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 TOXIC ALGAE ALERT
A red tide alert is in effect in northern and southern China following
an alert in the Bohai Sea area in eastern China last week. The red tide
appears to be spreading, and currently covers 680 square kilometres. Shrimp
and fish farmers have been advised to stop pumping ocean water into their
ponds. Seafood contaminated by the fastbreeding, oxygendepleting algae,
is unsafe to eat. Worsening pollution has led to an increase in the size
and duration of red tides in recent years, and 22 red tides were reported
along China's coasts in 1998. [ProMed, July 13, July 20,1999]
CHINESE TAIPEI CHOLERA O139
Taiwan's second indigenous case of cholera was reported on July 08, 1999.
The patient, a 73 year old man, became ill after a dinner of "hot steamboat"
with 17 relatives on June 27. The toxigenic O139 strain of Vibrio cholerae
was cultured from the patient.
[ProMed, July 1, 1999]
Note: The O139 strain of Vibrio cholerae was first isolated in India in
1996.
KOREA VIBRIO FOOD POISONING
The Korea Food and drug Administration (KFDA) has issued a warning against
food poisoning following detection of vibrio bacteria in the West and
South Seas. Vibrio parahaemolyticus was discovered in 11 coastal areas.
Vibrio cholerae has also been found on the West Coast and the National
Institute of Health expects cases of cholera to be reported. 50 workers
came down with food poisoning after eating fried squid and meat soup provided
at a company meal on Yongchongdo islet off Inchon.
[Korea Times, July 16, 1999]
HONG KONG IMPORTED CASE OF RABIES
The Department of Health has confirmed a report of a suspected case of
human rabies imported from the Philippines. The victim was a 22 yearold
woman who gave a history of having been bitten by a dog on May 15 this
year in her rural home in the Philippines, one week before coming to Hong
Kong. The last local human case of rabies in Hong Kong was reported in
1981, the last imported human case was in 1988, and the last animal case
was reported in 1987.
[Dr. KH Mak, Department of Health, Hong Kong, July 14, 1999]
PHILIPPINES FILARIASIS
Local health authorities in Baikingon, Cagayan Province, have urged residents
to destroy all possible breeding sites of mosquitoes. This advice follows
the results of blood tests in the city which found 59 people infected
with filariasis. A survey showed that filariasiscarrying mosquitoes were
present in the region. [Xinhua, July 14, 1999]
VIETNAM LETHAL MALARIA RESURGENCE
An increase in the number of malaria cases in Vietnam has health officials
worried about the situation. The disease was wiped out in the northern
region from 1954 to 1962, but came back with a vengeance in 1991, which
saw 144 outbreaks with more than 1 million victims and 4,600 fatalities.
Following the efforts of the government and local health care authorities,
the disease was brought under control between 1992 and 1997. The disease,
however, has made a comeback, and a total of 183 people died of malaria
last year. There were 130,403 malaria patients nationwide in the first
five months of this year, 6.8% less than the same period in 1998. However,
the main concern is an increase in the number of malignant malaria cases,
which has increased to 625, representing an increase of 51.7% over the
same period in 1998. Migrant laborers and changing weather conditions
have been blamed for the increase in cases.
[Xinhua, July 16, 1999]
OCEANIA
NEW ZEALAND WHOOPING COUGH OUTBREAK
An outbreak of whooping cough is spreading in Southland as predicted by
health authorities. The outbreak began last month when 16 cases were reported
to health officials. Southland may be the starting point of a nationwide
epidemic that was predicted as a result of low immunization rates in a
previous bulletin (Vol. II, No. 10).
[The Press, July 16, 1999]
NEW ZEALAND NINTH YEAR OF MENINGITIS EPIDEMIC
New Zealand is going through the ninth year of an epidemic of meningitis,
which is expected to last another five to seven years. The disease has
been labeled as a public health emergency. Experts are urging the Ministry
of Health to accelerate vaccine trials for serogroup B meningococcus which
affects about 85% of those who contract meningitis in New Zealand. 210
cases and 6 deaths have been reported nationally this year. A higher than
normal incidence of influenza could be contributing to the meningitis
outbreak.
[The Press, July 21, 1999] [New Zealand Herald, July 27, 1999]
AMERICAS
CANADA E. COLI OUTBREAK
Public health officials are investigating an outbreak of E. coli in the
Mocton area. At least 13 cases have been reported in the area since the
first week of June, and five have been hospitalized.
