Partial genetic sequence information for scientists about the Novel Coronavirus 2012

Phylogenetic tree constructed with partial sequences from the polymerase gene (nsp12) of representative coronaviruses from different groups is displayed in the attached Figure. The sequence obtained at HPA has been tentatively named as London1_novel CoV 2012 (boxed in red). The HPA sequence data is based on direct detection from clinical material from the London case. HPA do not yet have a virus isolate. There will shortly be a GENBANK accession number for the sequence. The attached phylogenetic tree is considered preliminary, as is virus nomenclature, and liable to change as more information or a virus isolate becomes available.

You may download the fasta file (as a zip file) from the link below:

• London1 novel CoV 2012 nsp12 (partial) (ZIP Archive, 330 byte)

Last reviewed: 25 September 2012

http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/RespiratoryViruses/NovelCoronavirus/respPartialgeneticsequenceofnovelcoronavirus/

CIDRAP: UK agency picks name for new coronavirus isolate

Robert Roos  News Editor

Sep 25, 2012 (CIDRAP News) – As the investigation of two severe illnesses associated with a novel coronavirus continued today, the United Kingdom's Health Protection Agency (HPA) released a preliminary phylogenetic tree for the virus and tentatively named it "London1_novel CoV 2012."

As reported previously, the virus has been identified in a 49-year-old Qatari man who is in a critical care unit in a London hospital and in a 60-year-old Saudi Arabian man who died in July in his home country. Both cases involve pneumonia and kidney failure, and the Qatari man had traveled to Saudi Arabia before he got sick.

In 2003, a then-novel coronavirus caused the SARS (severe acute respiratory syndrome) outbreak, which killed 774 people worldwide. Other coronaviruses are linked to the common cold.

The phylogenetic tree, constructed from partial sequences from the polymerase gene of various coronaviruses, shows that the new one is closely related to bat coronaviruses. The HPA also released the partial sequence for the virus's polymerase gene.

In other developments, the European Centre for Disease Prevention and Control (ECDC) said today the available information suggests that the current risk associated with the new virus is low.

Noting that there has been no sign of human-to-human transmission, the agency said, "The newly identified coronavirus is not genetically similar to the SARS coronavirus and does not signal the start of a new SARS outbreak."

Also today, the World Health Organization (WHO) commented via Twitter that the kidney failure reported in both patients infected with the new virus is a "unique feature" of the infection.

In addition, late today the WHO released an update and an interim case definition to help countries be on guard against the new virus. On the basis of the cases so far, the definition includes criteria for "a patient under investigation," a probable case, and a confirmed case, using clinical, epidemiologic, and laboratory variables. The update said no new cases were identified today.

And in Hong Kong, the region's Hospital Authority said that a previously reported cluster of coronavirus-related respiratory illnesses in Castle Peak Hospital was caused by a known coronavirus. The cases occurred in a "female long-stay ward" and are due to human coronavirus NL63, a strain that usually causes mild respiratory illness such as the common cold, the agency said in a statement.

See also:

Sep 25 HPA statement showing phylogenetic tree 

http://www.cidrap.umn.edu/cidrap/content/other/sars/news/sep2512corona.html

Indonesia: Chicken Husbandry Department Samarinda Find Ketawa Positive Bird Flu

September 23, 2012

Department of Fisheries and Livestock of Samarinda weekend again find poultry (chicken) were positive for the bird flu virus.

The findings were originally known from the reports of the Animal Husbandry Department had reported that chickens died suddenly. After the officer down checking spaciousness, and perform rapid test (rapid test), was one of seven chickens owned by a resident of Jl Bungtomo Sei Keledang Samarinda was positively infected with bird flu.

"Last week in the Sei Keledang Jl Bungtomo Samarinda Seberang, we find a positive laughter chicken bird flu, according to results of rapid tests that we do," said Jumianti, Head of Animal Health and Livestock Fisheries Samarinda to the Tribune, Sunday (23 / 9/2012).

According Jumianti, chicken coop bird flu that we have isolated, while 7 chickens had been culled. 

"Poultry cages were empty and we had our isolation. During one month of the cage can not be used and needs to be cleaned by spraying disinfectant on a regular basis," said Jumianti.

Said to him, the Animal Husbandry Department officials have done spraying disinfectant on chicken coop belonging to the bird flu and in a chicken coop belonging to others around them.

