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Combating Infectious Disease & Toxin Outbreaks, Natural & Man-made, through the Internet

Combating Infectious Disease & Toxin Outbreaks, Natural & Man-made, through the Internet. Jack Woodall Dept. of Medical Biochemistry Institute of Biomedical Sciences Federal University of Rio de Janeiro. ProMED Program for Monitoring Emerging Diseases <www.promedmail.org>.

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Combating Infectious Disease & Toxin Outbreaks, Natural & Man-made, through the Internet

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  1. Combating Infectious Disease & Toxin Outbreaks, Natural & Man-made, through the Internet Jack Woodall Dept. of Medical Biochemistry Institute of Biomedical Sciences Federal University of Rio de Janeiro

  2. ProMEDProgram for Monitoring Emerging Diseases<www.promedmail.org> • e-mail list & website, began 1994 • free subscribing • 30,000 subscribers (as of Nov.2004) • 150+ countries • 20,000+ archives (full text search)

  3. SARS, first report, 2003************************* • To: ProMED • Date:10 Feb. 2003 • “Have you heard of an epidemic in Guangzhou? ... An acquaintance... lives there & reports that the hospitals ... have been closed & people are dying.” • -- • Stephen O. Cunnion, MD, PhD, MPH

  4. ProMED:Pneumonia, pediatric China (Shanghai): RFI Date: 2 Nov 2004 my son Rahim Muhammad was transferred from Shnghai Childr HOsp (Beijing Road) to Fudan Hosp ICU even though the day b4 it was said he was too weak and critical to move. Now 5 children died in the same unit. My child hasnt been able to get over his pneumonia, even though he has been receiving the best treatment possible after my US embassy got involved… We had traveled on country bus to arrive in Shangh from Guandong the fews days prior to his hospitialization.

  5. ProMED:Pneumonia, pediatric China (Shanghai): (02) Date: 3 Nov 2004 From: Yang Li yangli@neuro-hemin.comSources: Strait News, Sohu.com, Sina.com.cn, Kantianxia.com, 2 & 3 Nov 2004 [in Chinese, edited] I did a Google search... 5 children died in Shanghai Children's Hospital (SCH), Beijing Road … no test results have been reported as of yet. The hospital has been under guard since the incident.

  6. ProMED:Pneumonia, pediatric China (Shanghai): (02) - more All the children had been transferred to SCH from other hospitals in Shanghai or other cities (not named). Autopsy results might take 10 days. The hospital declared that the children were mostly premature [infants] and seriously ill when transferred to SCH, but the parents denied this. One news report said there were 20 more children under close monitoring.

  7. ProMED:Mexico: West Nile Virus Infection SurveillanceData as of Thu 28 Oct 2004 Date: Thu 4 Nov 2004 Source: National Center for Epidemiologic Surveillance of Mexico web-site, Resumen Epidemiologico, Thu 28 Oct 2004 Humans: 225 seronegative and asymptomatic, one sick (Sonora state). Horses: 3065 horses from all 32 states tested: 2272 seronegative and 793 (25.9%) seropositive, all asymptomatic. Birds: 171/4660 (4%) seropositive, 2 sick (Sonora, Baja California), rest asymptomatic.

  8. CDC:West Nile virus Activity – Arizona, USAto Tue 2 Nov 2004 Date: Thu 4 Nov 2004 Source: Morbidity and Mortality Weekly Report, Fri 5 Nov 2004 / 53(43);1022-1023 Neuroinvasion 128 Fever w/o neuroinvasion 70 Insufficient clinical data 183 Total 381 Deaths 10

  9. CDC:West Nile virus Activity – Arizona, USA:to Tue 2 Nov 2004- more Blood donors: 38 presumptive West Nile viremic blood donors Horses: 109 (ca. 33% mortality) (New Mexico: 24, Texas: 67) Birds: 94 confirmed positive Squirrels: 6

