Saturday, March 30, 2013

#Coronavirus: Hong Kong Suspected Case Tests Negative

Hong Kong (HKSAR) - A spokesman for the Department of Health (DH) today (March 30) provided an update on the suspected case of Severe Respiratory Disease associated with Novel Coronavirus.

Preliminary laboratory test results for the respiratory specimens of the 55-year-old man today showed negative for Novel Coronavirus associated with Severe Respiratory Disease.
The 55-year-old man, with chronic illness, travelled with his wife to Italy from March 18 to 26. The man presented with fever and upper respiratory symptoms on March 28. He was admitted to United Christian Hospital for isolation and treatment yesterday (March 29).

His current condition is stable. His wife is asymptomatic.

"The Centre for Health Protection (CHP) of the DH will continue its surveillance mechanism with public and private hospitals, practising doctors and the airport for any suspected cases of Severe Respiratory Disease associated with Novel Coronavirus," a DH spokesman remarked.

"No human infection with this virus has been identified so far in Hong Kong," the spokesman stressed.

Continued

Source: HKSAR Government

Friday, March 29, 2013

Hong Kong: #Coronavirus - Deaths bring chill as SARS marked

 
Jeraldine Phneah
Thursday, March 28, 2013

The public will be informed at once should a new SARS-like virus killing patients overseas come to our shores - even if a case is only suspected.The undertaking yesterday by the Department of Health followed word from the World Health Organization that another two people had succumbed to the virus, bringing the death toll among 17 people infected since it was unearthed as novel coronavirus in the middle of last year to an alarming 11.
It also came as local authorities sought to dispel any potential criticism that they might be complacent by testing the bureaucracy for battle-readiness for any outbreak involving the quiet killer.

Roped into the simulation exercise - based on a scenario where Hong Kong faces having to cope with the arrival of a first case of novel coronavirus from overseas - were 36 key officials from three bureaus and nine departments.

Codenamed Exercise Ruby, the drill was organized by the Food and Health Bureau, the Centre for Health Protection and other government departments.

The exercise assessed the risk level by considering key factors such as:

Areas where the virus is likely to be transmitted;
Geographical spread;
Clinical severity;
Pre-existing immunity;
Availability of effective preventive measures; and
Recommendations by international authorities.
Once a case has been confirmed, key officials will convene a Serious Response Level steering committee meeting, chaired by the Secretary for Food and Health Ko Wing-man.
Ko is a health veteran who was in the thick of the battles Hong Kong waged when SARS laid waste to public confidence and the health system 10 years ago.

Also tested was the command structure as well as the mechanism to activate response levels.
The gravity of the threat was brought home by the deaths of a 73-year-old man from the United Arab Emirates in Munich on Tuesday and of a UK resident with a history of travel to Pakistan and Saudi Arabia.
The new virus is singularly different from its SARS cousin in that it causes rapid kidney failure.
The WHO does not yet know how it is transmitted or how widespread it is.
"The Centre for Health Protection will continue to work closely with the WHO and other overseas health authorities to monitor the latest development of this novel infectious disease," a department spokesman said.
Locally, the Centre for Health Protection will continue its surveillance of hospitals, doctors and at the Hong Kong International Airport for any suspected cases.
It is advising travelers returning from affected countries who have respiratory symptoms to wear face masks, seek medical attention and inform doctors of their travel history.
Marking the 10th anniversary of the SARS outbreak yesterday were Chief Executive Leung Chun-ying and health department officials.
They visited Gallant Garden to pay tribute to health- care workers who died in the front lines.
A minute's silence was also observed in honor of the 299 locals who died in 2003. Worldwide, a total of 775 succumbed to SARS.

http://www.thestandard.com.hk/news_detail.asp?pp_cat=11&art_id=132459&sid=39337703&con_type=1

#Coronavirus: Hong Kong Suspected Case - More Details

Hong Kong (HKSAR) - The Centre for Health Protection (CHP) of the Department of Health (DH) received a report from United Christian Hospital (UCH) today (March 29) of a suspected case of Severe Respiratory Disease associated with Novel Coronavirus.

The 55-year-old man, with chronic illness, presented with fever and upper respiratory symptoms yesterday (March 28). He was admitted to UCH for isolation and treatment today.

His current condition is stable.

Initial investigations by the CHP revealed that the patient travelled with wife to Italy from March 18 to 26. They took transit in Dubai and stayed in the airport for about four hours on March 27, and returned to Hong Kong on the same day.
His wife is asymptomatic.

