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
CHINA – 70% HIV INFECTION RATE AMONG INTRAVENOUS DRUG USERS
According to the China Daily newspaper, eight different strains of HIV/AIDS
have been identified in China, placing them at the head of the field in
the number of HIV/AIDS viruses isolated. It was also found that 70% of
intravenous drug users were HIV positive. 47.5% of samples were subtype
B, and over 34% were subtype C, which orginated from drug users in India.
9.6% were subtype E, which came from southeast Asia. [SEA–AIDS, August
06, 1999]
HONG KONG – REPORT ON INFLUENZA A H9N2
A report on the two cases of influenza A H9N2 suggests that this type
of avian flu virus causes relatively mild illness in humans and poses
no imminent threat to public health. While the possibility of human–to–human
transmission remains open, the main mode of transmission was from birds
to humans. There was no evidence for reassortment with influenza virus
genes. Enhanced surveillance for human and poultry infections will continue,
and the public has been issued an advisory against the disease. 70% of
poultry and four more people were found to have been exposed to the new
strain of virus. 2% of 100 poultry workers, compared 0.6% of 500 people
from the general population tested positive for antibodies against the
virus. Centralized slaughter of poultry is being actively considered by
health officials, though no concrete plans have been produced so far.
[Dr. Mak Kwok Hang, Hong Kong Department of Health, August 03, 1999] [South
China Morning Post, August 04, 1999]
HONG KONG – 400–FOLD RISE IN WATER BACTERIA
Bacteria levels in water pumped into Hong Kong have incrased almost 400–fold
in the past six months, according to a survey done by a lobby group.
E. coli had increased 390 times, while other bacteria levels had risen
239 times in the same area over a six month period. Run–off from pig farms
and industries have contributed to the problem. Tests showed that every
100 millimeters of water had up to 1.25 million E. coli organisms at Wei
Zhou, up from 3,200 in December.
[South China Morning Post, August 04, 1999]
JAPAN (TOKYO) – SERRATIA BACTERIA IN HOSPITAL WARD
Seven inpatients at a hospital in Tokyo's Sumida Ward were infected with
serratia bacteria, three of whom died last week. 14 inpatients at Sumida
Central Hospital reported suffering fevers and other symptoms early last
week. The three women who died were in their 70s, and hence weakened immune
systems are suspected to be the predisposing factors. Nevertheless, hospital
staff have been advised to take preventive measures, and to examine the
possibility of further infections.
[Japan Times, August 03, 1999]
JAPAN – Q FEVER
An outbreak of Q Fever is currently going on in Japan, and the Japanese
Respiratory Society will soon be establishing guidelines to effectively
diagnose and treat the illness. The disease, caused by Coxiella burnetii,
spreads from animals to humans by inhalation, and causes pneumonia and
hepatic disorder. 237 patients at 18 hospitals in Miyagi Prefecture were
studied over a two–year period, and 3.4% were found to have the bacterium.
Half of the patients had contact with animals before they noticed symptoms.
This is the first time a widespread outbreak of Q Fever has been reported
in the nation.
[ProMED, August 10, 1999]
PHILIPPINES – DENGUE REPORTING INCREASED
Increased awareness of dengue has been cited as a reason for an increase
in the number of cases reported so far this year. The provincial health
office in Pangasinan recorded 63 cases last month, the highest this year,
and a total of 125 cases since January. 742 cases of dengue were reported
in Nueva Ecija since January accounting for 22.08% of the national incidence.
[ProMED, July 31, 1999]
KOREA/PHILLIPINES – EPIDEMIC ALERT DUE TO FLOODING
Health officials in Korea and the Phillipines are trying to prevent the
outbreak of water–borne diseases like dysentery, and stomach and skin
diseases and measles as a result of flooding in these countries. Overcrowding
in evacuation centers and low medical supplies pose a threat in the Phillipines,
while in Korea, lack of potable water and exposure to contaminated water
are already reported to have caused skin diseases and dysentery. Health
officials in Korea have also issued a nationwide warning against Japanese
Encephalitis and advised parents to vaccinate their 3㪧 year old children
against the disease. The warning comes after more than half of the mosquitoes
tested on the southern island of Cheju late last month were found to be
carrying the virus causing Japanese Encephalitis.
[Korea Herald, August 05 and 07, 1999] [Phillipine Inquirer, August 05,
1999]
OCEANIA
AUSTRALIA (VICTORIA) – INCREASE IN LEGIONNAIRE'S DISEASE
Legionnaire's disease is a rapidly increasing disease in Australia, particularly
in Victoria. The number of cases have doubled since 1997, and so far this
year, a 40% increase has been reported. A third of these cases have been
in Victoria. Better diagnosis and increased use of air conditioning have
been cited as reasons for the increase in Victoria. Since the public are
notified only when more than one case is linked to a definite site, official
figures may not reflect the true incidence of the disease.
[ProMed, Aug. 01, 1999]
AUSTRALIA (TASMAINIA) – INFLUENZA–LIKE ILLNESS
An illness that resembles influenza has killed several Tasmanians in the
past three weeks. A doctor at Royal Hobart Hospital has confirmed the
deaths and believes the illness to be a viral respiratory infection that
was not influenza. The patients who died were high–risk patients who had
already had lung disease before they contracted the infection. Many of
the hospital's staff have also been ill with the infection. Major influenza
epidemics are currently occurring elsewhere in Australia and New Zealand.