Asked about the cause of the bird flu virus in chickens are laughing? He said it was likely that brought laughter chicken owners outside Samarinda.

"We have not had time yesterday to ask the owner, he bought a chicken laugh from, but probably from outside Kaltim" he said.

He appealed to the citizens to immediately report to the Department of Animal Husbandry through local RT or RW if found chickens that died suddenly, so that the Animal Husbandry Department immediately check whether the chickens are infected with bird flu or not. 

"Animal Husbandry Department officer will act quickly if there are reports of people," he said.

Added Jumianti, the case of chickens that died suddenly suspected of contracting bird flu in Dublin this year is somewhat reduced compared to previous years. 

Up to September this year, the number of chickens that died suddenly reported only about 50 birds.From the report, which was positively infected with bird flu is only a part, as well as chickens owned by residents in Sei laughed Keledang, it stated piositif bird flu.

Indonesia: Samarinda - Dangerous Disease Control Simulation

September 25, 2012

tribunkaltim / nevrianto hp tribunkaltim / nevrianto hp

tribunkaltim / nevrianto hp

tribunkaltim / nevrianto hp

SAMARINDA, tribunkaltim.co.id - Port Health Team led both ship's (ABK) are infectious diseases AI out of the ship Queen Soya special evacuation to the tent as Public Health Emergency Response Simulation Of International Concern (PHEIC) in the port of Samarinda, Tuesday (25/9). Health teams are also taking action infusion. Simulation is witnessed PHEIC sub head of the Directorate General of Health Quarantine (Karkes) Directorate General of Environmental Control (DG and PL) Ministry of Health, Dr. Zahimir Setiawan, Vice Mayor Ishmael Nusyirwan Samarinda Samarinda Bay Head Adpel M Hasani, Representative kppp.

Indonesia: Simulation - Samarinda 2 Crew Aboard ABK Queen Soya Suspected #H5N1 #Birdflu

Two crew KM Quen Soya "Suspect" Bird Flu September 25, 2012 Two Queen Soya crew who had been due to depart from the Port of Samarinda towards Pare-pare flui suspected infected birds were found on Tuesday (25/9). That day the ship will depart and have begun to increase passenger and freight activities. But 3 hours prior to departure suddenly get a report from the agency posts that get a report from the Master Vessel that two crew boats are sick. Following the post got the information from agents, officers Port Health Office (KKP), which is in the post immediately contacted the captain to seek infomasi about the symptoms of the two people who are sick crew. Because the disease is similar to ABK pandemic disease, then the Dublin Port Office stating KM ship Queen Soya temporarily not allowed to get out of the Samarinda, and must remain in place to wait for the examination and investigation of the officer CTF. Suddenly the atmosphere is inviting noise from passenger which will set out on the edge of the dock. They asked the ticket is refundable if the ship did not depart. Chief Administrator Office of the harbor (Ka Adpel) as a responsible authority in the port of Samarinda immediately ordered the Rapid Response Team command post for immediate action. Ports in the region immediately tighten vigilance. Tim Verification ensures that two crew was suspected. After that, the officer Immigration, Customs and Quarantine farm further examination on board the ship, using the Personal Protective Equipment (PPE) exhaustive. The medical team declared that suspects need to be reconciled in hospitals AWS. The medical team in the tent to report to the command post to contact AWS for the preparation of a referral hospital. Meanwhile, due to ship in quarantine it can not do the activities of people and goods up and down a passenger who had entered the ship became restless and afraid of contracting an infectious disease influenza type new, they demanded to be lowered from the ship, the ship demo, passenger anxiety began to subside after the CTF team and security team of Unity Port Security Administrator (KP3) and the Marine and Coastal Unity Babysitting (KPLP) gives verbal comprehension. With the fret board community particularly the Passenger Vessel will rise, and ojeg Street vendors who have worked in the port area, because they are forced to enter the restless harbor area. The situation can be controlled after the team provide a thorough understanding of the circumstances that happen to people. scenes Simulations That's part of public health emergency response is troubling the world (PHIEC) in the port of Samarinda.

