Hospital based febrile syndromic surveillance contin 

20 sites in Sangkhlaburi District.  Rapid, almost

ued this year in Kamphaeng Phet, Thailand.  Findings

immediate seroconversions indicated that pigs and

included 58 cases of EIA confirmed leptospirosis.

ducks are sensitive indicators but chickens are not.

Dip S Tick assays were also positive for Ehrlichia.

AFRIMS has also begun leptospirosis surveillance

One hundred and forty four adult dengue cases were

in a range of domesticated animals and rodents in

also serologically diagnosed, an unexpected finding

this region.  Of 245 feral rodents studied, about

since dengue is usually regarded as a pediatric illness.

10% had pathogenic strains of Leptospira grow

Another unexpected finding was seroconversion by

from kidney cultures.  

five patients to a Bartonella spp. never before described

in Thailand.  AFRIMS continued to support the DoD

The Royal Thai Army has a large medical care system

Global Influenza Surveillance Program by collecting

consisting of 37 hospitals that not only care for military

and forwarding 75 samples this FY from patients in

personnel but also many civilians.  In fact, 80% of the

Nepal and Thailand.  

patients are non military.  AFRIMS is supporting

efforts of the Royal Thai Army to establish a hospital

The strong veterinary medicine group at AFRIMS

information system network to support surveillance.

conducted adjunct surveillance efforts using sentinel

Also, for units in border regions without regular

animals.  Eighty pigs and 100 chickens and ducks

access to fixed hospitals, AFRIMS is helping to

were used for sentinel surveillance for flaviviruses at

adapt other software for syndromic surveillance.

U.S. Army Medical Research Unit   Kenya   (USAMRU K)   Nairobi, Kenya

including lack of a dedicated physician epidemiologist

to manage the program, and due to the declining

infrastructure in Kenya.  

It was possible, though, for the staff to continue sur 

veillance for diarrheal diseases in the Mathare slum

of Nairobi and among the rural Masai.  A total of

424 patients from Mathare met the case definition

between February 2000 and October 2001.  Diarrheal

specimens were also evaluated for 165 Masai from

March to November 2000.  At the Mathare site, the

overall isolation rates for diarrheal stools were 29%

Shigella spp, 19% pathogenic E. coli, 17%

Campylobacter, and 3% Salmonella.  Among the

Masai, E. coli species were the most common etiology,

accounting for 21% of all cases, followed by Shigella

As noted by the IOM,  USAMRU K is well positioned

(16%), Campylobacter (3%), and Salmonella (2%).

to meet the goals and objectives of DoD GEIS and

can substantially contribute to a global infectious

Of the E. coli isolates at the Mathare site, 100%

disease surveillance and response network.   However,

were resistant to ampicillin and erythromycin, while

FY 2001 was a major challenge to the DoD GEIS

more than 70% were resistant to tetracycline and

program at USAMRU K due to staff shortages,

sulfamethoxazole.  No resistance to norfloxacin or

31