His chest X-ray was clear. Respiratory specimens were taken and laboratory test results are expected to be available tomorrow (March 30).

"The CHP will continue its surveillance mechanism with public and private hospitals, practising doctors and the airport for any suspected cases of Severe Respiratory Disease associated with Novel Coronavirus," a DH spokesman remarked.



"No human infection with this virus has been identified so far in Hong Kong," the spokesman stressed.

Source: HKSAR Government

#Coronavirus Latest Confirmed Human Death Had Much Contact With Camels

March 27, 2013.  Translation out of Germany:
Excerpt:

Even the common cold infection is one of the coronavirus

In fact, it is related to the "swine flu" the SARS virus, "coronaviruses have six sub-types, that also includes four general viruses, which are manifested as a cold or flu infection," explains Prof. Dr. Clemens Wendtner, chief of Infectology at Schwabing Clinic."In addition, also SARS is a lower mold. If the type on which the patient has died today, it is but to human coronavirus, a novel virus."

-snip-
Coronavirus: Greatly reduced lung function...How dangerous is the virus and the strongly reduced lung function is apparent in the
Example of the late 73Jährigen: First flu symptoms expressed on 8
March, two days later he was taken to a hospital in Abu Dhabi. After
A week ago he had to be artificially ventilated.
His relatives decided
then for a transport to Munich. "He was in the past
often treated in Munich, "
says Wendtner." We also have a close
Cooperation with Abu Dhabi.
"This Schwabing Clinic also specializes in
such infectious diseases. It is one of the seven National Reference Centres in
Germany.
Patient in a private jet airliner flown no
On 19 March the patient was flown to Munich. "He was not, of course, in
transported a commercial airliner, "says Wendtner." In a private jet to and
special ventilation equipment, he came to Munich. "The wealthy 73-year old
there was further treated, but he died on coronavirus.

Coronavirus: patient had a lot of contact with racing camels

How the man could have been infected, is not safe. It is speculated. "The
Virus has a high similarity with the bat coronavirus, "
explains Wendtner.
He had been bitten but not by a bat. Ungulates can also
have such a virus. "One of the 17 so far in the novel coronavirus diseased
Patient was infected by a goat. Our patient had much contact with
Racing camels. "
We can only speculate, however, whether any of the camels also
the virus had in it. "Nothing is confirmed yet. All we know is that all the camels
apparently still live, "
says Wendtner.

No fear of pandemic: Novel Coronavirus not highly contagious
Fear of a pandemic due to the dead man had no
have. "The novel coronavirus is not highly contagious," said the expert.
"While it is transmitted by droplet infection, the virus infected but in the
deep lung sections. "
When Sars virus, it had 8000 confirmed cases in a short
Given time - 800 of them died. "The novel coronavirus is 17
confirmed cases over a year what in virology a very long period
meets "
says Wendtner." We should not have any panic. "

http://www.augsburger-allgemeine.de/bayern/Araber-stirbt-an-Coronavirus-Das-steckt-dahinter-id24609101.html?view=print

#Coronavirus: Hong Kong Suspected Human Case in Kowloon

 [Kwun Tong is the district that the United Christian Hospital is located.  It is one of 16 districts and is located in Kowloon.  This suspected case is interesting in that they only spent a few hours in the Dubai airport after traveling to Italy.  The wife had no symptoms.]


8 hours ago
The Centre for Health Protection of the Department of Health said today received the United Christian Hospital reported serious respiratory disease caused by a novel coronavirus suspected cases.
The 55-year-old man with chronic illness, with fever and upper respiratory symptoms yesterday, today to stay in the United Christian Hospital for treatment under isolation, is now in stable condition.
CHP Initial investigations revealed that the patient and his wife traveled to Italy on March 18 to 26, spent about four hours transit in Dubai airport on March 27, to return to Hong Kong on the same day. His wife did not have any symptoms.
Lung X-ray examination of the patient is normal, and has collected respiratory samples for laboratory testing, Laboratory test results are expected tomorrow.

