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EID Weekly Updates

EID Weekly Updates:

Emerging and Reemerging Infectious Diseases, Region of the Americas

Vol. 1, No. 26—31 December 2003
Main Updates index

Suspected SARS case in Guangdong, China

On Friday, 26 December, the Ministry of Health of China informed the World Health Organization about a suspected case of Severe Acute Respiratory Syndrome (SARS) in a hospital in Guangzhou, Guangdong province.

The patient, a 32-year-old television producer from Guangzhou, is in isolation in a hospital. His condition is stable, and his temperature has been normal for three days. The patient developed fever and headache on 16 December. On 20 December, he sought medical assistance at Zhongshan University 1st Affiliated Hospital and was diagnosed as having pneumonia. Chest x-rays showed changes in the lower right lung. He was placed in isolation, and on 24 December was transferred to the Guangzhou 8th People's Hospital.

Laboratory tests have been performed by three laboratories: two in China's Center for Disease Control (CDC), and one in Guangdong’s provincial CDC. The Ministry of Health has informed that the results indicate the possibility of SARS CoV infection. However, results at this stage are inconclusive, and further tests need performed. WHO has suggested that samples be sent overseas for international verification of the results.

Epidemiological investigations show that in the two weeks prior to the onset of symptoms the patient had no known contact with high-risk groups, such as health workers or animal handlers. The patient had remained in Guangzhou and had not eaten wild animal products. The source of the suspected SARS infection is therefore unclear at this stage.

Preventive measures included identification and testing of close contacts of the patient. All these individuals are well at present, although some are still under observation. Mandatory health declarations and temperature screening checks for passengers arriving from Guangdong have been established in airports. The Ministry of Health (MOH) has alerted doctors and laboratory personnel about the incident.

The Ministry of Health and WHO are collaborating in the following areas:

  • Technical laboratory support to review test results.

  • Technical support in the areas of epidemiological investigation and infection control.

  • WHO will facilitate the shipment of additional diagnostic materials.

Although the final diagnosis of this case is still awaited, WHO has been strongly assured that all appropriate steps have been taken by health authorities to ensure that any risk to the public health has been minimized.

Sources:

Confirmed bovine spongiform encephalopathy case in the state of Washington, USA

On December 25, the bovine spongiform encephalopathy (BSE) world reference lab in Weybridge, England, confirmed preliminary diagnosis of BSE in a Holstein cow. The cow was slaughtered on December 9 at Vern's Moses Lake Meats in Washington State. This case would represent the first case of BSE in the United States.

As a precautionary measure, the farm from which the sick cow originated, in the town of Mabton, was quarantined following a preliminary diagnosis made by the United States Department of Agriculture (USDA). Mandatory tests for EEB have been imposed in cases of bovine cattle deaths in commercial farming. The Food Safety and Inspection Service (FSIS) ordered a recall of 10,410 pounds of meat from the group of 20 animals slaughtered on December 9 at Verns Moses Lake Meats.

Preliminary results of the Animal and Plants Health Inspection Service (APHIS) epidemiological investigation suggest that the affected animal likely entered the United States as part of a group of 74 dairy cattle imported through Eastport, ID, from Canada in 2001. USDA is working with Canada to ascertain the accurate age of the animal, and initiating DNA testing, and is working to trace the whereabouts of all other animals from the same shipment. It must be emphasized that there is nothing to suggest that any of the other animals in the group were affected by BSE. The USDA established the disposition of the three calves born of the index animal: one died shortly after birth in October 2001; the second, a yearling heifer, is in the index herd in Mabton, WA, under State quarantine. The third animal, the most recently born bull calf, is in a herd in Sunnyside, WA, also under State quarantine.

Risk analysis studies carried out in a number of Latin-American countries confirm that both that region and the Caribbean are free of BSE and its human form, variant Creutzfeldt-Jakob disease (vCJD). For this reason, PAHO emphasizes the need to maintain surveillance systems on the alert to detect any signs of the disease. The introduction of BSE would represent an important public health problem and could also raise the threat of commercial embargoes.

PAHO’s work in this area includes:

  • Dissemination of technical information and guides on adoption of policies formulated by international organizations and government institutions.

  • Technical cooperation with the countries of Latin America and the Caribbean to help organize epidemiological surveillance of BSE.

  • Development of a network of laboratories to optimize surveillance systems.

  • Development of shared methods among countries for confronting any detected risk.

In 2001, PAHO organized a meeting of health and agriculture ministers and BSE experts from around the world in Montevideo, Uruguay, where a report establishing the scientific bases for decision-making on BSE and meat safety in the Americas was presented.

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