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Vol. II, No. 13 ~ EINet News Briefs ~ June 30, 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 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: Distance learning website on Emerging Infections of International Public Health Importance Overview of infectious–disease information from PRO–MED and other sources Updates from previous bulletins Notices How to add colleagues to the EINet listserv 1. DISTANCE LEARNING WEBSITE ON EMERGING INFECTIONS OF INTERNATIONAL PUBLIC HEALTH IMPORTANCE **A new teaching tool has been made available on the web to learn about Emerging Infections of International Public Health Importance. These materials include recent lectures and audiovisual materials by international experts, and are being made available without charge by the APEC EINET project, and we welcome your comments about their utility in your work. This distance learning course can be accessed at our website at www.apec.org/infectious ** 2. OVERVIEW OF INFECTIOUS–DISEASE INFORMATION FROM PROMED   Here is our regular 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), co–sponsored by WHO. ASIA BRUNEI– RESTAURANTS SHUT DOWN AS CHOLERA WORSENS 10 restaurants were closed down by health authorities following an outbreak of cholera that has struck more than 70 people. The restaurants, mainly in Gadong and the capital Bander Seri Begawan, fell short of required health standards and were temporarily shut down as part of nationwide checks on hygiene in food outlets. Supply of fresh food and fruit to schools were also suspended to stem the spread of the disease. The source of the outbreak is not known as yet. [Reuters, June 18, 1999] CHINESE TAIPEI– FIRST INDIGENOUS CASE OF CHOLERA An 80–year–old woman was diagnosed with cholera in a Hsinchu hospital. This is the first indigenous case of cholera in three decades in Taiwan, and has triggered panic among residents of Hukuo township, where the woman's family sells iced products in the local market. Health officials are monitoring the situation, and have instructed hospitals to report suspected cases. [China News Agency, June 18, 1999] KOREA – E.COLI O𤪍 REPORTED The first case of E. coli O𤪍 for this year was reported at a hospital in Kumi, Kyongsang–pukto on June 10. The patient was a 24–year old woman who ate contaminated food on June 6. The National Institute of Health dispatched a medical team to trace the distribution channel of contaminated food in Kyongsang–pukto. This is the second case of E. coli O𤪍 reported in Korea since 1997. [Korea Times, June 28, 1999] OCEANIA AUSTRALIA – ENTEROVIRUS 71 ACTIVITY Four out of six cases of acute flaccid paralysis in Perth since March 1999 have been attributed to enterovirus 71. Polio infection has been ruled out in two cases and results are pending on the other two. An additional 12 cases of aseptic meningitis associated with enterovirus 71 have been identified. These cases have occurred in association with a large hand, foot and mouth disease (HFM) epidemic in Perth over the same period. An enterovirus has also been isolated from 15 uncomplicated HFM cases. The recent epidemics of EV㫟 in southeast Asia may be related to this outbreak, and molecular epidemiology studies are in progress to identify the source of the virus. [ProMed, June 28, 1999] NEW ZEALAND – DRUG–RESISTANT BACTERIA WARNING Doctors have been advised to cut back on prescribing antibiotics to stop the increasing level of drug–resistant strains of bacteria. Penicillin–resistant Streptococcus pneumoniae has increased from 0% in 1992 to 22% in 1998 in the Canterbury and West Coastal areas. Laboratories all over New Zealand are noticing a similar trend. [The Press, June 26, 1999] NEW ZEALAND – MENINGITIS MIMICS INFLUENZA Health officials are warning young Northlanders with the flu to seek medical care, after 8 cases of meningococcal meningitis were reported in the past two weeks. The early stages of meningococcal meningitis are identical to influenza, though unlike the latter, the symptoms continue to intensify with headaches, fever, skin rashes, and vomiting. Six of the eight hit by the disease in the past fortnight were aged 5 or under, and the latest cases bring Northland's total for the year to 18– three more than for the same period last year. Authorities are on the lookout for clustering of the disease, but so far there has been no pattern forming in the Northland. [The New Zealand Herald, June 28, 1999] AMERICAS BRAZIL – DENGUE The State Health Secretary of Sao Paulo has attributed a 388% increase in number of dengue cases in 1998 to failure in prophylaxis in 1997. While 4567 cases of dengue were reported between January 1 and June 4 1999, only 847 cases were reported during the same period in 1997. [ProMed, June 18, 1999] BRAZIL – HEPATITIS A 17 students between the ages of 10 and 14 years in a municipal school in Rio de Janeiro were diagnosed with