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Vol. Vol. XI No. 8 ~EINet News Brief ~ 18 April 2008 ~ EINet News Briefs ~ Apr 18, 2008
*****A free service of the APEC Emerging Infections Network*****
APEC EINet News Briefs offers the latest news, journal articles, and notifications for emerging infections affecting the APEC member economies. It was created to foster transparency, communication, and collaboration in emerging infectious diseases among health professionals, international business and commerce leaders, and policy makers in the Asia-Pacific region.
In this edition:
1. Influenza News
- Global: Cumulative number of human cases of avian influenza A/(H5N1)
- Japan: Economy on the verge of approving plan to give pre-pandemic vaccine to healthcare workers
- Russia (Primorye): Agricultural Ministry confirms outbreak of avian influenza in poultry
- South Korea: Officials investigate H5N1 avian influenza cases
- South Korea: Poultry infected with H5N1 avian influenza illegally taken from quarantined zones
- USA: Experimental H5N1 avian influenza vaccine uses cold virus
- USA: Health and Human Services Secretary blogs on impasse with Indonesia
- Egypt (Cairo): WHO confirms country's 49th case (22nd death) from H5N1 avian influenza
- Egypt: Two-year-old boy infected with H5N1 avian influenza, country's 50th case
2. Infectious Disease News
- Japan: Man diagnosed with murine typhus after Indonesian surf trip
- Russia (Kirov Region): Two cases of tissue dirofilariasis recorded in 2008
- Russia: Crimean-Congo hemorrahgic fever (CCHF) on the rise
- Russia (Udmurtia): Troubling forecast for hemorrhagic fever with renal syndrome (HFRS)
- Canada (Toronto): Officials fear measles carrier may still be at large
- Canada (British Columbia): Metapneumovirus infection possibly linked to death of four seniors
- Peru: Researchers find high levels of MDR and XDR tuberculosis
- Peru: Researchers find new species of Leptospira in the Peruvian Amazon
- USA: New cases of progressive inflammatory neuropathy in pork plant workers
- USA: Investigators find toxic elements in dietary supplements
- USA (Wisconsin): Two new cases of measles confirmed
- USA: Man dies from human lymphocytic choriomeningitis virus infection, widow sues Petsmart Inc.
- USA: Rabies found in multiple states, human exposure
- USA (Colorado): Tests of the water supply find presence of two illness causing protozoa
- USA (Mississippi): Officials report State's first case of West Nile virus in 2008
- USA (Florida): Officials investigate outbreak of Staphylococcus aureus infections among 12 people
- Hong Kong: Officials urge vigilance against viral hepatitis E infection
- AVIAN PANDEMIC INFLUENZA
- CHOLERA, DIARRHEA, & DYSENTERY
- Confronting an influenza pandemic with inexpensive generic agents: Can it be done?
- Willingness to volunteer during an influenza pandemic: perspectives from students and staff at a large Canadian university
- Pathology, Molecular Biology, and Pathogenesis of Avian Influenza A (H5N1) Infection in Humans
- Evidence for avian influenza A infections among Iowa’s agricultural workers
- Human-Like Receptor Specificity Does Not Affect the Neuraminidase-Inhibitor Susceptibility of H5N1 Influenza Viruses
- APEC EINet Pandemic Influenza Preparedness Virtual Symposium: Partnerships and Continuity Planning for Critical Systems
- Eleventh Annual Conference on Vaccine Research
- ASTHO offers guidelines for protecting vulnerable groups during a pandemic
- AI.COMMuniqué: Preparedness for Influenza Pandemic
1. Influenza News
Global: Cumulative number of human cases of avian influenza A/(H5N1)
Economy / Cases (Deaths)
Total no. of confirmed human cases of avian influenza A/(H5N1), Dec 2003 to present: 381(240).
Avian influenza age distribution data from WHO/WPRO: http://www.wpro.who.int/sites/csr/data/data_Graphs.htm.
