rickettsia were established at the National Laboratory

based ASEAN Net for sharing outbreak information,

and Epidemology Center in Laos. Similarly capacity

continue to be seen as international models.  These

for bacterial, viral, and rickettsial testing was estab 

accomplishments point directly to the contributions of

lished at the joint National Institute of Public

DoD GEIS to the second objective of the PDD which

Health/NAMRU 2 lab in Cambodia, and leptospirosis

states that U.S. agencies will 

diagnostics were strengthened at the Pasteur Institute

in Vietnam.  All of this technology transfer was

  work with other nations and international

done in the context of protocol driven surveillance

organizations to establish a global disease surveil 

collaborations.

lance and response system, based on regional hubs

and linked by modern communications. 

NAMRU 2 has continued to offer popular regional

outbreak response training workshops and assisted

During the fiscal year NAMRU 2, in partnership with

with outbreak investigations in Cambodia (malaria),

the Indonesian Ministry of Health, received provisional

Laos (dengue), and Indonesia (dengue and hepatitis

approval for a U.S. patent for EWORS.  It also upgrad 

A).  In August 2001, 30 students from Vietnam

ed the EWORS software.  EWORS surveillance was

attended one of these 10 day workshops conducted

expanded to seven hospitals in Vietnam through a

collaboratively with the Ministry of Health.  In

partnership with the Pasteur Institute and arrangements,

response to a call by the November 2000 Asia Pacific

including necessary translation, were made to expand

Economic Cooperation (APEC) Leaders Summit for

EWORS to Laos.  By the end of the fiscal year, over

a regional emerging infections plan, this course was

500,000 EWORS entries, often from some of the

conducted as part of the U.S. government response

most remote and economically depressed parts of the

and under the official sponsorship of the APEC.

region, were available for instant syndromic trend

Previous workshops have been held in Indonesia,

analysis.  This tool has facilitated the recognition and

Laos, and Cambodia.  NAMRU 2's innovations in

characterization of four large outbreaks in Indonesia.

electronic public health surveillance, headlined by

It has been credited with providing early detection of

the expanding syndromic, near realtime Early

an incipient problem with dengue hemorrhagic fever

Warning Outbreak Recognition System (EWORS)

in Bali, allowing for timely procurement of essential

and by the design and implementation of the web 

blood products with consequent reductions in mor 

NAMRU 2 GEIS program conducts an Outbreak Response Training Workshop in

Vietnam in response to APEC's call for action against emerging infections.

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