

The Increasing Threat of Infectious Diseases
Bergendal,
Sollentuna, Sweden, June 11-13, 2001
organised by the Swedish Institute for Infectious
Disease Control and The Swedish Defence Research Authority on behalf of the
Swedish Ministry of Foreign Affairs
FINAL REPORT
Prepared by
the team:
Dr. Tatiana Gremyakova, Ph.D., M.D.,, SPM
gremyakova@istc.ru
Dr. Diana Pobedimskaya, Ph.D., SPM
pobedimskaya@istc.ru
Mrs. Tatiana Nikolenko, SPM
nikolenko@istc.ru
Headed by:
Mr Randall Beatty, Deputy Executive Director
CONTENT
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List of Participants
. |
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Summary from Working Group A. Antimicrobial
resistance B. Surveillance C. Vector-borne
diseases |
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Workshop Abstracts
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Biosketches .
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Review of
ISTC-Bio projects
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BIO-Abstracts
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Summary
of the Workshop Results
Tthe main aim now is to promote health through the acquisition of
fundamental knowledge on disease pathogenesis, epidemiology, monitoring,
diagnosis and prevention. It is necessary to establish a communications network
between clinical laboratories, institutes and public health organizations for
more rapid and adequate care with rapid diagnosis by molecular analysis.
All these issues were
discussed during the Working Groups Discussion. The participants from USA, EU,
Former Soviet Union Republics (Russia, Ukrain, Kazakstan, Georgia, Uzbekistan) and Japan emphasized the importance of these
topics. In this regard, the following approaches should be directed to the of
greatest concern:
·
Prevent
new infections (monitoring, estimation and forecasting of the condition of
health of the population);
·
Understand
pathogenic mechanisms;
·
Develop
highly sensitive, cheap and specific methods of rapid diagnostics;
·
Develop
safe, effective and innovative vaccines against the most dangerous pathogens;
·
Develop
new, safe and effective methods of prophylaxi and therapy of infectious diseases;
·
Creation
of information systems to coordinate programs, systemize information, exchange information on
scientific research.
All the detailed results and
working materials of the Workshop are enclosed below.
List of Participants
Dr. Alim Aikimbayev
Deputy Director in Science and Epidemiological Work
14, Kapalskaya St
Almaty
480074, Kazakhstan
Tel: (3272) 356624, 358829
Fax: (3272) 367641
Email: micro@netmail.kz
Yoshichika Arakawa
Director, MD.
National Institute of Infectious Diseases
4-7-1 Gakuen
208-0011 Musashi-Murayama
Tokyo
Japan
Phone: +81 42 561 0771
Fax: +81 42 561 7173
Email: yarakawa@nih.go.jp
Dr. Albert Askarov
Kazakhstan, Agency of Health Care
Tel: 7 (3172) 317477
Fax: 7 (3172) 317456
Email: zdrav@kaznet.kz
Vladimir Astakhov
Interpreter
Tel: 7 (095) 321-42-61
Fax: 7 (095) 797-60-14
