Thursday, December 5, 2013

ProMED: Avian influenza, human: China (HK) H7N9, quarantine

Date: Wed 4 Dec 2013
Source: The Standard [edited]
http://www.thestandard.com.hk/news_detail.asp?we_cat=11&art_id=140239&sid=41044259&con_type=3&d_str=20131204&fc=2


A total of 17 people who had contact with an Indonesian domestic helper critically ill with the [avian influenza] H7N9 strain are being sent to a holiday village for quarantine -- the 1st time the procedure has been activated since the SARS outbreak in 2003. The 36-year-old helper was confirmed on Monday [2 Dec 2013] as the 1st human case of H7N9 [avian influenza] in the city. She traveled to Shenzhen on 17 Nov 2013 to buy a live chicken at a market before slaughtering and cooking it in her employers' flat at Palatial Coast, Tuen Mun. She started displaying symptoms on 21 Nov 2013 and remains in critical condition in the intensive care unit of Queen Mary Hospital.

Among the 17 contacts are the helper's 2 employers and 8 of their family members, including their 2 sons, aged 10 and 13, and their parents, aged 78 and 80, who also live with them. They were sent to the Lady McLehose Holiday Village in Sai Kung for observation and retests. They could stay at the village for 10 days, which is the incubation period for this virus infection.

The rest of the close contacts, isolated at Princess Margaret Hospital, will also be moved to the camp over the next few days. The 10 family members and the helper's 33-year-old friend who accompanied her to Shenzhen have all tested negative for H7N9, which has so far killed 45 of 140 people infected in the mainland. 4 of the 10 have shown upper respiratory symptoms. 6 patients in the same ward as the helper at Tuen Mun Hospital where she was first admitted last Wednesday [27 Nov 2013] are waiting to be tested.

The 17 are among 200 contacts who have been traced and are being closely monitored. Another 7 doctors who had treated the woman at Tuen Mun and Queen Mary hospitals have upper respiratory symptoms but also tested negative. 2 private doctors in Tuen Mun who saw the woman still have to be tested. The Authorities said the risk of human-to-human transmission is low. "There is so far no evidence of the virus spreading to other persons," said Centre for Health Protection controller Leung Ting-hung. The Hospital Authority, meanwhile, said it will not allow visits at isolation wards in public hospitals.

[Byline: Mary Ann Benitez, Hilary Wong]

--
Communicated by:
ProMED-mail Rapporteur Mary Marshall

[Time will tell whether this is an over-action. So far there has been limited evidence of human-to-human transmission of avian H7N9 influenza virus infection. However the predominantly island location of Hong Kong provides an opportunity to critically examine this possibility.

Hong Kong is one of the 2 Special Administrative Regions of the People's Republic of China, the other being Macau. It is situated on China's south coast and, enclosed by the Pearl River Delta and South China Sea, With a land mass of 1104 sq km (426 sq mi) and a population of 7 million people, Hong Kong is one of the most densely populated areas in the world. Hong Kong's population is 93.6 percent ethnic Chinese and 6.4 percent from other groups. Hong Kong's Cantonese-speaking majority originate mainly from the neighbouring Canton (now Guangdong) province.

Under the principle of "one country, 2 systems", Hong Kong has a different political system from mainland China. Hong Kong's independent judiciary functions under the common law framework. Hong Kong Basic Law, its constitutional document, which stipulates that Hong Kong shall have a "high degree of autonomy in all matters except foreign relations and military defence," governs its political system. Hong Kong had the longest life expectancy of any region in the world in 2012. Maps of Hong Kong can be accessed at http://www.planetware.com/map/hong-kong-kowloon-new-territories-map-hk-hk10.htm and http://healthmap.org/r/1s3-. - Mod.CP]

http://www.promedmail.org/direct.php?id=2091984

Wednesday, December 4, 2013

Philippine airports on alert for bird flu #H7N9


MANILA, Dec. 4 (Xinhua) -- The Philippine government has alerted airport authorities to ensure that the deadly bird flu H7N9 could not enter the country following the recent discovery of first case in Hong Kong, the Philippines' Department of Health ( DOH) said Wednesday.

DOH spokesman Dr. Eric Tayag said the Philippines is still bird flu free at present, but Philippine "airports screen inbound travelers for fever so that early isolation can be done early."

Currently, he said the World Health Organization (WTO) and the DOH do not recommend travel ban to Hong Kong or China despite the reported first bird flu case in Hong Kong.

The Philippines, however, maintains ban on poultry imports from China as a precautionary measure against bird flu, he added.

Tayag said that symptoms of bird flu H7N9 include fever, sore throat or cough and progressive difficulty of breathing.

He advised the public to frequently wash the hands, cover the nose and mouth if coughing or sneezing, and wear face masks if needed.
To date there are 141 cases of bird flu and 47 deaths worldwide. Deaths were due to severe pneumonia with multi-organ failure. So far, two-thirds of bird flu H7N9 cases were males and two-thirds were more than 50 years old.

http://news.xinhuanet.com/english/world/2013-12/04/c_132941534.htm

Tuesday, December 3, 2013

CIDRAP: MERS-CoV: UAE reports cases, Qatar finds infected camels

December 2, 2013
Robert Ross

The United Arab Emirates (UAE) yesterday reported three Middle East respiratory syndrome coronavirus (MERS-CoV) cases in one young family, including a pregnant woman. That report came 4 days after Qatari officials revealed that the virus was found in three camels with links to two human case-patients.
The World Health Organization (WHO) said today that the UAE cases involved a 38-year-old man, a 32-year-old woman, and their 8-year-old son. Media reports said the three were from Jordan, but the WHO statement did not list their nationality. A report today in the UAE newspaper The National said the mother has died of her illness.

