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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 AsiaPacific 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:
JAPAN TOXIC SHOCK SYNDROME The results of an epidemiological
study has revealed the possibility of Toxic Shock Syndrome (TSS) associated
deaths during an influenza outbreak early this year, at which time 19
patients died. Although a causal relationship between the bacteria that
causes TSS, Methicillinresistant Staphylococcus Aureus (MRSA), and the
deaths was not found, the center that conducted the survey was able to
conclude the role of TSS in some of the deaths. According to the Ministry's
Infectious Disease Division, several studies have revealed patient experience
with TSS upon influenza infection. There is a possibility that TSS may
be caused by the invasion of bacteria into the respiratory tract after
membrane damage from influenza. AUSTRALIA (MELBOURNE) MENINGOCOCCAL DISEASE A third case of
deadly meningococcal disease has been reported in Melbourne. The 16year
old girl appeared to have the septicaemia form of the disease. The report
was made shortly after two 14year old girls with the same disease were
taken off the critical list at Royal Children's Hospital. It is still
unclear whether a connection between the three cases exists. USA (NEW YORK) E.COLI OUTBREAK The New York State Health Department
has confirmed 33 cases of E. coli in what may be considered one of the
country's worst outbreaks since 1993. To date, one child has died, another
is in critical condition, and 155 others appear to be infected, 45 of
which, remain hospitalized. The victims are children between the ages
of 3 and 14, or elderly, that attended the Washington County Fair on August
28 and 29. The Health Department believes that water contaminated with
manure from the dairy barns on the site is the likely cause of E. coli
contamination. The E. coliinfected water may have then been used to make
ice, drinks, wash lettuce, and prepare various foods. Although many strains
of E. coli are considered harmless, the strain, 0157: H7, identified in
many of the victims infected at the Washington County Fair, is deadly.
Health officials have not yet discovered a pattern among those who have
become ill. Individuals at greatest risk for spread and infection include
child care, health, and food service workers. USA (WASHINGTON) E. COLI OUTBREAK Since August 1, twentynine
culture confirmed cases of E. coli 0157:H7 have been reported in Washington
State. The Southwest Washington Health District and the Washington State
Department of Health have confirmed 4 cases among children, and continue
to investigate 20 others, associated with an outbreak at Battle Ground
Lake. Interviews revealed that three cases swam in the lake, and the other
was a secondary case linked to a sibling swimmer. The Washington State
Public Health Laboratory is currently conducting DNA fingerprinting by
pulsefield gel electrophoresis (PFGE) on lake isolates. The results to
date demonstrate a consistent "outbreak" pattern. Although the lake is
the primary suspect source, other possibilities have not yet been ruled
out. USA (NEW YORK) ST. LOUIS ENCEPHALITIS The New York Department
of Health has confirmed 5 cases of St. Louis Encephalitis (SLE) in Queens,
NY. Approximately 34 other possible cases in the area are currently being
investigated. A potentially fatal disease in the elderly and infants,
SLE is a mosquitoborne viral disease. Symptoms range in severity from
a slight headache or fever, to paralysis or death. The New York City Health
Department has issued an advisory to residents of Queens to take necessary
precautions to avoid mosquitoes. The city of New York has also contributed
to public health efforts by spraying the insecticide, Malathion, on potential
breeding grounds of the mosquitoes that carry SLE. USA (NEW YORK) MALARIA Two 11year old boys were infected with
the parasitic disease malaria at a Boy Scout camp on Long Island between
August 1ף, 1999. The boys did not exhibit any symptoms until they returned
home, as a result of the twoweek incubation period of the disease. Although
it is extremely rare that malaria is contracted within the United States,
the New York State Health Department believes that these cases were acquired
in the country. A search of the 200acre camp uncovered mosquitoes carrying
the disease. Residents have been asked to take the necessary precautions
to avoid mosquitoes. The most recent cases of locally acquired malaria
occurred in Queens in 1993. USA (SAN FRANCISCO) SYPHILIS ON THE WEB A recent outbreak of
syphilis has been tracked to an America Online (AOL) chat room. Six cases
in the San Francisco Bay Area traced their most recent sexual encounters
to partners met in a chat room created by AOL member, San Francisco Men
4 Men (SFM4M). Since the infected only knew their multiple partners by
their computer nicknames, or "handles", and AOL could not divulge the
participants' real names, the San Francisco Health Department was put
in touch with Planet Out, a worldwide online service for homosexuals.
The service contributed to public health efforts by posting messages to
people in chat rooms, and training volunteers to visit chat rooms to talk
to people about the outbreak. Of the 99 men directly exposed to syphilis,
33 have been tested so far. It is estimated that another third contacted
their own physicians, and the remaining are still unaware of their exposure. BLOOD DONATION BAN A ban on blood donations has been issued
to American and Canadian travelers to Britain during the country's madcow
disease crisis. The ban applies to anyone who has traveled or lived in
Britain for at least 6 months since 1980. The donor ban was issued as
a precaution to the human braindestroying illness associated with madcow
disease. Although there is no evidence of transmission through human blood
transfusions, scientists do not want to rule out the possibility of harm
from infected blood. The restriction could have a large impact on the
blood supply during a critical time of shortage. RUSSIA BOTULISM Botulism has claimed the lives of 4 residents
of the Southern Siberian Buryat autonomous republic. Approximately 48
persons have been affected, 24 of which were taken to the hospital. Doctors
believe that the source of poisoning was fish from Lake Baikal. Botulism,
which results from the ingestion of food containing toxins produced by
Clostridium botulinum, affects the human nervous system. This is the second
outbreak in UlanUde in less than half a month, when two men died after
eating poorly cooked fish. The botulism toxin can be inactivated with
heat (>100 degrees C) and refrigeration (of fish) prior to consumption.
GLOBAL HEALTH GAP According to researchers at the World Bank,
the global health gap between rich and poor countries continues to widen.
As a result, problems in poor countries are masked by the increasing rates
of noncommunicable diseases among the elderly. It was asserted that the
impact of communicable diseases among the poor is far greater than what
is suggested by global averages, and that noncommunicable diseases are
correspondingly less important. The research team used the 1996 global
burden of disease study (WHO) to compare communicable and noncommunicable
diseases among the poor and the rich.
USA (TEXAS) DENGUE Texas health officials have stepped up efforts
to rid the city of Laredo of the mosquito responsible for the spread of
dengue fever. In the past two weeks, 15 people have been treated for the
viral illness. Across the river from Laredo, in Nuevo Laredo, Mexico,
at least 106 cases of dengue have been confirmed. According to the Texas
Department of Health, of the 5 dengue cases in Webb County (the county
in which Laredo is located) , 4 had traveled to Nuevo Laredo. The other
case denies travel in the two weeks prior to becoming symptomatic. Other
suspect cases continue to be investigated. MALAYSIA NIPAH VIRUS During efforts to contain the Nipah virus
outbreak, 13 employees from the Veterinary Services Department tested
positive for the viral disease. The infected included laboratory workers
and those involved with the pig culling operations. Currently, they are
undergoing counseling and regular medical examinations as a precautionary
measure.
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