Email: tutukina@istc.ru
Dr. Bakyt Atshabar
Director, Kazakh Institute for Research on Plague Control
14, Kapalskaya St
Almaty
480074, Kazakhstan
Tel: 7 (3272) 35-75-58/88-29
Fax: 7 (3272) 36-76-41
Email: kirpc@netmail.kz
Dr. Serguei Bajan
Head of the Laboratory
State Research Center of Virology and Biotechnology Vector
Koltsovo
Novosibirsk region, Russia, 633159
Tel: (383 2) 324747
Fax: (383 2) 328831
Email: bazhan@vector.nsk.ru
Randall Lee Beatty
Tel: 7 (095) 321-42-61
Fax: 7 (095) 797-60-14
Email: beatty@istc.ru
Ruth Berkelman
Professor, Department of Epidemiology
Rollins School of Public Health
Room 440
Emory University
1518 Clifton Road
Atlanta, GA 30322
Tel: 404-727-2135
Fax: 404-727-8737
Email: rberkel@sph.emory.edu
Ivan Bezkopylny
Director, Lviv State Research Institute of Epidemiology and Hygiene
Zelena Str. 12
Lviv 79005 Ukraine
Tel: (380 322) 72-90-69
Fax: (380 322) 76 30 67
Olga Borisova
U.S. Embassy
Moscow
Russia
Email: borisovo@state.gov
Dr. Göran Bucht
Swedish Defence Research Agency (FOI)
SE-901 82 UMEÅ
Sweden
Phone: +46 90 10 66 00
Fax: +46 90 10 68 00
Email: goran.bucht@foi.se
Dr. Diego Buriot
Director of WHO/CSR office
Lyon
France
Phone: +33 4 727 6470
Email: buriotd@Lyon.who.int
Professor Elisabeth Carniel
Director of the National Reference
Centre and WHO Collaborating
Centre for Yersinia
Institut Pasteur
25-28, Rue du Docteur Roux
F-75724 PARIS
France
Mr. Dennis Curry
U.S. Embassy
Moscow
Russia
Email: curryde@state.gov
Sergei Elovsky
Interpreter
Tel: 7 (095) 321-42-61
Fax: 7 (095) 797060-14
Email: tutukina@istc.ru
Dr. Åke Forsberg
Swedish Defence Research Agency (FOI)
SE-901 82 UMEÅ
Sweden
Phone: +46 90 10 66 00
Fax: +46 90 10 68 00
Email: ake.forsberg@foi.se
Sweden
Mr. Rob Garverick
American Embassy Moscow
Office of Environment, Science and Technology
Email: garvericjr@state.gov
Professor Johan Giesecke
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 23 00
Dr. Yuri Golenyaev
Deputy Executive Director of Biopreparat Company
Russia
Tel: 8 (095) 362 26 56
Fax: 8 (095) 362 15 26
Tatiana Gremyakova
Senior Workshop Manager
Tel: 7 (095) 797-60-74
Fax: 7 (095) 797-60-14
Email: gremyakova@istc.ru
Elena Gryaznova
Senior Interpreter
Tel: 7 (095) 321-36-11
Fax: 7 (095) 797-60-14
E.mail: gryaznova@istc.ru
Peter H. Henry, Ph.D.
Director, Office for Europe and the NIS; OIRH/OPHS/OS
Department of Health and Human Services
Room 18-90 Parklawn Building
5600 Fishers Lane
Rockville, MD 20857
Tel: 301-443-9426
Fax: 301-443-0742
Email: Phenry@osophs.dhhs.gov
Dr. Shabat Hodjaev
Director, Institute of Virology
6 opt: 16 Shastri str
Centre 1 700000 Tashkent
Uzbekistan
Tel: (998 712) 24-83-26/24-79-65
Dr. Sven Hoffner
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 24 31
Fax: +46 8 30 1797
Email: sven.hoffner@smi.ki.se
Dr. Randy Hyer
WHO Headquarters
20 , Avenue Appia
CH-1211 GENEVA
Switzerland
Phone: +41 22 791 1304
Fax: +41 22 791 4893
Email: hyerr@who.ch
Dr. Gulnara Ibadova
Director, Institute of Epidemiology, Microbiology, and Infectious Diseases
700133
Tashkent sh.
