29 October 2013 -
WHO has been informed of an additional laboratory-confirmed
case of Middle East respiratory syndrome coronavirus (MERS-CoV)
infection in Qatar.
The patient is a 23-year-old man who was identified as a close
contact of a previously laboratory-confirmed case as part of the
epidemiological investigation. He is a worker in the animal barn owned
by the previously laboratory-confirmed case. The man developed mild
symptoms of illness and is in good condition. Preliminary
investigations revealed that he did not recently travel outside the
country.
Globally, from September 2012 to date, WHO has been informed
of a total of 145 laboratory-confirmed cases of infection with MERS-CoV,
including 62 deaths.
Continued:
http://www.who.int/csr/don/2013_10_29a/en/index.html
Tuesday, October 29, 2013
Sunday, October 27, 2013
MERS-CoV antibodies not found in children in 2010-11 or adults from 2012
From Virology Down Under Blog:
October 27, 2013
Gierer and colleagues from the German primate center and the University of Dammam in Saudi Arabia, have presented the findings of their study of antibodies to the Middle East respiratory syndrome coronavirus (MERS-CoV).
The publication, in Emerging Infectious Diseases (ahead of print - you can find it here, at least until it's other link here starts working), measured the antibodies capable of blocking infection by MERS-CoV, called "neutralising antibodies" with a method they have described before. The assay was not validated with multiple MERS-CoV-positive patient sera, but appeared specific in the testing completed.
Patient samples from the area served by King Fahd Hospital were obtained from:
October 27, 2013
Gierer and colleagues from the German primate center and the University of Dammam in Saudi Arabia, have presented the findings of their study of antibodies to the Middle East respiratory syndrome coronavirus (MERS-CoV).
The publication, in Emerging Infectious Diseases (ahead of print - you can find it here, at least until it's other link here starts working), measured the antibodies capable of blocking infection by MERS-CoV, called "neutralising antibodies" with a method they have described before. The assay was not validated with multiple MERS-CoV-positive patient sera, but appeared specific in the testing completed.
Patient samples from the area served by King Fahd Hospital were obtained from:
- Children (158 sera, 77 female, mean age 12 months) admitted to hospital with lower respiratory tract infections during 12-months form May 2010.
- Adult (110 plasma samples, all males, mean age 28-years, upper limit of 52-years) blood donors
No sera or plasma had neutralising MERS-CoV antibodies.
The authors conclude that <2.3% of children and <3.3% pod adults were seropositive though, because that accounts for the upper limit of the confidence intervals. They also note that their sampling of hospitalized children couldhave missed an antibody response (because it takes time to develop) if they had only just been admitted to hospital for MERS-CoV.
http://virologydownunder.blogspot.com.au/2013/10/mers-cov-antibodies-not-found-in.html
http://virologydownunder.blogspot.com.au/2013/10/mers-cov-antibodies-not-found-in.html
Study: Uncommon #H5N1 mutations may transmit in mammals
Excerpt
CIDRAP
CIDRAP
A study assessing H5N1 avian flu mutations as the virus spreads in ferrets found that mutations that were present in as few as 5.9% of the viruses infecting one ferret could be transmitted to another, according to data published this week in Nature Communications.
US and Japanese researchers, including Yoshihiro Kawaoka, DVM, PhD, of the University of Wisconsin, used data from transmission studies already conducted by Kawaoka in 2011 on engineered H5N1 strains. Publication of that controversial work was originally halted but later allowed by US biosecurity experts.
The team used deep sequencing to identify genetic mutations that happened as the virus replicated in and transmitted between ferrets. They found that during transmission natural selection acts strongly on hemagglutinin (HA), the protein the virus uses to attach to host cells.
They found that within-host genetic diversity in HA increases during replication but is dramatically reduced upon transmission via respiratory droplets—to only one or two distinct HA segments, a small portion of the viral genome.
However, the discovery that mutations present in only 5.9% of the viruses infecting one ferret could be transmitted to another suggests that even rare mutations could be transmitted if they have an evolutionary advantage, according to a Science Daily story on the study.
"Fully avian viruses may act differently in nature," said lead author Thomas Friedrich, PhD, from the University of Wisconsin. "But the data suggest to us that it wouldn't take many viruses from a chicken to infect a person, if the right mutations were there—even if they were a tiny minority of the overall virus population."
Oct 23 Nature Comm abstract
Oct 23 Science Daily story
Oct 23 Nature Comm abstract
Oct 23 Science Daily story
WHO: Human infection with avian influenza A(H7N9) virus – update October 24, 2013 #H7N9
24 OCTOBER 2013 - The National Health and Family Planning Commission, China notified WHO of a new laboratory-confirmed case of human infection with avian influenza A(H7N9) virus.