Thursday, March 28, 2013

#Coronavirus: ECDC airs geographic considerations

Mar 27, 2013 (CIDRAP News)
Excerpt:

In other developments, the European Centre for Disease Control and Prevention (ECDC) updated its epidemiologic assessment today, as four new cases have been reported since its last report on Feb 22.
It noted that three of the four cases were reported by Saudi Arabia's health ministry, with the last one reported on Mar 25 by Germany's Robert Koch Institute, the 73-year-old man from the United Arab Emirates who died in a Munich hospital yesterday.
The ECDC noted that six case-patients so far have been diagnosed and treated in Europe, three of whom were transferred from Arabian Peninsula countries where they were infected.
Though the number of NCoV infections increased over the past month, most cases continue to have links to the Arabian Peninsula, where contact tracing and epidemiologic investigations are under way, the group wrote.
Also, the ECDC issued a separate document that addresses the World Health Organization's (WHO's) NCoV surveillance update, which was published on Mar 18. Though the latest version from the WHO is more comprehensive, the ECDC took issue with one of the testing recommendations.
It noted that for testing, the WHO no long distinguishes between countries in which unexplained sporadic cases have occurred and those, such as in Europe, that have detected imported cases or infections linked to imported cases.
It said the November version of the WHO guidance specifically referenced countries in the Arabian Peninsula and their neighbors. However, the ECDC said it and the US Centers for Disease Control and Prevention (CDC) are retaining that recommendation. The CDC lists the countries considered in the Arabian Peninsula and neighboring areas as Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Palestinian territories, Qatar, Saudi Arabia, Syria, the United Arab Emirates, and Yemen. 

Novel #coronavirus lab studies hint at wide tissue susceptibility

Mar 27, 2013 (CIDRAP News) – Experiments by Hong Kong researchers to gauge the susceptibility of several human and animal cell lines to novel coronavirus (NCoV) found signs that it can infect a broad range of tissues, which might shed light on the disease's seemingly high mortality rate.
Though many questions remain about the source of the new virus and how it spreads, health officials know that it can cause severe clinical illness in some patients, including severe pneumonia and renal failure, the group wrote. They added that until more is known about the disease, lab studies could help provide clues.
The tests they conducted with NCoV and the cell lines are surrogates of virus growth in the tissues. They measured viral load in the cultures, nucleoprotein expression, and cytopathic effect. They published their findings yesterday in an early online edition of the Journal of Infectious Diseases (JID).
The group used an autopsy NCoV virus sample obtained from the first known case-patient, a Saudi Arabian man who died from the disease in June. They used 27 cell lines from different tissues and organs in their susceptibility tests, 14 from humans and 13 from animals.
Tests suggested that NCoV can infect human respiratory, kidney, and liver cells, as well as histiocytes. The impact on neuronal cells and monocytes was much less. 


‘More dangerous than SARS’: Scientists warn of deadly new #coronavirus

Chinese scientists have said that a new coronavirus, which has already killed 11, appears to be deadlier than SARS. The new virus, originating in the Middle East, can affect many different organs and kill cells more rapidly than SARS.
-snip-
"The SARS coronavirus infects very few human cell lines. But this new virus can infect many types of human cell lines, and kill cells rapidly," Yuen said. If the new virus mutates further, it could cause a deadly pandemic, the microbiologist warned.

Full Article:  http://rt.com/news/new-deadly-coronavirus-middle-east-970/

Australia: Flu outbreak kills two at Qld nursing home; Staff & Residents Vaccinated

Excerpt:

Dr Donohue told AAP on Thursday both were palliative care patients who had other serious medical conditions.
"A number of people (at the home) had been exposed to the virus before the outbreak was declared," Dr Donohue said.
"It's unfortunate the outbreak began before this year's flu vaccine was available."
The nursing home immunised staff and residents as soon as the vaccine was available.
Despite this, about 60 of the 128 residents and 15 of 117 staff have shown symptoms.

http://www.theaustralian.com.au/news/breaking-news/flu-outbreak-at-qld-facility-kills-two/story-fn3dxiwe-1226608144787

Australia: 14 Infected, 2 Dead in past 2 weeks at Northview Aged Care Facility from Influenza A, Vaccine Not Yet Available

March 28, 2013
Excerpt:

Queensland Health is monitoring an outbreak of influenza A in a nursing home at Mackay in the state's north, after the death of two residents.

Testing has confirmed 14 residents of the Northview Aged Care facility contracted influenza A.
Seven people from the nursing home have been hospitalised in the past couple of weeks, and the tests also confirmed the virus caused the death of two residents.