WHO's maps showing world's areas affected by H5N1 avian influenza (last updated 4.14.08): http://gamapserver.who.int/mapLibrary/
WHO’s timeline of important H5N1-related events (last updated 4.11.08): http://www.who.int/csr/disease/avian_influenza/ai_timeline/en/index.html
Japan: Economy on the verge of approving plan to give pre-pandemic vaccine to healthcare workers
Japan's health ministry on 15 Apr 2008 said it was on the verge of approving a plan to administer pre-pandemic vaccine to healthcare workers, which would make it the world's first country to tap its national stockpile for this purpose. Kishiko Yamaguchi, an official from Japan's health and welfare ministry, said the plan, which awaits approval on 16 Apr 2008, would allow the vaccination of about 6000 quarantine officials and healthcare workers by the end of 2008. Japan has already approved and stockpiled pandemic vaccines for 10 million people that are based on H5N1 viruses from China, Indonesia, and Viet Nam. The Research Foundation for Microbial Diseases of Osaka University and the Kitasato Institute made the vaccines.
In a November 2005 presentation for the WHO that summarized clinical study results for Japan's pandemic vaccine, Masato Tashiro, MD, PhD, with the National Institute of Infectious Diseases, revealed that the project is supported by the government, and the same formulation of the alum-adjuvanted whole-virus vaccine is produced by all of the manufacturers. Yamaguchi said that if initial tests show that the pre-pandemic vaccine is safe and effective, the ministry would consider vaccinating 10 million more people, including such vital workers as lawmakers, police, and other healthcare workers. The second vaccination wave would also include those who maintain infrastructure networks such as gas and electricity.
International health officials have been cautious about taking steps toward vaccination in advance of a pandemic because researchers are uncertain whether vaccines that are currently in national stockpiles will offer cross-protection against a future pandemic strain. Also, it's not clear whether any adverse events would arise from the use of the vaccine, which makes it difficult to weigh the usefulness of the strategy.
In a May 2007 bulletin, WHO acknowledged that as pre-pandemic vaccines become available, they could be used in poultry workers, healthcare workers, and whole populations. However, WHO did not recommend that countries undertake the strategy. Gregory Hartl, a spokesman for WHO, said that pre-pandemic vaccination is "a big roll of the dice" but said WHO doesn't oppose countries using the vaccines. The European Centre for Disease Prevention and Control in 2007 praised the development of pre-pandemic vaccines but said it did not support countries using them until WHO elevates its pandemic phase to five or six (from the current phase three), which would indicate that significant human-to-human transmission is occurring.
Russia (Primorye): Agricultural Ministry confirms outbreak of avian influenza in poultry
South Korea: Officials investigate H5N1 avian influenza cases
"We have received four fresh reports of suspected bird flu cases on 14 Apr 2008 and one is from a poultry farm in Pyongtaek city in Kyonggi province," the Farm Ministry said.
The ministry said that the farm in Pyongtaek, around 60 km south of Seoul, tested positive for H5 and more detailed results would be available on 17 Apr 2008. It said more than 2,000 birds at the farm would be slaughtered on 15 Apr 2008 and it had stopped the shipment of birds within a 10-km radius of the affected site.
South Korea, which has culled nearly two million poultry in April 2008, said it would continue quarantine work in suspected areas and encourage poultry consumption amid rising consumer concern. Duck and chicken prices have dropped 10 percent this month, while chicken sales at four major retailers surveyed by the ministry showed a 20 percent decline. South Korea had seven outbreaks of H5N1 between November 2006 and March 2007 and spent 58 billion won (USD 59.22 million) on quarantine measures.
