Two more cases of human infection with the H5N1 Avian Influenza virus were confirmed in Indonesia. One of the cases (the country's 59th case) was a 35-year-old woman from the remote sub-district of Cikelet in West Java Province. She developed symptoms on 8 August and died on 17 August. She was the third reported confirmed case from this sub-district in the past week. The other case (the country's 60th case) was a 6-year-old girl from Bekasi, an eastern suburb of Jakarta. She was receiving treatment in hospital and was recovering.

In addition, a suspected case of human infection of Avian Influenza has been reported in Simalungun regency near Medan of North Sumatra. A 35-year-old woman was admitted to hospital after showing symptoms of bird flu. Regarding the 18 suspected cases of human infection with bird flu in Cikelet, the investigation found no evidence of human-to-human transmission and no evidence that the virus was spreading more easily from birds to humans.

About 1 400 cases of Plague have been reported in Democratic Republic of Congo so far in 2006, 600 of them in June and July, compared to 800 cases for the whole year in 2005. Health workers were particularly concerned with the extremely contagious pneumonic Plague. The outbreak was near Lake Albert in northeast Ituri district.

The Beijing Bureau of Health of the Mainland reported that 70 people in Beijing have been diagnosed to have Guangzhou Angiostrongylus Meningitis. The meningitis outbreak had left 16 people critically ill. It was the first time the Guangzhou Angiostrongylus Meningitis has been found in Beijing.

The Beijing Friendship Hospital diagnosed the first case of meningitis on 24 Jun 2006 when a 34-year-old man suffered from violent headache and nausea after eating a dish of improperly cooked cold snail meat. The bureau warned people not to eat raw or half-cooked snails.

[Editor's note: The snail meat was from the Amazonian snail ("fushouluo" in Chinese), which is a host of the parasite Angiostrongylus cantonesis. Guangzhou Angiostrongylus Meningitis is a parasitic disease of the brain covering. The disease has an average latency period of 10 days. Infected people will suffer from headache, fever, vomiting and stiff neck.]

In Washington State of the USA, red tide has affected Puget Sound, Kitsap Peninsula, areas near Port Gamble, Port Ludlow and along the Strait of Juan de Fuca. Scientists were particularly worried by very high levels of the toxic organisms called Alexandrium species, which produce toxins that cause paralytic shellfish poisoning in humans. The State would close shellfish-growing areas when measurements of the toxins reach 80 micrograms (per 100 grams of shellfish meat). But many areas have been showing levels of 1000 micrograms or more, with mussels at Port Ludlow in Jefferson County containing nearly 10 000 micrograms.

[Editor's note: Shellfish poisoning results from ingestion of toxic shellfish. Bivalve shellfish such as clams, mussels, oysters, fan shells, scallops, etc. that are contaminated with toxin-producing algae are the common causes. Paralytic shellfish poisoning can be life-threatening. Symptoms are mainly neurological and their onset is rapid. Symptoms include tingling, numbness, burning sensation around the mouth, unsteadiness, fever and rash. These may last for a few days followed by spontaneous recovery. However, some severe cases may stop breathing within 24 hours of consumption of the toxic shellfish.

On 11 August, US Food and Drug Administration has advised consumers not to eat raw shellfish harvested in the Pacific Northwest because of reports of a significant increase in gastrointestinal illnesses caused by Vibrio parahaemolyticus]

In Sarawak state of east Malaysia, 13,800 children have been infected with Hand, Foot and Mouth Disease since the disease broke out early this year. The most affected areas were Sibu (3 025 cases), Miri (2 872), Kuching (2 125), Bintulu (1 761) and Sarikei (946). The disease has claimed 13 lives, including 7 who have tested positive for Enterovirus 71 (EV71).

[Editor's note: Sarawak has experienced 3 major outbreaks of human Enterovirus 71 infection, in 1997, 2000 and 2003.]

437 cases of Japanese Encephalitis have been reported in Henan province of the Mainland since July 2006, among whom 14 died.

The Hong Kong Department of Health has confirmed 3 imported cases of Dengue Fever. The first case was a 62-year-old man who developed fever and headache since 1 August. He was hospitalised on 4 August and had recovered. He had travelled to the Mainland before onset of symptoms. The second case was a 38-year-old man. He developed fever, headache and rashes and had recovered. He had travelled to Bangladesh. The third case was a 23-year-old man who developed symptoms on 18 August. He was hospitalised on 22 August and was in stable condition. He had visited India.

So far, there have been 23 reported cases this year, all were imported.

The rains and flooding in Gujarat state of India have led to an outbreak of Chikungunya Fever across the state, especially in Ahmedabad. Around 2 500 cases have been reported in the Gujarat so far.

[Editor's note: Around 100 000 cases of Chikungunya Fever had been reported from Tamil Nadu, Karnataka, Andhra Pradesh, Maharashtra, Madhya Pradesh, Gujarat and Kerala in the last 2 years. In Tamil Nadu alone, 49 567 people have been treated for the disease.]

In Lake Tahoe of the USA, health officials have identified 3 cases of tick-borne Relapsing Fever in this summer.

[Editor's note: The disease is rare and primarily found in high-altitude coniferous forests in western USA.