Dr Donohue says the outbreak happened before the seasonal flu vaccine was available.

http://www.abc.net.au/news/2013-03-28/two-die-in-qld-nursing-home-flu-outbreak/4598788


CDC: Risk Factors for Influenza among Health Care Workers during 2009 Pandemic, Toronto, Ontario, Canada

Abstract

This prospective cohort study, performed during the 2009 influenza A(H1N1) pandemic, was aimed to determine whether adults working in acute care hospitals were at higher risk than other working adults for influenza and to assess risk factors for influenza among health care workers (HCWs). We assessed the risk for influenza among 563 HCWs and 169 non-HCWs using PCR to test nasal swab samples collected during acute respiratory illness; results for 13 (2.2%) HCWs and 7 (4.1%) non-HCWs were positive for influenza. Influenza infection was associated with contact with family members who had acute respiratory illnesses (adjusted odds ratio [AOR]: 6.9, 95% CI 2.2–21.8); performing aerosol-generating medical procedures (AOR 2.0, 95% CI 1.1–3.5); and low self-reported adherence to hand hygiene recommendations (AOR 0.9, 95% CI 0.7–1.0). Contact with persons with acute respiratory illness, rather than workplace, was associated with influenza infection. Adherence to infection control recommendations may prevent influenza among HCWs.

The numerous outbreaks of influenza described in acute care hospitals indicate that influenza transmission in this setting is of major concern (13). Nonetheless, it remains unclear whether health care workers (HCWs) are at higher risk for infection than are adults working in nonclinical settings (non-HCWs). Vaccination recommendations for HCWs are intended primarily to protect patients from hospital-acquired influenza and influenza-associated death (4,5). Although working in hospitals has been proposed as a risk factor for influenza (6), findings that support that working in health care settings poses an occupational risk (7), or that performing particular activities or working in specific health care disciplines are associated with an increased risk for influenza infection, are sparse.

Better understanding of risk factors for infection among HCWs would support decision-making regarding priorities for seasonal influenza vaccination, antiviral treatment or prophylaxis programs, implementation of other measures to reduce influenza transmission in hospitals, and planning for pandemics. Therefore, we aimed to assess risk factors for influenza among HCWs and to determine whether, during the first 2 waves of influenza A(H1N1)pdm09, HCWs working in acute care hospitals were at higher risk than non-HCWs for symptomatic influenza.

Continued:  http://wwwnc.cdc.gov/eid/article/19/4/11-1812_article.htm?s_cid=eid-gDev-email

CDC: Predicting Hotspots for Influenza Virus Reassortment

Excerpts, editing is mine


Abstract
 The 1957 and 1968 influenza pandemics, each of which killed ≈1 million persons, arose through reassortment events. Influenza virus in humans and domestic animals could reassort and cause another pandemic. To identify geographic areas where agricultural production systems are conducive to reassortment, we fitted multivariate regression models to surveillance data on influenza A virus subtype H5N1 among poultry in China and Egypt and subtype H3N2 among humans. We then applied the models across Asia and Egypt to predict where subtype H3N2 from humans and subtype H5N1 from birds overlap; this overlap serves as a proxy for co-infection and in vivo reassortment. For Asia, we refined the prioritization by identifying areas that also have high swine density. Potential geographic foci of reassortment include the northern plains of India, coastal and central provinces of China, the western Korean Peninsula and southwestern Japan in Asia, and the Nile Delta in Egypt. 

Simultaneous infection with multiple influenza virus strains can affect virus fitness components, such as virus growth performance, and thus affect virus pathogenicity, transmission, or recombination (1). In a host infected with 2 closely related influenza viruses, the stains can reassort, exchanging gene segments to produce new strains, some of which might have increased virulence. Virulence might also trade off with transmission such that more pathogenic viruses spread more slowly (2). However, in some instances, a reassortant virus can have high transmissibility and high pathogenicity. For example, reassortment between influenza viruses of humans and birds resulted in the 1957 and 1968 pandemic viruses, each of which is estimated to have killed ≈1 million persons (3,4). The exchange of genes between pairs of influenza virus subtypes increased virulence in animal models, including reassortment between subtypes H9N2 and H1N1, between H5N1 and H1N1, and between H3N2 and H5N1 (5,6). We focus on reassortment between subtypes H3N2 and H5N1 because extensive data are available, but given sufficient data, our approach could be extended to other subtypes.
Figure 1. . . Potential influenza reassortment areas in Egypt. Districts in red are predicted to have an above average number of cases of influenza subtype H5N1 virus in poultry and an above average human population density, which is a proxy for subtype H3N2 virus infections.
Figure 3. . . Potential influenza reassortment areas in People’s Republic of China determined by using the influenza virus subtype H5N1 outbreak dataset. A) Density of swine. B) Spatial model of the risk for subtype H3N2 and H5N1 co-occurrence according to the outbreak dataset. C) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average swine density. D) Areas with a probability of subtype H5N1 and H3N2 co-occurrence >50% and above average human population density. See , for corresponding maps based on the subtype H5N1 surveillance dataset.