South Korea: Poultry infected with H5N1 avian influenza illegally taken from quarantined zones
In regards to the chicken farm, doubts have risen over quarantine management as the farm in Iksan was visited by a retail dealer who had been in contact with bird flu-infected ducks. According to the ministry and the Gimje Police Station, the 37-year-old dealer identified only by his surname (Park) had sold the H5N1 positive ducks to a restaurant in Geumsan-myeon, Gimje, from a farm located in Yongji-myeon, Gimje, which was included in the alert zone after a suspected outbreak had been reported there. Park bought 600 ducks from the farm between 4 and 6 Apr 2008, and sold some 40 of them to a duck seller. The probe found that Park sold 360 ducks among the remaining 560 to some 20 restaurants in six cities and districts including Jeonju, Gimje, Buan and Jeongeup, and buried the remainders.
USA: Experimental H5N1 avian influenza vaccine uses cold virus
An experimental bird flu vaccine that uses a common cold virus and bits of DNA from the H5N1 virus appears to stimulate an immune response in mice, U.S. researchers said on 17 Apr 2008. They said their experiment is a first step towards developing a next-generation bird flu vaccine that does not need to be grown for months in chicken eggs and that could protect against mutated versions of the virus.
"We want to have a vaccine that can be stored in advance and have the potential to provide protection for a period of time until we can change the vaccine to match the latest form of avian influenza," said Suresh Mittal of Purdue University in Indiana, who worked on the study. "The combination of flu genes that we've used to produce the vaccine, I think, will provide that capability."
At least 16 companies are working on vaccines to prevent bird flu infection in people, but the process is problematic. Flu vaccines are hard to make because they must be grown in chicken eggs for months, and the viruses themselves mutate every year. The seasonal flu vaccine must be reformulated every year and no one knows what would happen if H5N1 mutated into a form that people could transmit easily to one another.
If a pandemic broke out, using current technology it would be close to a year before anyone could be vaccinated. Suresh Mittal, Mary Hoelscher of the U.S. CDC and colleagues worked with H5N1 virus samples from Vietnam and Indonesia to make a vaccine that they hoped would work against even "drifted," or mutated, strains. They used a common cold virus, known as an adenovirus, to carry H5N1's hemagglutinin gene, which give flu strains the "H" of their names. Most current flu vaccines also focus on hemagglutinin. They also used another gene called nucleoprotein or NP, which has not been used in flu vaccines. The hope is that the NP gene will both promote an immune response against flu, and perhaps be a bit more stable than the highly mutation-prone hemagglutinin.
So far the researchers have only tested mice, but the vaccine caused a strong immune response that lasted at least a year.
"In humans we want a vaccine to be fully effective for at least a year," Mittal said. "This approach may prevent severe illness and death or shorten the course of future infection with H5N1 virus strains that are antigenically distinct from currently circulating strains, and it may offer stockpiling advantages that overcome the limitations associated with storage of egg-derived vaccines," the researchers wrote. Their technology has been licensed to PaxVax Inc, a privately held corporation.
USA: Health and Human Services Secretary blogs on impasse with Indonesia
In early 2007, Indonesia announced it had stopped sharing H5N1 virus samples with the World Health Organization (WHO) to protest, in its view, that poorer developing countries that share samples will not have access to or afford the pandemic vaccines that pharmaceutical companies in developed nations will manufacture using the samples. The US Navy's medical unit in Jakarta (NAMRU-2) is a WHO-collaborating laboratory, and its status in the country has been uncertain since Indonesia stopped sharing its H5N1 samples. However, on 10 Apr 2008 Kyodo News, a Japanese news service, reported that Indonesia's health ministry had banned NAMRU-2 from operating in the country.
In his blog post, which he wrote while still in Indonesia but posted on 17 Apr 2008, Leavitt said that NAMRU-2 can help any Southeast Asian country identify virus samples in the event of communicable disease outbreaks. He added that the laboratory has operated in Indonesia for decades; however, the memorandum of understanding (MOU) between Indonesia and the United States expired two years ago, and efforts to renew the agreement have been unsuccessful.
Leavitt wrote that much of his time was spent discussing virus-sharing issues and the status of NAMRU-2 with Supari. A WHO working group on virus sharing has been trying to hammer out a virus-sharing agreement between global health officials and developing countries, but has made little progress. The group last met in November 2007, and a smaller version of the group may meet again in May 2008 in advance of the WHO's World Health Assembly.