-SNIP-

Infected camels

Qatari officials reported the infected camels in a statement dated Nov 27, and the WHO followed up with its own statement Nov 29.

The WHO said the camel infections were found during the investigations of two human cases in Qatar, both in October. One involved a 61-year-old man who owns a farm and had significant contact with camels, sheep, and hens. The other case involved a 23-year-old man who worked in the other patient's barn. Qatar's Supreme Council of Health (SCH) said both of those patients recovered.

The WHO said the three infected camels were among a herd of 14 that were tested in the investigation of the human cases. All the camels seemed healthy or showed only mild signs of illness when samples were collected for MERS-CoV testing, and their status didn't change during their ensuing 40 days in isolation, the agency said.

Continued.  Complete article:  http://www.cidrap.umn.edu/news-perspective/2013/12/mers-cov-uae-reports-cases-qatar-finds-infected-camels 

Hong Kong to quarantine 17 people over bird flu case #H7N9

[editing is mine]
December 03, 2013
Beijing: Hong Kong will quarantine 17 people after the city confirmed its first human case of the deadly H7N9 bird flu, officials said on Tuesday.

The 17 are mostly relatives of the employer of a 36-year-old Indonesian domestic helper, who is in critical condition in a Hong Kong hospital after a visit to mainland China.

They were all taken to hospital for observation.

"If those who had been in close contact (with the patient) don't have symptoms, we will later arrange for them to enter quarantine facilities," health minister Ko Wing-man told a press conference.

"Tonight, five people who were in close contact and do not show signs of infection will enter the quarantine," Ko said, adding that they will be held until 10 days after their last contact with the carrier.

A government statement later said all 17 people had tested negative for the virus, but would be sent to a holiday village in the seaside town of Sai Kung "for medical surveillance".

The Indonesian domestic helper had a history of travelling to the mainland city of Shenzhen, just across the border with Hong Kong, and coming into contact with live poultry, Ko said on Monday.

"She has a history of travelling to Shenzhen, buying a chicken, slaughtering and eating the chicken," Ko said.

She was admitted to hospital on November 27 after developing a cough and shortness of breath.

The city has suspended imports of live poultry from Shenzhen and escalated its flu contingency plan to "serious".

"At this point, we reckon it could be an imported case, but the government will continue to follow this up with full effort," said Hong Kong Chief Executive Leung Chun-ying.

In all, 137 human cases of H7N9 have been reported in mainland China since February with 45 deaths, according to the World Health Organisation.

Continued:  http://www.timesofoman.com/News/Article-26555.aspx

Hong Kong confirms first case of #H7N9 bird flu

December 3, 2013
Hong Kong has confirmed its first case of the new strain of the H7N9 bird flu in a domestic worker from Indonesia.
The worker, 36, recently travelled to Shenzhen in the mainland and came into contact with live poultry. She is in critical condition, officials say.
H7N9 has infected more than 100 people since it emerged earlier this year.
The case in Hong Kong is a sign that the virus may be spreading beyond mainland China, where most infections have been reported, and Taiwan.
The World Health Organization (WHO) had said there was "no evidence of sustained human-to-human transmission", but also described H7N9 as an "unusually dangerous virus".
-snip-
Dr Ko Wing-man, Hong Kong's food and health secretary, confirmed the territory's first H7N9 case late on Monday.
He said that the patient "has a history of travelling to Shenzhen, buying a chicken, slaughtering and eating the chicken".
"She is now in critical condition at Queen Mary Hospital," he said, adding that four people in close contact with her were showing signs of flu-like symptoms.

Continued:  http://www.bbc.co.uk/news/world-asia-china-25181387

Bird Flu: Sneakly...Deadly...And lurking in China

December 2, 2013
Jason Gale

Chickens and ducks aren’t getting sick from a new strain of bird flu this flu season, but they’re giving it to people and some have died. People have killed infected birds to prevent its spread, but the virus still lurks. The new avian-flu variant killed 45 in China in the spring of 2013, provoking fear of a global contagion if it mutates. Live-bird markets were temporarily closed and farms were quarantined in response. That stopped human cases for two months. Two infections in October showed the virus circulating. Now a domestic helper living in Hong Kong has the disease, probably as a result of buying and slaughtering a chicken she bought in the neighboring Chinese city of Shenzhen. Scientists worry that poultry fattened for Chinese New Year feasts could spread avian influenza.


The Situation

Since February, 137 cases of H7N9 avian flu have been reported to the World Health Organization, most of them in eastern China in April. Some patients are still hospitalized after catching the germ, which can cause suffocation and organ failure. H7N9 isn’t nearly as infectious as the H1N1 swine flu strain that set off the 2009 influenza pandemic, the first in 41 years, but it appears to be a lot more deadly. Precisely how people get infected isn’t known, but poultry are implicated because most people are affected after exposure to fowl or to environments that might be contaminated with bird flu virus, like markets. There’s no evidence of sustained human-to-human spread. Dozens of farm workers have antibodies against H7N9, suggesting many were infected without getting sick.