Reshetov kochasi, 2
Uzbekistan
Tel: (998 712) 43-36-05
Email: reflab@phisic.uzsci.net
Email: rostok.med@online.ru
Dr. Paata Imnadze
Director, National Center of Disease Control
Tbilisi, Georgia
Tel:
Fax: 8 (99532)94 04 85
Email: ncdc@access.sanet.ge
Dr. Ingegerd Kallings
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 24 20
Jessica Kaplan
Program Specialist
U.S. Civilian Research and Development Foundation (CRDF)
1800 North Kent St., Suite 1106
Arlington, VA 22209
Tel: 703-526-9720, extension 253
Fax: 703-526-9721
Email: jkaplan@crdf.org
Ms. Maiken Karlsson
Senior Administrative Officer
Swedish Defence Research Agency (FOI)
SE-901 82 UMEÅ
Sweden
Phone: +46 90 10 66 00
Fax: +46 90 10 68 00
Email: maiken.karlsson@foi.se
Sweden
Prof. Zura Kesheleva
Science and Epidemiological Work
14, Kapalskaya St
Al-Farati st. 2,79
Almaty
480074, Kazakhstan
Tel: (3272) 356624, 358829
Prof. Vsevolod Kiselev
Deputy Director, Center for Molecular Diagnostics and Therapy
Simpheropolsky Blvd 8
Moscow
113 149 Russia
Tel: 7 (095) 113-2365
Fax: 7 (095) 113-2633
Email: svesh@aha.ru
Dr. Nikolai Klimov
Deputy Director
Research Institute of UltraPure Biopreparations
Pudozhskaya St, 7
St. Petersburg, Russia, 197110
Tel/fax: (812) 230-48-72
Fax: (812) 2304948
Email: nklimov@mail.ru
Alexandr Kosyak
Senior International Health Officer
Department of Health and Human Services
Room 18-90 Parklawn Building
5600 Fishers Lane
Rockville, MD 20857
Tel: 301-443-9426
Fax: 301-443-0742
Email: Akosyak@osophs.dhhs.gov
Dr. Birgitta Olsson Lesko
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 23 00
Dr. Pille Lindkvist
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 23 93
Dr. Victor Maleyev
Deputy Director, Central Research Institute for Epidemiology
Tel: 3055270, h 7024435
Fax: 3042209
Email: maleyev@co.ru
Dr. Vladimir M. Mikhailovitch
Engelhardt Institute of Molecular
Biology
Tel: 315 0559/135 9800
Fax: 1351405
Email lnovikova@genome.eimb.relarn.ru vmikh@aport.ru
David Morens
National Institutes of Health
Room 3149
6700-B Rockledge Drive
Bethesda, MD 20892-7630
Tel:
301-496-7453
Fax:
301-480-1594
Email:
DM270q@nih.gov
Ms. Natalia Mykhaylovska
Project Coordinator
Science and Technology Center in Ukraine
Tel.: +380 (44) 490-7150
Fax: +380 (44) 490-7145
E-mail: nataly@stcu.kiev.ua
Dr. Kensuke Nakajima
Ministry of Helath, Labour and Welfare
Deputy director, Infection Disease Control Division
1-2-2, Kasumigaseki, Chiyoda-ku
100-8045 Tokyo
Japan
Phone: +81 3 3595 2263
Fax: +81 3 3581 6251
Email: makajima-kensuke@mhlw.go.jp
Dr. Aminjon Nematov
Director, Center for Prophylaxis and Quarantine of Most Hazardous Infection
2, E. Bobokhon Street
700169, Tashkent
Uzbekistan
Tel: (998 712) 46-06-05
Fax: (998 712) 46-48-33
Dr. Sergei Netesov
Director of the Institute of Molecular Biology
State Research Center of Virology and Biotechnology Vector
Koltsovo,
Novosibirsk region, Russia, 633159
Tel: (383 2) 324747
Fax: (383 2) 328831
Email: netesov@vector.nsk.su
Tatiana Nikolenko
Senior Project Manager
Tel: 7 (095) 321-47-01
Fax: 7 (095) 797-60-14
Email: nikolenko@istc.ru
Daniel Nord
Ministry of Foreign Affairs
SE-103 39 Stockholm
Sweden
Phone: +46 405 10 00
Fax: +46 8 723 11 76
Professor Ragnar Norrby
Director-General
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 2300
Barbro Olsson-Liljeqvist
Swedish Institute for Infectious Disease Control
SE-171 82 Solna
Sweden
Phone: +46 8 457 24 68
Julie Pavlin
Walter Reed Army Institute of Research
Division of Preventive Medicine
503 Robert Grant Ave.
Silver Spring, MD 20910-7500
Tel: 301-319-9346
Fax: 301-319-9104
Email: julie.pavlin@amedd.army.mil
Dr. Kenneth Penman
Proliferation Arms Controls Secretariat, UK MOD.
