From www.promedmail.org:

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Canadian case of malaria imported from the Dominican Republic
Jay Keystone, GeoSentinel Site Director in Toronto, informed us
of a case currently in the ICU in Toronto. All cases so far have been
short-term resort travelers to the Punta Cana and adjacent areas, and many
have presented as extremely ill with high parasitemias and life-threatening
disease.
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Some Key Points for Healthcare workers:

1. Physicians should give people the right advice about prophylaxis for travel (CDC has changed their recommendations: Revised Recommendations for Malaria Prophylaxis in Dominican Republic)
   
2. People should be vigilant for symptoms of malaria in ill travellers returning from the Dominican Republic.
   
3. Treatment should be available to patients anywhere in Ontario.

Access PDF document here: Laboratory Biosafety Manual - Third Edition

Pigs are susceptible to infection from avian and human forms of influenza viruses. It is believed that if both types of viruses infect the same pig, it could potentially result in a genetic exchange of the influenza segmented genome. Such an occurrence has the potential to produce a new, pandemic influenza strain.

WHO Press Release: H5N1 detected in pigs in China

WHO Press Release: Implications of H5N1 infections in pigs in China

The case is a 20-year-old nurse who developed SARS-like symptoms in Beijing on 5 April and was admitted to hospital on 7 April. As her condition did not improve, she was transferred on 14 April to a second Beijing hospital, where she was placed in intensive care. Results of initial blood tests, received today, indicate a likely infection with the SARS coronavirus. However, further testing is needed before a diagnosis of SARS can be confirmed.

Contact tracing has identified 171 contacts, who have been placed under observation. Of these, five have developed fever.

To access the WHO update, click here.
To access the China Daily news article, click here.

A new case of laboratory-confirmed infection with the SARS coronavirus (SARS-CoV) has been reported today by the Ministry of Health in China. This is the fourth case (3 confirmed and one probable) detected in China since 16 December 2003.

To access the entire WHO update, click here.

Health authorities in China announced a second laboratory-confirmed case of SARS in the southern province of Guangdong on 17 January 2004. The patient, a 20-year-old female waitress, has fully recovered and has been discharged from hospital. None of her known contacts have shown any signs or symptoms suggestive of SARS and the observation period has now ended. Two laboratories in the WHO SARS Reference and Verification Laboratory Network verified the test results. WHO now considers this individual to be a confirmed case of SARS coronavirus (SARS-CoV) infection.

A third person – a 35-year old business man – fulfils the WHO laboratory case definition for probable SARS described in the document ‘WHO SARS Reference and Verification Laboratory Network: Policies and Procedures in the Inter-Epidemic Period’ . He has tested positive for SARS-CoV infection at a national reference laboratory in China and on preliminary serological tests performed by WHO SARS International Reference and Verification Network laboratories in Hong Kong. He was discharged from hospital on 21 January.

To access the entire WHO review, click here.

According to the World Health Organization, genetic tests of the influenza A (H5N1) strain currently in Asia reveal that this strain is resistant to the popular anti-influenza drugs amantadine and rimantadine. A single amino acid replacement is enough for a flu strain to gain resistance to amantadine and rimantadine. Fortunately, the neuraminidase inhibitors Oseltamivir and Zanamivir are still effective.

To access the Promed posting, click here.

In related news to the world of respiratory illnesses:

"As a precautionary measure, WHO is moving forward with the procedures needed to rapidly produce a new influenza vaccine capable of protecting humans against the H5N1 strain of avian influenza recently detected in Viet Nam. These procedures have been initiated following mounting concern over 5 laboratory confirmed human cases of H5N1 avian influenza in Hanoi, Viet Nam in recent weeks. All 5 cases were fatal." - WHO Update

To access the entire WHO Update, click here.

A 35-year-old man from southern China who developed a fever on Dec 31st, has become the 3rd suspected SARS case. 14 close contacts and 14 casual contacts have all been isolated and showing no symptoms. For details, click here.

A Hong Kong newspaper also reported a possible fourth suspected SARS case in Shenzhen, but this was later declared a case of bacterial pneumonia.

A new suspected case of SARS in the southern province of Guangdong was announced today by Chinese officials. The patient is a 20-year-old woman from Henan Province who works at a restaurant in Guangzhou. The patient has been under isolation since December 31, and diagnosed as a suspected case following review by a panel of Chinese SARS experts. The patient has been afebrile for the past seven days and is said to be in stable condition. For details, click here.

The 32-year-old confirmed SARS case in Southern China has fully recovered and will be discharged from hospital tomorrow. For details, click here.

Officials still do not know how the patient came in contact with the virus, but some suspect that rats may be the missing link in SARS transmission. For details, click here.

Results from laboratory tests over the weekend have led the Ministry of Health of China and the World Health Organization (WHO) to upgrade the suspected SARS case in southern China to a laboratory-confirmed case. For more information, click here.

The WHO would like to reiterate the following:

• One confirmed SARS case does not constitute an immediate public-health risk.
• It is perfectly safe for members of the public to travel to Guangdong Province.
• There is no evidence of a spread of infection from the patient to date. All the 81 identified contacts are reported to be well.
• Health authorities in Guangdong Province, together with the Ministry of Health of China and the Chinese Centre for Disease Control and Prevention, have treated this case all along as though it was SARS, using the system established following the outbreak of 2003 (including the tracing, isolation and medical observation of contacts).
• Health authorities in Guangdong Province and Hong Kong have worked together to implement safety measures in the area, in terms of travel, temperature checking and other steps in the wake of this case in Guangzhou.
• Health authorities have been using this case as a way to determine how well the current surveillance system works, and a review of the process so far in this case is already under way.

A 32-year-old man from Guangzhou is in isolation in hospital. The patient developed a fever and headache on December 16th, and was later diagnosed as having pneumonia. Chest x-rays showed changes in the lower right lung. His current condition is stable, and his temperature has returned to normal. All close contacts of the patient have been identified by public health authorities in Guangdong, and given the necessary advice. All the contacts are presently well, the authorities say.

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. For more information about this development, please click here.

The Singapore Ministry of Health provided an update on the SARS situation through a press release that can be accessed here.

The press release states that contact tracing has been completed and a total of 276 people have been identified to have come into contact with the Taiwanese SARS patient while he was in Singapore. With the stringent public health measures that are in place, the Ministry would like to assure the public that there is no cause for alarm.

The public health authorities in Taipei have reported a single case of infection with SARS coronavirus. The patient is a 44-year-old senior research scientist who was studying SARS in a laboratory at the National Defense Medical Center. The infection appears to have been acquired in the laboratory on Dec 5th, possibly due to an event where proper biosafety practices were not followed.

This event is similar the another case of SARS acquired in a research laboratory in Singapore a few months earlier. Although these events both resulted in isolated cases, they do highlight the importance of following proper biosafety practices and precautions in the laboratory.