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update December 2, 2013

December 2, 2013


On 1 December 2013 WHO was informed of an additional three laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) in the United Arab Emirates
The three cases belong to a family in Abu Dhabi – a mother (32 years old) who died 2 December 2013*, father (38 years old) and son (8 years old). The earliest onset of illness was 15 November 2013. The father is in a critical condition in hospital. The mother and father had no travel history, no contact with a known confirmed case and no history of contact with animals. While hospitalized, the mother gave birth to a newborn child. The 8 year old son, who has mild respiratory symptoms, was detected from epidemiological investigation of family contacts, and is being kept in hospital isolation. Further investigations into close contacts of the family, the newborn baby, and healthcare workers are on-going.
Additionally, two previously laboratory-confirmed cases from Qatar died on 15 and 21 November 2013**.
Globally, from September 2012 to date, WHO has been informed of a total of 163 laboratory-confirmed cases of infection with MERS-CoV, including 71 deaths.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.
Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.
Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.
All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

http://www.who.int/csr/don/2013_12_02/en/index.html 

Sunday, December 1, 2013

Vincent Racaniello & James Van Etten: 1st International Symposium on Giant Virus Biology


Giants among viruses
December 1, 2013

Vincent meets up with Chantal and Jean-Michel at the first International Symposium on Giant Virus Biology in Tegernsee, Germany, to discuss their work on Mimivirus, Megavirus, and Pandoravirus.

Click arrow to play Download TWiV 261 (52 MB .mp3, 72 min)

http://www.twiv.tv/2013/12/01/twiv-261-giants-among-viruses/

China Zhejiang New Human Case of #H7N9

November 29, 2013
A new human H7N9 bird flu case was diagnosed at the No.1 Affiliated Hospital of College of Medicine, Zhejiang University, the fifth in China this autumn, local health authorities said yeterday.
The patient surnamed Zhang, 57, from Anji County had tested the positive for the H7N9 virus on Wednesday when he chekced in for treatment for a fever, said the Zhejiang Provincial Health Department.
He then suffered respiratory failure and went into shock. His condition is critical, doctors said.

Friday, November 29, 2013

Abu Dhabi: Two cases Jordanian Corona resident and his wife #MERS #Coronavirus

November 28, 2013
Translation

Abu Dhabi HIV / Corona / two cases. Abu Dhabi on November 28 / WAM / announced the Health Authority of Abu Dhabi for the diagnosis of two cases of the virus, corona virus that causes AIDS Middle East respiratory patient Jordanian resident and his wife in a hospital in Abu Dhabi. has a patient age 38 years, suffering from respiratory symptoms admitted to hospital evacuated, where he was diagnosed and is receiving treatment currently in intensive care. was discovered injured wife the same disease which is eight months pregnant and infected with symptoms of acute respiratory and receiving treatment in intensive care at a hospital in the state. confirmed the Health Authority of Abu Dhabi they are in coordination with the Ministry of Health and bodies Health and relevant state in this regard and has taken the necessary measures and precautions in accordance with the recommendations of the scientific and conditions and criteria adopted by the World Health Organization, including epidemiological investigation of Mkhaltin. explained the Ministry of Health that the first HIV infection coronary new "virus Koruna" had been announced in the September 20, 2012 from by the World Health Organization until the end of November 2013 the organization announced about 163 confirmed cases of HIV Koruna globally. indicated the Ministry of Health to the World Health Organization confirmed that the virus is not a concern for public health at the moment and stressed that the current situation does not require any action to ban travel to any country in the world and does not require tests early in the ports states do not impose any restrictions on trade. assured the ministry everyone that cases detected around the world are still limited deployment compared to the types of other flu confirmed that health status is not a cause for concern and that the ministry is following the situation closely and including ensures the health and safety of everyone. WAM /

http://www.wam.org.ae/servlet/Satellite?c=WamLocAnews&cid=1290007543044&pagename=WAM%2FWAM_A_Layout

Thursday, November 28, 2013

Qatar MOH: Three camels hit by MERS Coronavirus in Qatar

Doha - Wednesday, 27 Nov 2013
The Supreme Council of Health and the Ministry of Environment in collaboration with the National Institute of Public Health and Environment (RIVM) of the Ministry of Health and the Erasmus Medical Centre in the Netherlands announced confirmation of the first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in 3 camels in a herd in Qatar in a barn, which is linked to two confirmed human cases who have since then recovered.
 
For transparency purposes, we can confirm that the 3 camels were investigated among a herd of 14 camels, and the samples were collected as part of the epidemiological investigation in coordination between the Public Health Department and the Department of Animal Resources. It is to be noted that none of the 14 camels showed any sign of disease when the samples were collected. As a precautionary measure, the 14 camels were put in quarantine since the initial sampling and after 40 days as of now, none have shown any symptom or sign of the disease.
 
For information, the presence of the MERS-CoV is newly recognized among animals, and currently there is neither clear scientific case definition nor enough information as to the role animals may play in transmitting and spreading the diseases.
 