WHO: Case Definition for Case Finding Severe Respiratory Disease associated with NOVEL CORONAVIRUS

Interim case definition as of 25 September 2012

Patient under investigation:

Clinical definition:

A person with acute respiratory syndrome which may include fever (≥ 38°C , 100.4°F) and cough
• requiring hospitalization
OR
• with suspicion of lower airway involvement (clinical or radiological evidence of consolidation)
not explained by any other infection or any other aetiology.
AND

Epidemiological criteria:

Close contact* within the last 10 days before onset of illness
• with a probable or confirmed case of novel coronavirus infection while the case-contact was ill
OR
• travel to or residence in an area** where infection with novel coronavirus has recently been reported or where transmission could have occurred.

Probable Novel Coronavirus Case:

A person fitting the clinical definition AND epidemiological criteria above but no laboratory confirmation.

Confirmed Novel Coronavirus Case:

A person with laboratory confirmation of infection with the novel coronavirus.

---

* Close contact is defined as:

• Anyone who provided care for a confirmed or probable case including HCW and family members in a health care setting or in the community.
• Anyone who stayed at the same place (e.g. lived with, visited) as a probable or confirmed case while they have been symptomatic.
• Anyone with significant casual exposure with the patient such as sitting nearby in a classroom, sharing a taxi, sitting close by on an airplane.

** Area where infection with novel coronavirus where transmission could have occurred:

Kingdom of Saudi Arabia, Qatar (as of 25 September 2012)

http://www.who.int/influenza/case_definition_NovelCoronavirus_20120925/en/index.html

WHO: Novel coronavirus infection - update

25 September 2012 -  

As of 25 September 2012, no additional cases of acute respiratory syndrome with renal failure due to infection with a novel coronavirus have been reported to WHO. WHO is continuing investigations into two recently confirmed infections identified as a novel coronavirus. Today WHO issued an interim case definition to help countries strengthen health protection measures against the new virus. 

The case definition, based on the cases so far, includes criteria for identifying a ‘patient under investigation’, a ‘probable case’ and a ‘confirmed case’. These criteria are based on clinical, epidemiological and laboratory indicators. 

Following the confirmation of the novel coronavirus, WHO - under the International Health Regulations - immediately alerted all its Member States about the virus and has been leading the coordination and providing guidance to health authorities and technical health agencies. WHO is also identifying a network of laboratories that can provide expertise on coronaviruses for countries. 

On 22 September 2012, the United Kingdom (UK) informed WHO of a case of acute respiratory syndrome with travel history to the Kingdom of Saudi Arabia (KSA) and Qatar.

The case is a previously healthy, 49 year-old male Qatari national that presented with symptoms on 3 September 2012 with travel history to KSA several days prior to onset of illness. On 7 September he was admitted to an intensive care unit in Doha, Qatar. On 11 September, he was transferred to the UK by air ambulance from Qatar. The Health Protection Agency of the UK (HPA) conducted laboratory testing and subsequently confirmed the presence of the novel coronavirus. 

The HPA compared the sequencing of the virus isolate from the 49 year-old Qatari national with that of a virus sequenced previously by the Erasmus University Medical Centre, Netherlands. This latter isolate was obtained from lung tissue of a fatal case earlier this year in a 60 year-old Saudi national. This comparison indicated 99.5% identity, with one nucleotide mismatch over the regions compared. 

Though it is a very different virus to SARS, given the severity of the two confirmed cases so far, WHO is engaged in further characterizing the novel coronavirus. As such, international efforts are being stepped up across all WHO six regions to ensure an appropriate and effective response with a WHO specialist team in daily contact with more than a dozen international and regional technical partners.

In addition WHO is working closely with KSA, as in previous years, to support the country’s health measures for all visitors participating in the Haji pilgrimage to Mecca next month.

http://www.who.int/csr/don/2012_09_25/en/index.html

Ron Fouchier on the New Coronavirus: We Need to Fulfill Koch's Postulates

by Martin Enserink 
 24 September 2012, 1:57 PM 

Click on link for full article: 
http://news.sciencemag.org/scienceinsider/2012/09/ron-fouchier-on-the-new-coronavi.html

Bird Flu Outbreaks Reported Around China

September 24, 2012
Outbreaks of H5N1 avian influenza, better known as bird flu, have occurred across China this year.

Information on bird flu’s spread in China was made public in January in a Hong Kong health report to the World Health Organization (WHO), saying that China was one of the 15 affected countries in the world with 18 provinces and cities experiencing H5N1 avian influenza outbreaks. Now, the Guangdong Province Department of Agriculture has also admitted that there is an outbreak.