DERA Porton Down,
Salisbury, SP4 OJQ
Wiltshire
UK
Phone: +44 1980 613690
Fax: +44 1980 613311
Email: kjpenman@dera.gov.uk
Dr. Mark Perkins
WHO
Avenue Appia 20
Geneva 27
CH-1211
Switzerland
Phone: +41 22 791 4141
Fax: +41 22 791 4854
Email: Perkinsm@who.int
Dr. Michel Pletschette
DG KRO/SON 1/122
European Commission
200, rue de la Leri
Bruxelles
Belgium
Phone: +39 2 2956282
Fax: +39 2 296 6252
Email: michel.pletschette.ecec.eu.int
Ms. Diana Pobedimskaya
Moscow
Russia
Tel: 7 (095) 797-47-61
Fax: 7 (095) 797-60-14
Email: pobedimskaya@istc.ru
Dr. Andrei Pokrovsky
Head of the Laboratory of Retroviruses
State Research Center of Virology and Biotechnology Vector
Koltsovo,
Novosibirsk region, Russia, 633159
Tel: (383 2) 366011
Fax: (383 2) 328831
Email: pokrovsky@vector.nsk.su
Roger Roffey
Director of Research
Swedish Ministry of Defence
Unit for International and Security Affairs
SE-103 33 Stockholm
Sweden
Phone: +46 8 405 4208
Fax: +46 8 10 26 86
Email: roger.roffey@defence-ministry.se
Elizabeth Scharl
Foreign Affairs Officer
NP/PTR Room 1480
U.S. Department of State
Washington, D.C. 20520
Tel: 202-736-4747
Fax: 202-736-7698
Email: scharlec@T.state.gov
Dr. Igor Shemyakin
Executive Deputy Director, State Research Center for Applied Microbiology
Obolensk, Serpukhov District
Moscow region, Russia, 142279
Tel: (0967) 360060
Fax: (0967) 360010
Email: info@nrciam.serpukhov.su
Thomas Shinnick
Chief of the TB and Mycobacteriology Branch
Mailstop G35
Centers for Disease Control and Prevention
1600 Clifton Road, NE
Atlanta, Georgia 30333
Tel: 404-639-1474
Fax: 404-639-1287
Email: tms1@cdc.gov
Professor Anders Sjöstedt
Department of Clinical Bacteriology
Umeå university
SE-901 85 Umeå
Sweden
Dr. Konstantin Soloviev
Head of Division for Aerosol Toxicometry
Research Center for Toxicology and Hygienic Regulation of Biopreparations
Tel: 7 (0967) 75 97 38
Fax: 7 (0967) 75 97 38
Email: toxic@online.stack.net
Thomas Lund Sörensen
International Technical Adviser
Dep. of Microbiological Research and Development
Statens Seruminstitut
Artillerivej 5
DK-2300 Copenhagen S
Denmark
Phone: +45 32 68 3191
Fax: +45 32 68 3787
Email: tls@ssi.dk
Professor. Nils Christian Stenseth
Department of Zoology,
University of Oslo,
Oslo, Norway.
Phone: +47 22 85 45 84
Fax: +47 22 8546 05
Email: n.c.stenseth@bio.uio.no
Nahoko Shindo
Senior Researcher
National Institute of Infectious Diseases
Toyama 1-23-1
Shinjuku-ku
162-8640 Tokyo
Japan
Phone: +81 3 5285 1111
Fax: +81 3 5285 1129
Email: nshindo@nih.go.jp
Irina Tutukina
Administrative Assistant
Tel: 7 (095) 321-42-61
Fax: 7 (095) 797-60-14
Email: tutukina@istc.ru
Dr. Yukinori Uchida
Director General
Kobe Quarantine Station
Toyahama-eho Hyego-ku
652-0866 Kobe
Japan
Phone: +81 78 672 9651
Fax: +81 78 672 9660
Email: y-uchida@forth.ga.jp
Dr. Vladimir Volkov
Deputy Director, State Research Center for Applied Microbiology
Obolensk, Serpukhov district
Moscow region
Russia 142279
Tel: (0967) 36010/36003
Fax: (0967) 360010
Email: volkov@gncpm.serpukhov.su
Dr. Ivan Vynograd
Chief of Transmissible Viral Infections Laboratory
Lviv State Research Institute of Epidemiology and Hygiene
Zelena Str. 12
Lviv 79005 Ukraine
Tel: (380 322) 76 31 43
Fax: (380 322) 76 30 67
Andrew Weber
Special Advisor for Threat Reduction Policy
The Pentagon, Room 3C288
Washington, D.C. 20301-2900
Tel: 703-693-0289
Fax: 703-614-4365
Email: andyweber@aol.com
A. Work Group on Antimicrobial
Resistance
Participants:
Yoshichika Arakawa, National Institute of Infectious Diseases, Japan
yarakawa@nih.go.jp
Alim Aikimbayev, Kazakh Institute for Research on Plague Control
micro@netmail.kz
Vsevolod Kiselev, Research Center for Molecular Diagnostics &
Therapy, Russia
e.severin@mtu-net.ru
Thomas Shinnick, CDC, USA
tms1@cdc.gov
Kenneth Penman, MOD,UK
kjpenman@dera.gov.uk
Vladimir Mikhailovich, Engelhardt Institute of Molecular Biology, Russia