All contacts of the two recovered MERS-CoV cases, including relatives, friends and workers in the same barn have been screened with negative results. The two Departments are following up with the reference laboratory and Erasmus Medical Centre to test additional samples from other animal species and from the environment of the barn. The joint team of the Supreme Council of Health and the Department of Animal Resources is continuously monitoring the development of this disease and taking all necessary measures to prevent the spread of the disease.
 
This discovery came as a result of the collaborative efforts between the two ministries, and the RIVM laboratory and Erasmus Medical Centre in the Netherlands, together with the World Health Organization (WHO). Currently the two Departments are conducting a national survey to investigate the presence of virus in animals, humans and the environment, and the potential modes of transmission and exposure to the virus among humans who are in close contacts with animals. Until more information is available, it is recommended, that as a precautionary measure, any animals that have been in close contact with newly detected human MERS-CoV cases are separated for investigation of the presence of infection with the virus.
 
It is also recommended that people with underlying health conditions, such as heart disease, diabetes, kidney disease, respiratory disease, the immunosuppressed, and the elderly, avoid any close animal contacts when visiting farms and markets, and to practice good hygiene, such as washing hands

http://www.sch.gov.qa/sch/En/catcontent.jsp?scatId=833&scatType=1&CSRT=13447084398935985536

Friday, November 22, 2013

WHO Summary & Literature Update #MERS #Coronavirus - Chart

The whole document is located on the right side-bar under MERS - Coronavirus, for future reference. Below is a Chart within the document.
http://www.who.int/csr/disease/coronavirus_infections/Update12_MERSCoV_update_22Nov13.pdf

Middle East respiratory syndrome coronavirus (MERS - CoV) summary and literature update – as of 22 November 2013

Since  April  2012,  157  laboratory-­‐confirmed  and  19  probable  cases  of  human  infection  with  Middle   East  respiratory  syndrome  coronavirus  (MERS-­‐CoV)  have  been  reported  to  WHO.    Three  new   countries—Spain,  Kuwait,  and  Oman—have  reported  patients  with  MERS-­‐CoV  since  the  last  update.   Infections  in  Kuwait  and  Oman  were  likely  acquired  locally,  while  the  two  probable  cases  reported   by  Spain  were  both  recent  travellers  to  the  Middle  East.  The  cases  in  Spain  have  not  yet  been   confirmed,  pending  finalization  of  the  laboratory  testing.  To  date,  affected  countries  in  the  Middle   East  include  Jordan,  Kingdom  of  Saudi  Arabia,  the  United  Arab  Emirates  (UAE),  Qatar,  Oman  and   Kuwait.  Europe  countries  reported  include:  France,  Germany,  the  United  Kingdom  (UK),  Italy  and   Spain,  and  in  North  Africa:  Tunisia  (Figure  1).
Eighteen  of  the  27  new  cases  reported  since  the  last  update  cases  were  sporadic,  that  is,  cases  that   were  reported  to  have  no  prior  contact  with  another  known  case  and  including  cases  that  were  the   first  case  within  a  cluster.    Seven  cases  reported  contact  with  previous  confirmed  cases  and  two  are   unclassified  due  to  lack  of  information.  
Of  note,  all  four  recently  confirmed  cases  from  Qatar  were  reported  to  have  farm  contact.  The  first   case  was  a  61-­‐year-­‐old  Qatar  national  without  history  of  travel  or  contact  with  confirmed  cases.  The   farms  include  a  variety  of  animals,  including  camels,  sheep  and  poultry.  The  second  case  is  a  23-­‐year-­‐ old  male  resident  who  worked  on  the  farm  owned  by  the  first  case.  He  displayed  very  mild   symptoms  and  was  discovered  as  part  of  contact  screening.  The  third  and  fourth  cases  are  a  48-­‐year-­‐ old  man  and  a  61-­‐year-­‐old  man,  respectively.  Both  had  no  history  of  contact  with  previously   laboratory-­‐confirmed  cases  but  a  preliminary  investigation  indicated  that  they  had  frequent   interactions  with  farm  animals.  A  comprehensive  investigation  into  animal  exposures  of  the  cases   has  been  launched  by  the  Supreme  Council  of  Health  of  Qatar.   
On  10  November  2013,  the  Ministry  of  Health  of  Saudi  Arabia  announced  the  detection  of  MERS-­‐CoV   in  a  specimen  taken  from  an  ill  camel  owned  by  a  laboratory-­‐confirmed  case  from  Jeddah.  This  case   had  direct  contact  with  the  ill  camel.  If  confirmed,  this  will  represent  the  first  detection  of  MERS-­‐CoV   in  camels.    
Of  the  176  laboratory-­‐confirmed  and  probable  reported  cases  to  date,  69  (39.2%)  have  died  and   65.3%  of  those  for  which  sex  is  known  were  male  (111/170).  The  median  age  of  the  cases  with   reported  age  is  51  years  (range  14  months  -­‐  94  years;  n=172).    Sporadic  cases  (n=62)  are  more  likely   to  be  male  (76%  vs.  58%)  and  above  the  age  of  50  years  old  (66%  vs.  39%)  compared  with  secondary   cases  (n=97).