"The minister's main point is that what she wants should not be considered 'royalties' or 'compensation,'" he wrote. "What she says she wants is for the contributing countries to be eligible for some share of the value commercial companies create out of the influenza samples they provide."
Leavitt acknowledged Supari's legitimate concerns about her country's access to medicine and vaccines, but emphasized that health officials need to retain incentives that enable pharmaceutical companies to develop new countermeasures. Leavitt said linking sample sharing to payment would erode the world's ability to make any vaccines, "because the slope is slippery, and there will be no end to the demands."
Indonesia's coordinating minister Aburizal Bakrie suggested that the United States and Indonesia spend the next two months working on a solution to the impasse, Leavitt reported. He said he instructed his representative Bill Steiger and ambassador John Lange, the State Department's special representative for avian and pandemic influenza, to continue discussions with Indonesia. Leavitt warned that, despite the new negotiations, the situation might never be resolved.
"If we haven't been successful in resolving the matter, I think it will be time for the world to just accept Indonesia's unwillingness to participate in the WHO influenza system and move on to other ways of making the world safer."
Egypt (Cairo): WHO confirms country's 49th case (22nd death) from H5N1 avian influenza
The Ministry of Health and Population of Egypt has announced a new human case of avian influenza A (H5N1) virus infection. The case is a 30-year-old female from Al-Matarya, Cairo Governorate. She developed symptoms on 2 Apr 2008 and was hospitalized and died on 11 Apr 2008. The case was confirmed as being infected with A (H5N1) by the Central Public Health Laboratories and by Cairo-based US Naval Medical Research Unit 3 (NAMRU-3). Investigations into the source of her infection indicate a history of contact with sick and dead poultry. Of the 49 cases confirmed to date in Egypt, 22 have been fatal.
Egypt: Two-year-old boy infected with H5N1 avian influenza, country's 50th case
2. Infectious Disease News
Japan: Man diagnosed with murine typhus after Indonesian surf trip
A 23-year-old Japanese man who returned from Bali, Indonesia, was diagnosed and confirmed to have murine typhus on 10 Apr 2008.
While staying on Bali from 20 Jan 2008 to 11 Mar 2008, he often went surfing at Madewi and Kuta beaches. He was admitted to the hospital on 24 Mar 2008 (on the seventh day of illness). Fever, thrombocytopenia, and renal impairment were seen on admission. Rickettsiosis was suspected since erythematous rash appeared on his eighth day of illness. Rickettsia typhi DNA was detected from his blood and skin specimen by PCR at the National Institute for Infectious Diseases (NIID), Japan. An indirect immunofluorescence assay (IFA) and immunoperoxidase assay (IP) for antibodies reactive with R. typhi antigens showed raised levels of IgM and IgG. He was given minocycline and completely recovered.
Another case of murine typhus was reported in Chiba, Japan, in April 2008. The NIID detected R. typhi DNA from the patient's blood. Murine typhus is not believed to be endemic in Japan. Considering the incubation period of murine typhus, they contracted the disease abroad. Further investigation of the second case is continuing. These two consecutive cases of imported murine typhus in Japan suggest that murine typhus may be endemic at some surf spots in Bali.
Russia (Kirov Region): Two cases of tissue dirofilariasis recorded in 2008
Russia: Crimean-Congo hemorrahgic fever (CCHF) on the rise
Russia (Udmurtia): Troubling forecast for hemorrhagic fever with renal syndrome (HFRS)
To escape the risk of infection officials recommend taking measures to prevent incursion of rodents. This includes paying attention to sanitation, eradication of garbage dumps, clearing undergrowth from nearby forest, and active rodent control measures. Gardens require special attention, as every fifth infection occurs there. The most dangerous time for infection is the first visit to the cottages after the winter months. Only wet methods are recommended for cleaning cottages. The most frequent mode of infection is air-dust in up to 85 percent of cases. It is necessary also to ventilate the rooms thoroughly. The food should be protected and rodent-exposed food should not be used. Hand washing is mandatory before meals and smoking. Bed linens should be exposed to sunlight for two-three hours. All these simple measures will prevent infection.
