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Vol. II, No. 10 ~ EINet News Briefs ~ May 18, 1999
****A free service of the APEC Emerging
Infections Network*****
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 AsiaPacific
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:
- Overview of infectiousdisease
information from PROMED and other sources
- Updates from previous bulletins
- Notices
- How to add colleagues to the EINet
listserv
1. 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.
ASIA
CHINA HEPATITIS B VACCINATION ENCOURAGED
Health officials in China have called for enhanced efforts to vaccinate
newborn babies against hepatitis B, citing this as the most efficient
and economical method to curb this contagious disease. The number of HBV
carriers are expected to drop below from 10% to 1% percent in 50 years
if vaccinations are given to all newborn from now on. Only 30% of infants
born in rural areas are vaccinated against the virus compared to over
90% vaccination rate among infants in urban areas. Ignorance and lack
of money have been cited as reasons for this disparity. 40% of hepatitis
B infections in China are through mothertochild transmission. Hepatitis
B vaccination was included in the EPI program I 1992. Health economists
have warned that the country could suffer 3.6 to 6 billion U.S. dollars
in extra medical expenditures annually due to the spread of hepatitis.
[Xinhua, April 25, 1999]
CHINA STD RISE HIGHEST IN DECADE
The Chinese National Sexually Transmitted Disease Control Center reports
that cases of sexually transmitted disease rose to 632,512 last year,
an increase of 37 percent. In China, STDs have become the third most common
infectious disease, preceded only by dysentery and hepatitis. Statistics
from the Health Ministry also show that by the end of 1998, 12,580 cases
of HIV or AIDS were reported nationwide.
[South China Morning Post, May 07, 1999]
HONG KONG HIV STATUS
46 people were found to be positive for HIV I the first quarter of 1999,
bringing the cumulative total number of reported infections to 1,192.
18 new AIDS cases were reported in the same quarter, bringing the total
number of confirmed cases to 390.
[Xinhua, May 07, 1999]
HONG KONG CHOLERA SUSPECTED
A 31yearold business man who traveled from Bangladesh to Hong Kong last
week is believed to be suffering from cholera at Princess Margaret Hospital.
The case, if confirmed, would be the third this year.
[South China Morning Post, May 12, 1999]
KOREA ADVISORY AGAINST SKINDECAYING EPIDEMIC
The Health and Welfare Ministry has issued an advisory against Vibrio
vulnificus septicemia, a deadly disease which causes severe skin decay
in infected persons. The bacterium was discovered in oysters and other
shellfish collected from the coastal regions of South Cholla Province
on May 13. Abnormally high temperatures this spring have led to the early
appearance of this bacteria. Vibrio vulnificus infections generally occur
between July and October among residents in coastal areas. High fever,
stomachaches, vomiting and diarrhoea are the main symptoms, and 40㫊%
of cases, infections can lead to death. Those at highest risk are men
in their 40s with diabetes, alcohol addiction, or who have chronic liver,
stomach, or kidney problems. People have been advised to eat only fully
cooked seafood and to avoid raw fish and oysters. Activities such as swimming
and cleaning fish while nursing an open wound are also not recommended.
The number of Vibrio vulnificus septicemia infections have increased to
50 this year compared to 23 from last year.
[Korea Herald, May 15, 1999]
KOREA JAPANESE ENCEPHALITIS ADVISORY
A national warning against Japanese Encephalitis has been issued by the
Ministry of Health and Welfare. Mosquitoes in the coastal regions of South
Cholla Province were found to be carrying the virus, and the carriers
are believed to have appeared early this year due to the abnormally warm
weather. Parents having children between the ages of 3 and 15 years have
been advised to get their children vaccinated.
[Korea Herald, May 14, 1999]
PHILIPPINES MEASLES ON THE RISE
A total of 743 cases of measles have been reported in the first three
months of this year compared to 264 cases during the same period last
year. 60 children have died as a result of measles, and health officials
are puzzled at the rise in the incidence of the disease. The Philippine
measles Elimination Campaign (PMEC) was launched last year, but it was
noted that only 11% of patients were immunized against the disease. Most
of the cases were from Metro Manila, and 87% of patients at the San Lazaro
Hospital were less than five years old. The PMEC aims to immunize millions
of children between nine months and 14 years of age and has been promoting
the program in different parts of the country. Incomplete coverage, and
inefficacy of the vaccine have been cited as possible reasons for the
rise in cases this year. The Department of Health is still confident that
measles will be eliminated by the year 2008 in the Philippines.
[The Manila Times, May 06, 1999]
PHILIPPINES DENGUE ADVISORY
Health authorities have called for greater vigilance following reports
of a relatively high number of dengue cases nationwide this year. The
peak dengue months are from July to October which are the rainiest months,
but the disease is expected to surface earlier this year because of the
sudden and unexpected change in the weather. Health officials have issued
advisories to the public with special emphasis on elimination of mosquito
breeding habitats. Fumigation machines, medicines, diagnostic kits, and
blood for transfusion are being prepared for distribution to dengueafflicted
provinces. Most of the dengue cases from previous years were from Metro
Manila, Eastern and Central Visayas, Southern Tagalong, Central Luzon,
Bicol and Cagayan Valley. 31,780 dengue cases were reported nationwide
last year, of which 493 deaths were recorded.
