A Reer-Reviewed Journal Tracking and Analyzing Disease Trends Vol.7, No.5, SepOct 2001 Emerging Infectious Diseases: The New Zealand Perspective Perspectives Emerging Infectious Diseases in an Island Ecosystem: The New Zealand Perspective.......................767 J.A. Crump et al. Implementing a Network for Electronic Surveillance Reporting from Public Health Reference Laboratories: N.H. Bean & An International Perspective....................................................... 773 S.M. Martin Cover: The Arrival of the Maoris in New Zealand (1898) by Louis J. Steele and Charles F. Goldie. Synopses Auckland Art Gallery Toi o Tamaki, bequest of Helen Boyd, 1899. Potential Infectious Etiologies of Atherosclerosis: See page 914. A Multifactorial Perspective........................................................780 S. O’Connor et al. Changing Epidemiology of Q Fever in Germany 1947–1999 .....789 W. Hellenbrand et al. Letters Cost-Effectiveness of a Potential Vaccine for Coccidioides immitis..................................................................... 797 A.E. Barnato et al. First Documentation of Rickettsia conorii Infection (Strain Indian Tick Typhus) in a Traveler Research ................................................... 909 P. Parola First Isolation of La Crosse Virus from Naturally Multidrug-Resistant Pseudomonas Infected Aedes albopictus ............................................................. 807 R.R. Gerhardt et al. aeruginosa Producing PER-1 Extended-Spectrum Serine-b-Lacta- Factors Contributing to the Emergence of mase and VIM-2 Metallo-b- Escherichia coli O157 in Africa .................................................... 812 P. Effler et al. Lactamase ................................. 910 J.-D. Docquier Clinical Consequences and Cost of Limiting Use of Vancomycin for Perioperative Prophylaxis: Jamestown Canyon Virus: Example of Coronary Artery Bypass Surgery.............................820 G. Zanetti et al. Seroprevalence in Connecticut ................................................... 911 Intraoperative Redosing of Cefazolin and Risk D. Mayo for Surgical Site Infection in Cardiac Surgery............................ 828 G. Zanetti et al. A Newly Discovered Variant of a Pneumococcal Surface Protein A of Hantavirus in Apodemus peninsulae, Invasive Streptococcus pneumoniae Isolates Far Eastern Russia .................... 912 from Colombian Children............................................................. 832 M.C.Vela Coral et al. L. Yashina Epidemiology of and Surveillance for Postpartum Infections.................................................................. 837 D.S. Yokoe et al. The opinions expressed by authors contributing to this journal do not necessarily reflect the opinions of the Centers for Disease Control and Molecular Identification of Streptomycin Prevention or the institutions with which the Monoresistant Mycobacterium tuberculosis Related authors are affiliated. to Multidrug-Resistant W Strain................................................. 842 P. Bifani et al. Dispatches Research continued Ehrlichia-Infected Ticks on Clonal Expansion of Sequence Type (ST-)5 and Migrating Birds...........................877 Emergence of ST-7 in Serogroup A Meningococci, Africa ......849 P. Nicolas et al. A. Bjöersdorff et al. Multidrug-Resistant Tuberculosis in Mycobacterium tuberculosis Beijing Prison Inmates, Azerbaijan .....................................................855 G.E. Pfyffer et al. Genotype Strains Associated with Febrile Response to Treatment ...880 Rapid Emergence of Ciprofloxacin-Resistant R. van Crevel et al. Enterobacteriaceae Containing Multiple Gentamicin Resistance-Associated Integrons in a Dutch Hospital............862 A. van Belkum et al. Lactococcus lactis subsp. lactis Infection in Waterfowl: First Confir- Topical Insecticide Treatments to Protect mation in Animals ......................884 Dogs from Sand Fly Vectors of Leishmaniasis .......................872 R. Reithinger et al. J. Goyache et al. First Epidemic of Echovirus 16 News and Notes Meningitis in Cuba .....................887 L. Sarmiento et al. International Conference on Emerging Infectious Diseases 2002................................. 913 Expanding Global Distribution of Rotavirus Serotype G9: Detection in Opportunities for Peer Reviewers ................................................................................... 913 Libya, Kenya and Cuba ..............890 N.A. Cunliffe et al. The Cover.......................................................................................................................... 