Antara, Mar. 27, 1999]
JAPAN SALMONELLA TYPHIMURIUM DT104
Four outbreaks of food poisoning in 1997 and 1998 have been confirmed
to have been caused by the antibioticresistant serotype of Salmonella
known as DT104. A total of 27 people were affected in these outbreaks
and none died. Many of the cases contracted the bacteria by eating raw
[Asahi Shimbun, Mar. 23, 1999]
KOREA TB DEATH RATE HIGHEST AMONG OECD NATIONS
Korea's death rate from TB has been found to be 7.4/100,000, the highest
among the 29 members of the Organization for Economic Cooperation and
Development. A majority of the estimated 429,000 TB patients fall within
the age range of 20㪶 years. In 1997, 3,455 people died of TB, 51.4%
in the age range of 15㫘 years, and 48% aged 65 years and older. Approximately,
142,000 people contract the disease every year.
[Korea Herald, Mar. 24, 1999]
KOREA SWINE FEVER
Japan had has suspended pork imports from Korea beginning April 1, 1999,
in an attempt to eliminate hog cholera and declare a cholerafree region
before 2001. It has expanded the scope of pork import ban from the present
within 2 km radius of the cholera outbreak in Korea to a 10 km radius.
In other words, pigs raised within a radius of 10 km of the region where
there was an outbreak of hog cholera will not be allowed into Japan regardless
of vaccination status. Korean officials are trying to negotiate with Japan
with regard to this ban, especially since the nation's pork imports to
Japan are expected to reach $350 million worth this year, up from $313
million in 1998.
[Korea Herald, Mar. 22, 1999]
SINGAPORE HIV INCIDENCE IN 1998
199 people were infected with HIV during 1998 bringing the total number
to 930 at the end of last year. Heterosexual transmission accounted for
72% of all reported cases since 1991.
[Reuters, Mar. 27, 1999]
SINGAPORE HUMAN MELIOIDOSIS
Melioidosis, a deadly soil disease has claimed 19 lives and infected 114
people in 1998. These numbers are double the number of cases and deaths
seen in 1997. Since 1989, there have been 544 cases and 175 deaths making
it a bigger killer than dengue and malaria combined. The bacteria causing
melioidosis is Burkolderia pseudomallei, and is found in wet soil and
on the surface of muddy water. In Singapore, those suffering from the
disease appear to have some preexisting condition like diabetes, cancer,
or respiratory problems, and the majority were above the age of 65 years.
[The Straits Times, Mar. 30, 1999]
THAILAND ANTHRAX OUTBREAK
An outbreak of anthrax has claimed the lives of 20 dairy cows, and 3 people
have been infected following consumption of infected meat during the month
of March. Cattle smuggled in from Burma are believed to have infected
cows at the ThaiDanish Dairy Farm's Cooperative at Ban Huay Sat Yai
in Tambon Huay Sat Yai. An advisory has been issued to local farmers about
the disease with regard to notification and disposal of infected carcasses.
More than 3,500 cows at Cooperatives at Ban Huay Sat Yai, and Ban Pa
Teng in Tambon Huay Sat Yai have been vaccinated against anthrax. While
authorities have assured the public about the safety of beef sold in markets
their main concern is the smuggling of unvaccinated cattle across the
[Bangkok Post, Mar. 28, 1999]
AUSTRALIA HIV VACCINE READY FOR HUMAN TRIALS
A human trial of a vaccine against HIV is expected to commence in early
July after approval by scientists and community groups. The vaccine known
as Avipox, was shown to be effective in monkeys by protecting them against
becoming infected with HIV when exposed to the virus. The vaccine works
by producing Tcell immunity. The vaccine is expected to produce only
80% protection against HIV, and hence behavioral modification will still
have to be a target for prevention of the disease. The first phase of
the trail would involve vaccination of about 40 people in Sydney and Melbourne
to check of adverse reactions. The final phase, which could start within
a year, would involve vaccination of thousands of people from highrisk
groups in Australia and SouthEast Asia. High risk groups, like IV drug
users and the gay community that are potentially exposed to the virus
are expected to participate in the trail.
[Sydney Morning Herald, Mar. 29, 1999]
PERU CHOLERA ADVISORY
Following the detection of a case of cholera in the city of Cuzco, health
authorities, and the municipality and national police have implemented
a health education campaign in the community. Several cases of cholera
have been reported in the provincial capitals of Canchis and La Convencion,
and are believed to be a result of improper hygiene in food handling.
The Holy Week is a period during which food items are sold without controls,
including the clandestine sale of red meat and fish without veterinary
examination in the streets.
[El Comercio, Mar. 27, 1999]
3. UPDATES FROM PREVIOUS BULLETINS
AUSTRALIA IMPORTED MEASLES
The Department of Human Services in Victoria is providing free MMR vaccine
to people in the age group of 18㪶 years who do not have documentation
of at least one dose of measles vaccine or definite history of measles.
48 laboratory confirmed cases of measles have been reported so far, as
a result of one infected returned traveler from Bali, Indonesia.
[Victorian Infectious Diseases Reference Laboratory, Mar. 29, 1999]
SOUTH KOREA FOOD POISONING ADVISORY
Health authorities in Korea have decided to step up food safety control
over meals provided by schools, following an epidemic of bacillary dysentery
that has already infected 125 people in the first two months of this year.
4,577 people were diagnosed with food poisoning last year, 30.2% being
students infected after having meals at schools. The disease normally
occurs in the summer after July.
[Korea Herald, Mar. 24, 1999]
SEATTLE TO HOST APEC MEETING ON HEALTH, BIOTECH Health issues
will be an even more prominent part of the 17th meeting of the ISTWG,
which will be hosted by the United States in Seattle, Washington, on Aug.
16㪬, 1999. The APEC Emerging Infections Network and the University of
Washington are proud to be cosponsoring and helping organize major event
that will help increase health policy informationsharing and cooperation
by policymakers, officials and others throughout the APEC economies. In
addition to the regular business sessions, this ISTWG meeting will feature
a special daylong seminar and set of sessions dealing with emerging infections,
biotechnology and other related topics. The activities will also include
site visits to internationally known healthcare institutions and corporations
based in the Seattle area.
We urge you to set aside the dates Aug. 16㪬 so that you or colleagues
in your economy can attend this event, which will help set the stage for
collaboration into the new century. Those people who do not wish to become
delegates to the full ISTWG meeting will be welcomed at the separate health
and biotech events. More information about the tentative agenda and expected
speakers will be forthcoming, through EINet News Briefs and on the EINet
Web site (http://www.apec.org/infectious). For further information, contact
APEC EINet Communications Manager Cliff Meyer at firstname.lastname@example.org.
WEBSITES FOR INFORMATION ON OUTBREAK IN MALAYSIA
Health information for travelers on the viral encephalitis outbreak in
Malaysia can be obtained at the following web sites: http://www.cdc.gov/travel/index.htm
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