  10. UNDIAGNOSED DEATHS – INDIA****** Date: 7 Nov 2004 From: ProMED Source: India Express, 30 Oct 2004 6 more lives were claimed by the mystery disease stalking [children in] western Uttar Pradesh, taking the death toll to 98… all cases appeared to be of viral encephalitis…

  11. UNDIAGNOSED DEATHS – INDIA (cont.)*********** ProMED moderator comment: […While Japanese encephalitis is the most likely etiology, one should not forget that henipavirus has been responsible for unusual encephalitis outbreaks in Bangladesh and North Bengal in India, and Chandipura virus has been implicated elsewhere in India. A lack of a definitive diagnosis of Japanese encephalitis now 6 weeks following the 1st newswire posting might be considered cause for concern. - Mod.MPP]

  12. Dengue - China (Zhejiang) Date: 30 Oct 2004 From: ProMED-mail Source: Xinhua, CEIS, 27 Oct 2004 The dengue fever epidemic in Cixi, a city of east China's Zhejiang Province, has been brought under control… To date, 80 of the 83 dengue fever patients detected have been discharged from the hospital.

  13. Dengue - China (Zhejiang) (cont.) ProMED moderator comment: [According to the Cixi town website, the town has 37 414 children in school, which translates to a total population of around 100 000. It seems rather remarkable that an outbreak of dengue could be controlled in just 2 weeks after only 83 cases, unless there is only a very small focus of the mosquito vector, or all the cases were acquired elsewhere. - Mod.JW]

  14. Dengue - China (Zhejiang) (02) Date: Tue 2 Nov 2004 14:40:29 +1100 From: Laurent Guillaumot lguillaumot@pasteur.nc … the climatic conditions also should be taken into account… if [Cixi] has a semi-temperate climate, it could be that the decreasing temperatures in October helped a lot in controlling dengue fever. Below a certain temperature, the reduced activity of the vector(s?), and even more the extension of the extrinsic incubation make virus transmission much more difficult.

  15. Yellow Fever - Bolivia******************* • From: ProMED 23 Mar 2002 • Source: El Deber (Bolivia)23 Mar 2002 • <http://www.eldeber.net/20020323/> • [in Spanish] • “The first death was registered in the Yapacani Hospital 27 Feb 2002 ...”

  16. Yellow fever - Bolivia - more****************** • From: Outbreak Verification List, • WHO, Geneva 27 Mar 2002 • Source: ProMED [23 Mar 2002] • Media reports of 4 confirmed cases including 2 deaths ...

  17. Diphtheria - Paraguay ****************** • To: ProMED 15 May 2002[posted 17 May] • In Paraguay 3 weeks ago an outbreak of Diphtheria began.... • -- • Antonio Arbo, MD, MSc • Chief of Pediatric Department • Tropical Medicine Institute, • Asuncion, Paraguay

  18. Unknown - Paraguay***************** • From: Outbreak Verification List, WHO, Geneva 22 May 2002 • Source: ProMED [17 May 2002] • 10 cases including 3 deaths... None of the cases had received DPT...

  19. Measles - Papua New Guinea*********************** • From: Outbreak Verification List, • WHO, Geneva 22 May 2002 • Source: ProMED [4 May 2002] • 1200 cases including 102 deaths (Jan-Apr 02) were reported by the media. MoH is vaccinating children aged 3 - 59 months...

  20. Unidentified fever, British troops - Afghanistan ************************ • From: ProMED 15 May 2002 • Source: BBC News Online, 15 May 2002 • “Eighteen British soldiers serving in Afghanistan have been struck down with a mystery fever. The Ministry of Defence (MoD) has confirmed that two are "seriously ill".

  21. Unidentified Fever, British Troops - Afghanistan ************************* • To: ProMED Sat. 18 May 2002 • “The epidemiological and viral results confirm Norwalk-like virus as the major cause...” • -- • Dr Angus Nicoll, Director • Dr Dilys Morgan, Dr Olof Horstick • Communicable Disease Surveillance Centre, UK

  22. Acute Respiratory Syndrome- Bosnia & Herzegovina******************* • From: Outbreak Verification List, • WHO, Geneva 3 Apr 2002 • Source: ProMED [27 Mar 2002] • 28 suspected cases of Q Fever were reported... 14 of them among UN staff...

