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Vol. II, No. 17 ~ EINet News Briefs ~
August 26, 1999
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:
MALAYSIA – NIPAH VIRUS The Nipah Virus has claimed the lives of
approximately 105 Malaysians. Contracted from pigs, human infection leads
to respiratory and heart failure. The disease causes morbidity and mortality
among animals and humans, as well as places economic costs on the pig
industry. Current public health interventions include placing limitations
on the movement of pigs between farms and human evacuation from high–risk
areas and farms. INFLUENZAE SURVEILLANCE – HONG KONG The recent influenzae outbreak
among chickens has generated increased attention towards Hong Kong's techniques
for influenzae surveillance. Control measures and surveillance on chicken
farms must occur simultaneously with efforts to increase the availability
of information about the disease to public and private sectors. Issues
related to trade, economics, and politics must also be addressed. The
development of a robust public health infrastructure is necessary to enhance
prevention efforts. ENTERICS AND E. COLI – JAPAN Frequent travel and trade activities
contribute significantly to the rapid spread of EHEC in Japan. Improved
surveillance techniques and increased information exchange among countries
can largely influence the occurrence of disease. Prevention and further
spread of disease will require that government agencies work together
in response to public health emergencies. GONORRHEAL RESISTANCE SURVEILLANCE – APEC The severity of gonorrheal–associated
complications (i.e. increased HIV transmission with infection) is preventable
through early and appropriate treatment. Approximately one half of the
estimated 60 million cases were diagnosed in the Western Pacific and South
East Asian regions. Epidemiological and lab based surveillance are reliable
guides in selecting treatment guidelines. The WHO WPR GASP systems is
an effective long running surveillance system with multi–country involvement.
[Dr. John Tapsall, WHO Western Pacific Region Collaborating Center for
STD and HIV, Australia]
GLOBAL CHILDHOOD IMMUNIZATION FOR THE 21st CENTURY – RATIONALE FOR
THE BILL AND MELINDA GATES FOUNDATION The Children Vaccine Program
was founded by Bill and Melinda Gates in response to the International
Declaration of the Rights of the Child that "every child has the right
to the timely receipt of the needed life saving vaccines without regard
to their socioeconomic status or country". Millions of children in need
of newer vaccines are dying today as a result of increased costs and trade
agreements. The foundation aims to upgrade and improve the global expanded
immunization program (EPI) to achieve immunization equity. Advocacy is
important in the development of an effective vision and strategy. Activities
to date include cooperative agreements with WHO and UNICEF, and support
for Hepatitis B and Hib vaccine activities. PULSENET Decreased costs and mass distribution in food production
has led to an increased number of widespread food–borne disease outbreaks.
Techniques to investigate these situations are necessary to prevent further
spread. Pulse Net, a food safety network, links public health laboratories
and state health departments with investigators at the Centers for Disease
Control and Prevention (CDC), Food and Drug Administration (FDA), and
Agriculture Department so that outbreaks of food–borne diseases are identified
more quickly. Its use has been successful, specifically with the early
and rapid detection of E. Coli 0157 outbreaks in Seattle, Alpine, WY,
and Canada. The combination of technology and thorough field investigation
is vital to minimizing the impact of similar adverse events. SUMMARY Public Health is important from a biological to an economical
standpoint. Increased funding to battle emerging infections is necessary
to prevent further spread of disease. As a result, politicians must be
informed about the nature of some outbreaks. The use of technology for
rapid testing, the dissemination of information, the need for accurate
and timely information and sound epidemiology training all must occur
simultaneously to battle infectious diseases.
TUBERCULOSIS INFECTION A study conducted by the WHO has revealed
that more than half of the new tuberculosis (TB) cases reported in 1997
occurred in five southeast Asian nations. The finding was attributed to
poor control strategies and weakened immune systems. Southeast Asia accounted
for the largest number of TB cases, with 44% of the area's population
infected. The countries with highest incidence were India, China, Indonesia,
Bangladesh, Pakistan, and the Phillipines. The study estimated that in
the 212 countries monitored, 1.86 million people, or 32% of the global
population, carry the TB bacterium today. SOUTH KOREA – CHOLERA IMPORTED The NIH has confirmed that a 24
year–old man from Naju has contracted cholera. The man was infected with
the disease after he visited Bangkok, Thailand during August 5㪢. Cholera
was detected in his stool sample after a medical check–up for a diarrheal
condition. The institute is currently tracing the 258 passengers on the
man's flight for any other afflictions. Officials have issued an advisory
to overseas travelers to pay extreme caution to personal hygiene (i.e.
