GIDEON was quoted in a recent ProMED post related to a case of unknown hemorrhagic disease in China:

Background information on HGA in China is available on the Global Infectious Disease and Epidemiology Network (GIDEON) website.

Seropositive ruminants have been documented in Xinjiang Uygur Autonomous Region area. (see ref 1 below)
- Seropositive rodents have been documented in Jilin Province: Japanese field mouse (_Apodemus peninsulae_), Black-striped field mouse (_A. agrarius_) and Siberian chipmunk (_Tamias sibiricu_). (see
ref 2 below)
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A variety of spotted fever group Rickettsiae are reported in Spain.

The incidence of Mediterranean spotted fever cases has decreased in recent years, from 870 cases in 1989, to 234 in 2003. 77.76% of cases are reported from Andalucia, Castilla La Mancha, Castilla y Leon and Cataluna, with most occurring during July through October. 38 fatal cases were reported during 1980 to 1994.

Seroprevalence surveys:
8% of healthy persons and 26.1% of dogs in Catalonia - highest rates in seimrural areas (1997)
8.7% of persons in southern Spain (2002)
3.4% of persons in southern Spain (Bar29 infection, 2006 publication)
3.7% of persons in Catalonia (Rickettsia slovaka, 2008 publication)
56.4% of dogs in northeastern Spain (2006 publication)
24.6% of dogs in Ourense and Pontevedra (northwestern Spain, 2008 publication)
44% of cats in northeastern Spain (2006 publication)

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In an undiagnosed case of hemorrhagic disease in China, Marjorie Pollack, a ProMED editor, used GIDEON to help figure out the differential diagnosis. From the ProMED note:

Using the database of the Global Infectious Disease and Epidemiology Network (GIDEON ) to see possible etiologies for a hemorrhagic fever syndrome in China, the most likely diagnosis would be Old World hantavirus infection (57 percent probability), followed by _Streptococcus suis_ infection (40 percent), leptospirosis (1.8 percent) and Crimean-Congo hemorrhagic fever (CCHF — less than one percent probability).

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An ongoing outbreak in Denmark belies the fact that salmonellosis rates in Scandinavia have remained fairly constant during the past decade. In the attached graph rates for the United States are added for comparison. Some additional background data on salmonellosis in Denmark – source www.GideonOnline.com (more…)

A recent outbreak of suspected salmonellosis among British travelers at a hotel in Italy highlights the risk for such infections among tourists, expatriates and similar groups in transit through foreign countries. The following chronology of similar episodes is abstracted from GIDEON:

1976 - An outbreak (550 cases) of Salmonella typhimurium infection affecting 4 international air flights (Las Palmas-Helsinki, Las Palmas-Honover) was caused by contaminated mayonnaise prepared in Spain.
1985 - An outbreak (168 cases) of Salmonella minnesota infection was reported at a Filipino workers’ camp in Saudi Arabia. (more…)

Rickettsial spotted fever was first reported in Brazil in 1920.

The disease is known locally as ‘Brazilian spotted fever’ and ‘Febre maculosa brasileira’

Cases are reported in Minas Gerais, Rio de Janeiro, Bahia, Goias, Rio Grande do Sul and Espirito Santo.

Seroprevalence surveys:
10.6% of healthy students and 4.11% of dogs in the endemic areas of Minas Gerais (1998)
77.3% of horses and 31.3% of dogs in Pedreira Municipality, Sao Paulo State (2001)
1.6% of healthy persons in Minas Gerais (2005 publication)
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The following background information on Trypanosomiasis in Angola is abstracted from GIDEON:

Trypanosomiasis was first identified in Angola in 1871, in the Quixama region (Kwanza River area, south of Luanda).

A resurgence of disease rates during the 1980’s does not represent a general phenomenon for Africa, and appears to be related to civil unrest in the country. See graph

Trypanosomiasis is endemic to 7 of the country’s 18 provinces.
- Risk areas include the northern provinces of Bengo, Kwanza north and Kwanza south, Luanda, Malange, Uige, and Zaire.
- Widespread disease in the southern provinces of Kunene, Huambo, Namibe, and Huila was first reported in 2003.
- 2.5 to 4 million persons are considered at risk in 6,000 villages north of the Kuanza River.

Trypanosoma brucei gambiense predominates (mostly in the northwestern region - Zaire, Uige, Luanda and Cuenza Norte).
- Sporadic disease due to Trypanosoma brucei rhodesiense is also reported.

Tsetse flies are present in 14 of Angola’s 18 provinces.
- The local vectors are Glossina palpalis (found in Zaire, Bengo, Kwanza Norte, Kwanza Sul and Cuando Cubango), G. fuscipes ssp. quanzensis and martinii (found in Uige, Malanje, Lunda Norte and Lunda Sul), and G. morsitans (found in Malanje, Kwanza Sul, Bia, Moxico and Cuando Cubango).

Quoted in ProMED

Recent outbreaks highlight the fact that Hand, foot and mouth disease (HFM) is the second most commonly reported viral disease in Singapore. In fact, since 2001 rates of HFM have approached those of varicella. See graph.