hepatitis A. The onset of the illness was between June 1㪬, 1999. The source of infection has not been found as yet. [ProMed, June 23, 1999] UNITED STATES (MULTISTATE)– SALMONELLA FOUND IN ORANGE JUICE 19 cases of salmonellosis in three states have been linked to contamination of non–pasteurized orange juice. Sun Orchard Co. of Tempe, Arizona has recalled the product and halted further distribution. According to a statement issued by the company, this was the only product that was blended with juice from an outside supplier. The juice, shipped in gallon, half–gallon or quart clear plastic containers, had a "use by" date between June 23 and July 8. The serotype in this outbreak is Salmonella serotype muenchen. [Associated Press, June 28, 1999] UNITED STATES – CLOSTRIDIUM PERFRINGENS TRANSMITTED BY NEEDLES Sharing of intravenous needles among drug users in San Francisco has resulted in five cases of necrotizing fasciitis, including two fatalities as a result of infection with Clostridium perfringens. [ProMed, June 21, 1999] UNITED STATES (MULTISTATE)– CYCLOSPORIASIS An outbreak of diarrheal illness among participants at a May convention has been confirmed as cyclosporiasis. Eight of the twenty–four people who fell ill tested positive for Cyclospora cayetanensis. Investigators from the CDC are focusing their probe on fresh produce imported from foreign farms because cyclospora is not typically found in the United States. Twenty–eight states were represented at the convention. [ProMed, June 25, 1999] OTHER VIETNAM– TINY ONE–EYED CRUSTACEAN COULD ERADICATE DENGUE Mesocyclops, a tiny one–eyed crustacean offers new hope in the effort to eradicate dengue in Vietnam. In one year, the introduction of the Mesocyclops in six test communes in northern Vietnam by volunteers working with school children has virtually eliminated the mosquito larvae carrying dengue fever which claims hundreds of lives in Vietnam and thousands worldwide. The Mesocyclops has a voracious appetite for the larvae of the Aedes Aegypti larvae and can eat about 40 larvae a day. These hungry crustaceans are found in abundance in most lakes and ponds in northern Vietnam, and can be transported to other regions of the country, or grown in laboratories and sent to villages. The Australian Foundation for the People of Asia and the Pacific is involved in this venture, which is also financed by Britain. [Vietnam News, June 25, 1999] NEW ZEALAND – "BREAKTHROUGH" FLU DRUG Relenza, new drug for influenza, administered as an oral inhaler has completed required approval and registration. Clinical trials in New Zealand, Australia, and South Africa showed that influenza patients treated with the drug experienced a significant reduction in the severity of their symptoms. The trials also indicated that recovery speeds up to 30% faster than with present treatments. Relenza is the first of a new class of drugs known as neuraminidase inhibitors. [The Press, June 29, 1999] 3. UPDATES FROM PREVIOUS BULLETINS MALAYSIA – NIPAH VIRUS Three more pig farms in the state of Johor were found to be positive for the Nipah virus, bringing the number of affected farms to 11. The Veterinary Research Institute in Penang will launch "full–scale" Nipah virus tests on cats and dogs nationwide in two to three weeks. Testing of 95% of pig farms has been completed. [ProMed, June 18, 1999] [Star Online, June 19, 1999] 4. 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. INTERNATIONAL CONFERENCE ON EMERGING INFECTIOUS DISEASES The International Conference on Emerging Infectious Diseases will be held from July 16㪫, 2000 at Atlanta, Georgia. The program will include plenary sessions and symposia with invited speakers, presentations on emerging infections activities, and oral and poster presentations. Major topics will include current work on surveillance, epidemiology, research, communication and training, bioterrorism, and prevention and control of emerging diseases, both in the U.S. and abroad. Abstracts are invited and will be accepted beginning in September, 1999. For more information: Phone: (202)942� e–mail: meetinginfo@asmusa.org website: www.cdc.gov/ncidod/iceid2k.htm NINTH WFPHA INTERNATIONAL CONGRESS The theme of the 9th World Federation of Public Health Associations (WFPHA) International Congress to be held at Beijing, PRC from September 2ע, 2000 is "Challenges for Public Health at the Dawn of the 21st Century". This Congress will be co–hosted by the China Preventive Medical Association (CPMA) and the Chinese Academy of Preventive Medicine (CAPM). Some of the megatrend issues to be discussed include: Health and the Environment; HIV/AIDS; Re–emerging Diseases; Global Communication; and Demographic–Economic Transitions and Health. For further information, please contact Allen Jones at Comm–Intern2@apha.org 5. 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 Asia–Pacific 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.