wash hands after being outdoors), to drink boiled water, and to avoid
raw fish in coastal areas. HONG KONG – VANCOMYCIN RESISTANCE A new strain of Staphylococcus
aureus with partial resistance to vancomycin was recently found in Hong
Kong. Vancomycin is considered the last killer of some bacteria strains
resistant to other antibiotics. The discovery may have identified as a
result of Hong Kong's high consumption of vancomycin per capita (among
Asian countries), and/or a good surveillance system. Physicians have been
asked to prescribe antibiotics with extreme caution. AUSTRALIA – ANTIBIOTIC ABUSE A medical specialist strongly recommends
that Australia ban the use of avoparcin in animals. An antibiotic that
belongs to the same group as the drug used to treat human staph, vancomycin,
avoparcin is used to fatten chickens, calves, pigs, beef, and dairy cattle.
The physician reports that many people are developing a resistance to
vancomycin through the food chain. The use of avoparcin has been recently
banned in Europe. USA – HEPATITIS C Approximately 27 million people in the United
States are chronically infected with HCV. Persons between the ages of
30 and 49 account for 65% of those infected. Among subjects between 17
to 59 years of age, the strongest factors independently associated with
HCV infection were illegal drug use and high–risk sexual behavior. Other
factors included poverty, education (<12 years), and divorce or separation.
Neither sex nor ethnicity were independently associated with HCV. The
results were determined by the third National Health and Nutrition Examination
Survey, conducted between 1988 and 1994. USA (TEXAS) – DENGUE The Texas Department of Health has confirmed
Dengue in two Laredo residents. Currently, other suspect cases are being
investigated. The use of PCR to determine the circulation of any other
serotypes has revealed DEN ן in one specimen to date. Dengue has also
been reported in Nuevo Laredo, located just inside the Mexico border.
The last outbreak of Dengue in Texas occurred in 1995, when 29 cases,
mostly travelers, were reported. USA (N. CAROLINA) – ALERT: HEPATITIS A Health officials have issued
a warning to patrons of the Texas Steakhouse in Smithfield (Johnston County)
on July 24, 25, 25, 31, and August 1, 2, 7, 8, 1999 after 3pm about possible
exposure to Hepatitis A. An employee that worked during those times was
recently diagnosed to with Hepatitis A. It is possible that 3000 diners
were exposed. For more information, please call the Johnston County Health
Department at (919) 989 – 5200. RUSSIA – BUBONIC PLAGUE The first known death of plague in the
Central Asian state of Kazakhstan was reported on August 8, 1999. A 13
year–old boy fell ill from septic bubonic plague two days after a flea
bite in the Kyzyl–Orda region. The 20 people in contact with the boy have
been isolated. Plague is more commonly transmitted to man by a flea that
carries the organism, Yersinia pestis. RUSSIA – ANTHRAX A quarantine was imposed in Nizhnecheremoshnoya
Village upon the hospitalization of four residents with anthrax. It was
determined that all the individuals had cut carcasses of slaughtered animals
prior to infection. Anthrax was found in at least 20 cows. Before word
about the cows' illness was known, meat was sold to neigboring villages.
At least 14 cases of Anthrax in another eastern Russian region were reported
last month.
JAPAN – Q FEVER OUTBREAK A Health and Welfare Ministry Research
Team in Japan has reported the first widespread outbreak of Q Fever in
the country. The bacterium responsible for the fever condition was discovered
in 8 patients. The similarity of symptoms between the disease and influenza
has raised concern about misdiagnosis. Insufficient knowledge about the
disease has generated increased efforts to inform hospitals about proper
testing methods, criteria for diagnosis, and effective treatment procedures.
The last and only case in Japan was reported in 1988. USA (OHIO) – COLESLAW TAINTED WITH E. COLI Coleslaw served at
four Kentucky Fried Chicken restaurants in the Ohio Valley between July
5㪳 have been linked to 30 reported cases of E coli. The source of contamination
was traced by the FDA to the improper preparation of the coleslaw (washing
of cabbage). As a result, KFC restuarants received a clean bill of health.
USA (MASSACHUSETTS) – SHIGELLOSIS Over the past couple of weeks,
cases of Shigellosis have skyrocketed from 24 to nearly 100 in cities
and towns in Hampden County. The potential of the intestinal disease to
rapidly spread has prompted health officials to issue an advisory about
the importance of proper hand washing, particularly after toilet use.
A similar outbreak in 1991 sickened more than 1000 people in the county.
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