A 2-year-old boy from Hong Kong contracted bird flu in early June as confirmed by the Department of Health in Hong Kong. A duck sample from Jiangnan Market in the Haizhu District of Guangzhou, Guangdong Province, where the boy had visited in mid-May, was tested positive for the H5N1 virus. Samples from another market in the same district also tested positive, according to the Center for Disease Control and Prevention in Guangdong Province.

Continued:  http://www.theepochtimes.com/n2/china-news/bird-flu-outbreaks-reported-around-china-295921.html

BBC: How threatening is the new coronavirus?

24 September 2012 Last updated at 06:59 ET
Excerpts:

As it has only been recently described, and this is only the second laboratory confirmed case, there is limited information on how much of a threat it may pose to humans.

At this point it is not clear whether these cases are typical of infection with this virus or whether it could be circulating more widely and only very rarely causing a severe illness.

Doctors do not yet know what the best treatment is, but people with severe symptoms will need intensive medical care to help them breath. There is no vaccine for it.
As with any newly identified virus that may be associated with severe illness, it is better to err on the side of caution. All infection control precautions to prevent the spread of this virus are therefore being taken in the case of the London patient with the confirmed diagnosis. This includes isolation of the patient, barrier nursing and making sure that all staff wear the appropriate protective equipment.

Experts do not yet know where the virus originated from. It may have been the result of a new mutation of an existing virus. Or it may be an infection that has been circulating in animals and has now made the jump to humans.

http://www.bbc.co.uk/news/health-19699677

Hong Kong alert for novel coronavirus cases

September 24, 2012
 
The Centre for Health Protection has formed an enhanced surveillance mechanism with public and private hospitals to watch for cases of novel coronavirus infection.

The move follows the World Health Organisation's report on September 23 of a case of novel coronavirus infection. The case involved a previously healthy 49-year-old Qatari man who had been in Saudi Arabia prior to the onset of illness on September 3. He is being treated for severe respiratory illness in London.

The UK's Health Protection Agency has confirmed the presence of a novel coronavirus. It said the virus isolate from the patient is highly similar to the coronavirus identified from a fatal case in a 60-year-old Saudi man reported on September 20.

Coronaviruses are a large family of viruses, which include those that cause the common cold and Severe Acute Respiratory Syndrome. The WHO is gathering more information to determine the public health implications of these two confirmed cases.

In Hong Kong, the centre reported that the Public Health Laboratory Centre has the capacity to detect this virus. No human infection with this virus has been identified here so far.

The centre will closely monitor the progress of further epidemiological investigations and surveillance, and the corresponding advice from the WHO.


http://www.news.gov.hk/en/categories/health/html/2012/09/20120924_193624.lin.shtml

A case of novel coronavirus infection confirmed in Britain: WHO

2012-09-24

Excerpt:

Given that this is a novel coronavirus, WHO is currently in the process of obtaining further information to determine the public health implications of these two confirmed cases.
Coronaviruses are a large family of viruses which includes viruses that cause the common cold and severe acute respiratory syndrome (SARS).

http://news.xinhuanet.com/english/health/2012-09/24/c_131869910.htm

Health Arabia" mobilize forces in control of the ports infected with avian coronavirus and provide care for pilgrims

24-9-2012 "Health Arabia" mobilize forces in control of the ports infected with avian coronavirus and provide care for pilgrims Excerpt: Original: علي الصعيد الداخلي قررت اماره المنطقه الشرقيه في المملكه اطلاق حمله توعيه لمحاصره المرض، خصوصا بالمدارس واماكن التجمعات ومع دخول فصل الشتاء، حيث تكثر العدوي واتخاذ احتياطات في جميع المنافذ لمراقبه المسافرين. Translation Internally decided Eastern Province Emirate [ اماره المنطقه الشرقيه في ] in the kingdom to launch an awareness campaign to besiege the disease, especially in schools and places of gatherings with the onset of winter, with frequent infections and precautions in All ports to monitor passengers. http://gate.ahram.org.eg/News/254406.aspx

CNN Arabia: Saudi Arabia warns pilgrims flu virus "killer"

[We are entering the season of Hajj and Umrah. This article is from CNN Arabic] الاثنين، 24 أيلول/سبتمبر 2012، آخر تحديث 

Dubai, United Arab Emirates (CNN) - Saudi authorities called pilgrims "House of God" to adhere to preventive health procedures, for their own safety and health, after monitoring three cases of HIV disease causes a rare type of influenza, called "crowns", two of whom died , while the third is still receiving treatment.