[Philippine Daily Inquirer, May 11㪥, 1999]
OCEANIA
NEW ZEALAND HIGH RATES OF DISEASE CAUSE ALARM
Low immunization rates are blamed for New Zealand's high rates of deadly
childhood diseases. Measles and whooping cough account for unacceptably
high rates of diseases, and the problem could get worse with a whooping
cough epidemic that is expected to sweep the country this winter. Figures,
based on the death rate of children aged under five, show New Zealand's
health status has got worse in the last 30 years. In the 1960s New Zealand
was ranked sixth out of 21 comparable OECD countries, but in the 1990s
it ranks 15th, and has child health statistics worse than those of some
Third World countries.
[The Press, May 11, 1999]
PAPUA NEW GUINEA AIDS DEATHS ON THE RISE
The Health Minister Ludger Mond has warned that HIV/AIDS will be the leading
cause of death in the National Capital District(NCD)within the next 12
months. The NCD recorded 468 new cases of HIV between January and December
1998, followed by the Western Highlands(37), Morobe(34), and Simbu(22).
On the national scale 642 new HIV cases, 185 AIDS and 23 deaths were recorded
last year. Papua New Guinea's AIDS statistics remain the highest in the
South Pacific region. 50% of affected individuals were men. There has
also been an increase in the number of children under two years who have
been diagnosed with HIV at the Port Moresby General Hospital. While efforts
were being made to improve the situation, an increasing number of AIDS
victims are adding to the pressure on existing scarce resources. A comprehensive
surveillance system, and a national strategy for HIV/AIDS control are
being planned. [Post Courier, May 14, 1999]
AMERICAS
MEXICO GNATHOSTOMIASIS
Gnathostomiasis, a form of visceral larva migrans, is now an emerging
public health problem in Mexico since 1970. The parasitic disease which
is highly prevalent in Southeast Asia is caused by Gnathostoma spinigerum,
a nematode parasite of dogs and cats. Humans acquire this disease by eating
raw or undercooked freshwater fish that are intermediate hosts for the
parasite. The symptoms of the disease are not serious, but severe illness
or even death may occur if the parasite migrates to vital organs of the
host. Between 1993 and 1997, 98 cases of gnathostomiasis were identified
in Mexico.
[ProMed, May 13, 1999]
PERU YELLOW FEVER
Yellow fever has killed 3 individuals and affected 15 people between the
towns of Lamas and Moyobamba. A vaccination campaign against yellow fever
has been implemented, and will include persons in transit, as the affected
communities are located near the Marginal Northern Highway of the Department
of San Martin that runs from the coast to the mountains. An increase in
the number of insects as a result of the rains has been attributed the
spread of the disease. The disease may be newly introduced to the area
as it is mentioned in the WHO Diseases subject to regulation.
[ProMed, May 09, 1999]
USA HEPATITIS C TESTS NEEDED BY 1 MILLION
1 million Americans who received blood transfusions before 1992 are believed
to be infected with the incurable hepatitis C virus. Only 6,500 individuals
have been notified of this possibility so far. The chief of the hepatitis
branch at the Centers for Disease Control and Prevention has advised individuals
to get tested for the virus if they had received a blood transfusion before
July 1992. The screening test to detect the virus in blood supply was
developed only in 1992, and hence those who received transfusions before
this period are considered to be at risk for infection with the virus.
The government's "lookback" program was launched in 1997 to identify
infected donors and recipients through hospitals and transfusion centers.
The FDA had identified 290,000 units of blood donated by people who were
later found to infected with hepatitis C. Another 113,000 units are expected
to be identified. The Food and Drug Administration has approved the first
home test kit for hepatitis C to facilitate testing at home.
[Reuters, May 06, 1999]
USA (NEBRASKA) E. COLI, GROUND BEEF RECALL
More than 80,000 pounds of ground beef were recalled by an Omaha meat
company following detection of E. coli O157:H7 by USDA inspectors. No
illnesses linked to the meat have been reported so far. Most of the meat
was sold and apparently consumed in Illinois, Indiana, and Michigan. The
packages of meat were sold in 10pound lots, and produced on April 14
with a "sellby" date of April 28. The establishment code was 20420.
[ProMed, May 04, 1999]
OTHER
RESEARCHERS FIND GENE THAT SWITCHES ON INFECTION FROM BACTERIA
A gene that activates bacterial infection in its host has been discovered
by researchers in California. The DAM gene was found after a fiveyear
process of examining bacterial genes that are turned on at the start of
an infection in an host animal. The work shows how salmonella bacteria,
a major source of food poisoning in humans, causes illness. The salmonella
DAM gene makes a protein that activates other genes to start a biological
cascade that leads to infection. Strains of salmonella that contained
a permanently altered DAM gene could not cause disease in mice, and instead
facilitated the development of antibodies to the disease. Injection of
lethal doses of salmonella into the mice did not produce disease. This
finding has important implications for the development of vaccines and
new antibiotics. A variety of other bacterial pathogens, including cholera,
plague and Shigella, also have DAM genes, raising the possibility that
those diseases could also be disabled by blocking DAM.