vmikh@aport.ru
Sven Hoffner, Swedish Institute for Infectious Disease Control, Sweden
sven.hoffner@smi.ki.se
Andrei Pokrovsky,Vector, Russia
pokrovsky@vector.nsc.ru
Thomas Lund Sørensen, SSI (WHO-representative), Denmark
tls@ssi.dk
Igor Shemyakin, GosNIIPM (Applied Microbiology), Russia
shemyakin@nrciam.serpukhov.su
Ingegerd Kallings, Institute of Infectious Disease Control, Sweden
ingegerd.kallings@smi.ki.se
Barbro Olsson-Liljequist, Institute of Infectious Disease Control,
Sweden
barbro.olsson-liljequist@smi.ki.se
Diana Pobedimskaya, ISTC, Russia
pobedimskaya@istc.ru
Paata Imnadze, Natinal Center for Disease Control, Georgia
nede@access.sanet.ge
Projects in the area of antimicrobial resistance should contain considerations of the
following:
·
Collaboration
between several institutions is encouraged. In particular, collaboration
between research institutions and clinical microbiology laboratories. The
partners should preferably be institutions abroad as well as institutions in
the same country.
·
Projects
of surveillance of antimicrobial resistance should be initiated in
collaboration between relevant professional groups e.g. clinical microbiologists,
hospital infection control committees and hospital pharmacists.
·
In
joint projects scientists and clinical institutions may be under guidance of a
coordinating body/institution.
·
Training
in drug resistance surveillance and site-visits
·
Transfer
of knowledge from research in new technologies e.g. molecular techniques to the
clinical setting in order to increase the benefit for the patient of the
treatment using the advantage of rapid diagnostic results.
·
Secure
the application of the outcome of research in the field of molecular science
considering the public health perspective, when appropriate.
·
Acknowledge
the need for base-line data on resistance frequencies and the use of
antimicrobial agents in the community as well as in hospitals
·
The
presence of national and local guidelines for e.g. standard operational
laboratory procedures (SOPs), treatment
guidelines, national essential drug lists, etc.
·
To
participate and/or initiate networks on regional, national and international
levels
1. Establishment of networks of laboratories
to evaluate, standardise and quality assure kits for rapid diagnosis of
tuberculosis and drug resistant tuberculosis.
2. Use of molecular technologies to study the
natural history of drug resistance in TB including spread in hot spots e.g.
hospitals and prisons and the occupational-risk in health care workers
3. Availability of anti-TB drugs, the quality
of anti-TB drugs and adherence to treatment schemes and the impact of results
from these studies on the emergence of resistance in mycobacterium tuberculosis
4.
Research
to identify new targets for anti-TB drugs
1.
Use of
molecular technologies to study the clonal spread of hospital infections
2.
Surveillance
using molecular techniques for resistance in hospital acquired infections,
including the changing of the treatment schemes and infection control measures
3.
Secure
continuous medical education of staff at all levels in order to keep them
updated in the newest advances as appropriate
4.
Document
effect of infection control measures on e.g. resistance frequencies, number of
cases reported, morbidity and containment of outbreaks
1. Use of molecular technologies to study the frequency of resistance in first time diagnosed (untreated infections) cases preferably as part of a surveillance system
2. Adherence to treatment schemes and
development of resistance in HIV
3. Availability of antiviral drugs and the
development of new drugs for treatment of HIV-infection
B. WORK GROUP ON PUBLIC HEALTH SURVEILLANCE
Scope of the Problem:
Participants included representatives from 5 countries, including Russia, Ukraine, Kazakhstan, Georgia, and Uzbekistan.