The patient is a 67-year-old man from Zhejiang Province. He is a farmer, and has had contact with live poultry. He became ill on 16 October 2013, was admitted to a local township hospital on 18 October 2013, and was transferred to another hospital on 21 October 2013 as his condition deteriorated. He is currently in a critical condition.
To date, WHO has been informed of a total of 137 laboratory-confirmed human cases with avian influenza A(H7N9) virus infection including 45 deaths. Currently, four patients are hospitalized and 88 have been discharged. So far, there is no evidence of sustainable human-to-human transmission.
The Chinese government has taken the following surveillance and control measures:
- strengthening of epidemic surveillance and analysis;
- deployment of medical treatment;
- conducting public risk communication and information dissemination;
- strengthening international cooperation and exchanges; and
- is continuing to carry out scientific research.
WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.
Nearly 1m pilgrims received medical aid this Haj #MERS #Coronavirus
October 27, 2013
RIYADH — Nearly half of the pilgrims who came from abroad for this year's Haj received various kinds of healthcare services during their stay in the holy cities, according to the Kingdom's deputy minister of health.
"A total of 997,379 pilgrims from various nationalities have received healthcare services of varying degrees," Ziad Maimish said while addressing the fourth Islamic Health Ministers Conference currently under way in the Indonesian capital Jakarta.
Maimish explained how the Kingdom was able to successfully organize an epidemic-free Haj at a time the entire world was apprehensive of a possible Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak during the annual pilgrimage.
Maimish cited a number of measures put in place by the Saudi health authorities to prevent any outbreak of contagious diseases among pilgrims.
These measures included policies formulated by the National Committee for Infectious Diseases on prevention and dealing with infections, levels of emergency preparedness and application of necessary measures to intensify early epidemiological surveillance, including special procedures for MERS-CoV.
In addition, the Health Ministry made available laboratory equipment and materials necessary to conduct quick tests and analysis for all viruses, vectors and pathogens. It also ensured the continuation of developing health centers in the holy cities of Makkah and Madinah.
The authorities also secured most modern diagnostic and therapeutic devices for ambulatory services to enable fast field treatment or hospital transfers. This was in addition to developing speedy ambulance tracking and directing services, Maimish said.
To face the MERS-CoV challenge, he said, the Saudi authorities installed a new laboratory at Mina Wadi Hospital, which is at the heart of the pilgrimage zone, for rapid conduct of tests for suspected cases and getting test results within a matter of hours.
This was in addition to existing laboratory facilities in Jeddah and Madinah.
Some 22,500 health workers from across the Kingdom arrived to staff 25 hospitals with 5,250 beds and 141 health centers at four main pilgrim centers.
As part of this year's health guidelines for incoming pilgrims, the National Scientific Committee for Infectious Diseases recommended that people older than 65, children, pregnant women and those with underlying conditions should postpone their pilgrimage due to the MERS-CoV risk.
Maimish pointed out that the health authorities conducted random checks of pilgrims at air, land and sea ports of entry to monitor compliance with the preventive health measures for Haj. More than 2,000 healthcare professionals were deployed at various entry points to carry out this task.
As many as 613,050 external pilgrims were vaccinated at the entry points — 430,500 against polio and 182,550 against meningitis, Maimish said.
He added that in addition to detailed investigations of every suspected case, case-control studies for index cases and intensive follow-up of contacts with serological testing to improve understanding of the critical features of MERS-CoV infection were carried out.
This year’s Haj was termed critical by the World Health Organization (WHO) due to the looming MERS virus that has claimed at least 58 lives — mostly in Saudi Arabia — since it first emerged in 2012.
For the fourth consecutive year, WHO has been invited by the Ministry of Health to observe and to provide any required technical assistance during the Haj.
http://saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20131027184826
RIYADH — Nearly half of the pilgrims who came from abroad for this year's Haj received various kinds of healthcare services during their stay in the holy cities, according to the Kingdom's deputy minister of health.
"A total of 997,379 pilgrims from various nationalities have received healthcare services of varying degrees," Ziad Maimish said while addressing the fourth Islamic Health Ministers Conference currently under way in the Indonesian capital Jakarta.
Maimish explained how the Kingdom was able to successfully organize an epidemic-free Haj at a time the entire world was apprehensive of a possible Middle East Respiratory Syndrome Coronavirus (MERS-CoV) outbreak during the annual pilgrimage.
Maimish cited a number of measures put in place by the Saudi health authorities to prevent any outbreak of contagious diseases among pilgrims.
These measures included policies formulated by the National Committee for Infectious Diseases on prevention and dealing with infections, levels of emergency preparedness and application of necessary measures to intensify early epidemiological surveillance, including special procedures for MERS-CoV.
In addition, the Health Ministry made available laboratory equipment and materials necessary to conduct quick tests and analysis for all viruses, vectors and pathogens. It also ensured the continuation of developing health centers in the holy cities of Makkah and Madinah.