  23. Anthrax, mail-borne - USA********************** • To: ProMED 18 Nov 2001“ProMED-mail with CNN was our main source for information through most of the recent anthrax outbreak! Keep up the good work.” • -- • D.A. Henderson, Director • Office of Public Health Preparedness, DHHS, Washington, D.C.

  24. Typhus - Sri Lanka **************** • To: ProMED 4 Sep 2001 • “We would like to propose our help to the victims of the typhus epidemic ...” • -- • Didier Raoult, Pierre-Edouard Fournier • Unité des Rickettsies • Faculté de Medecine, Marseille, France

  25. Spin-off Networks • APIC-list (Association for Professionals in Infection Control) • Brazil - LISAS • Korea - K-ProMED • Netherlands - Inf@ct

  26. ProMED: Asia/OceaniaNo. reports of outbreaks by country 1994-2003

  27. 749 Dengue 424 Ebola 265 Yellow fever 728 West Nile 422 E.coli O157 209 Unknown 597 FMD 340 Hantavirus 195 Legionella 578 Cholera 332 CJD 183 SARS 578 BSE 329 Influenza 182 Meningitis 557 Rabies 308 Salmonella 181 Hepatitis 474 Anthrax 279 Malaria 180 Newcastle ProMED: Top 21 diseases, No. of reports, 1994-2003

  28. ProMED Sponsors • Bill & Melinda Gates Foundation • Oracle Corporation • The Rockefeller Foundation • Harvard School of Public Health • Anonymous • Individual subscribers

  29. Editor Lawrence C. Madoff ISIDProgram Director Timothy Brewer Associate Editors Stuart Handysides Donald Kaye Marjorie P. Pollack Daniel S. Shapiro Jack Woodall The ProMED Team

  30. Moderators Peter Cowen Tam Garland Richard I. Hamilton Martin Hugh-Jones Larry I. Lutwick Luiz Jacintho da Silva (PORT) Eskild Petersen Craig R. Pringle Michael Service Arnon Shimshony Jaime Torres (ESP) The ProMED Team (cont.)

  31. PRO-RUS: ProMED in Russian Moderators & Correspondents: Nilufar Rakhmanova – Uzbekistan Natalia Pechnikova – Russia Alexander Vadim - Sponsored by: NTI - Nuclear Threat Initiative

  32. ProMED-mail<www.promedmail.org>is a programof theInternational Society for Infectious Diseases

  33. END

  34. Country ProMED date Official date Brazil Jan. Jan. Brazil May 8 -- Burkina Faso Oct.8 Oct.10 Cameroon Oct.10 Nov.11 Colombia July 8 June? Cote d’Ivoire Nov.14 Nov.14 Yellow fever, 2003 Comparative reporting speed

  35. Country ProMED date Official date Guinea Jan.9 Jan.20 Guinea Sep.2 --? Peru Aug.17 --? Senegal Jan.10 Jan. Sierra Leone Aug.19 Aug.19 Sudan May 23 May 27 Venezuela Aug.23 --? Yellow fever, 2003 (cont.)Comparative reporting speed

  36. Country No. Country No. 1. China 84 6. Russia 47 2. India 47 7. Japan 400 3. USA 20 796 8. Pakistan 4 4. Indonesia 23 9.Bangladesh 1 5. Brazil 464 10. Nigeria zero ProMED: No. subscribers, 10 most populous countries by rank, 2003

  37. ProMED: No. items postedPORT=Portuguese, ESP=Spanish

  38. USA 20 796 Brazil 464 Australia 1541 France 461 Canada 1387 Japan 400 U.K. 961 Italy 346 Germany 601 ... ... Netherlands 473 ProMED Top 10 subscribers

  39. National Government Subscribers May 20022581 from 26 countries

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