Canada (Toronto): Officials fear measles carrier may still be at large
Public health officials are concerned the original carrier of a recent outbreak of measles may still be at large after it was determined that none of four reportedly infected people has traveled recently, effectively ruling them out as the source.
Officials said measles continues to have potentially serious consequences, and a warning will be in effect for the Greater Toronto Area at least until the end of April 2008 should no new cases be reported. Despite obvious concern, the risk to the general public is described as low, thanks to extremely high immunization levels.
"When we know that measles was acquired in the city, that's what concerns us because that means that some people somewhere have the infection and are transmitting it to others unknowingly," said Vinita Dubey, associate medical officer of health for Toronto Public Health.
The first case was confirmed on 1 Apr 2008, when an Oakville man in his 30s was diagnosed. Since then, three cases have sprung up in Toronto in a 10-year-old girl, a 34-year-old woman, and a 42-year-old man. A fourth is being investigated.
Canada (British Columbia): Metapneumovirus infection possibly linked to death of four seniors
Peru: Researchers find high levels of MDR and XDR tuberculosis
Because of the occurrence of resistance to second-line antituberculous drugs, defined as extensively resistant tuberculosis (XDR TB, M. tuberculosis strains simultaneously resistant to isoniazid, rifampin, a fluoroquinolone and a parenteral second-line drug), during 2007 INS performed susceptibility tests for first- and second-line antituberculous drugs for all M. tuberculosis isolates received from the Public Health Laboratory Network, according to the regulations issued by the Sanitary Strategy for TB Prevention and Control. From January to June 2007, 2,235 results of susceptibility tests of isolates from 1,895 patients throughout Peru were assessed. Of these, 698 (36.8 percent) had multidrug resistant TB (MDR, defined as resistance at least to rifampin and isoniazid); and 45 were reported as XDR TB (2.4 percent of the total number of patients and 6.4 percent of all MDR TB patients).
XDR TB is a form of the disease produced by bacteria resistant to all effective antituberculous drugs, and it is generally resistant to every first-line drug and to most second-line drugs. The occurrence of XDR TB strains reflects the deficiency of resistant TB control and therapy programs. The high mortality rates associated with these strains, particularly in those places with a high prevalence of HIV infection, as it is the case for South Africa, has led international sanitary authorities to declare a worldwide alert because of the emergence of these micro-organisms, and recommendations for their control have been issued.
Such measures include strengthening the laboratory services in order to perform M. tuberculosis susceptibility testing in places with a high incidence of MDR TB. This is the reason why the INS will soon transfer tests for a rapid diagnosis of MDR TB to the regions where this disease is highly prevalent. Since MDR TB represents a threat for public health in Peru, it is urgent to implement the measures recommended by WHO, including isolation of these patients in safe places until their infectiousness state is controlled.
Peru: Researchers find new species of Leptospira in the Peruvian Amazon
Patients with severe forms of leptospirosis have jaundice, renal failure, and lung hemorrhage, with high fatality rates. Joseph Vinetz, MD, professor of medicine in UC San Diego's Division of Infectious Diseases, working in collaboration with colleagues from Universidad Peruana Cayetano Heredia in Lima, Peru, and others, headed the study that led to discovery of the new species in the family of pathogens, Leptospira, which is spread from animals to humans. Leptospirosis is a severe, water-borne disease transmitted from animals to humans, with tens of millions of human cases worldwide each year. Fatality rates can range as high as 20 to 25 percent in some regions. It is particularly prevalent in tropical countries where poor people live under highly crowded condition, or in rural areas where people are exposed to water contaminated by the urine of Leptospira-infected animals such as rats.