The following data regarding Enteroviral infection in Singapore are extracted from GIDEON [primary reference available on request]

Enteroviruses are responsible for 0.2% of lower respiratory infection in the age group 0 to 20 years (1990 to 1994).

During 1996 to 1997, 44% of school children ages 5 to 12, and 50% of their mothers were found to be seropositive toward Enterovirus 71.
- Enterovirus 71 accounted for 71% of enteroviral isolates in 2000; 44.3% in 2001; 3.5% in 2002.

Epidemics of hemorrhagic conjunctivitis due to (more…)

As quoted by Steve in ProMED:

Travel-related episodes of endemic typhus are relatively uncommon.
The following chronology is abstracted from GIDEON

1997 (publication year) - Three Norwegian tourists acquired endemic typhus - in Guinea-Bissau, Crete and Thailand
1998 (publication year) - Three European travelers acquired endemic typhus in Indonesia.
1998 - Two Norwegians acquired endemic typhus - in China and Crete.
1999 - A Norwegian acquired endemic typhus in Malta
2001 (publication year) - A German tourist acquired murine typhus in Thailand.
2002 (publication year) - A traveler from Hong Kong acquired endemic typhus in China.
2003 - A Czech tourist acquired endemic typhus in Egypt.
2003 - A Japanese national developed endemic typhus in Vietnam.
2008 - Two Japanese nationals acquired endemic typhus overseas - one in Indonesia.

A recent outbreak highlights the fact that New Caledonia has one of the highest rates of leptospirosis in the Pacific region (see graph). In fact, in these islands, Leptospirosis is more common than Salmonellosis, Hepatitis A, Hepatitis B, Gonorrhea and Tuberculosis (see graph).

The following background information regarding Leptospirosis in New Caledonia is abstracted from GIDEON:

Leptospirosis is most common in west coast cattle-farming areas and rural Melanesian settings

• Disease rates are highest in the Bourail area.
• Disease rates peak during March to May.

Notes:

1. An average of 4 fatal cases are reported yearly.
2. 57 cases were diagnosed during 1983 to 1985.
3. 239 cases were reported during 2001 to 2005. The principal serogroups were Icterohaemorrhagiae (69%), Australis (8%), Pyrogenes (6%)

58% of cattle are seropositive.

The principal reservoirs in this country are rodents, pigs, horses and cattle.

The principal species are Leptospira serovars. Icterohaemorrhagiae, tarassovi, pyrogenes, canicola, australis and pomona.

• Serovar tarassovi accounts for 22% of cases, icterohaemorrhagiae 18% and pyrogenes 17%.

Notable outbreaks:
1989 - An outbreak (144 cases, 6 fatal) was reported, with 41% of the cases caused by serovar icterohaemorrhagiae.

Update: Also mentioned in ProMED

Appeared in ProMED:

The following background information on “newer” viral respiratory infections in Canada was abstracted from GIDEON:

Prevalence surveys

• Human matapneumovirus (HMPV) is found in 4.1 per cent of adults with community-acquired pneumonia (2005 publication).
• HMPV is found in 9.5 per cent of respiratory specimens from the community and 25 per cent of outbreaks; median age was 24 months (Calgary, 2007 publication).
• HMPV is found in 14.8 per cent of patients with acute respiratory tract infection (4 provinces, 2001 to 2002 influenza season).
• HMPV is found in 8 per cent of acute lower respiratory tract infections (Montreal, 2001).
• HMPV is found in 3.9 per cent of pediatric inpatients and outpatients (Alberta, 2002 to 2003).
• HMPV is found in 6 per cent of children below age 3 years hospitalized for acute respiratory tract infections (Quebec, 2001 to 2002).
• HMPV is found in 13.5 per cent of children aged under 5 years, 26.1 per cent of children aged 6 to 10 years, 32.3 per cent of children aged 11 to 15 years, 99.0 per cent of persons agd 16 to 30 years, 91.7 per cent of adults aged 31 to 60 years, 93.8 per cent of persons aged over 60 years in Saskatchewan seropositive (2007 publication).
• HMPV is found in 4 per cent of adults hospitalized with community-acquired pneumonia (Edmonton, 2008 publication).

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As reported in ProMED:
Notwithstanding the recent episode in Uganda [see: ProMED-mail post Hepatitis E virus - Uganda 20080304.0894], outbreaks of hepatitis E in Sub-Saharan Africa are rarely reported. The following summary was abstracted from GIDEON.

Botswana
1985 - An outbreak (245 cases) in Maun was ascribed to possible water contamination.

Central African Republic
2002 - An outbreak (48 confirmed cases) in Bangui may have been caused by contaminated drinking water.
2004 - An outbreak (10 cases) in Bangui was caused by contaminated water sold by a street vendor.

Chad
2004 - An outbreak (1442 cases, 46 fatal) was reported in Goz Amer and Goz Beida - Sudanese refugee camps.
2005 - An outbreak (50 or more fatal cases) was reported in the area of Goz Beida (eastern Chad).
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