USACHPPM
HEALTH INFORMATION OPERATIONS (HIO)
UPDATE
6 June 2002
The HIO Update provides information regarding global medical and veterinary issues
of interest to the United States (US) Army. The HIO Update does not attempt to
analyze the information regarding potential strategic or tactical impact to the
US Army and as such, should not be regarded as a medical intelligence product.
Medical intelligence products are available at http://mic.afmic.detrick.army.mil/.
The information in the HIO Update should provide an increased awareness of current
and emerging health-related issues.
HOT ISSUES.
Anthrax Toxin Protection -
Recombinant Antibody Fragments.
Blood Donation Screening Updates
- US.
Blooborne Pathogens - OSHA
Revised Fact Sheets.
Counterterrorism Study - National
Academies.
Plague Treatments - FDA..
Respirators for First Responders
- NIOSH..
Smallpox Forums - CDC..
Smallpox Research - CDC..
Terrorism Pocket Guides - Veterans
Administration.
Updated Fact Sheets - WHO..
USCENTCOM..
BSE - Israel
Cholera - Afghanistan.
Crimean-Congo Hemorrhagic Fever
(CCHF) - Iran.
Cutaneous Leishmaniasis (CL)
- Afghanistan.
Malaria - Afghanistan.
Undiagnosed Deaths - Pakistan.
Unexploded Ordinance (UXO)
and Environmental Damage - Afghanistan.
USEUCOM..
BSE - Poland.
Bubonic Plague - Malawi and
Mozambique.
Cryptosporidiosis Outbreak
- Ireland.
HIV/AIDS - Zimbabwe.
Norwalk-like Virus (NLV) Outbreak
- London Hospital
Nurse Prescribers - UK..
Pesticide Contamination - Mali
USJFCOM..
Air Contaminants - World Trade
Center (WTC) Disaster Site.
Avian Influenza - Virginia.
Influenza B - Oregon.
Mass Casualty (MASCAL) Exercise
- New Mexico.
New Drug and Biological Product
Regulation Amendments - FDA..
Nursing Shortage - US.
Salmonellosis Investigation
Concluded - Texas.
Veterinary Drug Recall - US.
West Nile Virus - Louisiana,
Texas Next?.
USPACOM..
Cholera - Hong Kong.
Foot and Mouth Disease (FMD)
- South Korea.
Neonatal Hepatitis B Vaccine
- China.
USSOUTHCOM..
Avian Influenza - Chile.
Dengue Fever - Venezuela.
Flooding - Central America.
Flooding - Haiti and Jamaica.
ACRONYMNS.
The June issue of Nature Biotechnology reports
that a group of scientists have engineered a panel of toxin-neutralizing antibodies
that compete with the cellular receptor for binding of the protective antigen
of anthrax in both an in vitro cell culture assay and in an in vivo
rat model. The authors reported that these antibodies may have therapeutic value
in alleviating symptoms of anthrax toxin in infected individuals for medium-term
prophylaxis to infection. The article is at Maynard JA, Maassen CBM, Leppla SH,
Brasky K, Patterson JL, Iverson BL, and Georgiou G. Protection against anthrax
toxin by recombinant antibody fragments correlates with antigen affinity. Nature
Biotechnology 20, 597-600 (2002). A media review is at http://news.bbc.co.uk/hi/english/health/newsid_2018000/2018665.stm.
On 31 May, Cable News Network (CNN) reported
on a concern from blood donation centers about an estimated loss of more than
300,000 blood donations as a result of FDA's
stricter limitations on blood donors that screen for potential BSE
exposure, which went into effect on 31 May. The new requirements prevent people
from donating blood if they have (1) lived in France for five years or more beginning
in 1980, (2) visited or lived in Britain for three months or more between 1980
and 1996, (3) received a blood transfusion in Britain during or after 1980, or
(4) current or former military personnel and their dependents who spent six months
or more on military bases in northern Europe from 1980-1990 or in southern Europe
from 1980-1996. The report is at http://www.cnn.com/2002/HEALTH/05/31/new.blood.rules.reut/index.html.
On 31 May, OSHA announced a newly revised
Bloodborne Pathogens fact sheet that explains what bloodborne pathogens are, protections
offered by OSHA's Bloodborne Pathogen standard, and steps employers can take to
protect their workers. The fact sheets are at http://www.osha.gov/OshDoc/data_BloodborneFacts/index.html.
