Published Date: 2013-11-12 13:01:10
Archive Number: 20131112.2051424
Date: Tue 12 Nov 2013
From: Ziad Memish <zmemish@yahoo.com> [edited]
The
Saudi Ministry of Health [MoH] continues to follow carefully all new
cases of MERS-CoV diagnosed in KSA [Kingdom of Saudi Arabia] with
routine contact tracing of all contacts inclusive of family contacts and
HCWs [healthcare workers] who cared for the patient. On 7 Nov 2013 the
Saudi MoH reported a new case: a 43-year-old male from Jeddah, who
developed symptoms on 27 Oct 2013. He sought medical treatment on 3 Nov
2013. He is currently in an intensive care unit. The patient does not
have any underlying chronic disease. He has no recent travel history
outside of Jeddah. He had significant contact with animals but no
contact with a known positive human case. To complete the investigation
extensive environmental/animal contact sources were pursued. Camels
owned by the patient which were symptomatic with fever and rhinorrhea
were tested for MERS-CoV and tested positive.
This is the 1st
time that a camel related to a case tests positive for MERS-CoV by PCR.
Further testing is ongoing to sequence the patient and the camel virus
and compare genetic similarity level to conclude causality.
The
Saudi MoH will continue to follow the situation carefully with the
Ministry of Agriculture and keep the public health community informed of
any new developments.
--
Ziad A Memish, MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia
<zmemish@yahoo.com>
[ProMED-mail
is very grateful to Prof Ziad Memish for the firsthand, authoritative
information above. It also adds data on the clinical signs observed in
the camels owned by the human patient, as earlier requested by us.
'Rhinorrhea' is a medical term for 'runny nose' (from the Greek words
"rhinos" meaning "of the nose" and "rhoia" meaning "a flowing"). The
term commonly applied in veterinary medicine for such condition in
animals is 'rhinitis' (in some instances, 'catarrh').
From
previous, media-derived information, it appears that the tissue sampled
was mucous or saliva; confirmation will help. In case the saliva
includes the virus, the unpleasant habitude of camels to spit may add
effectiveness and actual range to their potential role as virus
disseminators.
Some perspective can be found at http://www.cidrap.umn.edu/news-perspective/2013/11/reports-mers-cov-found-saudi-patients-camel. - Mod.AS]
[If
the virus isolates are shown to be genetic matches, this will serve as
the 1st confirmation of the previously suspected possibility of
transmission from camels to humans.
As a reminder, the role of
the camel in transmission of the MERS-CoV to humans was raised as a
possibility early on in the history of this emerging disease. A Qatari
national was treated in Germany for severe illness associated with
MERS-CoV infection beginning in late October 2012. Investigations at
that time noted that the case owned a camel and goat farm, with a number
of the goats at that time noted to be ill as well as the animal
caretaker (see ProMED-mail Novel coronavirus - East. Med. (07): Saudi
Arabia, UK, Germany 20130221.1554109). In April 2013 there was a report
of a UAE national with severe illness associated with MERS-CoV
infection. This individual was the owner of racing camels. The
possibility of transmission from the camels was raised at the time (see
ProMED-mail Novel coronavirus - Eastern Mediterranean (15): camel
exposure 20130405.1623188). We await the results of the genetic
sequencing. - Mod.MPP
http://www.promedmail.org/direct.php?id=2051424
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