Continued:  http://www.who.int/csr/disease/coronavirus_infections/Update12_MERSCoV_update_22Nov13.pdf

#MERS #Coronavirus MOH Saudi Arabia Update - November 21, 2013

21 November 13 A continuation of the work of the epidemiological investigation and constant follow-up carried out by the Ministry of Health of the Corona virus that causes respiratory syndrome Middle East, announced the ministry for an HIV-positive status register of a citizen of Riyadh region, at the age of 37 years, has died God's mercy. http://www.moh.gov.sa/CoronaNew/PressReleases/Pages/mediastatemenet-2013-11-21-001.aspx

#MERS #Coronavirus Saudi Arabia: New Case in Riyadh - 37 yo - & Death

Translation
November 22, 2013

Explicitly - Riyadh: Health Affairs announced in Riyadh today for the death of a person at the age of 37 years, after being Pfyrus Corona. In this case, the number of victims of the virus to the Corona (55) deaths from 130 cases since the discovery of the virus Smptmbr 2012.
 http://www.sra7h.com/?p=62197

Thursday, November 21, 2013

H7N9 avian influenza Latest news: Experts say the next few months, significantly increased risk of human infection

Translation
November 21, 2013
Since entering China in autumn and winter the number of cases of human infection with H7N9 emergence of bird flu, experts said recently, is expected in the coming months cases of human infection with H7N9 avian influenza risk will be significantly increased and remind motives and next year in spring this year, need to pay attention defense.

Continued:  http://translate.google.com/translate?hl=en&sl=zh-CN&u=http://www.ibtimes.com.cn/articles/33784/20131121/h7n9.htm&prev=/search%3Fq%3DH7N9%26newwindow%3D1%26client%3Dfirefox-a%26hs%3DyuT%26sa%3DX%26rls%3Dorg.mozilla:en-US:official%26biw%3D1096%26bih%3D744%26tbs%3Dqdr:h

#MERS #Coronavirus Saudi Arabia Details on Latest 2 Cases

[Posted earlier, here, this article from Arab News give us more details]

November 21, 2013
Health authorities on Wednesday announced a new MERS death, raising to 54 the number of people killed by the coronavirus in the Kingdom with the most fatalities.
A 73-year-old Saudi woman, infected by the virus and who had suffered chronic illnesses, died in Riyadh, the Health Ministry said in a statement on its website.
It also reported a new infection of a 65-year-old Saudi man in Al-Jouf province, currently receiving treatment at a Riyadh hospital.

http://www.arabnews.com/news/480691#.Uo3f-vKdr6Q.twitter

ProMED: MERS-CoV - Eastern Mediterranean (89): animal reservoir, camel susp

Published Date: 2013-11-19 17:24:58
Archive Number: 20131119.2064239
Date: Mon 18 Nov 2013
Source: CIDRAP [summarised, edited]
http://www.cidrap.umn.edu/news-perspective/2013/11/who-confirms-kuwaits-mers-cases-spain-cites-new-case


The World Organisation for Animal Health (OIE) said on [15 Nov 2013] that there was still no convincing evidence that camels are a source of MERS-CoV infections in humans, despite recent findings pointing in that direction. "Currently, there is no strong evidence to consider that camels are a source of infection for human cases of MERS," the OIE said in an update of its questions and answers about the virus.

In serologic studies reported in recent months, camels in Egypt, Oman, and the Canary Islands were found to have antibodies to MERS-CoV or a closely related virus. Further, last week, Saudi health officials reported finding the virus in a sick camel that belongs to a 43 year old case-patient from Jeddah.

Saudi officials said the camel tested positive for the virus by polymerase chain reaction. They said they were sequencing the genomes of the camel and patient's isolates to see whether they match; the results have not yet been reported.

The OIE statement focused on the serologic findings and did not refer to the report of the infected camel. "Currently, there is no strong evidence to consider that camels are a source of infection for human cases of MERS," the statement said. "Based on available epidemiological data, it is difficult to explain the relationship between positive serological results in camels and cases of human infections with MERS CoV.

"Indeed, to date, there is no potential similarity between the strain of MERS CoV isolated in humans and the suspicions shown in camels. It is important to remain open minded about all potential sources of exposure for human cases until more information is available."

The agency went on to say that, thanks to cross-reactivity, serologic tests may not distinguish between antibodies to different viruses that have genetic or antigenic similarities. "Serology tests for MERS CoV have not yet been validated in animals and may not be reliable," the OIE added. "If these tests, which may not be sufficiently specific, are used in animals, there is a risk that 'false positive' results will occur because it may not be possible to differentiate antibodies to MERS CoV from antibodies to other coronaviruses, commonly found in animals. This is why tests in animal should focus on isolating and identifying the virus itself," the agency said.

The OIE voiced a similar view back in July [2013] in an earlier version of the question-and-answer statement. At that point, there were no reports of serologic or virologic findings pointing to camels as a source of the virus, but at least one MERS patient had been reported to have had contact with a sick camel before he got sick.

[byline: Robert Roos]

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[OIE's "Questions and Answers MERS coronavirus (CoV)," updated on 15 Nov 2013, are available at http://www.oie.int/for-the-media/press-releases/detail/article/questions-and-answers-mers-coronavirus-cov/.