And revealed the Ministry of Health in Saudi Arabia for such injuries, in a statement issued Sunday, said that he came "within the framework of its preventive efforts to prevent importation of disease, and a continuation for its follow-up and a survey of all transmitted diseases between human and keen to approach transparency of what matters public health. "

The ministry said in a statement, reported by the official Saudi Press Agency "SPA", that "with the acceleration of climate change, and enter the season of Hajj and Umrah, it was diagnosed pattern rare coronavirus, a seasonal influenza viruses are known, where he was diagnosed three cases infected with the virus . "

The Saudi Ministry of Health in its statement that one of these cases to a Saudi citizen at a hospital in Jeddah, and the second for another Saudi citizen, the third event of injury to the Gulf citizen in Britain, and said that two of the injured died as a result they got sick.

And sought the ministry to reassure citizens and residents, saying that the virus "crowns" known, and most people are recovering, after providing treatment pads and simple, without complications, and in very rare cases, In Style Nader of this virus, complications occur respiratory and kidney, has lead to death, especially for the elderly, and those with heart disease, and chronic chest and HIV.

The ministry stressed that "these cases are rare, and the health situation reassuring, nor call for concern", he called on those who wish to Hajj or Umrah, from inside or outside the Kingdom, commitment vaccinations and instructions issued by the Ministry of Health, and attention to personal hygiene, washing hands, and wearing a mask in crowded places, and change them periodically. "

The ministry concluded by emphasizing that they relay constantly emerging in this regard, at the national level, regional and global levels, in coordination with the concerned authorities and international health bodies.

Saudi Arabia: فيروس إنفلونزا نادر في السعودية يقتل شخصين

Original: [Translation below]

أعلنت وزارة الصحة السعودية عن وفاة مواطنَين بفيروس الإنفلونزا الموسمي الكرونا، وقالت إن أحدهم توفي في مستشفى بمحافظة جدة، فيما توفي الآخر في بريطانيا.

وأشارت الوزارة إلى أنه تم تشخيص نمطٍ نادرٍ من فيروس "الكرونا"، أحد فيروسات الإنفلونزا الموسمية المعروفة، حيث تم تشخيص ثلاث حالات مصابة بهذا الفيروس. 

وأضافت الوزارة أن فيروس "كرونا" يتماثل المصابون به للشفاء بعد تقديم علاج مساند وبسيط من دون مضاعفات، وفي حالات نادرة جداً وفي نمط نادر من هذا الفيروس تحدث مضاعفات تصيب الجهاز التنفسي والكلى وقد تؤدي الى الوفاة.

وقال الدكتور زياد ميمش، وكيل وزارة الصحة المساعد للطب الوقائي، لنشرة الرابعة على "العربية": "إن تغيرات المناخ عادة ماتسبب الالتهابات الفيروسية التي تصيب الجهاز التنفسي، حيث يوجد حوالي 60 نوعاً من الفيروسات التي تسببها الالتهابات".

ويضيف: "بالنسبة لفيروس "الكرونا" فهو يسبب 15% من الالتهابات، عادة تكون بسيطة حيث يشعر المريض بالاحتقان في الحلق والسعال وتكرار السعال وارتفاع في درجة الحرارة وضيق التنفس، ويتماثل 95% من المرضى للشفاء عن طريق الراحة وشرب السؤال وأخذ الفيتامينات اللازمة".

وعن الحالات الثلاث التي أصيبت بهذا النمط الجديد من فيروس "الكرونا" والذي لم يكتشف من قبل يقول د. ميمش: "إذا كان لدى الأشخاص أمراض مزمنة قلبية أو صدرية، أو يكونون كباراً في السن بالتأكيد ستكون هناك مضاعفات تلحق الجهاز التنفسي، ويمكن أن يحدث التهاب رئوي، وأيضاً قد تصيب الجهاز الكلوي وتعطل وظائفة ما يؤدي إلى الوفاة".