On 29 May, the National Academies announced
that it expects to complete the first phase of its science and technology counterterrorism
study in late June. The first phase addresses risks and research needs in key
areas of vulnerability: human, animal, and agricultural health systems; toxic
chemicals and explosive materials; nuclear and radiological hazards; information
technology; transportation and distribution systems; energy systems; cities and
fixed infrastructure; people; and interdependent systems. The press release is
at http://www4.nationalacademies.org/news.nsf/(ByDocID)/2673CD106339341785256BC800706404?OpenDocument
On 30 May, the FDA posted a notice in the
Federal Register announcing the expected availability of FY 2002 funds for awarding
grants to support clinical trials on the safety and effectiveness of drug products
for the treatment of human plague (bubonic, pneumonic, meningitic, or septicemic)
caused by Yersinia pestis. The grant program is part of FDA's counter-terrorism
efforts. The notice is at http://www.fda.gov/OHRMS/DOCKETS/98fr/053002e.pdf.
On 3 June, the NIOSH issued its first approval
of respirators for occupational use by emergency responders against chemical,
biological, radiological, and nuclear agents. NIOSH approved Spiromatic Models
9030, 6630, and 4530, manufactured by Interspiro USA Inc., Branford, Connecticut.
The respirators are a self-contained breathing apparatus (SCBA) that provide users
with air from a pressurized cylinder or tank carried on the back. The approval
signifies that the products are expected to protect firefighters and other responders
from chemical, biological, radiological, and nuclear exposures in the line of
duty. The report is at http://www.cdc.gov/niosh/interspup.html.
On 30 May, the CDC announced that public forums
would be held on 6, 8, and 11 June to provide health professionals and the general
public with information about smallpox and smallpox vaccine, and to solicit comments
on the use of smallpox vaccine before and after a potential smallpox outbreak
or bioterrorist attack. The National Academy of Science (NAS) will hold a scientific
forum on 15 June in Washington DC to obtain input from scientists, clinicians,
and other about the options for smallpox vaccine use. The NAS Forum will be broadcast
live (audio only) on the Internet at http://www.iom.edu/iom/iomhome.nsf/18ace18eb695f74c85256691007102f5/60515167fc6d0ffe85256a1500627d81?OpenDocument.
The ACIP
will then meet in Atlanta on 19-20 June to formulate recommendations to be presented
to the CDC and DHHS.
The news release is at http://www.cdc.gov/nip/smallpox/News.htm.
On 2 June, the Washington Post reported
that the CDC would dedicate one of its two maximum-containment laboratories to
smallpox-only research for an indefinite period. According to the report, the
CDC took this step reluctantly since it reduces the capacity to study other highly
lethal diseases such as Ebola. The decision was reportedly made to speed the
race to create an arsenal of protection beyond the current vaccine that is today's
only defense. Some of the research will focus on: (1) creation of a gene-based
test that could detect smallpox infection days before the characteristic rash,
possibly allowing quarantine before the person is contagious; in vitro
studies were accurate at spotting four copies of a viral gene in blood; (2) further
development of an experimental smallpox test that is capable of diagnosing a new
mutant version of the related Vaccinia virus that could prove crucial in
pinpointing the source of an outbreak; (3) completion of gene mapping and hunting
for a safer vaccine and new drug targets. The report is at http://www.washingtonpost.com/wp-dyn/articles/A46413-2002Jun2.html.
The Veterans Administration recently posted
pocket guides on (1) Biological Terrorism, (2) Terrorism with Ionizing Radiation,
and (3) Chemical Terrorism, which are available at http://www.oqp.med.va.gov/cpg/BCR/BCR_Base.htm.
The WHO recently released two updated fact
sheets: poliomyelitis and non-polio enteroviruses. The ten polio-endemic countries
are divided into areas with high-intensity transmission (India, Pakistan/Afghanistan,
and Nigeria/Niger) or low-intensity transmission (Somalia/Sudan/Ethiopia, Angola,
and Egypt). Enteroviruses are found worldwide and humans are the only known natural
hosts. Transmission is increased by poor hygiene and overcrowded living conditions.
These viruses are resistant to many disinfectants but remain susceptible to chlorinated
bleach or iodized disinfectants. Enteroviruses can result in the closing of schools
or childcare facilities in order to reduce transmission especially among young
children. The poliomyelitis fact sheet is at http://www.who.int/inf-fs/en/fact114.html,
and the non-polio enterovirus fact sheet is at http://www.who.int/inf-fs/en/fact174.html.