The authorities also secured most modern diagnostic and therapeutic devices for ambulatory services to enable fast field treatment or hospital transfers. This was in addition to developing speedy ambulance tracking and directing services, Maimish said.
To face the MERS-CoV challenge, he said, the Saudi authorities installed a new laboratory at Mina Wadi Hospital, which is at the heart of the pilgrimage zone, for rapid conduct of tests for suspected cases and getting test results within a matter of hours.
This was in addition to existing laboratory facilities in Jeddah and Madinah.
Some 22,500 health workers from across the Kingdom arrived to staff 25 hospitals with 5,250 beds and 141 health centers at four main pilgrim centers.
As part of this year's health guidelines for incoming pilgrims, the National Scientific Committee for Infectious Diseases recommended that people older than 65, children, pregnant women and those with underlying conditions should postpone their pilgrimage due to the MERS-CoV risk.
Maimish pointed out that the health authorities conducted random checks of pilgrims at air, land and sea ports of entry to monitor compliance with the preventive health measures for Haj. More than 2,000 healthcare professionals were deployed at various entry points to carry out this task.
As many as 613,050 external pilgrims were vaccinated at the entry points — 430,500 against polio and 182,550 against meningitis, Maimish said.
He added that in addition to detailed investigations of every suspected case, case-control studies for index cases and intensive follow-up of contacts with serological testing to improve understanding of the critical features of MERS-CoV infection were carried out.
This year’s Haj was termed critical by the World Health Organization (WHO) due to the looming MERS virus that has claimed at least 58 lives — mostly in Saudi Arabia — since it first emerged in 2012.
For the fourth consecutive year, WHO has been invited by the Ministry of Health to observe and to provide any required technical assistance during the Haj.
http://saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20131027184826
#MERS #Coronavirus Saudi Arabia 3 recorded cases of Corona virus in the East
Translation
October 27, 2013
October 27, 2013
In the framework of the epidemiological investigation and ongoing follow-up carried out by the Ministry of Health for HIV (Corona) that causes respiratory syndrome Middle East MERS-CoV Ministry announces the registration of three cases infected with the virus in the Eastern Province.
First of citizenship at the age of 83 years, close contact with a confirmed case and has several chronic diseases and receive intensive care treatment and in stable condition.
Second resident working in the health sector at the age of 54 years old, and has a chronic illness and receiving treatment for intensive care and in a stable condition.
Third citizen at the age of 49 years, receiving intensive care treatment and his condition is stable. We wish for all healing.
Friday, October 25, 2013
WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update October 24, 2013
24 October 2013 -
The National Health and Family Planning Commission, China
notified WHO of a new laboratory-confirmed case of human infection with
avian influenza A(H7N9) virus.
The patient is a 67-year-old man from Zhejiang Province. He is a farmer, and has had contact with live poultry. He became ill on 16 October 2013, was admitted to a local township hospital on 18 October 2013, and was transferred to another hospital on 21 October 2013 as his condition deteriorated. He is currently in a critical condition.
To date, WHO has been informed of a total of 137 laboratory-confirmed human cases with avian influenza A(H7N9) virus infection including 45 deaths. Currently, four patients are hospitalized and 88 have been discharged. So far, there is no evidence of sustainable human-to-human transmission.
The Chinese government has taken the following surveillance and control measures:
http://www.who.int/csr/don/2013_10_24a/en/index.html
The patient is a 67-year-old man from Zhejiang Province. He is a farmer, and has had contact with live poultry. He became ill on 16 October 2013, was admitted to a local township hospital on 18 October 2013, and was transferred to another hospital on 21 October 2013 as his condition deteriorated. He is currently in a critical condition.
To date, WHO has been informed of a total of 137 laboratory-confirmed human cases with avian influenza A(H7N9) virus infection including 45 deaths. Currently, four patients are hospitalized and 88 have been discharged. So far, there is no evidence of sustainable human-to-human transmission.
The Chinese government has taken the following surveillance and control measures:
- strengthening of epidemic surveillance and analysis;
- deployment of medical treatment;
- conducting public risk communication and information dissemination;
- strengthening international cooperation and exchanges; and
- is continuing to carry out scientific research.
http://www.who.int/csr/don/2013_10_24a/en/index.html
WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update October 24, 2013
24 October 2013
WHO has been informed of two laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia on 18 and 19 October 2013, and three laboratory-confirmed cases on 18 September 2013.
Of the five laboratory-confirmed cases, two died. The ages of the five patients range from 35 to 83 years old; four men and one woman; two from Medinah and three Riyadh. Four patients had underlying medical conditions. Two patients reported having no contact with a laboratory-confirmed case or with animals prior to becoming ill.
