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The administering Power added that the provisions of market is leased by the Cayman Islands Farmers' Cooperative sanitary facilities for indigents, a rodent control programme and managed by a government-employed agricultural and the extension of refuse collection services have all marketing officer. contributed to the improvement of sanitary conditions. (...) The administering Power adds that the Public Health Law of 1981 provides basic coverage in the areas of water quality, nuisance abatement, offensive trades, prevention or suppression of disease, solid waste management and rodent control. Some administrative and programme changes have been introduced in order to strengthen environment health activities, with emphasis on water quality, surveillance, sanitation, solid waste management and rodent control.

SIN NOMBRE VIRUS The area of distribution is South and North America. The vectors are rodents, primarily deer or certain hamsters and rats.

Injuries Surveillance of morbidity following floods is limited and little information is available A community survey conducted following the 1988 floods in Nimes, France found that 6% of households reported mild injuries (contusions, cuts, and sprains) related to the flood. Vector and rodent borne diseases A small risk of vector borne and rodent borne diseases has been observed, depending on the diseases present.

; R al worked to develop a pilot project to conduct sputum testing for tuberculosis; collaborated conduct a mass canine rabies vaccination campaign as part of the rabies control program; collaborated with Ministry of Health to develop data for decision m q Sierra Leone: Provided epidemiological assistance to assess the problem of cervical in Freetown; continuing the nationw c South Africa: Tested collections of sera from healthy populations in various geographic areas for anti-hepatitis E; provided technical assistance in the area of HIV/AIDS prevention education; assisted the national AIDS council to develop program strategies and workplan participated in the first international immunization review which included the nine newly formed provinces of South Africa; provided technical assistance in the area of maternal and child health; provided consultative assistance and cooperative surveillance training materials relevant to occupational health; provided consultation on the diagnostics of congenital syphilis; made presentations and provided consultations on the area of tobacco control; assisted in the development of clinical trials of new a p Sri Lanka: Continued collaboration to investigate the ep h Taiwan: Continued collaborative studies on the antigenic and biological characteristics of alphaviruses isolated from rodents; continued collaborative studies on dengue and dengue haemorrhagic fever; provided consultation and advice on diagnosis, prevention, surveillance and control of dengue and dengue haemorrhagic fever; continued the field epidemiological training program; collaborated on studies of transmission, distribution in rodents, antibody prevalence and pathogenicity in humans of hantavirus; advised on the national nosocomial infection control program; provided consultation on epidemiologic methods and surveillance to the Department of Health; provided an overview of methods to develop and characterize o Tanzania: Participated in an evaluation of the national tube a Thailand: Investigated an outbreak of cholera among tourists and prepared a report; installed the patient tracking program and provided on-site training of personnel in its use established a cooperative research program to use c-DNA technology to develop second generation dengue vaccines; continued pathophysiologic studies of dengue fever using PC assays; provided assistance to public health officials in the development of epidemiology bulletins; provided assistance in conducting an epidemiology training course in sexually transmitted diseases; continued the field epidemiology training program; provide technic assistance in protocol development and review of HIV related tuberculosis; continued a collaborative study on heterosexual transmission of HIV under the HIV/AIDS collaboration BWC/AD HOC GROUP/CRP.4 page 7 ate a ettsia lly; ram to monitor and evaluate the medical screening xaminations provided to refugees.

• • 8/2802 English Page 9 An earlier one, which took a shorter time, had been undertaken on 15 and 16 July, when the Commission went by special plane, train and jeep via Chichihar . and Laha to visit the localities in the Kan-Nan district which had been the scene of the dissemination of plague-infected rodents (see Appendix). These places are located in Reilungchiang province on the border of IImer Mongolia.

Examples of environmental and climate factors that affect disease dynamics include rainfall and flooding, which led to the emergence of a new rodent-borne virus (Sin Nombre) in the Southwestern United States, and increase the risk of malaria, dengue, and cholera epidemics in many parts of the world; unusually warm conditions, which have been linked to food-borne disease outbreaks in Europe; and environmental modifications such as encroachment on previously forested area, which can facilitate emergence of previously unknown zoonotic diseases, such as Lyme disease in the northeastern United States. 3.