Discussion

The spatial models presented here predict that a reassortant influenza (H3N2/H5N1) virus is most likely to originate in the coastal and central provinces of China or the Nile Delta region of Egypt. The probability that subtypes H3N2 and H5N1 will co-occur in these regions is high (Figure 1; Figure 3, panel C; Technical Appendix Adobe PDF file [PDF - 1.61 MB - 9 pages]Figure 4, panel C), which could lead to dual infection in mammalian hosts, such as swine or humans in China or humans in Egypt. Co-infection could subsequently result in in vivo reassortment. Although the influenza A(H1N1)pdm09 virus is hypothesized to have originated from Mexico (20), southern China remains a major hotspot for the generation of novel influenza viruses (21). Our spatial models are compatible with this longstanding observation insofar as we predict that the southern coastal province of Guangdong is a potential hotspot for the evolution of novel influenza viruses by reassortment.
A caveat is that even if virus subtypes H3N2 and H5N1 were to reassort in swine, the spread of the reassortant virus among humans might require further virus adaptation events; for example, mutations might be required for the virus to replicate efficiently in humans or to be transmitted among humans (22). Recent work has shown that as few as 5 aa substitutions are required for aerosol spread of subtype H5N1 among mammals (23). With these qualifications in mind, this analysis provides actionable recommendations about which areas to target for intensified farm and market surveillance. Such surveillance could enable early detection of a reassortant influenza (H3N2/H5N1) virus, should it arise in swine, and facilitate containment of the virus before it crosses the species barrier to humans.
Our finding that in China the probability of subtype H3N2 infection increases with human population density is compatible with previous studies that detected a positive association between population, influenza cases, and mortality rates (12,24). Reasons for this association could be that the number of susceptible human hosts increases with population (11) or that surveillance efforts are greater in populous areas (25). Our results with regard to subtype H5N1 in birds are also largely consistent with those of previous studies that mapped subtype H5N1 hotspots in China and Egypt. In China, several provinces identified as having high ecologic suitability for subtype H5N1 (including Shandong, Jiangsu, and Sichuan) were also identified as subtype H5N1 hotspots in a previous study that used a different statistical model and different predictor variables (11). In China, previous analyses have concluded that risk for subtype H5N1 increases with the density of domestic ducks (26). In Egypt, earlier studies identified high-intensity crop production as a statistically significant predictor of subtype H5N1 in poultry (27). Similarly, we found that subtype H5N1 infections in poultry were associated with poultry density, which was highly correlated with crop production. In a previous study, models constructed from satellite images of vegetation predicted that the highest environmental suitability for subtype H5N1 is along the Nile River and in the Nile Delta (28). Our models were constructed from different predictor variables, such as poultry density, but yielded similar results: the highest number of subtype H5N1 cases in poultry were predicted to occur in districts in the Nile Delta.
Efforts to contain the A(H1N1)pdm09 virus would have been more effective if the virus had been detected in animal populations before it was transmitted to humans (29). Continuous zoonotic influenza surveillance is needed in China and Egypt and requires a network of laboratories to screen surveillance samples and requires financial incentives to encourage poultry producers and sellers to report outbreaks. One strategy for early detection of a reassortant virus could involve increasing farm and market surveillance in the identified areas (i.e., live-bird markets in 6 provinces in China [Guangdong, Hunan, Jiangsu, Shanghai, Sichuan, and Zhejiang] that have a >50% chance of subtype H3N2 and H5N1 co-occurrence and above average swine density). Increased monitoring could identify hotspots where subtype H5N1 is circulating, leading to more efficient targeted vaccination of poultry, and could pinpoint prefectures at high risk for a reassortant virus. In China, sanitary practices, such as cage disinfection and manure disposal, would substantially reduce risk for subtype H5N1 in live-bird markets (30).