The new species reflects Amazonian biodiversity, according to Vinetz, and the pathogen has apparently evolved to become an important cause of leptospirosis in the Peruvian Amazon region of Iquitos. There, Vinetz leads an international team of physicians from the United States and Peru in an National Institutes of Health (NIH)-funded training program studying malaria, leptospirosis, and other infectious diseases that impact disadvantaged populations in developing countries. The researchers found that the new species, Leptospira licerasiae, cultured from a very small number of patients, as well as eight rats, is significantly different from other forms of the bacteria at a genomic level and has novel biological features.
"This strain has fundamentally different characteristics," said Vinetz, adding that the next step is to sequence its genome. "We think that hundreds of patients are infected with this pathogen, which is so unique that antibodies for the disease don't react to the regular tests for leptospirosis."
In testing 881 patients in a prospective clinical study of fever, the researchers found that 41 percent of them had antibodies that reacted only to this new strain of the bacteria, showing a much higher incidence of leptospirosis than previously suspected. "This observation is relevant to other regions of the world where leptospirosis is likely to be common, because it's necessary to identify the right strain of the Leptospira in order to make the correct diagnosis," Vinetz said.
USA: New cases of progressive inflammatory neuropathy in pork plant workers
Dr. Daniel Lachance, a Mayo Clinic neurologist, said there are now 18 confirmed cases among people who have worked at the Quality Pork Processors plant in Austin, Minnesota. That's up from 13 cases reported as of February 2008. Lachance also said there are now about five cases among workers at a pork plant in Indiana, compared with two confirmed earlier, and one recently identified case at a plant in Nebraska. Officials have not publicly named the Indiana and Nebraska plants.
Researchers don't think the general public is at risk. "It doesn't appear that the slaughtered pigs have been ill," said Dr. James Sejvar, a neurologist and epidemiologist at the CDC. "It doesn't appear that this is in any way a foodborne illness. And it doesn't appear as if this particular illness can be transmitted person to person."
Lachance said none of the patients have recovered completely, though all have improved or stabilized to a degree. He also said some have had relapses. Some of the patients have required only pain medication, while the most seriously ill have undergone drug treatments to suppress their immune systems.
The three plants are the only ones investigators have found in the United States that used compressed air to harvest pig brains, which are considered a delicacy in some Asian countries. Sejvar said the CDC has been working with WHO to see whether the procedure has been used in any plants abroad. So far, they haven't identified any. Even if the illness turns out to be an isolated problem, Lachance said he hopes researchers will be able to apply what they've learned to other auto-immune illnesses. Scientists still don't know what triggers many of them, he said.
USA: Investigators find toxic elements in dietary supplements
The FDA has received 43 reports of persons from nine states who experienced serious adverse reactions using these products. On 27 Mar 2008, the FDA warned consumers not to purchase or use Total Body Formula in flavors Tropical Orange and Peach Nectar and Total Body Mega Formula in the Orange/Tangerine flavor of these products after receiving reports of adverse reactions in users in Florida and Tennessee. The adverse reactions generally occurred after five to 10 days of daily ingestion of the product, and included significant hair loss, muscle cramps, diarrhea, joint pain, deformed fingernails, and fatigue.
Selenium, a naturally occurring mineral, is needed only in very small amounts for good health. Selenium can boost the immune system. Generally, normal consumption of food and water provides adequate selenium to support good health. Excessive intake of selenium is known to cause symptoms to include significant hair loss, muscle cramps, diarrhea, joint pain, fatigue, loss of fingernails, and blistering skin. Analyses of samples of the products by FDA laboratories have now found most of the samples contain extremely high levels of selenium — up to 40,800 micrograms per recommended serving, or more than 200 times the amount of selenium per serving (i.e., 200 micrograms) indicated on the labels of the products. Presently, the FDA has 43 reports of adverse reactions including cases from Alabama, Florida, Georgia, Kentucky, Michigan, New Jersey, North Carolina, Tennessee, and Texas.