BSE - Israel
On 4 June, the Jerusalem Post announced that a 10-year old Holstein
cow born in Beit She'an and raised in the Golan Heights area died earlier in the
week from symptoms suggestive of BSE. According to ProMED-mail, the Chief Veterinary
Officer of Israel stated that confirmatory results were positive for BSE on 4
June. The cohorts (3) of the deceased cow and her two living progeny have been
put under quarantine pending destruction. The slaughter of bovines older than
30 months throughout Israel was banned since the preliminary diagnosis. A planned
BSE-control action scheme is being put into operation, which includes testing
of all slaughtered cattle over 30 months of age and destruction of all specified
risk material. Israel banned mammal meat-and-bone meal from the UK in 1988 and from all countries
in 1990. The reports are at http://www.jpost.com/NASApp/cs/ContentServer?pagename=JPost/A/JPArticle/Full&cid=1022691079156
and http://www.promedmail.org/pls/askus/f?p=2400:1001:244576::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,18410.
On 26 May, the WHO
announced that Inter-Agency Cholera Task Forces have been put in place in Kabul,
Faizabad, Mazar, Herat, and Jalalabad due to increasing concerns about cholera
outbreaks with the onset of warm weather during the summer months. Lack of latrines
and safe drinking water are particular concerns. The task forces conduct preventive
activities such as health education, chlorination of shallow well and water sources,
disease surveillance, transport of lab specimens to confirm outbreak(s), and preparation
of medical supplies. Malnourished children are particularly prone to death from
diarrhea. Outbreak season in Afghanistan is mid-June through the end of August.
The WHO states that half of Afghanistan's children have stunted growth due to
malnutrition. The report is at http://www.who.int/disasters/repo/7758.doc.
On 30 May, AFMIC reported that warmer weather
will likely lead to an increase in cases of CCHF in Iran. The report is at
http://mic.afmic.detrick.army.mil/
(requires registration).
On 22 May, the WHO
reported an estimated 200,000 cases of CL in Kabul. The WHO predicts that repatriation
efforts and movement of IDPs will likely increase the incidence of this disease
within the coming months. CL has been endemic in Afghanistan for several years
with foci of zoonotic (animal reservoir to human) transmission mainly in the northern
provinces and anthroponotic (human to human) transmission usually in large cities.
The WHO is collaborating with other agencies to form an emergency action plan
to control the spread of CL in Kabul by the end of 2003. Priority interventions
include provision of impregnated bednets, early treatment of cases with first
line drugs, recruitment and training of intervention teams, and health education.
The report is at http://www.who.int/disease-outbreak-news/n2002/may/22may2002.html.
On 28 May, the British Broadcasting Council (BBC) News reported that an
Iranian radio station announced that an outbreak of malaria was occurring in the
Balkhab in the northern province of Sar-e Pol Province in Afghanistan. According
to the report, deaths had occurred. No further information was provided.
On 21, 25, and 30 May, ProMED-mail reported on an outbreak of an unknown
etiology resulting in 35 cases with 10 deaths in the village of Malik, which is
10 kilometers from Moro near the Indus River. Symptoms include a blackening of
the patient's hands and feet followed by swelling of the head, severe fever, and
death. According to the reports the "classic" causes of epidemic gangrene
are ergotism and typhus. The reports can all be accessed at http://www.promedmail.org/pls/askus/f?p=2400:1001:243573::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,18370.
On 4 June, the UN
OCHA reported that
an Afghanistan NGO, an implementing partner of
the UN's mine-action programme [sic], would conduct a three-month survey to determine
areas affected by UXO in Kabul, the southern province of Kandahar, the northern
provinces of Konduz and Mazar-e-Sharif, and Paktia in the east. The survey will
include an environmental damage assessment caused by the UXO and will identify
mines in areas that were previously inaccessible during the ongoing civil war
in Afghanistan. According to the report, Afghanistan is one of the most heavily
mined countries in the world, with up to 300 people dying from UXO and mines every
month. The report is at http://www.irinnews.org/report.asp?ReportID=28120.
BSE - Poland
On 31 May, the OIE
clarified information regarding the destruction of three cows during an investigation
into the first BSE case detected in Poland on 4 May. Because the identification
and registration system in Poland has not been finalized, Polish authorities decided
to perform genetic tests to confirm the relationship between two animals kept
in the same pen with the cow diagnosed with BSE and another cow thought to be
the mother. The tests revealed no relationship with the two cohort animals but
did confirm the relationship with the cow considered to be the mother of the case.