Globally, from September 2012 to date, WHO has been informed of a total of 144 laboratory-confirmed cases of infection with MERS-CoV, including 62 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.
http://www.who.int/csr/don/2013_10_24/en/index.html
Monday, October 21, 2013
#MERS #Coronavirus Saudi Arabia Dr. Memish: Pilgrims' Health Status Is Reassuring...No Epidemic Cases Detected
16 October 2013
Speaking of the ways of dealing with any Coronavirus case, Allah
forbid, Dr. Memish said that the Ministry has a several-phase plan to
face these potential cases; such a plan starts with diagnosing the case
and testing the health practitioners, with isolation of the positive
cases in rooms allocated for this purpose and examination of the close
people, pointing out that the laboratories have already been equipped
with equipments.
http://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/news-2013-10-16-005.aspx
The
Deputy Minister for Public Health and the Head of the Hajj Curative
Medicine Committee, Dr. Ziad bin Ahmed Memish, said that the health
situation is reassuring, and there are no epidemic diseases among
pilgrims thankfully so far.
In addition, the Ministry of Health (MOH) has not yet recorded any
cases of meningitis or food poisoning in the Holy Sites, expressing his
hope that the health situation continues as it is now so that the
pilgrimage season passes safely without recording any epidemic or
quarantine diseases.
Within the same vein, Dr. Memish announced at a news conference
held on Tuesday that the Kingdom has updated its health requirements
this year after following up and monitoring the global heath situation
throughout the year in collaboration with the World Health Organization
(WHO) and the research and diseases centers in America and Europe.
In addition, Dr. Memish underscored that the MOH has launched a
huge awareness campaign targeting the countries from which the pilgrims
come, adding that such campaigns focus on the pilgrimage ports and
areas; contributing significantly to obtaining such good fruits so far.
Within the same vein, Dr. Memish pointed out that based upon the
MOH’s accumulated experiences and study of cases with Coronavirus, the
Ministry advices the elderly people, patients with chronic diseases,
pregnant women and children to postpone the performance of Hajj, after
founding that 75% of the Coronavirus deaths which are recorded locally
and globally occur amidst such segments of people.
Moreover, Dr. Memish underscored that the Ministry is currently
working on preparation and implementation of 10 studies expected to help
in dealing with the pilgrims and contributing to the development of
solutions to any emergent health problems, especially the infectious and
epidemic diseases which attract the attention of the Ministry, noting
that some of such studies are related to Coronavirus while others are
related to meningitis and the other viruses widely spread in the world.
Furthermore, Dr. Memish mentioned that the study teams have ended
the first phase, during which random samples were taken from pilgrims
coming from abroad, noting that the second phase will kick off on
Thursday 12/12/1434H (corresponding to 17/10/2013) by taking samples
from the pilgrims before their departure to make sure that they are free
from diseases and to recognize their health status.
http://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/news-2013-10-16-005.aspx
Flu virus wipes out immune system’s first responders to establish infection
Hat-tip: Flutrackers.com
October 19, 2013
CAMBRIDGE, Mass. – Revealing influenza’s truly insidious nature, Whitehead Institute scientists have discovered that the virus is able to infect its host by first killing off the cells of the immune system that are actually best equipped to neutralize the virus.
Confronted with a harmful virus, the immune system works to generate cells capable of producing antibodies perfectly suited to bind and disarm the hostile invader. These virus-specific B cells proliferate, secreting the antibodies that slow and eventually eradicate the virus. A population of these cells retains the information needed to neutralize the virus and takes up residence in the lung to ward off secondary infection from re-exposure to the virus via inhalation.
On the surface of these so-called memory B cells are high-affinity virus-specific receptors that bind virus particles to reduce viral spread. While such cells should serve at the body’s first line of defense, it turns out that flu virus exploits the specificity of the cells’ receptors, using them to gain entry, disrupt antibody production, and ultimately kill the cells. By dispatching its enemies in this fashion, the virus is able to replicate efficiently before the immune system can mount a second wave of defense. This seemingly counter-intuitive pathway to infection is described this week in the journal Nature.
“We can now add this to the growing list of ways that the flu virus has to establish infection,” says Joseph Ashour, a co-author of the Nature paper and a postdoctoral researcher in the lab of Whitehead Member Hidde Ploegh.
“This is how the virus gains a foothold,” adds Ploegh lab postdoc Stephanie Dougan, also a co-author of the study. “The virus targets memory cells in the lung, which allows infection to be established—even if the immune system has seen this flu before.”
Continued: http://wi.mit.edu/news/archive/2013/flu-virus-wipes-out-immune-system-s-first-responders-establish-infection
October 19, 2013
CAMBRIDGE, Mass. – Revealing influenza’s truly insidious nature, Whitehead Institute scientists have discovered that the virus is able to infect its host by first killing off the cells of the immune system that are actually best equipped to neutralize the virus.
Confronted with a harmful virus, the immune system works to generate cells capable of producing antibodies perfectly suited to bind and disarm the hostile invader. These virus-specific B cells proliferate, secreting the antibodies that slow and eventually eradicate the virus. A population of these cells retains the information needed to neutralize the virus and takes up residence in the lung to ward off secondary infection from re-exposure to the virus via inhalation.
