bidity. EWORS surveillance data from Cambodia

ASEAN Health Initiative at the ASEAN Health and

also helped preclude costly but off target disease

Development Secretariat Meeting held in October

responses to severe flooding.  

of 2001.  

ASEAN Net, a direct outgrowth of the joint

NAMRU 2 supported during FY 2001 targeted surveil 

NAMRU 2/Indonesian Ministry of Health September

lance into important causes of enteric and hemorrhagic

2000 regional action conference on emerging infections

diseases.  Based on surveillance work done in

surveillance and response funded by U.S. Pacific

Indonesia, Laos, Vietnam, and Cambodia, leptospirosis

Command reported in last year's annual report, aims

appears to be one of the more important causes of

to facilitate rapid yet confidential dissemination of

febrile disease.  NAMRU 2 supported surveillance of

outbreak information within the region, catalogue

U.S. troops involved with humanitarian and Joint Task

regional expertise and laboratory capabilities, and

Force Full Accounting operations in Laos, Cambodia,

disseminate information on training opportunities.

and Vietnam.  Personnel are screened in Hawaii

ASEAN Net was officially adopted as part of the

before deployment and in Thailand after exposure.

In prior years, important early findings

were published suggestive of in vivo

drug resistance associated with

Orientia tsutsugamushi. Final results

are pending. Serologic surveillance of

Gurkha troops and their families based

in Singapore before and after their six 

month home leave to Nepal is also

ongoing.

During FYs 2000 and 2001 surveillance

of 6,760 hospitalized children and

adults with several diarrheal diseases

yielded isolations of Shigella flexneri

(39%), Salmonella spp. (26%), Vibrio

spp. (17%), Shigella sonnei (7%),

Campylobacter jejuni (4.4%),

Salmonella typhi (3%), and Shigella

dysenteriae (2.3%). S. dysenteriae

reemergence was noted in Bali,

Kalimantan, Batam, and Jakarta after

an apparent absence of 15 years.  All

bacterial isolates were susceptible to

quinolones, with the exception of C.

jejuni and Salmonella spp., which

were resistant to ciprofloxacin,

norfloxacin, and nalidixic acid.

These findings highlight the decline

of V. cholerae, the rise of S. flexneri,

and the reemergence of S. dysenteriae

in Indonesia. 

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