914 Human Herpesvirus-8 and Other Viral Infections, Papua New Guinea ....................................................893 G. Rezza et al. A Unique Mycobacterium Species Isolated from an Epizootic of Striped Bass (Morone saxatilis) ..............896 M.W. Rhodes et al. Wind-Blown Mosquitoes and Introduction of Japanese Encephalitis The print journal is available at no charge to public health professionals into Australia ..............................900 S.A. Ritchie et al. YES, I would like to receive Emerging Infectious Diseases. Perceived Etiologies of Foodborne Please print your name and Illness Among Public Health Personnel business address in the box and ....................................................... 904 return by fax to 404-371-5449 or T.F. Jones et al. mail to EID Editor Fluoroquinolone Resistance among CDC/NCID/MS D61 Streptococcus pneumoniae in Hong 1600 Clifton Road, NE Kong Linked to the Spanish 23F Atlanta, GA 30333 Clone...........................................906 Moving? Please give us your new address (in the box) and print the number of your old mailing label P.L. Ho et al. here______________ Perspectives Emerging Infectious Diseases in an Island Ecosystem: The New Zealand Perspective John A. Crump,* David R. Murdoch,† and Michael G. Baker‡ *Centers for Disease Control and Prevention, Atlanta, Georgia, USA; †Canterbury Health Laboratories, Christchurch, New Zealand; and ‡Institute of Environmental Science and Research, Porirua, New Zealand Several unique features characterize infectious disease epidemiology in New Zealand. Historically, well-organized, government-run control pro- grams have eliminated several zoonoses. More recently, however, commu- nicable disease control has been mixed. Rates of rheumatic fever, tuberculosis, and enteric infections are high, and rates of meningococcal disease are increasing. These diseases are overrepresented in New Zealanders of Polynesian descent, who generally live in more deprived and overcrowded conditions than do those of European descent. Measles and pertussis epidemics are recurring because of inadequate vaccine coverage, despite a well-developed childhood immunization program. A progressive response to the HIV epidemic has resulted in relatively low rates of infec- tion, particularly among injecting drug users; however, the response to other sexually transmitted infections has been poor. A key challenge for the future is to build on successful strategies and apply them to persisting and emerg- ing infectious disease threats in a small, geographically isolated country with limited economic resources. Unique Historical and Epidemiologic Features countries are occupied by mammalian species. Native para- New Zealand (known as Aotearoa in Maori), a South sitic arthropods matched the limited range of terrestrial Pacific nation with a population of 3.8 million, is the largest fauna. It is thought that relatively few microorganisms capa- island group in Polynesia (Figure). It shares strong biologic ble of infecting humans existed in New Zealand before the similarities with other islands in Polynesia, although it is arrival of the first settlers. often wrongly grouped with Australia. New Zealand has sev- The first evidence of humans in New Zealand dates to eral unique features of special interest in the study of emerg- approximately 700 years ago. The colonizing Polynesian pop- ing infectious diseases. These include unusual native fauna, ulation is now known as the Maori. Strong oral and artistic lack of native terrestrial mammals, and recent incursions of traditions maintained by the Maori are not particularly exotic fauna. With exotic fauna came a limited range of revealing of early health history. zoonoses that were successfully controlled and excluded by a strict quarantine system. Furthermore, New Zealand has unusually high rates of some endemic infectious diseases and delayed impact from infectious diseases emerging in other parts of the globe. New Zealand developed from the margin of the southern landmass of Gondwana. Separation from Australia and Ant- arctica occurred 100 to 75 million years ago (1). The country is one of the most geographically isolated and remote tem- perate islands in the world. Until recently, this isolation allowed a peculiar native fauna to evolve in the absence of natural predators and incursions by exotic species. The only native mammals of New Zealand are two genera of bats (Chalinolobus spp. and Mystacina spp.). Native bird and insect species evolved to fill ecologic niches that in other Address for correspondence: John A. Crump, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Mail- Figure. New Zealand and the region of Polynesia. stop A38, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA; fax: 404-639-2205; e-mail: [email protected] Vol. 7, No. 5, September-October 2001 767 Emerging Infectious Diseases Perspectives European