[Globe and Mail, July 15, 1999]
MEXICO HUMAN EHRLICHIOSIS
The first human case of ehrlichiosis in Mexico was reported in Yucatan
in February 1999. Ehrlichiosis is tickborne zoonotic disease, the clinical
spectrum of disease being similar to other febrile illnesses. Without
adequate and timely treatment, approximately 5% of patients die. A deliberate
search for cases is indicated following this report of the first human
case in Mexico.
[ProMed, July 13, 1999]
USA VIBRIO PARAHEMOLYTICUS IN OYSTERS
Consumption of oysters tainted by Vibrio parahemolyticus has sickened
368 people in Texs, Florida, Oklahoma, Georgia, Tennessee, Colorado, and
California. Galveston Bay was closed to oyster harvesting on June 26.
[ProMed, July 25, 1999]
USA (TEXAS) ST. LOUIS ENCEPHALITIS ALERT
An advisory against St. Louis encephalitis is in effect in southeast Dallas
following a positive test in a chicken, indicating that mosquitoes in
the area are carrying the virus. Routine insecticide spraying is being
carried out, and the public have been advised to be aware of stagnant
water, which is a breeding habitat for mosquitoes. [ProMed, July 10, 1999]
USA ROTAVIRUS VACCINATION SUSPENDED
Following the development of intussusception in at least 23 children who
received a new vaccine against rotavirus, the CDC and the American Academy
of Pediatrics are recommending the postponement and suspension of vaccinations
for rotavirus until November 1999. Parents of vaccinated children have
been advised to watch for symptoms of the condition.
[CNN, July 15, 1999]
USA LYME DISEASE FASTEST GROWING INFECTIOUS DISEASE
The incidence of Lyme disease, a tickborne disease, is expected to increase
this summer as result of larger deer tick populations than last year.
This increase has been attributed to the lasting effects of El Nino. Individuals
spending time outdoors are at risk of contracting the disease, which if
left untreated can progress to debilitating, longterm arthritic or neurologic
conditions.
[PR Newswire, July 15, 1999]
OTHER
NEW AND AFFORDABLE DRUG REDUCES MOTHERTOCHILD HIV TRANSMISSION
Nevirapine, a new drug that costs only US$4 per treatment has been shown
to reduce mothertochild transmission of HIV more effectively than the
currently used AZT. The study involved 600 HIVinfected mothers in Uganda,
and involved two doses of nevirapine, one given during labor, and one
given to the newborn three days after delivery. The risk of transmitting
the virus to the child dropped to 13%, compared to 25㪶% without any
HIV medications. The drug while being affordable may also reduce transmission
of the virus through breast milk.
[CNN, July 14, 1999]
VITAMIN A REDUCES MALARIA ATTACKS
A team of researchers has studied the effect of Vitamin A supplements
in reducing the number of malaria attacks in 240 children between six
months and five years of age. A 30% reduction in malaria episodes was
associated with Vitamin A, approaching levels of protection seen with
insecticidetreated bednets and exceeding protective levels of fieldtested
experimental malaria vaccines. The most striking improvements were seen
in children between 12 and 36 months of age, who normally have the highest
sickness rate. The supplements did not have any impact on the rate of
anemia and did not prevent the most intense malaria attacks.
[Reuters, July 15, 1999]
NASAL SPRAY PREVENTS FLU
A nasal spray has proved to be effective in protecting healthy adults
against the flu virus, and the painless vaccine is expected to reach the
market within two years. The findings were published in the Journal of
the American Medical Association. The spray, called FluMist, would offer
an alternative to the standard flu shot. [Associated Press, July 15, 1999]
2. UPDATES FROM PREVIOUS BULLETINS
USA (MARYLAND) LEGIONELLOSIS
A third person has succumbed to Legionnaire's disease at Harford Memorial
Hospital in Maryland, bringing to five the total number of confirmed cases.
Additional cases are expected as the incubation period for the disease
is 2㪢 days, and the water system was flushed on July 02. The bacteria
has also been isolated from a nursing one day after the death of a former
resident who was sent to Harford Memorial Hospital, suggesting that the
exposure was not confined to the hospital.
[ProMed, July 13, July 20, 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.