to ciprofloxacin.  Susceptibility to ciprofloxacin tended

and densities were documented in different Amazon

to hold for all bacteria tested, with the exception of

ecologies.  Tests on paired sera from febrile humans

Campylobacter. Ciprofloxacin resistance in

identified cases of infection with Caraparu and

Campylobacter appeared to vary considerably across

Venezuelan equine encephalitis viruses (VEE).  

locations, but fortunately 96% of Campylobacter

isolates were susceptible to azithromycin. Broad

The problem of acute febrile syndromes of undeter 

resistance also appeared to be on the rise for entero 

mined etiology has made standardized, lab based

toxigenic Escherichia coli.  To highlight the data

etiologic surveillance for these conditions a key

from Bolivia, the Technologic Food Institute in Sucre

NMRCD DoD GEIS program.  During FY 2001 such

sponsored a well attended drug resistance symposium

surveillance was conducted at six sites in Peru, two in

for the local medical community.  

Ecuador, and one in Bolivia.  Acute and convalescent

sera for antibody testing and agent isolations were

Mosquito surveillance in the Amazon is an ongoing

collected from patients meeting various case defini 

NMRCD program to document arboviral threats and

tions.  Among 79 samples from Ecuador, dengue type

develop insight into appropriate control.  In FY 2001

1, 2, and 3 viruses and VEE virus were isolated.

over 37,000 mosquitoes of more than 80 species were

Among 779 samples from six sites in Peru, 29 dengue

collected (when the surveillance started in 1996, only

and 5 VEE isolations were made.  Two seroconversions

25 species were known in the region of Iquitos).

to Oropouche were also noted.  Seven of 60 Peruvian

Viral isolations done with the support of USAMRIID

samples showed seroconversion to Rickettsia rickettsii.

and the University of Texas have so far yielded 16

Other screening serological studies suggested evidence

different viruses, including eastern equine encephalitis

of infections with R. typhi, Coxiella burnetii, and

virus.  Fortunately despite the fact that this potentially

Borrelia burgdorferi.  Among 117  paired specimens

deadly virus makes up the majority of isolates isolated

from febrile patients in Bolivia, no viruses could be

from mosquitoes, analyses of human sera indicate

isolated nor was evidence of seroconversion noted.

that eastern equine encephalitis virus is not the most

Clearly there are still many causes of acute febrile

likely cause of febrile illness of unknown origin.

syndromes yet to be determined.

Substantial differences in mosquito species distributions

Naval Medical Research Unit Number 2 (NAMRU 2)   Jakarta, Indonesia

Indicative of NAMRU 2's outstanding contributions

to global emerging infections surveillance and

response, during FY 2001 it was redesignated for

another prestigious four year term as a World Health

Organization Collaborating Center for Emerging and

Re emerging Diseases.  NAMRU 2's DoD GEIS

program has featured technology transfer of diagnostic

capabilities to regional partners as central to leveraging

its finite resources.  For example, enteric diagnostic

capabilities in various parts of Indonesia were

expanded beyond cholera to include campylobacter,

shigella, and enterotoxigenic Escherichia coli.

Testing capacities for dengue, leptospirosis, and

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