On the surface of these so-called memory B cells are high-affinity virus-specific receptors that bind virus particles to reduce viral spread. While such cells should serve at the body’s first line of defense, it turns out that flu virus exploits the specificity of the cells’ receptors, using them to gain entry, disrupt antibody production, and ultimately kill the cells. By dispatching its enemies in this fashion, the virus is able to replicate efficiently before the immune system can mount a second wave of defense. This seemingly counter-intuitive pathway to infection is described this week in the journal Nature.
“We can now add this to the growing list of ways that the flu virus has to establish infection,” says Joseph Ashour, a co-author of the Nature paper and a postdoctoral researcher in the lab of Whitehead Member Hidde Ploegh.
“This is how the virus gains a foothold,” adds Ploegh lab postdoc Stephanie Dougan, also a co-author of the study. “The virus targets memory cells in the lung, which allows infection to be established—even if the immune system has seen this flu before.”
Continued: http://wi.mit.edu/news/archive/2013/flu-virus-wipes-out-immune-system-s-first-responders-establish-infection
Saturday, October 19, 2013
World Health Organization (WHO): Saudi Arabia has succeeded in protecting the 1.5 million pilgrims from the #coronavirus #MERS & epidemic diseases
October 19, 2013
Translation
Said Dr Ala Din Alwan , director of the Eastern Mediterranean Region , World Health Organization ( WHO ) that the Saudi authorities succeeded in preventing the spread of epidemics and viruses private Coruna center of more than 1.5 million pilgrims during the Hajj season .
The announcement came ahead of Alwan leave Cairo on Saturday on his way to Amman to participate in some activities of the regional organization.
Said Alwan : " WHO participated in monitoring the health status of the pilgrims through some observers and observers did not monitor any cases of epidemic or cases of HIV Coruna among the pilgrims so far , with no surveillance of our units are any cases of the virus Corona or serious diseases threaten the safety of pilgrims and has provided authorities Saudi Arabia and health services adequately in each ritual sites and has developed several health points and medical centers in the holy sites in Mina . "
He added: " WHO was worried about the spread of Corona and some epidemics amid pilgrims this season was sent teams of software epidemic diseases to participate in a technical mission to monitor , guide and advise on precautionary measures to prevent the spread of Corona and assist in the early detection of the spread of the epidemic , but the performance of the authorities Saudi Arabia has succeeded in protecting both the number of pilgrims from the spread of epidemics season so far passed an unprecedented rate of success health . "
http://gate.ahram.org.eg/News/407347.aspx
Translation
Said Dr Ala Din Alwan , director of the Eastern Mediterranean Region , World Health Organization ( WHO ) that the Saudi authorities succeeded in preventing the spread of epidemics and viruses private Coruna center of more than 1.5 million pilgrims during the Hajj season .
The announcement came ahead of Alwan leave Cairo on Saturday on his way to Amman to participate in some activities of the regional organization.
Said Alwan : " WHO participated in monitoring the health status of the pilgrims through some observers and observers did not monitor any cases of epidemic or cases of HIV Coruna among the pilgrims so far , with no surveillance of our units are any cases of the virus Corona or serious diseases threaten the safety of pilgrims and has provided authorities Saudi Arabia and health services adequately in each ritual sites and has developed several health points and medical centers in the holy sites in Mina . "
He added: " WHO was worried about the spread of Corona and some epidemics amid pilgrims this season was sent teams of software epidemic diseases to participate in a technical mission to monitor , guide and advise on precautionary measures to prevent the spread of Corona and assist in the early detection of the spread of the epidemic , but the performance of the authorities Saudi Arabia has succeeded in protecting both the number of pilgrims from the spread of epidemics season so far passed an unprecedented rate of success health . "
http://gate.ahram.org.eg/News/407347.aspx
Friday, October 18, 2013
#MERS #Coronavirus WHO Update October 18, 2013
Middle East respiratory syndrome coronavirus (MERS-CoV) - update
18 October 2013 - WHO has been informed of an additional laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Qatar.
The patient is a 61-year-old man with underlying medical conditions who was admitted to a hospital on 11 October 2013. He is currently hospitalized and is in a stable condition. The patient was tested positive for MERS-CoV infection in Qatar and was confirmed by the reference laboratory of Public Health England yesterday.
Preliminary investigations revealed that the patient had not travelled outside Qatar in the two weeks prior to becoming ill. The patient owns a farm and has had significant contact with the animals, including camels, sheep and hens. Some of the animals in his farm have been tested and were negative for MERS-CoV. Further investigations into the case and the animals in the farm are ongoing.
Globally, from September 2012 to date, WHO has been informed of a total of 139 laboratory-confirmed cases of infection with MERS-CoV, including 60 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.
Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.
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.
http://www.who.int/csr/don/2013_10_18/en/index.html
18 October 2013 - WHO has been informed of an additional laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Qatar.
The patient is a 61-year-old man with underlying medical conditions who was admitted to a hospital on 11 October 2013. He is currently hospitalized and is in a stable condition. The patient was tested positive for MERS-CoV infection in Qatar and was confirmed by the reference laboratory of Public Health England yesterday.
Preliminary investigations revealed that the patient had not travelled outside Qatar in the two weeks prior to becoming ill. The patient owns a farm and has had significant contact with the animals, including camels, sheep and hens. Some of the animals in his farm have been tested and were negative for MERS-CoV. Further investigations into the case and the animals in the farm are ongoing.
Globally, from September 2012 to date, WHO has been informed of a total of 139 laboratory-confirmed cases of infection with MERS-CoV, including 60 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.
Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.
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.
http://www.who.int/csr/don/2013_10_18/en/index.html
Wednesday, October 16, 2013
#H7N9 WHO: Human infection with avian influenza A(H7N9) virus – update 10/16/13
16 October 2013 -
The National Health and Family Planning Commission, China
notified WHO of a new laboratory-confirmed case of human infection with
avian influenza A(H7N9) virus. This is the first new confirmed case of
human infection with avian influenza A(H7N9) virus since 11 August 2013.
The patient is a 35-year-old man from Zhejiang Province. He was admitted to a hospital on 8 October 2013 and is in a critical condition. Additionally, a previously laboratory-confirmed patient from Hebei has died.
To date, WHO has been informed of a total of 136 laboratory-confirmed human cases with avian influenza A(H7N9) virus infection including 45 deaths. Currently, three patients are hospitalized and 88 have been discharged. So far, there is no evidence of sustainable human-to-human transmission.
The Chinese government continues to take strict monitoring, prevention and control measures, including: strengthening of epidemic surveillance and analysis; deployment of medical treatment; conducting public risk communication and information dissemination; strengthening international cooperation and exchanges; and is continuing to carry out scientific research.
WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.
http://www.who.int/csr/don/2013_10_16/en/index.html
The patient is a 35-year-old man from Zhejiang Province. He was admitted to a hospital on 8 October 2013 and is in a critical condition. Additionally, a previously laboratory-confirmed patient from Hebei has died.
To date, WHO has been informed of a total of 136 laboratory-confirmed human cases with avian influenza A(H7N9) virus infection including 45 deaths. Currently, three patients are hospitalized and 88 have been discharged. So far, there is no evidence of sustainable human-to-human transmission.
The Chinese government continues to take strict monitoring, prevention and control measures, including: strengthening of epidemic surveillance and analysis; deployment of medical treatment; conducting public risk communication and information dissemination; strengthening international cooperation and exchanges; and is continuing to carry out scientific research.
WHO does not advise special screening at points of entry with regard to this event, nor does it currently recommend any travel or trade restrictions.
http://www.who.int/csr/don/2013_10_16/en/index.html
Tuesday, October 15, 2013
INFLUENZA (58): WORLD HEALTH ORGANIZATION GLOBAL UPDATE NO.196
A ProMED-mail post
Date: Mon 14 Oct 2013
Source: WHO surveillance & monitoring update 196 [edited]
http://www.who.int/influenza/surveillance_monitoring/updates/2013_10_14_surveillance_update_196.pdf
Influenza Update No. 196 - 14 Oct 2013
--------------------------------------
Summary
Although in many European countries influenza-like illness activity started to increase, influenza activity in the northern hemisphere temperate zones remained at inter-seasonal levels.
In most regions of tropical Asia, influenza activity was at a low level, with the exception of Hong Kong Special Administrative Region, China, where influenza transmission increased due to influenza A(H3N2).
In the Caribbean region of Central America and tropical South American countries, cases of influenza decreased, while acute respiratory illness remained stable in the Caribbean and Central America. Respiratory syncytial virus (RSV) predominated, but the RSV activity remained within expected seasonal levels.
Influenza activity peaked in the temperate countries of South America and in South Africa in late June 2013. Temperate South American countries reported acute respiratory disease activity within expected seasonal levels, and RSV activity largely declined.
In Australia and New Zealand, numbers of influenza viruses detected and rates of influenza-like illness seemed to have peaked. Co-circulation of influenza A(H1N1)pdm09, A(H3N2) and B viruses was reported in both countries.
Additional and updated information on non-seasonal influenza viruses can be found at: http://who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/inde.
Countries in the temperate zone of the northern hemisphere
--------------------------------
North America
Overall influenza activity in North America remained at low levels throughout the region. In Canada and the United States of America, influenza activity remained at interseasonal levels. In Mexico, influenza activity remained low after a period of 2 months (July-August 2013) with higher influenza activity.