In Egypt, our results support increased surveillance of backyard flocks near Benha, Cairo, Dumyat, El Faiyum, Shibin el Kom, and Tanta, where suitability for subtypes H5N1 and H3N2 is predicted to be high. Control measures could include compensation plans and vaccination of poultry with a recently developed subtype H5N1 vaccine that is more effective than previous vaccines against strains circulating in Egypt (10). Reporting of poultry disease outbreaks in Lower Egypt is poor (31), probably because farmers fear loss of income if authorities cull their flocks. Indeed, birds suspected to be infected with subtype H5N1 are often sold quickly at a discount, resulting in virus transmission to buyers’ flocks and families (32). If equitable compensation schemes were implemented, reporting of subtype H5N1 might increase and outbreaks could be contained more quickly, reducing opportunities for subtypes H5N1 and H3N2 to co-infect humans or domestic animals and, thus, for reassortment.
In general, policies such as culling must have a scientific basis because these measures have major effects on the economy and animal welfare. For example, when part of a swine herd is culled to contain an outbreak, it might become necessary to euthanize the entire herd, including animals with no influenza exposure, because buyers will not accept them (33). Furthermore, influenza outbreaks among livestock can trigger major global declines in meat prices, and the nature and timing of veterinary health authorities’ responses to an outbreak can affect the extent to which demand recovers after the crisis. In particular, when control measures such as culling are scientifically well justified and explained to the public soon after the start of an outbreak, consumer confidence is restored more quickly (34).
Although our maps suggest a risk for reassortment in Lower Egypt and eastern and central China, in vivo reassortment of subtypes H3N2 and H5N1 has not been detected in humans in these areas. On the other hand, numerous infections with influenza (H3N2)v, a reassortant virus that contains genes from a subtype H3N2 virus circulating in swine and from the A(H1N1)pdm09 virus, have been detected in humans in North America (35,36). This finding raises the question of why subtype H3N2v has spread but subtype H3N2/H5N1 reassortants have not. Spread of subtype H3N2v could result from the fact that the reassortant virus contains the M gene from the A(H1N1)pdm09 virus, which increases aerosol transmission (35,37). Our models might explain why, in contrast with subtype H3N2v reassortants, no subtype H3N2/H5N1 reassortants have been detected in humans. For example, we predict that subtypes H3N2 and H5N1 occur in Hunan, China, a province that has high swine density and was the geographic origin of subtype H5N1 viruses in clade 2.1 (38). Influenza (H3N2/H5N1) reassortants in which the nonstructural gene comes from a clade 2.1 virus replicate poorly in mice (5). Thus, subtype H3N2/H5N1 reassortants might not have emerged as often as subtype H3N2v reassortants because the provinces where subtypes H3N2 and H5N1 overlap contain a clade of subtype H5N1, whose genes reduce the fitness of reassortant viruses. If this hypothesis is correct, if subtypes H5N1 and H3N2 infect a pig in central China and exchange genes, the hybrid virus might not replicate efficiently or transmit to other hosts. Furthermore, a reassortant virus with surface proteins similar to those of subtype H3N2 viruses that have circulated in humans recently might have poor transmissibility because of preexisting immunity (18).