USA (Wisconsin): Two new cases of measles confirmed
"We would consider even one case of measles to be of the greatest concern, that's why we are being aggressive on case investigation," said Dan Hopfensperger, director of the Wisconsin Immunization Program, which is part of the state Division of Public Health.
Authorities were alerted on 9 Apr 2008 of a five-month-old and a 12-month-old with early symptoms of measles. Both children came in contact with a 23-month-old whose case was reported to authorities 4 Apr 2008, Hopfensperger said. All three children attended a Greenfield daycare, and its workers and other children have now been quarantined in their homes, he said. A 37-year-old Milwaukee man also is infected, but his case has not been connected with the children. The 23-month-old Franklin girl's symptoms started before 4 Apr 2008, Hopfensperger said. The man's symptoms started in mid-March 2008. One of the new cases lives in Milwaukee, according to the Milwaukee Health Department. Health officials are trying to determine where the man and the 23-month-old picked up the measles. No other people in the state have been infected since 2005.
USA: Man dies from human lymphocytic choriomeningitis virus infection, widow sues Petsmart Inc.
USA: Rabies found in multiple states, human exposure
In Arizona, the Pinal County Public Health Services District is issuing an advisory for animal rabies to all residents of Pinal County. On 31 Mar 2008, a bobcat bagged in the Peppersauce campgrounds near Oracle tested positive for rabies at the Arizona State Public Health Laboratory. The bobcat attacked and exposed at least two individuals at the campsite. Both individuals are currently receiving a series of shots to prevent contracting the rabies virus. This is the fifth animal to test positive in Pinal County in 2008.
In Georgia, a bite from a rabid fox in Whitfield County underscores the need to aggressively combat the deadly disease, officials in Georgia and Tennessee say. Chad Mulkey, environmental county manager in Whitfield for the North Georgia Health District, said the attack illustrates how development crowds wild animals and humans closer together. Mr. Mulkey wasn't surprised Jimmy Cooper encountered a fox near his home during the week of 31 Mar - 4 Apr 2008. "Up there where this bite occurred, I'd say the habitat being destroyed is what pushed this fox out," Mr. Mulkey said.
USA (Colorado): Tests of the water supply find presence of two illness causing protozoa
These samples were drawn by CDC before the water system was flushed and disinfected. More sampling is needed to confirm that the parasites have been eliminated.
New water samples were taken on 9 Apr 2008 by the state's Water Quality Control Division. Once testing shows the water is suitable for drinking, the state's boil order will be lifted. But lab results are not expected on the latest samples until the weekend of 12-13 Apr 2008 at the earliest. As of 8 Apr 2008, there were 389 total cases of salmonella, with 107 of these culture-confirmed and 16 hospitalized.
USA (Mississippi): Officials report State's first case of West Nile virus in 2008
"This just means we've got West Nile in that area, and likely it's in other areas of the state, too," said State Epidemiologist Dr Mary Currier. Although a March case of West Nile virus is atypical, as the season for the virus extends from mid-summer through fall, Currier said cases have been reported as early as January and as late as December. "It can happen at any time of the year," she said. "Mosquitoes can be around at any time of the year, and we all need to take precautions."
USA (Florida): Officials investigate outbreak of Staphylococcus aureus infections among 12 people
Hong Kong: Officials urge vigilance against viral hepatitis E infection
The cases were distributed throughout Hong Kong and involved patients aged between 16 and 84. So far, the food histories provided by the patients have not shown a single common source outbreak related to any particular food premises, Dr. Chuang said. Dr. Chuang said hepatitis E was acquired by ingestion of contaminated food or water and, therefore, is preventable by observing good personal and food hygiene. The incubation period ranges from 15 to 64 days before onset of symptoms. Hepatitis E is usually more active during the winter and spring seasons. Clinical features of acute hepatitis E resemble those of other types of viral hepatitis, including anorexia, malaise, fever, and vomiting, followed by jaundice, passing tea-colored urine, and hepatomegaly.