Europe
Influenza activity in Europe remained at interseasonal levels. None of the specimens collected from sentinel sites between 10-22 Sep 2013 tested positive for influenza. However, many countries started reporting increased consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI).
Northern Africa and the Western Asia region
Influenza activity was low in the Northern Africa and western Asia regions. Only Qatar reported influenza activity, mainly influenza A virus (not subtyped), since the end of August 2013.
Northern Asia
Influenza activity in the temperate region of Asia remained at interseasonal levels since late May 2013. In Mongolia, clinical activity started to increase since mid-August 2013, but no influenza viruses were detected in this period.
Countries in the tropical zone
-----------------------
Tropical countries of the Americas/Central America and the Caribbean:
Overall influenza activity in the Caribbean and Central America was at a low level throughout the region. Decreasing numbers of influenza A virus have been seen throughout the region, but influenza transmission had largely come to an end in the last few weeks in these countries. Co-circulation of influenza A(H3N2) and influenza B viruses were reported, and RSV predominated among respiratory viruses in Costa Rica, El Salvador, Nicaragua, and Panama.
In tropical South America, respiratory virus activity continued decreasing following a period of high influenza activity in July and August 2013. In Colombia, the proportions of outpatient visits, hospitalizations, and ICU admissions were similar to reports for the same period in previous years. In Venezuela, ARI and pneumonia levels were reported within the expected values for the time of year. In Ecuador, the number of positive influenza samples steadily decreased since its influenza peak in August 2013. In Peru, reports of ARI in children under 5 years of age have been increasing since July 2013, but were consistent with levels from previous years. In the Plurinational State of Bolivia, the proportion of SARI-related hospitalizations were reported as elevated compared to the data from the same period last year [2012], and laboratory data from CENETROP [National Center of Tropical and Infectious Diseases] in Santa Cruz showed that of 182 SARI samples analyzed in the beginning of October 2013, 33 percent were positive for a respiratory virus (a 9 percent increase from the previous week). Brazil showed a continuing decline in the number of positive influenza samples since July 2013, and among recent positive samples, influenza A un-typed and influenza B viruses were detected.
Central African tropical region
Cote d'Ivoire, Ghana, and Kenya reported circulating influenza viruses. In Cote d'Ivoire and Ghana, influenza B and A(H3N2) were the predominant viruses detected. Kenya reported low influenza activity due to both influenza A(H3N2) and influenza B viruses.
Tropical Asia
Influenza transmission in southern and Southeast Asia was low in most countries. Both influenza A(H1N1)pdm09 and A(H3N2) viruses were reported in this area. Since early July 2013, an increase in influenza transmission was seen in Hong Kong Special Administrative Region (SAR), China. The influenza transmission in Hong Kong SAR was predominated by influenza A(H3N2) virus. This increased transmission was also seen in the influenza associated hospital rates in this region; mainly the rates among 0-4-year-old patients increased over the past month. In the south of China, influenza activity remained at an interseasonal level. However, the number of influenza virus detections has been higher in this year's [2013] interseasonal period compared to the previous year.
Countries in the temperate zone of the southern hemisphere
-----------------------------------
Temperate countries of South America
In the temperate countries of South America, ARI activity was reported at expected levels for the time of year, and RSV continued to be the most common respiratory virus detected in Argentina and Chile, although cases had largely decreased. In Argentina, ILI activity continued its decreasing trend since its peak in June and July of this year [2013]. In Chile, the proportion of SARI-associated hospitalizations continued to decrease. In Paraguay, the ILI consultation rate was higher than expected for the time of year but with decreased influenza and respiratory virus detection. In Uruguay, the proportion of SARI-associated hospitalizations increased from levels reported in the previous week, but proportions of ICU admissions continued to decline.
Temperate countries of Southern Africa
After a peak in influenza activity in South Africa due to influenza A(H1N1)pmd09 in June 2013, a small 2nd peak was observed in the last few weeks due to increased influenza A(H3N2) and influenza B circulation.
Overall, in Australia, New Zealand, and the Pacific Islands, influenza activity seemed to have peaked.
In Australia, during the period from 30 Aug to 13 Sep 2013, the distribution of influenza types and subtypes was variable across jurisdictions. In Western Australia, influenza A(H3N2) remained the predominant virus subtype; however, the proportion of A(H1N1)pdm09 increased. Influenza type B continued to represent over half of Victoria's influenza notifications. In recent weeks, there have been increasing proportions of influenza B virus in Queensland and South Australia. Influenza positivity levels ranged from 15 percent (309/2114) in the national sentinel laboratory surveillance to 28.1 percent (56/199) in the Australian Sentinel Practices Research Network (ASPREN). The Influenza Complications Alert Network (FluCAN) sentinel hospital surveillance system reported that the rate of influenza associated hospitalisations had been relatively stable since mid-August 2013. Almost 15 percent of influenza associated hospitalisations were admitted directly to the ICU. The age distribution of hospital admissions showed peaks in the 0-9 and over 60 years age groups.