[Associated press, May 07, 1999]
US WON'T DESTROY SMALLPOX STOCKS
The United States will not destroy the remaining stocks of smallpox virus
for reasons that affect scientific, health, and national security interests.
The World Health Assembly is scheduled to debate the issue when it meets
in Geneva on May 17. The biggest concern is whether all existing stocks
of the highly contagious virus have been recorded. Many experts fear that
the stocks held by the former Soviet Union may have leaked out of its
main biologicalweapons facility in Kotsovo. The threat of bioterrorism
exists as a result of this possibility. New and important discoveries
that have the potential to improve human health is another reason that
has been cited by the United States to preserve the stocks.
[Inter Press Service, April 26, 1999]
2. UPDATES FROM PREVIOUS BULLETINS
MALAYSIA NIPAH VIRUS OUTBREAK
The outbreak of Nipah virus has now spread to five states in Malaysia.
Kelantan and Malacca are two states that have recently joined the list
following the discovery of the deadly virus in pigs from pig farms. While
no new human cases of encephalitis have been reported since April 30,
pigs will continue to be slaughtered in affected areas until they are
found to be negative for the virus. The World Health Organization has
stated that the epidemic is virtually over as a result of mass culling
of more than 900,000 pigs. Local authorities in Kuala Lumpur plan to launch
a massive ratkilling campaign if rats test positive for the virus. The
specificity of the ELISA test for the Nipah virus is being questioned
by private veterinarians following positive results in dogs that were
not from highrisk areas. In Singapore, 695 out of 706 horses that were
tested for the Hendra virus (as a surrogate for Nipah virus) were negative,
and results are still pending for the rest. Meanwhile, the ban on movement
of horses between Singapore and Malaysia remains in place.
[Star Online, May 17, 1999]
[Associated Press, May 17, 1999]
[Reuters, May 09, 1999]
[The Straits Times, May 08, 1999]
[ProMed, May 05㪩, 1999]
KOREA DYSENTERY OUTBREAK
29 students from Ponghwa Middle and High Schools were diagnosed with bacillary
dysentery after consumption of school lunches. 19 elementary, middle and
high schools in Ponghwa County, North Kyongsang Province, decided to temporarily
suspend lunches at their school cafeterias for the time being. Investigations
to identify the infection route are in progress. Family members, and other
individuals connected with the schools are being examined for the disease,
and antiepidemic efforts are also being carried out by the local government.
The rise in incidence of dysentery follows a report on unusually warm
weather this year that facilitates the spread of foodborne diseases.
[Korea Herald, May 07, 1999]
MALAYSIA (SARAWAK) DENGUE PREVENTION
The State Health Director has classified nearly all districts in the state
as "high risk areas" for dengue outbreaks. The state has recorded 260
cases of dengue as of May 01 this year. The risk of breeding more Aedes
mosquitoes is increased during the dry season when people store water
in containers. Open burning and other activities that could enhance the
possibility of a fresh dengue outbreak have been banned by the state government.
The public have been asked to cooperate in preventing an outbreak of
dengue by eliminating breeding habitats of the mosquitoes like banana
trees and yams within 200 metres of residential areas, and disposing of
empty bottles, cans and other refuse that could potentially trap and retain
water. [Sarawak Tribune, May 06, 1999]
CANADASOURCE OF YERSINIA OUTBREAK FOUND
An outbreak of Yersinia tuberculosis that affected at least 73 people
in British Columbia last fall was traced to a batch of pasteurized whole
milk delivered to stores late last October or early November. The B.C.
outbreak lasted for the month of November and affected residents in the
Vancouver area and Fraser Valley. More than half of the cases occurred
in children under the age of three.
[ProMed, May 04, 1999]
NEW SMALLPOX VACCINE DEVELOPMENT
American and Russian researchers are planning to develop a new vaccine
against smallpox with the help of genetic engineering. The existing vaccine
may prove fatal to AIDS patients due to complications arising from the
vaccine.
[ProMed, May 04, 1999]
3. NOTICES
APEC ISTWG MEETINGS SEATTLE, AUGUST 15㪬
The APEC Working Group on Industrial Science and Technology will meet
in Seattle, August 15㪬. Organizers have planned a seminar for Monday,
August 16, on emerging infections in the region, and a side meeting of
delegates to consider progress under the APEC Initiative on Emerging Infections
(adopted 1997) will be held on Tuesday, August 17. Colleagues in Health
and Science in APEC economies are advised to contact their ISTWG delegation
heads for further information, or to contact Laura Schubert (lschub@u.washington.edu)
for further information.
4. HOW TO JOIN THE EMAIL LIST
and receive EINet News Briefs regularly 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 colleagues in
the AsiaPacific Rim. 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. |