AVIAN PANDEMIC INFLUENZA
CHOLERA, DIARRHEA, & DYSENTERY
The government has been holding campaigns to educate the public as well as to check residential and construction sites in efforts to stem the steady rise in dengue cases. However, despite the efforts, the number of cases and deaths continue to rise each year.
Philippines (Negros Oriental)
The city-state is spending 200,000 Singapore dollars (USD 145,000) a day in a massive effort to destroy breeding sites and a targeted war against mosquitoes in areas where two or more people fall ill. In 2007, more than 5,000 homeowners were fined 200 Singapore dollars (USD 145) for allowing mosquitoes to breed. Construction sites found with the insect pests breeding are fined 2,000 Singapore dollars (USD 1459).
“We cannot understand why the numbers are climbing,” Ng said.
Confronting an influenza pandemic with inexpensive generic agents: Can it be done?
Fedson DS. The Lancet Infectious Diseases. Early Online Publication, 16 April 2008
Willingness to volunteer during an influenza pandemic: perspectives from students and staff at a large Canadian university
Pathology, Molecular Biology, and Pathogenesis of Avian Influenza A (H5N1) Infection in Humans
Evidence for avian influenza A infections among Iowa’s agricultural workers
Human-Like Receptor Specificity Does Not Affect the Neuraminidase-Inhibitor Susceptibility of H5N1 Influenza Viruses
APEC EINet Pandemic Influenza Preparedness Virtual Symposium: Partnerships and Continuity Planning for Critical Systems
APEC EINet is pleased to host a special videoconference on pandemic influenza preparedness. This videoconference is a follow-up to our first virtual symposium, which was conducted in January 2006 with great success (participating economies were Australia, Canada, China, Korea, Philippines, Singapore, Chinese Taipei, Thailand, USA, and Viet Nam). You can view a five-minute videoclip of our previous virtual symposium at: http://depts.washington.edu/einet/symposium.html. Our upcoming videoconference will be held in late May 2008. It will take place during the evening hours of 29 May in the Americas and in the morning hours of 30 May in Asia, for approximately 5 hours. Our objective is to describe how private and public sectors in the APEC region can cooperate and work effectively to prepare for and respond to an influenza pandemic.
Through this videoconference, we hope to promote regional information sharing and collaboration to enhance pandemic preparedness. In order to improve preparedness regionally, it is vital to understand how each economy in the region is undertaking this task. In this process, EINet will:
Eleventh Annual Conference on Vaccine Research
ASTHO offers guidelines for protecting vulnerable groups during a pandemic
ASTHO officials credit Toby Merlin, MD, deputy director of the CDC's Influenza Coordinating Unit, for coming up with the idea for the At-Risk Populations Project, which they describe as unique because it is federal guidance developed by non-federal groups. "Toby Merlin came to us to ask ASTHO to organize, with CIDRAP and Keystone, a process for developing guidance outside the federal government, and also including the very important component of community engagement," said Jarris. "We've had community engagements around pandemic community mitigation measures and vaccine prioritization before, but what was really new was moving the engagement outside the federal government."
ASTHO is inviting the public to comment on the guidance document for 30 days (from 15 Apr 08). After that, plans call for editing the document and releasing the final version by 31 May 08, according to Anna DeBlois, ASTHO's senior director for immunization and infectious disease. The project has been on a tight schedule because of CDC budgetary considerations, said Jarris.
A few examples of the many recommendations in the guidance document:
AI.COMMuniqué: Preparedness for Influenza Pandemic
Please see The Communication Initiative's Avian Influenza Theme Site at: http://www.comminit.com/avianinfluenza.html for a full display of avian influenza communication knowledge in support of your work. Also see the Academy for Educational Development's Avian Influenza Web site at http://www.avianflu.aed.org.
AI.COMMuniqué is very interested in your knowledge and experience in avian influenza communication - your projects and programs, strategic thinking, support materials, and any other relevant documentation. Please contact firstname.lastname@example.org with any input.