The investigation will continue to establish the genealogy of the case and a feed
history. The report is at http://www.oie.int/eng/info/hebdo/AIS_69.HTM
- Sec0.
On 31 May, the UN
OCHA reported that
Malawi's existing health challenges of cholera, malnutrition, malaria, and HIV/AIDS
have been joined by 71 cases of bubonic plague reported in the far south of the
country since April. Outbreaks of bubonic plague have occurred in the Nsanje
district, the southernmost part of the country, since 1994 with the number of
cases peaking at 304 in 1999. However, there were no reported cases for the two
years before April. According to the report, bubonic plague has also been reported
in Mozambique, resulting in cross-border collaboration. The report is at http://www.reliefweb.int/w/rwb.nsf/480fa8736b88bbc3c12564f6004c8ad5/65c64abc437a44be49256bcd000b30cd?OpenDocument.
On 30 May, the Eurosurveillance Weekly reported the first outbreak of cryptosporidiosis
associated with a public water supply. The outbreak was identified when the Department
of Public Health noted that the number of cases reported by a laboratory had increased
to 13 cases in April-May from a background of one to two cases per month. The
contaminated water source was a spring-fed lake serving a population of about
25,000. The water was chlorinated but not filtered. The area surrounding the
lake is predominantly farmland. Cryptosporidium oocysts were detected
in one domestic tap sample, two filtered samples from the lake, and environmental
samples taken at a number of farms in the area. Meteorological data revealed
a period of dry weather followed by very heavy rains, which would have facilitated
the ingress of animal excrement into the lake. The outbreak remains ongoing.
Water testing is continuing and remedial measures for farming practices are being
undertaken. The local authority is planning to implement a filtration system.
The report is at http://www.eurosurv.org/2002/pfp/020530_pfp.htm.
On 28 May, the UN
OCHA reported the Zimbabwe
government had declared a state of emergency, effective for six months, due to
HIV/AIDS. The declaration will allow the government and other authorized people
to make or use any patented drug used in the treatment of HIV/AIDS or HIV/AIDS-related
conditions. According to the report, confusion exists regarding which specific
drugs were targeted for importation and/or manufacture. The report is at http://www.irinnews.org/report.asp?ReportID=27998.
On 30 May, the CDR
Weekly reported an outbreak of NLV from a district general hospital in northeast
London. Four cases were identified on 21 May with cases increasing by 10-15 new
cases per day. NLV was identified by electron microscopy in three of the early
cases. Over 80 patients and 70 staff were affected across 13 different wards,
including an elderly care ward and an intensive care treatment unit. The Emergency
Department was closed temporarily. Symptoms included mild-to-moderate diarrhea
and vomiting lasting 24-48 hours. A prominent symptom is projectile vomiting,
which can lead to widespread environmental contamination and indirect but rapid
person-to-person spread. According to the report, NLV is the most common cause
of infectious intestinal disease in the UK,
Netherlands, and the US. The report is at http://www.phls.co.uk/publications/CDR
Weekly/PDF files/2002/cdr2202.pdf.
On 30 May, the BBC News reported that the first group of UK supplementary
nurse prescribers would be fully qualified by the end of the year. The nurses
will be able to prescribe treatments for long-term conditions such as asthma and
diabetes as well as hormone replacement therapy and anti-coagulation treatment.
The report is at http://news.bbc.co.uk/hi/english/health/newsid_2016000/2016110.stm.
On 27 May, the UN
OCHA reported that
no human activity is possible at Gao Poudriere and at a site near the village
of Tin-essako in northern Mali due to expired pesticide contamination of 20,000
metric tons of earth. The areas have reportedly been walled in and their soil
covered with a film of plastic to prevent water runoff from contaminating other
areas. Annefice, a polluted well near Gao Poudriere, has been closed since 1998.
According to the report, the dieldrin content at Gao Poudriere is 1,190 mg/kg
of earth. Dieldrin is a restricted use insecticide because it accumulates in
animal tissues. The report is at http://www.irinnews.org/Report.asp?ReportID=27978.
On 31 May, the CDC
reported that workers at the WTC site were not exposed to hazardous levels of
toxic air contaminants (such as asbestos and silica dust) during 18 September
- 4 October rescue and recovery operations after the 11 September terrorist attack.