Participants agreed that public health surveillance needs to be improved in all countries.
The first priority will be training in two areas. First, training is needed for epidemiologists that will be part of the modern programs that will be developed. Second, training is needed for laboratory specialists on new techniques for infectious diseases; training will include scientists who formerly worked in closed facilities. In addition, some of these scientists from these facilities are likely to be valuable in helping to train other scientists in sophisticated laboratory techniques needed to support public health surveillance. The priority is for in-country training; however, for some specific problems, this training may need to be supplemented by specialized training outside the country.
In particular, training will be focused on high priority diseases, including MDR-tuberculosis, HIV, sexually transmitted diseases, hepatitis, and emerging infectious diseases.
Training of individuals from multiple countries together may be possible and should be considered as training programs are developed.
Participants also agreed that information sharing amongst the countries in the CIS is very important. Although hard copies may go from one country to another, it is not clear that those who need to know the information have access to these hard copies. A website to which all countries in the region could participate was considered an important opportunity.
Countries and organizations outside the NIS which are assisting the NIS in improving their communicable disease programs should work to harmonize those programs to the extent possible and in accordance with national policy.
Co-Chairs: Elizabeth Carniel, Pasteur Institute, France
Bakyt Atshabar, Kazakh Institute for Research on Plague Control
Rapporteurs: Anders Sjostedt, FOA, Sweden,
Aminjan Nematov, Institute of Virology, Uzbekistan
Participants:
Åke Forsberg, FOA, Sweden
Elena Gryaznova, ISTC, Russia
Tatiana Gremyakova, ISTC, Russia
Shabat Hodzaev, Uzbekistan
Paata Imnadze, Georgian CDC
Kensuke Nakajima, Ministry of health, Labour and Welfare, Japan
Aminjon Nematov, Institute of Virology, Uzbekistan
Ivan Vinograd, Lviv State Research Institute of Epidemiology and Hygiene, Ukraine
Andrei Pokrovsky,
Vector, Russia
Anders Sjöstedt, FOA, Sweden
Yukinori Uchida, Kobe Quarantine
Station, Japan
Andy Weber, DOD, USA
Almost all the represented
countries have natural foci of bacterial, viral and parasite diseases. Among
emerging and top prioritised infections 4 were identified - Congo-Crimean Hemorrhagic Fever, West Nile,
borreliosis, plague.
In viral infections most
acute are - Congo-Crimean Hemorrhagic
Fever, Tick-Borne Encephalites, West Nile, infections caused by group of Arbo-
and Hanta-viruses, in bacterial -
Anthrax, Rickettsia, Plague, Borreliosis, Tularemia, Brucellosis, in parasite - Malaria, Leishmania.
Important subjects
with regard to the prioritized infections
Scientific match-making
usefulness of the workshops - to initiate multi-national collaborations.
Important not only to conduct large workshops, but to be able for specialists
in one infection to meet and discuss
items for collaboration. As # 1 direction for collaboration surveillance is
determined, necessity of development of diagnostics basic, new, express
Actual for clinical personnel -
training -and laboratory-based diagnosis, traditional methods of
diagnostics prioritized for diagnostics
of extremely dangerous infections. Prospective is creation of national training centers.
Proposed projects
Actual for :Uzbekistan,
Kazakhstan, Ukraine, Georgia, Russia, Kirgisia CCHF, West Nile, borreliosis
surveillance, epidemiology, therapy
Important for Uzbekistan, Kazakhstan, Georgia, Russia,
Kirgisia - plague, surveillance, epidemiology, therapy
The special issue for
collaboration is development of
vaccines, e.g., tularemia vaccine as
prospective collaborative project
between Kazakhstan, Russia.
Surveillance and communication
in the area of Aral Sea is of special
importance for Kazakstan and Uzbekistan.
Consensus on priorities - National Control System
Training
(International and regional training centers)
Epidemiological, laboratory, new staff
Communication
- electronic, Internet-access, databases
Diagnostic methods - improve existing, develop new ones