ومن أجل الوقاية يؤكد د. ميمش أن الفيروس مماثل لفيروسات الإنفلونزا الأخرى (أ، ب، ج)، حيث ينتقل عن طريق السعال والعطس وإفرازات الجهاز التنفسي على الأيدي، لذا يشدد على الوقاية بتغطية الفم بالكمامات في الأماكن المزدحمة وتعقيم الأيدي بصفة دورية. 

وعن التلقيح الوقائي للفيروس يقول ميمش: "الكرونا" لا يوجد له علاج خاص الآن، حيث إنه فيروس جديد، لكن وزارة الصحة تحرص على تفعيل الدور الوقائي للمرض ومنع الإصابة.

وعن طرق علاج الفيروس أضاف أن الأمراض الفيروسية عامة يكون العلاج فيها عن طريق حقن السوائل الوريدية وأخذ الفتامينات اللازمة ودعم المريض إلى أن يتماثل للشفاء، أما في حالة حدوث مضاعفات فلابد من التدخل بإعطاء الأدوية التي تناسب الحالة.

Translation - Site includes a Video interview in Arabic

Sunday, November 07, 1433 - September 23, 2012  

Happens respiratory complications and kidney may lead to death The Ministry of Health Saudi Arabia for the death of citizens infected with seasonal influenza krona, and said that one of them died in hospital in Jeddah, while the other died in Britain.

The ministry had been diagnosed pattern rare virus "krona", a seasonal influenza viruses are known, where he was diagnosed three cases infected with the virus. ministry added that the virus "crowns" equal living with recovering after providing treatment pads and simple without complications, and in very rare cases in pattern rare virus complications occur respiratory and kidney may lead to death.

Said Dr. Ziad Memc, Undersecretary of the Ministry of Health Assistant for Preventive Medicine, the Bulletin fourth "Arab": "The climate changes usually Mazbb viral infections that affect the respiratory system, where there are about 60 species of virus caused by infections." and adds: "For the virus" krona "It causes 15% of infections, usually simple where the patient feels Balaanqan in the throat, coughing and repeated coughing and high temperature and shortness of breath, and an equal 95% of patients to heal through rest and drink question and taking vitamins necessary." and three cases that hit this the new type of virus, "the krona," which did not discover by Dr. Memc: "If the people chronic diseases attack or chest, or are elderly persons, certainly there will be complications cause respiratory, and can occur with pneumonia, and also may affect the device and renal failure and functions leads to death."

In order to prevent loneliness . Memc that the virus is similar to other influenza viruses (a, b, c), where transmitted through coughing and sneezing and respiratory secretions on their hands, so emphasizes preventing Cover your mouth Emamat in crowded places and disinfecting hands regularly. and vaccination preventive virus says Memc: " krona "has no special treatment now, as it is a new virus, but the Ministry of Health is keen on activating the protective role of the disease and prevent infection. and ways to treat the virus added that viral diseases generally be treated there by injecting intravenous fluids and taking Fattaminac necessary and support the patient to be recovering, in the case of complications must be intervention by giving drugs that fit the situation.

Qatari Man in London Hospital with Sars-like Virus

[editing is mine] Excerpt:  September 24, 2012
By Ewan Palmer 

A respiratory illness similar to the Sars Virus which killed hundreds of people has been detected in a man at a London hospital who recently travelled to the Middle East.

The 49-year-old man from Qatar became ill after traveling to Saudi Arabia where another man died of a similar illness earlier this year, the Health Protection Agency (HPA) and World Health Organization (WHO) confirmed.

The man in the new case was sickened by a coronavirus, which causes most common colds but also causes Sars, or severe acute respiratory syndrome.

He was transferred from Qatar to Britain on 11 September and is being treated in an intensive care unit at a London hospital for problems including kidney failure. The UN health agency says virus samples from the patient are almost identical to those of a 60-year-old Saudi national who died earlier this year.

Michael Osterholm, a flu expert at the University of Minnesota said: "You don't die from the common cold. This gives us reason to think it might be more like Sars."
 

  -snip- http://www.ibtimes.co.uk/articles/387360/20120924/sars-virus-britain-qatar-saudi-arabia-hpa.htm

WHO: Novel Coronavirus infection in the United Kingdom

23 SEPTEMBER 2012 - On 22 September 2012, the United Kingdom (UK) informed WHO of a case of acute respiratory syndrome with renal failure with travel history to the Kingdom of Saudi Arabia (KSA) and Qatar.