High exposures to carbon monoxide (CO) and cadmium during specific job tasks were
found. One torch cutter was overexposed to cadmium; another worker was overexposed
to CO while cutting metal beams with an oxy-acetylene torch or a gasoline-powered
saw; and two more were possibly overexposed to CO. NIOSH has issued guidelines
for addressing a variety of occupational safety and health hazards at similar
disaster sites, which is available at http://www.cdc.gov/niosh/emhaz2.html.
The report is at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5121a1.htm.
On 24 May, Newsleader.com reported that a spokesperson for the Virginia
Department of Agriculture stated that the average number of farms quarantined
per week had dropped from between four and 11 during the past few months to 2.5
during the past week. The comment was made at the first farm out of at least
165 farms to refuse a depopulation order. Reporters described strict biosecurity
measures to prevent the spread of the virus, which can be carried by wind, vehicles,
birds, or people. The report is at http://www.newsleader.com/news/stories/20020524/topstories/370752.html.
On 24 May, the Oregon Department of Human Services announced that influenza
B was identified as the source of illness among schoolchildren in Klamath County.
The influenza B cases were discovered as part of a public health investigation
into higher-than-average levels of absenteeism in a few Klamath County schools.
The specific strain of influenza B is not yet known. Public health officials
are not recommending vaccination based on inconclusive testing, the fact that
influenza B typically causes mild illness, and the fact that cases of influenza
B/Victoria lineage were identified in the US during the 2001-02 influenza season.
The 2001-02 influenza vaccine B component is expected to provide lower levels
of protection against viruses of the influenza B/Victoria lineage. The report
is at http://www.ohd.hr.state.or.us/news/2002/0524acd.htm.
On 28 May, the Central and Northern Regional Trauma Advisory Councils of
Emergency Medical Services (EMS) Region I announced that a MASCAL exercise would
occur from 3-9 June and involve 13 counties of central and northern New Mexico.
EMS Region I contains over 50% of the state's population and handles over 80%
of the 911 response calls. The exercise will use the Simple Triage and Rapid
Treatment (START) system. START uses a standard process for the classification
of patients, using color-coded tags associated with the severity of the injury
or illness. The debriefing will evaluate successful and best practices, as well
as identify areas for performance and process improvement. The report is at http://www.health.state.nm.us/press/05-28-02Triage.htm.
On 30 May, the FDA announced that a final rule, which was published in the
Federal Register on 31 May, would help improve the nation's ability to respond
to emergencies, including terrorist events. Under this new rule, certain new
drug and biological products used to reduce or prevent the toxicity of chemical,
biological, radiological, or nuclear substances may be approved for use in humans
based on evidence of effectiveness derived only from appropriate animal studies
and any additional supporting data. Products evaluated for effectiveness under
this new rule will be evaluated for safety under preexisting requirements for
establishing the safety of new drug and biological products. The report is at
http://www.fda.gov/bbs/topics/NEWS/2002/NEW00811.html.
On 4 June, the DHHS
announced a series of grants totaling more than $30 million to help ease the shortage
of nurses across the country. The grants will help pay for education and to increase
the number of nurses with advanced degrees. The DHHS Secretary had identified
the nursing shortage as a critical national priority early in his tenure. The
report is at http://www.hhs.gov/news/press/2002pres/20020604.html.
On 29 May, the Texas Department of Health announced that it had ended an
eight-week long investigation of a salmonellosis outbreak in people who had consumed
food or beverages at the Wyndham Anatole Hotel in Dallas in March and April.
The investigation found that a hotel food-service worker who did not have symptoms
of the illness but who later tested positive might have been the source of the
outbreak. The food most commonly consumed by those who tested positive for salmonellosis
was salsa, which was made in the hotel. Some 50 people were confirmed to have
salmonellosis and 650 people from all 50 states reported having had symptoms consistent
with the illness. Nine other food service employees also became ill and tested
positive for Salmonella. Preventive countermeasures taken during the outbreak
included serving bottled water, purchasing commercially prepared ice, temporarily
relocating the main banquet food preparation to a secondary kitchen, and requiring
food handlers to show negative tests for Salmonella before being allowed
to work. The report is at http://www.tdh.state.tx.us/news/b_new417.htm.