Applying our modeling framework to other zoonotic influenza subtypes, such as H3N2v, could yield insight about geographic hotspots of reassortment and the pattern of spatial spread of reassortants. To accomplish this, 2 data limitations must be overcome. First, to be incorporated into spatial models, influenza sequences submitted to GenBank or GISAID should be accompanied by geographic data at relatively high spatial resolution, for example, names of cities or counties where sampling was conducted. However, such sequences are often accompanied by only the state or country of the sample, which reduces the usefulness of the data for fine-scale spatial modeling (39). For example, we searched online databases and confirmed that the geographic data available for Indonesia are insufficient to construct a spatial model to predict sites with a high risk for reassortment. Second, more extensive surveillance of livestock is needed to provide sufficient sample sizes to parameterize geographic models. Currently, the number of influenza subtype H1, H3, and H5 viruses from swine in major databases is an order of magnitude lower than that available for humans (Technical Appendix Table 3 Adobe PDF file [PDF - 1.61 MB - 9 pages]). Additional surveillance of swine could lead to better predictions about hotspots of influenza in livestock and sites of potential swine-to-human transmission. Livestock surveillance campaigns should sample large geographic areas and include regions where production is high (35). 

The potential for reassortment between human and avian influenza viruses underscores the value of a One Health approach that recognizes that emerging diseases arise at the convergence of the human and animal domains (29,40). Although our analysis focused on the influenza virus, our modeling framework can be generalized to characterize other potential emerging infectious diseases at the human–animal interface.

http://wwwnc.cdc.gov/eid/article/19/4/12-0903_article.htm?s_cid=eid-gDev-email 

Wednesday, March 27, 2013

#Coronavirus: WHO Update on 16th Case

The Ministry of Health in Saudi Arabia has informed WHO of a new confirmed case of infection with the novel coronavirus (nCoV).
The patient is a contact of the previous case reported in the Disease Outbreak News on 12 March 2013. This person suffered a mild illness, and has recovered and been discharged from hospital. Currently, there is insufficient information available to allow a conclusive assessment of the mode and source of transmission.
To date, WHO has been informed of a global total of 16 confirmed cases of human infection with nCoV, including nine deaths.
Based on the current situation and available information, WHO encourages all Member States (MS) to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. WHO is currently working with international experts and countries where cases have been reported to assess the situation and review recommendations for surveillance and monitoring.
All MS are reminded to promptly assess and notify WHO of any new case of infection with nCoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course.
WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.
WHO continues to closely monitor the situation.

http://www.who.int/csr/don/2013_03_23/en/index.html

#Coronavirus: WHO Update on 17th Confirmed Case

The Robert Koch Institute informed WHO of a new confirmed case of infection with the novel coronavirus (nCoV).

The patient was a 73-year-old male from United Arab Emirates, who was transferred from a hospital in Abu Dhabi to Munich by air ambulance on 19 March 2013. He died on 26 March 2013.

In the United Kingdom, the index patient in the family cluster reported on 11 February 2013 with travel history to Pakistan and Saudi Arabia prior to his illness, has died.
To date, WHO has been informed of a global total of 17 confirmed cases of human infection with nCoV, including 11 deaths. 

Based on the current situation and available information, WHO encourages all Member States (MS) to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. WHO is currently working with international experts and countries where cases have been reported to assess the situation and review recommendations for surveillance and monitoring.

All MS are reminded to promptly assess and notify WHO of any new case of infection with nCoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course.

WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.
WHO continues to closely monitor the situation.

Tuesday, March 26, 2013

#Coronavirus - Latest Death Out of Germany Updates

 Excerpt:
3/26/13

Now the case can advance research: The man - possibly a sheik - have visited shortly before his camel-herd disease. He could have been infected at one of its racing camels, explains Prof. Wendtner. The talks with the family of the deceased would have arisen. Also one of the animals had fallen ill. The camel in turn could have the virus from a bat. The Arabs had fallen ill in early March and last Tuesday was flown by private jet from Abu Dhabi to Munich for treatment. Now, the body will be transferred promptly to his homeland.
A risk of infection for the population did not pass loud city. The patient lay on the isolation that some 50 members and contact persons would continue to be monitored. So far there are no abnormalities, according to health department.

-snip-
The illness of the 73-year-old Arab is a particularly stark case of medical tourism: Already hovering in mortal danger, he was flown by private jet to treat - attached to the ventilator. He was several times on the Isar for treatment because the family probably just promised here is a chance of recovery.

So the thousands to see every year: The five hospitals welcomed the Municipal Hospital in the past year about 1500 patients mainly from Arab countries and from Russia. Most wanted in Bogenhausen Schwabing or under the knife - and paid the treatment itself Most interventions were the chief physicians in the fields of orthopedics, plastic surgery and reconstruction, neurosurgery, gastroenterology and diabetes. That has already gone off in the 90s because of the reputation of the physician, hospital spokesman says Matthias Winter. "The potential is still great."
Somewhat smaller, the figures are at the University Hospital: In Grosshadern and in the city there were in 2011 just 1225 patients. "The number is far lower than you might think," said hospital spokesman Philip Kressirer. On the right of the Isar River are consistently steady around 300 Arab patients per year. The number of patients treated staionär from Russia had recently risen to 500 a year, says hospital spokeswoman Eva Schuster.
On the international patients, the clinics have long set-with websites, brochures, advertising. On the right of the Isar Clinic there is even a patient off at Lufthansa.
 