The case is a previously healthy, 49 year old male Qatari national that presented with symptoms on 3 September 2012 with travel history to the KSA prior to onset of illness. On 7 September he was admitted to an intensive care unit (ICU) in Doha, Qatar. On 11 September, he was transferred to the UK by air ambulance from Qatar. The Health Protection Agency of the UK (HPA) conducted laboratory testing and has confirmed the presence of a novel coronavirus .

The HPA has compared the sequencing of the virus isolate from the 49 year old Qatari national with that of a virus sequenced previously by the Erasmus University Medical Centre, Netherlands. This latter isolate was obtained from lung tissue of a fatal case earlier this year in a 60 year-old Saudi national. This comparison indicated 99.5% identity, with one nucleotide mismatch over the regions compared.

Coronaviruses are a large family of viruses which includes viruses that cause the common cold and SARS. Given that this is a novel coronavirus, WHO is currently in the process of obtaining further information to determine the public health implications of these two confirmed cases.

With respect to these findings, WHO does not recommend any travel restrictions. Information regarding requirements and recommendations for the Hajj season in 2012 can be found at http://www.who.int/ith/updates/20120730/en/index.html

 http://www.who.int/csr/don/2012_09_23/en/index.html

Questions and answers - novel corona virus September 2012

{I will put this post on the right side-bar for easy access}

How many new cases have been reported to date?

This new coronavirus has been laboratory confirmed in only two cases globally to date: both occurred between July - September 2012.

The first case was confirmed in a patient in Saudi Arabia who has since died in Saudi Arabia.

The second case was confirmed in a patient from Qatar who had recently travelled to Saudi Arabia. This patient acquired their infection in the Middle East and had the infection diagnosed after travelling to London.

A further small number of possible cases are also being investigated.

What are coronaviruses?

Human coronaviruses were first identified in the mid 1960s and are named for the crown-like projections on the surface of the virus. They are a group of viruses causing respiratory infections in humans and animals. There are 3 main sub-groupings of coronaviruses, known as alpha, beta and gamma.

What type of coronavirus is this?

This is the first time this particular strain of coronavirus has been identified in the UK and only the second time in the world - in both cases the infection was acquired in the Middle East. The virus was identified by the Health Protection Agency's virus reference laboratories at Colindale. It is genetically the same as one recently isolated in a laboratory in Saudi Arabia, which was then confirmed and its genetic material sequenced in a laboratory in the Netherlands. As it has only been recently described, and this is only the second laboratory confirmed case, there is limited information on clinical impact, transmission and severity at this stage.

What are the main symptoms?

The virus has so far only been identified in two cases of acute, serious respiratory illness who presented with fever, cough, shortness of breath, and breathing difficulties. At this point it is not clear whether these cases are typical of infection with this virus or whether it could be circulating more widely, but causing a milder illness, and only very rarely causing a severe illness.

What is the treatment?

We do not have enough information yet to make specific treatment recommendations. However, acute respiratory support for those with severe symptoms and who have been hospitalised would be advised.

How do you catch this infection?

Coronaviruses are typically spread like other respiratory infections such as influenza. This infection is therefore likely to be passed from person to person when an infected person coughs or sneezes, though much is unknown at this stage.

How contagious is it?

Tranmission appears to be very limited as, if it were very contagious, we would have expected to have seen more cases in other countries or the people caring for these two cases, the first of which occurred over three months ago.

With any newly identified virus, that may be associated with severe illness, it is better to err on the side of caution. All infection control precautions to prevent the spread of this virus are therefore being taken in the case of the London patient with the confirmed diagnosis. This includes isolation of the patient, barrier nursing and making sure that all staff wear the appropriate protective equipment.

Coronaviruses are fairly fragile, and outside of the body their survival time is only around 24 hours. They are easily destroyed by usual detergents and cleaning agents.

Where has this infection come from?

At this stage we do not know. New infections may occur from a mutation (change) to an existing virus which causes it to behave differently in the type or seriousness of infection caused. Some new infections may be caught from infectious agents, such as bacteria or viruses, circulating in the animal population (zoonoses). Certain infections may cause only mild infection in an animal species but more serious infections in people (and vice versa). At this stage we have no evidence that this is a zoonosis.

Is there a vaccine for this?

No, a vaccine is not available.

Is there a laboratory test?