The following 2 passages may be of particular interest:

"1. What about serological tests in animals?

Serology tests aim to detect antibodies produced by the animal against the virus and not to search for the presence of the virus itself. Often, it is difficult and sometimes impossible to distinguish antibodies to different viruses having genetic or antigenic similarities, due to what is known as serological 'cross reactivity'.

Serology tests for MERS CoV have not yet been validated in animals and may not be reliable. If these tests, which may not be sufficiently specific, are used in animals, there is a risk that 'false positive' results will occur because it may not be possible to differentiate antibodies to MERS CoV from antibodies to other coronaviruses, commonly found in animals.

That is why tests in animals should focus on isolating and identifying the virus itself.

2. What would happen if MERS CoV is identified in animals?

If information from public health investigations identifies a possible animal source, OIE will support further joint investigations.

OIE Member Countries would be obliged to report a confirmed case of MERS CoV in animals to OIE, as an 'emerging disease' in accordance with article 1.1.3 of the OIE Terrestrial Animal Health Code. If MERS CoV was identified in an animal, this would not necessarily mean that the animal is a source of human infection. Detailed investigations would then be needed to understand the relationship between any animal cases and human cases and whether a finding in animals would be significant for human infection."

On 12 Nov 2013, Saudi Arabia's Ministry of Health notified the 1st time that a camel related to a human case tested positive for MERS-CoV by PCR (posting 20131112.2051424). Reportedly, further testing was ongoing to sequence the patient and the camel virus and compare genetic similarity levels to conclude causality. The results of these tests are not yet available.

If the camel strain is found homologous to the human strain, OIE's requirements, as spelled out above, will have to be fulfilled, namely notification of the case as an 'emerging disease'. In the meantime, precautionary measures, including the isolation of in-contact animals on the suspected farm, have been undertaken by the Saudi authorities (posting 20131113.2053932).

For a recent response from neighbouring Dubai, see http://gulfnews.com/news/world/usa/mers-link-to-camels-opens-a-pandora-s-box-1.1255185. - Mod.AS

http://www.promedmail.org/direct.php?id=2064239

Wednesday, November 20, 2013

#MERS #Coronavirus High mortality virus Coruna in Saudi Arabia to 54 people

Translation
11/20/2013 11:12:31 AM
The Ministry of Health announced Wednesday Arabia and the death of a citizen Corona virus, bringing the total number of those who have died of this disease to 54 people.
The ministry said on its website the death of the first infected a citizen in Riyadh (73 years) suffering from several chronic diseases.
She added that the citizen (65 years) from the northern region of Jawf, suffering from several chronic diseases, HIV and injured receives treatment in the Riyadh region intensive care.
Thus, the number of deaths from the virus Coruna 54 people out of 129 have suffered the disease in Saudi Arabia.
In total, constitutes Arabia first nucleus of the Corona virus that causes respiratory syndrome Middle East recorded the largest number of infections since the virus appeared in September 2012.
The ministry announced on 11 this month for the first time the discovery of sentences infected with Corona in Jeddah, western Saudi Arabia.
As long as the World Health Organization (WHO) expressed the belief that the virus is transmitted via the animals but has been unable so far to find concrete evidence on it.

WHO: Frequently Asked Questions on Middle East respiratory syndrome coronavirus (MERS-CoV)

Updated 19 November 2013

http://www.who.int/csr/disease/coronavirus_infections/faq/en/index.html

WHO: Seroepidemiological Investigation of Contacts of Middle East Respiratory Syndrome Coronavirus ( MERS - CoV ) Patients

19 November 2013
A Screen Shot:



http://www.who.int/csr/disease/coronavirus_infections/WHO_Contact_Protocol_MERSCoV_19_November_2013.pdf

WHO issues global red alert on respiratory infections

hat-tip makoto_au_japon - editing is mine -
By Victor Iluyemi
November 19, 2013 19:07:44pm GMT
WorldStage Newsonline-- The World Health Organisation (WHO) in a statement on Tuesday placed all health care providers on red alert on possible outbreak of Severe Acute Respiratory Infections (SARI).

WHO urges all countries to maintain their surveillance for SARI and to carefully review any unusual patterns.
It said recent travellers returning from the Middle East who develop SARI should be tested for Middle East respiratory syndrome coronavirus (MERS-CoV) as advised in the current surveillance recommendations.
Globally, from September 2012 to date, WHO has been informed of a total of 157 laboratory-confirmed cases of infection with MERS-CoV, including 66 death.

WHO also  informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) from Kuwait. The first patient, the statement noted, is a 47 year-old man who became ill on 30 October 2013 and was hospitalised on 7 November 2013. He is in critical condition. The second patient is a 52-year-old man with underlying medical conditions. He became ill on 7 November and was hospitalised on 10 November 2013. He is in critical condition.

Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.

Health care facilities, WHO stated are reminded of the importance of systematic implementation of infection prevention and control (IPC).

“Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors,” it said.
"All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
"WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
"WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met."

#MERS #Coronavirus Qatar - Confirmed Case of 61(M) Has Died

November 20, 2013

Qatar's Supreme Council of Health said in a statement on Tuesday that the 61-year-old man died after contracting MERS, adding the man also suffered from underlying “chronic illnesses.”