 


http://www.tz-online.de/aktuelles/muenchen/kam-killervirus-von-einem-kamel-schwabing-patient-verstorben-tz-2822100.html 

#Coronavirus: Confirmed Death in Germany

 3/26/13 - Translation out of Germany

Munich - The Munich-patient did not make it, the death virus has claimed another victim: The infected with the novel coronavirus in the Schwabing Hospital last night has died, confirm Municipal Hospital and city.

The 73-year-old from the United Arab Emirates fell ill in early March and last Tuesday was flown by private jet from Abu Dhabi to Munich for treatment. On Saturday, the lab had confirmed the infection with the novel coronavirus. The patient suffered last night, according to hospital circulatory shock in the context of infection and its serious underlying medical conditions. "Due to the quite advanced infection and septic disease, the prognosis for the patient was unfortunately very unfavorable, so that his maximum intensive care could not be saved" regretted Clemens Wendtner, Chief of Infectious Diseases in Schwabing.

The patient lay on the isolation, a risk of infection for the population, according to hospital and did not pass city. The body of the patient will promptly transferred to his homeland - in consultation with the Robert Koch Institute in Berlin and the Health Department of the City. The 50 or so members and contact persons are monitored medically unchanged. This brings the death toll of the sinister agent: So far, the 17 infections are known to have died eleven patients. Last week, according to British media reports, a 60-year-old Briton has died, which seemed to have overcome the coronavirus. The man had been infected in Pakistan or Saudi Arabia and home probably infected his 38-year-old son, who died before his father.


http://www.tz-online.de/aktuelles/muenchen/todesvirus-patient-gestorben-2821564.html 

Sunday, March 24, 2013

#Coronavirus: Index Case in UK Cluster Dies

March 23, 2013
Birmingham grandad Abid Hussain has become the UK’s second victim to the new Sars-like bug Coronavirus.
The tragedy comes as Mr Hussain’s wife and daughter were in Pakistan after burying his son Khalid, 38, who had also fallen victim to the killer disease.

The dad-of-two, in his 60s, of Winson Green, was being treated at Wythenshawe Hospital, in Manchester, and seemed to be improving.

But he took a turn for the worse and lost his battle on Tuesday.

-snip-
“It was a shock to discover he was suffering from this terrible disease when he came back from Mecca. His daughter had gone out there with him, but was given the all clear.”

Continued:  http://www.birminghammail.co.uk/lifestyle/health/birmingham-grandad-abid-hussain-uks-1877516
Hat-tip Flu Trackers

Hong Kong: Fever patient tested negative for novel #coronavirus

 Ends/Sunday, March 24, 2013
Issued at HKT 18:32

The Centre for Health Protection (CHP) of the Department of Health (DH) received a report from Queen Mary Hospital (QMH) today (March 24) of a suspected case of Severe Respiratory Disease associated with Novel Coronavirus.

     The four-year-old girl, with good past health, presented with fever and headache since March 22 and is currently being isolated in QMH. Her condition is stable.

     Investigations by the CHP revealed that the patient is a tourist from Qatar. She travelled with her parents from Qatar to Hong Kong on March 22. Her parents are asymptomatic.

     Her chest X-ray was clear. Preliminary laboratory test result today for the patient's respiratory specimens showed negative for Novel Coronavirus associated with Severe Respiratory Disease by QMH but positive for adenovirus.

Continued:  http://www.info.gov.hk/gia/general/201303/24/P201303240467.htm

Coronavirus: New Case, #16, A Contact of Case #15

A new Coronavirus case has been reported to WHO.  Not much information given, other than the fact that it is a contact of Case #15 which was reported on March 12th.  The latest case is from Riyadh, as noted in the 2nd article below.

The Ministry of Health in Saudi Arabia has informed WHO of a new confirmed case of infection with the novel coronavirus (nCoV).
The patient is a contact of the previous case reported in the Disease Outbreak News on 12 March 2012. This person suffered a mild illness, and has recovered and been discharged from hospital. Currently, there is insufficient information available to allow a conclusive assessment of the mode and source of transmission.
To date, WHO has been informed of a global total of 16 confirmed cases of human infection with nCoV, including nine deaths.
 http://www.who.int/csr/don/2013_03_23/en/index.html

Excerpt:
There was another case of coronavirus infection in the Kingdom, according to the World Health Organization (WHO).
Ziad Al-Memish, undersecretary to the Ministry of Health for Public Health, confirmed the new case. “It was a mild infection in a person from Riyadh and the patient is already discharged from the hospital after complete recovery,” Al-Memish said.

http://www.arabnews.com/news/445886