The main test for this particular coronavirus is a PCR followed by sequencing. Full sequencing of the virus' genetic material is a complex test to absolutely confirm the strain of the virus.

What should I do if I am planning to travel to the Middle East?

Given that there have only been two confirmed cses worldwide, people planning to travel to the Middle East should continue with their plans. Travel advice will be kept under review if additional cases occur or when the patterns of transmission become clearer.

If I visited the Middle East and have signs of a cold/fever should I be worried?

If the symptoms are mild you almost certainly have an upper respiratory tract infecftion due to a common respiratory virus such as the common cold. However if the symptoms worsen considerably and you become very breathless you should contact your General Practitioner or NHS Direct mentioning which countries in the Middle East you have visited. Even with severe respiratory illness it is most likely that the diagnosis will be another more common respiratory pathogen, rather than this newly recognised coronavirus.

Is this similar to SARS?

SARS was also caused by a coronavirus but this is not SARS. Coronaviruses can cause a range of symptoms varying from mild symptoms such as the common cold to more serious respiratory illnesses. The two laboratory confirmed cases have experienced a serious respiratory illlness which makes it similar to SARS in this respect.

Last reviewed: 23 September 2012

http://www.hpa.org.uk/webw/HPAweb&HPAwebStandard/HPAweb_C/1317136202755

UN issues global alert over new SARS-like virus

 updated 1 hour 48 minutes ago

Qatari man is treated for disease almost identical to one that killed Saudi Arabian earlier this year

 A new virus belonging to the same family as the SARS virus that killed 800 people in 2002 has been identified in a Qatari man who had recently been in Saudi Arabia, the World Health Organisation said Sunday.

The United Nations health body, which issued a statement through its "global alert and response" system, said tests on the patient, a 49-year-old Qatari man, confirmed the presence of a new, or novel, coronavirus.

It said the U.K. scientists compared gene sequences of the virus from the Qatari patient with samples of virus sequenced by Dutch scientists from lung tissue of a fatal case earlier this year in a 60-year-old Saudi Arabia national. The two were almost identical, it said.

Coronaviruses are a large family of viruses which includes the common cold and SARS.

"Given that this is a novel coronavirus, WHO is currently in the process of obtaining further information to determine the public health implications," the statement said.

A statement by U.K. government experts said the symptoms included fever, cough or other respiratory symptoms.

The Qatari patient, who was moved to the U.K. for treatment, was in "strict respiratory isolation" with staff looking after him wearing protective clothing, it added.

SARS, or Severe Acute Respiratory Syndrome, appeared in China in 2002 and killed some 800 people globally before being brought under control.

Peter Openshaw, director of the Centre for Respiratory Infection at Imperial College London, said at this stage the novel virus looked unlikely to prove a concern, and may well only have been identified due to sophisticated testing techniques.

 Video: Taking precautions to prevent contagion (on this page)

"For now, I would be watchful but not immediately concerned," he told Reuters.

Openshaw said the fact the two cases found so far are apparently unrelated suggests "that what has been picked up is just some rare event that in past times might have been undiagnosed."

But he added: "Any evidence of sustained human-to-human transmission or of contact would be more worrying, raising the worry that another SARS-like agent could be emerging."

The WHO said it was not recommending any travel restrictions but would be seeking further information on the virus.

Yet another pig flu virus infects people

The WHO said the Qatari patient had first presented to doctors in Qatar on Sept. 3 with symptoms of an acute respiratory infection.

On Sept. 7, he was admitted to an intensive care unit in Doha, Qatar, and on Sept. 11, he was transferred to Britain by air ambulance from Qatar.

"The Health Protection Agency of the U.K. conducted laboratory testing and has confirmed the presence of a novel coronavirus," the WHO said.

Bird flu, pig flu, now bat flu?

A statement on the HPA's website quoted Professor John Watson, head of its respiratory diseases department, said that "in the light of the severity of the illness ... immediate steps have been taken to ensure that people who have been in contact with the U.K. case have not been infected, and there is no evidence to suggest that they have."

"As we are aware of only two cases worldwide and there is no specific evidence of ongoing transmission, at present there is no specific advice for the public or returning travellers to take but we will share any further advice with the public as soon as more information becomes available," he added.

Reuters contributed to this report.

http://www.msnbc.msn.com/id/49145381/ns/health-health_care/#.UGBC7NCXR8M