The statement also said that another man, 48, was discharged from a hospital following a three-week treatment for the coronavirus.

In September, Qatar’s health officials announced two other deaths from MERS.

Earlier this month, the World Health Organization (WHO) said that it was informed of 152 confirmed cases of MERS across the world, adding that at least 64 people died from the disease by November 4.

Saudi Arabia’s Health Ministry said in a statement on November 10 that a total of 53 people have died from the virus in the kingdom.

MERS is a cousin of SARS virus that broke out in Asia in 2003, killing some 800 people.

The virus first emerged in the Middle East, and was discovered on September 2012 in a Qatari man who had recently traveled to Saudi Arabia.

Cases have also been reported in Jordan, Qatar, Germany, France, Italy, Tunisia and the United Kingdom. 


http://www.presstv.ir/detail/2013/11/20/335628/man-dies-of-mers-coronavirus-in-qatar/

Monday, November 18, 2013

CIDRAP: WHO confirms Kuwait's MERS cases; Spain cites new case

CIDRAP Update
November 18, 2013
Excerpt:

Another likely case in Spain

Meanwhile, Spanish officials said a woman who traveled to Saudi Arabia with Spain's first probable MERS case-patient is believed to have the virus, the Canadian Press reported today. Officials said the two women shared sleeping quarters.
Spain's health ministry said there was not enough evidence to determine if one of the women caught the disease from the other or if both caught it from a common source, the story said.
The ministry said both women have recovered and have been released from hospitals. Also, authorities said that so far the two women's contacts, including airline passengers and contacts in Spain, have all tested negative for the virus.
Both women tested positive for the virus, but their cases are classified as probable because the WHO case definition requires additional testing, according to the story.
Hartl commented via Twitter today that the first case in Spain, reported by Spanish authorities on Nov 6, still "has not been confirmed to WHO standards." Spanish officials said the case involved a 61-year-old woman.

OIE cool on camel connection

In other developments, the World Organization for Animal Health (OIE) said on Nov 15 that there was still no convincing evidence that camels are a source of MERS-CoV infections in humans, despite recent findings pointing in that direction.
"Currently there is no strong evidence to consider that camels are a source of infection for human cases of MERS," the OIE said in an update of its questions and answers about the virus.
In serologic studies reported in recent months, camels in Egypt, Oman, and the Canary Islands were found to have antibodies to MERS-CoV or a closely related virus. Further, last week Saudi health officials reported finding the virus in a sick camel that belongs to a 43-year-old case-patient from Jeddah.
Saudi officials said the camel tested positive for the virus by polymerase chain reaction. They said they were sequencing the genomes of the camel and patients isolates to see if they match; the results have not yet been reported.
The OIE statement focused on the serologic findings and did not refer to the report of the infected camel.
"Currently there is no strong evidence to consider that camels are a source of infection for human cases of MERS," the statement said. "Based on available epidemiological data it is difficult to explain the relationship between positive serological results in camels and cases of human infections with MERS CoV.
"Indeed, to date, there is no potential similarity between the strain of MERS CoV isolated in humans and the suspicions shown in camels. It is important to remain open minded about all potential sources of exposure for human cases until more information is available."
The agency went on to say that, thanks to cross-reactivity, serologic tests may not distinguish between antibodies to different viruses that have genetic or antigenic similarities.
"Serology tests for MERS CoV have not yet been validated in animals and may not be reliable," the OIE added. "If these tests, which may not be sufficiently specific, are used in animals there is a risk that 'false positive' results will occur because it may not be possible to differentiate antibodies to MERS CoV from antibodies to other coronaviruses, commonly found in animals."
"This is why tests in animal should focus on isolating and identifying the virus itself," the agency said.
The OIE voiced a similar view back in July in an earlier version of the question-and-answer statement. At that point there were no reports of serologic or virologic findings pointing to camels as a source of the virus, but at least one MERS patient had been reported to have had contact with a sick camel before he got sick.
http://www.cidrap.umn.edu/news-perspective/2013/11/who-confirms-kuwaits-mers-cases-spain-cites-new-case

#MERS #Coronavirus Kuwait Update on 2 Confirmed Cases & Surveillance

November 18, 2013
Translation - Excerpt:

In the meantime, the head of the Unit for Combating epidemics Ministry of Health, Dr. Musab al-Saleh, the existence of two مصابتين virus Coruna in Kuwait, including not live up to as it «epidemic» so far, which means that the chances of turning into an epidemic in the future «very small» because of the nature of the disease , diminishing any need to reduce movement and visit public places, hospitals and travel in order to avoid becoming infected with Corona. And the common good, in a press conference yesterday that the two cases Kuwait announced officially last week they got infected Corona «are still shall receive the treatments under medical supervision extensively in rooms, intensive care», indicating that the first case, lying in a hospital communicable diseases, the second is in Adan Hospital (south of the country), the fact that the patient is suffering problems of the heart muscle, and has the expertise in Adan Hospital for treatment. Saleh stressed that Kuwait has not recorded any new cases of Corona virus since last week, revealing that the number of cases suspected of being infected with the virus that have been tested since the announcement of the first case of infected reached 64 people, and all results were negative.

http://aawsat.com/details.asp?section=4&issueno=12775&article=750737&feature=#.UoqrfmTk-DM