On 31 May, the FDA
announced a nationwide recall of Miracle Leg Paintฎ for horses because the
product contains a mercuric chloride blistering agent, a poison to animals and
humans. All products remaining on the market are subject to this recall. Consumers
and veterinarians who have purchased this veterinary drug are advised to not use
it but to instead destroy the product by contacting their local waste management
services. The product was distributed nationwide to veterinarians, dealers, and
consumers. The report is at http://www.fda.gov/oc/po/firmrecalls/equine05_02.html.
On 26 May, ProMED-mail reported the third equine death in Louisiana for
this year occurred earlier this month. Although no cases in humans or animals
have been found in Texas, a health official reportedly said infection was "imminent."
The report is at http://www.promedmail.org/pls/askus/f?p=2400:1001:244750::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1010,18333.
On 23 May, the Hong Kong Department of Health announced
the confirmation of the first cholera case for 2002. An 81-year-old woman living
in Kwun Tong had diarrhea on 12 May and was admitted to the hospital on 22 May.
A total of 38 confirmed cholera cases were reported in Hong Kong last year (2001)
of which 25 were considered locally-acquired. The report is at http://www.info.gov.hk/dh/new/bulletin/02-05-23e.htm.
On 3 June, NineMSN reported that South Korea had confirmed
a new case of FMD in pigs at a farm in Pyongtaek, 70 kilometers south of Seoul.
According to the report 1,551 pigs were ordered destroyed on the 13th farm to
be hit by the epizootic. The new case was outside the quarantine cordon around
the other 12 farms. Quarantine authorities have already slaughtered more than
120,000 animals since the first case was reported on 2 May. Pyongtaek is 30
kilometers south of Suwon, one of 10 South Korean cities holding World Cup matches.
The European Union has warned football fans to be careful about their movements
to avoid spreading the outbreak. The report is at http://news.ninemsn.com.au/Health/story_32915.asp.
On 1 June, the New York Times reported that
China plans to vaccinate all newborns against hepatitis B within the next five
years. According to the report, about 60% of Chinese people will get the hepatitis
B virus, and 10% will become chronic sufferers. Liver cancer, although rare
in the US, is the leading cause of cancer deaths in China. UN studies have demonstrated that 1/3 of Chinese children
have contracted hepatitis B by the time they are five years old. Funding for
the program will include money to purchase vaccines, train health care workers,
and provide 500 million syringes with a disabling device to prevent reuse.
A major route of transmission is through the reuse of syringes. The report
is at (requires free registration) http://www.nytimes.com/2002/06/02/international/asia/02HEPA.html.
On 31 May, the OIE reported that the Department of Animal Protection
in Chile had detected a higher than normal mortality rate among hens in a hen
breeding farm in the Province of San Antonio, Fifth Region (Valparaํso). Preliminary results indicate serological evidence
of avian influenza infection using ELISA and
AGID. Pending tests will
determine if the virus strain involved has the virulence of highly pathogenic
avian influenza (HPAI). This is the first time that positive serology of avian
influenza has ever been detected in Chile. Since January 2000, more than 70,000
serological tests have been performed with negative results. The report is
at http://www.oie.int/eng/info/hebdo/AIS_69.htm.
On 4 June, ProMED-mail reported that the Venezuelan
health authorities have issued an epidemiological alert in several regions of
the country due to a dramatic increase in the number of cases of several infectious
diseases, e.g., malaria, measles, and dengue fever. According to the report
the situation regarding dengue fever is particularly alarming with 18,330 cases
reported in the whole country of which 9% have dengue hemorrhagic fever. The
number of cases reported represents an increase of 7,784 cases (73.8%) compared
to the same period last year. The states most severely affected are Zulia (6,542),
Lara (2,002), Merida (1,893), and Tachira (1,135). The report is at http://www.promedmail.org/pls/askus/f?p=2400:1001:244804::NO::F2400_P1001_BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,18395.
On 31 May, the International Federation of the Red
Cross and Red Crescent Societies reported significant flooding in Costa Rica,
Honduras, Nicaragua, and Panama. In Costa Rica, an estimated 8,000 families
have been affected with 600 houses damaged, one bridge destroyed, and 6,000
people evacuated of which 4,800 remain in shelters. Wells have been contaminated
and rural aqueducts destroyed. The province of Lim๓n was most severely affected. In Honduras floods
and landslides have affected 13 communities of which three have been totally
cut off by floodwaters. The departments of Olancho, Francisco Morazแn, El Paraํso,
and Valle are most severely affected. In Nicaragua the government declared
a status of yellow alert and launched a request for international assistance
after torrential rain flooded hundreds of homes and damaged roads and bridges.
