over age 70. In the Nuweiba area (on the eastern

security restrictions imposed on the shipping of dengue

coast near Israel), West Nile prevalences were much

reference strains for the neutralization assays from the

lower, generally about 5% or less in most age strata.

U.S. to Egypt.  Among 46 nursing students in Djibouti,

There was evidence in both regions of the Sinai for

the West Nile IgG prevalence rate (as measured in a

generally low rates of transmission with Sinbus and

generic flavivirus IgG ELISA) was 88.5%, though

Sicilian sandfly fevers.  The data suggested that

proximity to a yellow fever immunization may have

Naples sandfly fever was a bit more common, though

produced cross reactions.  Among two groups of police

antibody prevalences remained less than 10% in

recruits totaling 266 persons, the overall prevalence

most age groupings.  Complete analysis of collected

was 6.8%.  Dengue titers are pending.  Dengue results

arthropods and sentinel chicken sera is pending.

from hospital surveillance are also pending though

none of 59 patients had IgM to West Nile, Sinbis,

NAMRU 3 has played an integral role in strengthening

sandfly fevers (Sicilian and Naples), and Rift Valley

WHO influenza surveillance in the region.  Training

fever.  The serosurveillance of over 800 university

of laboratorians from partner countries has been

students in Yemen documented West Nile prevalences

central to this effort.  Influenza isolates are sent to

of between 4.2% and 6.9%.

CDC influenza laboratory for detailed characterization

as indicated.  Other respiratory viruses isolated are

Like all the other DoD overseas laboratories,

being provided to the Enterovirus Section at CDC and

NAMRU 3's DoD GEIS program also conducts

to the GEIS supported respiratory infections program

antimalarial drug resistance studies. Northern Ghana

at the Naval Health Research Center, San Diego.

is the primary focus for these efforts.  In August 2001,

Since the surveillance began in 1998, over 5,120

497 children aged 6 to 20 months were enrolled in the

samples have been obtained in Egypt.  In 2000/2001

Kassena Nankana District.  They will be followed for

all subtyped influenza A viruses were A/New

the occurrence of clinical malaria and the in vivo

Caledonia/20/99 like H1N1s and all type Bs were

efficacy of chloroquine and Fansidar compared in

B/Sichuan/379/99 like.  Over the course of several

mild cases.

years, 125 cases from Syria were studied.  After over 

coming significant liquid nitrogen availability problems

NAMRU 3 also supported many regional outbreak

and investigator illness, Djibouti provided from two

investigations during FY 2001, including the first

sites 24 samples during the year, two of which were

outbreak of Rift Valley Fever on the Arabian

positive for viruses other than influenza.  Using

Peninsula, and outbreaks of salmonella and newborn

CENTCOM funds surveillance was initiated in Oman

sepsis in Egypt.  The problem with newborn sepsis

in the late summer of 2001.  In just a few months, over

appeared related to contamination of IV fluids with

300 samples were collected and analysis is pending.

several agents (mostly Klebsiella pneumoniae).  As

a result of the sepsis investigation, a project targeted

NAMRU 3 DoD GEIS program.  Serosurveys were

towards 40 hospitals was jointly developed with the

undertaken in Djibouti and Yemen and hospital surveil 

Egyptian government to evaluate laboratory capacity

lance (both rural and urban) for dengue like illness was

and initiate surveillance, to assess infection control

established in Djibouti.  Significant problems have

practices and provide training, and to monitor labo 

arisen with respect to completing the assays due to

ratory improvement.  

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