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update November 18, 2013

WHO has been informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) from Kuwait.
The first patient is a 47 year-old man who became ill on 30 October 2013 and was hospitalised on 7 November 2013. He is in critical condition. The second patient is a 52-year-old man with underlying medical conditions. He became ill on 7 November and was hospitalised on 10 November 2013. He is in critical condition.
Globally, from September 2012 to date, WHO has been informed of a total of 157 laboratory-confirmed cases of infection with MERS-CoV, including 66 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.
Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.
All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.
WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

Sunday, November 17, 2013

Kuwait: Two Almassabtan cases are still under medical care

Translation
November 18, 2013

Health Ministry denied what has been circulated in some social networking sites (Twitter) with respect to the occurrence of new infections disease Corona citizen in the fourth decade of life yesterday.
The ministry said in an official statement it yesterday, that the information frequent the presence of new cases of HIV Corona incorrect, where was no positive case in the laboratories of the Ministry of Health until today (yesterday), noting that the case المصابتين are still in the hospital Adan and communicable diseases, explaining they were under close medical care, and wished a speedy recovery for them.

Awareness campaign
Furthermore, the Chairperson of the Committee announced awareness for the prevention of respiratory diseases in the Ministry of Health, d. Ghalia Al-Mutairi, start a ministry to the implementation of the second phase of awareness against respiratory diseases, including 'Corona', where she was the first phase in September and October, two years, and focused on the pilgrims in particular.
She added, in a press statement yesterday that the second phase during November and December, and will be a class doctors from within the categories, to achieve awareness for all categories of society, pointing out that the second phase has already started, by holding Enlightening meeting is important for physicians about the disease Corona, and was attended by nearly 150 doctors from various disciplines, indicating that within the continuing education programs by 3 points, and have been the work of awareness messages (SMS) to the nursing body on how to deal with suspected cases of bird flu and infectious respiratory disease and ways to prevent them.

She Mutairi that the ministry has recently formed a committee to raise awareness about respiratory diseases, including «Corona» and the Commission during the past two months to intensify its efforts to sensitize many categories of the community about the seriousness of respiratory diseases and ways to prevent them, announcing cooperation with the Girl Guides Association of Kuwait, to deliver a lecture on Multi vaccination Alanlfonza and methods of prevention of diseases, respiratory infections for patients with diabetes at the Assembly Bpenid bitumen, which will be the distribution of publications and brochures for the prevention of diseases, respiratory diseases, as was agreed with the Academy of Saad Al-Abdullah to set up on an awareness and a lecture on how to prevent diseases, respiratory diseases.

Corona viruses {}
She stressed the existence of cooperation with the Ministry of Education, where he was to open channels of communication with officials in the private education sector, noting boil that there will be a periodical educational The Commission issued in collaboration with the Ministry of Education by twice each semester, through which the dissemination of health information documented and awareness students, teachers and parents healthy behaviors, in addition to organizing awareness open day involving several schools of different age groups, where it has been agreed to be in the month of December, in collaboration with the school run by the health and direction of physical education in special education administration.

64 deaths
Regarding the current status of the virus, indicated d. Al-Mutairi, that Corona is a virus common in all parts of the world, cause colds usually, indicating that the virus Koruna new which causes what is now called «syndrome Middle East respiratory MERS» cause «between April 2012 to today» infecting number of 152 laboratory-confirmed case including 64 deaths, a banner Elian symptoms were fever, cough, shortness of breath, as this virus is different from viruses المكللة the other wounded people, and caused them to diseases, it also differs from this virus also virus Corona that caused SARS (severe acute respiratory), in in 2003.

Health Promotion Department
Included Undersecretary of the Ministry of Health. Khaled Sahlawi, both d. Dreams Ruwaih and Mishari Anzi from the Department of Health Promotion, in addition to d. Nur ÇáäíČÇŃí to membership of the Sub-Committee for health awareness to combat Coruna, while re-agent Sahlawi the formation of the Standing Committee of publications headed by an observer health records in the National Center for Health Information Fatima Al-Kandari.


http://www.alqabas.com.kw/node/815001

Kuwait: Health Ministry Is Ready For A Pandemic

Translation
November 18, 2013

According to a member of the Committee on Health and Labour MP Khalil Saleh that his committee met today with the team and the Ministry of Health, headed by the undersecretary of the ministry, for the order to stand on their readiness for a pandemic «Corona» he said, adding that the committee listened to a detailed explanation of the entire all precautionary measures undertaken by the ministry to address for this disease, which began to emerge in Kuwait through the registration of two cases.

He assured the good citizens and residents that was confirmed by a team of the Ministry of Health that people with just individual cases do not cause panic and fear, pointing out that the number of infections disease Coruna in the whole world did not exceed 165 cases, in particular the spread is very slow compared to swine flu or SARS and other .

And revealed that he turned out to members of the Health Committee, said the Ministry of Health has a general willingness to confront the disease and respond to and deal with scientific methods at the highest level.

Saleh stressed that the health committee will Taatdkhr effort to follow the steps the ministry and its strategic plan to address all diseases, whether through the provision of medical staff or medications and treatments, indicating that the ministry stressed that the team the opportunity to turn this disease epidemic in Kuwait is very weak.