Approximately 9,000 people have been affected of which 2,000 people have been
evacuated, mostly in Managua and on the Pacific coast. In Panama, flooding
and landslides occurred in Bocas del Toro, several districts of Panama City,
and in San Miguelito where a total of 1,500 people are affected. Weather forecasts
called for rain to continue. A Nicaraguan health official predicted an increase
in illness as stagnant pools of water serve as a breeding ground for the vectors
of dengue and malaria. The reports are at http://www.ifrc.org/cgi/pdf_appeals.pl?rpts02/cmfloods3.pdf and http://www.reliefweb.int/w/rwb.nsf/6686f45896f15dbc852567ae00530132/c29326f284670bd3c1256bca0046c910?OpenDocument.
On 31 May, the International Federation of the Red
Cross and Red Crescent Societies reported torrential rains had produced flash
floods over the southern part of Haiti resulting in 12 deaths and 20 missing
persons. Housing and infrastructure were severely damaged with loss of cattle
and crops. Some roads remain impassable. A state of emergency will likely
be declared in the south of the country. In Jamaica, at least seven people
died and 240 were evacuated after seven days of heavy rain, which caused flooding
and landslides particularly in the south and east of the country. At least
145 persons will require emergency shelter for at least three months due to
severe damage to the agricultural and poultry sectors. Flooding can increase
the threat of vectorborne diseases. The report is at http://www.ifrc.org/cgi/pdf_appeals.pl?rpts02/jamfl1.pdf.
Please contact the below-listed POC for suggested improvements
and/or comments regarding this report. This report is also available on the
USACHPPM website at http://chppm-www.apgea.army.mil/Hioupdate/.
POC: Barbara E. Davis, DVM, MPH/MCHB-CS-OHD/584-7663
mailto:Barbara.Davis1@APG.amedd.army.mil
ACIP
- Advisory Committee on Immunization Practices
AFMIC
- Armed Forces Medical Intelligence Center
AFPS
American Forces Press Service
AGID
- Agar Gel Immunodiffusion
AVIP
- Anthrax Vaccine Immunization Program
BMJ
- British Medical Journal
BSE
Bovine Spongiform Encephalopathy
CDC Centers for
Disease Control and Prevention
CDR
Communicable Disease Report (England)
DARPA
Defense Advanced Research Projects Agency, the central research/development
organization for the DoD
DHHS Department of Health and Human Services
DoD - Department
of Defense
DOE Department
of Energy
DOS Department
of State
DOT Department of Transportation
EISS European Influenza Surveillance Scheme
ELISA - Enzyme-Linked Immunosorbent Assay
EPA Environmental Protection Agency
ESSENCE Electronic Surveillance System for the Early Notification of Community-Based
Epidemics
FDA Food and Drug Administration
FEMA Federal Emergency Management Agency
FMD Foot and Mouth Disease
FSIS Food Safety Inspection Service
GAO US General Accounting Office
HIV/AIDS Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome
IAEA - International Atomic Energy Agency
IDP Internally Displaced Persons
ICRC International Committee of the Red Cross
IRCS International Red Cross Society'
MOU - Memorandum of Understanding
MSDS - Material Safety Data Sheet
NAS National Academy of Sciences
NGO - Non-Governmental Organization
NIH National Institutes of Health
NIOSH National Institute for Occupational Safety and Health
NRC Nuclear Regulatory Commission
OCHA - Office for the Coordination of Humanitarian Affairs
OIE World Organisation [sic] for Animal Health
OSHA - Occupational Safety and Health Administration
PAHO - Pan American Health Organization
PCR Polymerase Chain Reaction
PPE - Personal Protective Equipment
TB Tuberculosis
UK United Kingdom England, Northern Ireland, Scotland, and Wales
UN United Nations
UNHCR United Nations High Commissioner for Refugees
USAID - United States Agency for International Development
USAMRIID - United States Army Medical Research Institute of Infectious Diseases
USDA United States Department of Agriculture
USPS - United States Postal Service
vCJD
- variant Creutzfeldt-Jakob Disease
VOA Voice of America, an international multimedia broadcasting service funded
by the US Government
WHO World Health Organization
WMD - Weapons of Mass Destruction
