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Vol. II, No. 14 ~ EINet News Briefs ~ July 13, 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: 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. 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 JAPAN – OFFICIAL WARNING ON TB TO BE ISSUED An aging population and lack of awareness about TB are contributing to the re–emergence of the disease in Japan. Health officials, faced with a rise in cases of TB that mirrors a global trend, plan to issue a warning to help keep the disease from spreading. About 3,000 Japanese die from the disease every year, and in 1997, the number of infected people rose for the first time in nearly four decades. The cases of mass infection, in which an individual transmits the disease to 20 or more people, have quadrupled in the past four years. Specific guidelines will be issued for hospitals and schools along with a formal warning to the public. [Reuters, July 09, 1999] KOREA – MALARIA–CARRYING MOSQUITOES FOUND Health officials in Seoul are taking preventive measures following the discovery of 277 malaria–carrying mosquitoes belonging to the species "Anopheles sinensis". The mosquitoes were found in a month–long collection at 10 locations across the city. The carriers of the parasite accounted for 5% of the total mosquitoes collected. The discovery of the mosquito species in Seoul occurs one month after reports that malaria was spreading in northern Kyonggi Province. [The Korea Herald, July 07, 1999] Note: The government of Korea and the WPRO office of WHO collaborated on a integrated assessment of surveillance in February. This mission identified the recrudescence of malaria (P. vivax) along the DMZ as a priority area for coordinated prevention. More than 2000 total cases of malaria have been reported by North and South Korea over the last year, and efforts at control are being stepped up. [APEC EINET] PHILIPPINES – DENGUE CONTROL The Philippines is using a computerized system to track the occurrence of dengue and to immediately notify local health officials. Education and control campaigns are then carried out in their districts by keeping homes clean and free of containers of standing containers and larvaciding. [ProMed, July 12, 1999] OCEANIA NEW ZEALAND – DEATH RATE SOARS IN FLU "PLAGUE" The flu may have been a final complication in the deaths of up to 100 people at Middlemore Hospital last month. While official hospital mortality figures were not available, flu–related deaths appeared to have increased sharply in June in South Auckland, with about 100 people dying mainly from respiratory illnesses. The government has extended free flu vaccinations for high risk individuals (elderly or those with chronic respiratory or other illnesses) until the end of this month. While the Sydney strain of influenza virus has been predominant so far, other strains could emerge before the end of winter. [New Zealand Herald, July 06, 1999] AMERICAS USA/CANADA – INFLUENZA ACTIVITY At least 532 people, mostly tourists and tourism workers in Alaska and Canada's Yukon Territory are stricken with influenza. The outbreak of influenza A which began on May 22 has been confined mostly to passengers of cruise ships who are able to spread the disease easily to fellow passengers. This is the earliest that influenza activity has ever been detected in the Northern Hemisphere during the summer months. Several factors may account for the emergence and spread of influenza and influenza–like illness early this summer. These are, an increasing number of travelers from all over the world visiting Alaska and the Yukon Territory, waning of vaccine–induced immunity, close contact of large numbers of people in relatively confined spaces, and a higher proportion of older adult travelers. The Centers for Disease Control and Prevention has urged vulnerable individuals to consult a doctor before traveling to these regions. [Reuters, July 01, 1999] [Associated Press, July 01 and 11, 1999] [ProMed, July 03, 1999] CANADA(ONTARIO)– CYCLOSPORIASIS OUTBREAK LINKED TO SOCIAL FUNCTION Eight confirmed cases of cyclosporiasis and 79 other suspected cases of the same disease have been linked to a private social function in the York region in late May. 175 of the 400 guests who attended the event have been contacted by the York Region Health Service, and 46% have reported some of the symptoms typical of the disease. The source of contamination is yet to be identified. [Globe and Mail, July 03, 1999] USA – E. COLI O111 A non–O157:H7 Shiga toxin–producing E. coli has been identified as the cause of an outbreak of diarrheal illness in 52 people who attended a drill team camp at the University of North Texas in Denton early last month. While the source of illness is not known as yet, this is the first report of a large outbreak of E. coli O111 in the United States. [ProMed, July 07, 