[ProMED, August 05, 1999]
AMERICAS
USA (MASSACHUSETTS)– SHIGELLOSIS OUTBREAK
An outbreak of shigellosis in Hampden County that has affected 24 people
has public health officials on the alert. Most of the cases have involved
person–to–person contact within families or small groups. Day care centers,
camps, and food vendors have been urged to take precautions to prevent
the spread of the disease. [ProMed, Aug. 01, 1999]
USA (OHIO) – E. COLI OUTBREAK
An outbreak of E. coli 0157:H7 has affected at least 25 people in four
counties. Investigators from the Centers for Disease Control and Prevention
(CDC) are currently trying to identify the source of outbreak. It is more
likely that more than one source of contamination was involved in the
outbreak due to the lack of common circumstances among the cases. DNA
fingerprinting using the pulsed field gel electrophoresis is currently
underway. So far, two samples have been matched. Three cases in Kentucky
and one in Indiana have been reported, and officials are investigating
the possibility of a link to the local clusters in Ohio. No deaths have
been reported.
[ProMED, August 08, 1999]
USA (CONNECTICUT) – HEMOLYTIC UREMIC SYNDROME
Infection with E. coli is suspected in ten children who became ill after
swimming in a lake in East Haddam. Three children developed hemolytic
uremic syndrome.
[ProMED, August 07, 1999]
USA – DRUG RESISTANT STREPTOCOCCUS PNEUMONIAE
The Centers for Disease Control (CDC), using data collected from a population–based
surveillance system in 1997 has found that the prevalence of drug–resistance
Streptococcus pnuemoniae has increased from 14% in 1993㫶 to 25%. Regional
variation in resistance was noted along with a wide range of resistance
among individual hospitals.
[ProMED, August 08, 1999]
OTHER
RUSSIA – DRUG RESISTANT TUBERCULOSIS
The percentage of primary multi–drug resistant tuberculosis cases in Russia
has increased from 3.8% to 9.4% between 1996 and 1998. This study was
part of an international collaboration with the WHO, CDC, and others.
[ProMED, August 08, 1999]
3. UPDATES FROM PREVIOUS BULLETINS
AUSTRALIA – ENTEROVIRUS 71
The epidemic of hand, foot, and mouth disease (HFM) associated with enterovirus
type 71 in Perth appears to be declining. No new cases of acute flaccid
paralysis or enteroviral meningitis have been reported recently, and far
fewer cases of HFM have been reported in the past two weeks.
[ProMED, July 30, 1999]
MALAYSIA – NIPAH VIRUS
A slaughterhouse worker who marked pig carcasses is the latest victim
to succumb to the Nipah virus. Officials found this finding troubling
because the risk of infection is low for those at the end of the slaughter
process compared to those who handle live pigs. Scientists are still trying
to answer questions about the virus with regard to its predilection to
the brain, immune response, and selectivity of people affected.
[ProMED, July 31, 1999]
NEW ZEALAND – FLU EPIDEMIC
The influenza epidemic in New Zealand has affected more than 10% of adults,
and workplaces are bearing the brunt of the illness. This year's epidemic
has hit mainly working–age adults. While the Sydney A virus is the main
culprit, a B strain could also be circulating as well. Workers in almost
every industry have been affected, and nursing staff are particularly
hard hit. People's attitude towards the disease and vaccinations have
been cited as main reasons fro the epidemic making New Zealand's influenza–prevention
program inadequate.
[ProMED, August 05, 1999]
USA – E. COLI O111
Barrels of ice used by participants of the drill team on the University
of North Texas campus have been identified as the source of contamination
in the outbreak of E. coli O111 in June. While the original source of
the organism is unknown, investigators believe that one or more campers
could have contributed to contamination of the ice, especially since they
used their hands to scoop out the ice from barrels. [ProMed, July 30,
1999]
USA – SALMONELLA CONATMINATION FROM MEXICO
Isolation of salmonella bacteria from a tanker load of juice from Mexico,
has led to a ban on imports of Mexican orange juice. Blended juice from
Mexico has been identified as the source of salmonellosis that struck
more than 200 people throughout the West, including 32 in Arizona. The
juice was sent back to Mexico and the Mexican producer must pass inspection
for Salmonella five times before the juice will be allowed into the United
States again. [ProMed, July 30, 1999]
USA (MULTISTATE) – CYCLOSPORIASIS
The source of contamination in an outbreak of cyclosporiasis that sickened
94 people has been narrowed down to a fresh fruit platter, though there
is no evidence to single out which fruit carried the bacteria. Berries
may be the source, as some raspberries and blackberries might have come
from Guatemala.
[ProMED, August 01, 1999]
INFLUENZA ACTIVITY
Alaska, the Yukon Territory, New Zealand, and Australia are continuing
to experience outbreaks of influenza. The Sydney strain of influenza A
(H3N2) has been identified in Alaska and the Yukon Territory, while influenza
A and B have been isolated in New Zealand and Australia. An outbreak of
influenza at San Antonio's Lackland Air Force Base in Texas, USA, has
affected at least 165 members. Most of the members are from Puerto Rico
and are studying English at the Defense language Institute in San Antonio.
[ProMED, August 1ס, 1999]
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 Laura Schubert at lschub@u.washington.edu.
Further information about the APEC Emerging Infections Network is available
at http://www.apec.org/infectious.