1999] USA(MARYLAND) – LEGIONELLOSIS A water storage tank at a hospital in Maryland has been identified as the source of an outbreak of Legionnaire's disease. Four cases have been reported with two fatalities. All patients who were hospitalized have been contacted with information on the outbreak and instructions for identifying signs and symptoms associated with the disease. [ProMed, July 09, 1999] USA – FDA ADVISORY ON FOODBORNE HAZARDS, SPROUTS The Food and Drug Administration has issued an updated health advisory to increase awareness of the risks associated with the consumption of raw sprouts. Particularly, individuals at high risk of developing illness have been cautioned against eating raw sprouts. Preventive measures have also been outlined by the FDA in this advisory. A detailed version can be accessed at http://www.fda.gov [ProMed, July 11, 1999] MEXICO(NUEVO LEON) – DENGUE ALERT A dengue alert is in effect in the state of Nuevo Leon bordering with the United States following detection of dengue outbreaks in the region. 150 cases of dengue have been recorded so far in the metropolitan area of Monterrey and is double the number of cases recorded last year. The municipality of Linares has also documented some outbreaks. Health authorities have started spraying more than 200,000 homes in the areas where outbreaks have been reported. [Promed, July 09, 1999] OTHER JAPAN – TREATMENT IN EV 71 INFECTION Short–term extracorporeal lung support has been suggested as a hopeful treatment for neurogenic pulmonary edema with brainstem encephalitis related to entrovirus 71 infection. Doctors at the Osaka City General Hospital have used this form of treatment in successfully treating a 5 year old boy. They believe that this treatment works as the pulmonary edema in EV 71 infection is a result of increased capillary permeability and is not cardiogenic. [ProMed, July 11, 1999] HONG KONG – SURVEILLENCE WAR ON SUPERBUGS A database on drug resistance was commenced on July 02 as part of a new surveillance programme to combat the rise of deadly bacteria resistant to antibiotics. The surveillance will cover the Department of Health's 64 public outpatient clinics and 28 private doctors. The surveillance will try to identify the effects of the abuse of antibiotics. Doctors will collect four types of samples from patients based on the condition that they are being treated for. These include throat swabs, urine, stool samples, and nostril secretions. More than 1,800 samples are to be collected each month. [South China Morning Post, July 02, 1999] SCIENTISTS CRACK MALARIA SECRET Scientists have discovered the mechanism by which the malarial parasite disarms the immune system. The parasite is said to disable special dendritic cells and prevent them from activating T–cells that can fight off the infection. The research, published in the journal Nature, raises the possibility of an effective vaccine. 2. UPDATES FROM PREVIOUS BULLETINS USA – SALMONELLOSIS FROM ORANGE JUICE Unpasteurized orange juice contaminated with salmonella has so far affected more than 90 people in the States of Washington, Oregon and Nevada. Four people in British Columbia, Canada have also been diagnosed with salmonellosis as a result of drinking the contaminated product imported from the United States. The company has halted production of unpasteurized juice and is now pasteurizing all of its juice products. The juice products were sold under the labels Earls & Joey's Tomato's, Trader Joe's, Markon, Sysco, Aloha and Voila!, and was dated for use by July 7 or earlier. [ProMed, July 1㪣, 1999] MALAYSIA – NIPAH VIRUS Pigs continue to be culled in the state of Penang, while residential areas at former pig farming areas in Lukut that were hit by the outbreak of Nipah virus have been declared safe for occupation. There will be no restrictions on movement of people in Lukut while surveillance will continue in the region. [ProMed, June 30 and July 07, 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. THE FIFTH ASIA–PACIFIC CONGRESS OF MEDICAL VIROLOGY The 5th Asia–Pacific Congress of Medical Virology will be held from June 26㪴, 2000, at Denpasar, Bali, Indonesia. The abstract submission deadline is 26 January, 2000. The scientific programme will include symposia on viral diagnosis, anti–viral agents and viral vaccines. Free papers/posters on hepatitis; arbovirus; retrovirus; herpesvirus; enteric viruses; tumour viruses; respiratory viruses; cell–virus interaction; emerging viral diseases; immunology and pathogenesis will also be presented. The Congress is organised by Indonesian Society for Microbiology. For more details contact: Department of Microbiology, Medical Faculty University of Indonesia Jl. Pegangsaan Timur 16 Jakarta 10320 INDONESIA Fax: 62㪭� e–mail: amin0207@medscape.com 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 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.