In New Zealand, ILI activity was almost at the baseline threshold in early September 2013 but decreased since then. Out of 303 samples received in the last week, 161 were positive for influenza (53 percent): 49 were influenza B, 16 were influenza A(H3N2), 22 were influenza A(H1N1)pdm09, and 74 were influenza A (not subtyped). In Auckland and Counties Manukau District Health Boards, decreased influenza activity was reported in community surveillance and hospital surveillance.
http://www.promedmail.org/direct.php?id=20131015.2003667
Date: Mon 14 Oct 2013
Source: WHO surveillance & monitoring update 196 [edited]
http://www.who.int/influenza/surveillance_monitoring/updates/2013_10_14_surveillance_update_196.pdf
Influenza Update No. 196 - 14 Oct 2013
--------------------------------------
Summary
Although in many European countries influenza-like illness activity started to increase, influenza activity in the northern hemisphere temperate zones remained at inter-seasonal levels.
In most regions of tropical Asia, influenza activity was at a low level, with the exception of Hong Kong Special Administrative Region, China, where influenza transmission increased due to influenza A(H3N2).
In the Caribbean region of Central America and tropical South American countries, cases of influenza decreased, while acute respiratory illness remained stable in the Caribbean and Central America. Respiratory syncytial virus (RSV) predominated, but the RSV activity remained within expected seasonal levels.
Influenza activity peaked in the temperate countries of South America and in South Africa in late June 2013. Temperate South American countries reported acute respiratory disease activity within expected seasonal levels, and RSV activity largely declined.
In Australia and New Zealand, numbers of influenza viruses detected and rates of influenza-like illness seemed to have peaked. Co-circulation of influenza A(H1N1)pdm09, A(H3N2) and B viruses was reported in both countries.
Additional and updated information on non-seasonal influenza viruses can be found at: http://who.int/influenza/human_animal_interface/HAI_Risk_Assessment/en/inde.
Countries in the temperate zone of the northern hemisphere
--------------------------------
North America
Overall influenza activity in North America remained at low levels throughout the region. In Canada and the United States of America, influenza activity remained at interseasonal levels. In Mexico, influenza activity remained low after a period of 2 months (July-August 2013) with higher influenza activity.
Europe
Influenza activity in Europe remained at interseasonal levels. None of the specimens collected from sentinel sites between 10-22 Sep 2013 tested positive for influenza. However, many countries started reporting increased consultation rates for influenza-like illness (ILI) and acute respiratory infection (ARI).
Northern Africa and the Western Asia region
Influenza activity was low in the Northern Africa and western Asia regions. Only Qatar reported influenza activity, mainly influenza A virus (not subtyped), since the end of August 2013.
Northern Asia
Influenza activity in the temperate region of Asia remained at interseasonal levels since late May 2013. In Mongolia, clinical activity started to increase since mid-August 2013, but no influenza viruses were detected in this period.
Countries in the tropical zone
-----------------------
Tropical countries of the Americas/Central America and the Caribbean:
Overall influenza activity in the Caribbean and Central America was at a low level throughout the region. Decreasing numbers of influenza A virus have been seen throughout the region, but influenza transmission had largely come to an end in the last few weeks in these countries. Co-circulation of influenza A(H3N2) and influenza B viruses were reported, and RSV predominated among respiratory viruses in Costa Rica, El Salvador, Nicaragua, and Panama.
In tropical South America, respiratory virus activity continued decreasing following a period of high influenza activity in July and August 2013. In Colombia, the proportions of outpatient visits, hospitalizations, and ICU admissions were similar to reports for the same period in previous years. In Venezuela, ARI and pneumonia levels were reported within the expected values for the time of year. In Ecuador, the number of positive influenza samples steadily decreased since its influenza peak in August 2013. In Peru, reports of ARI in children under 5 years of age have been increasing since July 2013, but were consistent with levels from previous years. In the Plurinational State of Bolivia, the proportion of SARI-related hospitalizations were reported as elevated compared to the data from the same period last year [2012], and laboratory data from CENETROP [National Center of Tropical and Infectious Diseases] in Santa Cruz showed that of 182 SARI samples analyzed in the beginning of October 2013, 33 percent were positive for a respiratory virus (a 9 percent increase from the previous week). Brazil showed a continuing decline in the number of positive influenza samples since July 2013, and among recent positive samples, influenza A un-typed and influenza B viruses were detected.
Central African tropical region
Cote d'Ivoire, Ghana, and Kenya reported circulating influenza viruses. In Cote d'Ivoire and Ghana, influenza B and A(H3N2) were the predominant viruses detected. Kenya reported low influenza activity due to both influenza A(H3N2) and influenza B viruses.
Tropical Asia
Influenza transmission in southern and Southeast Asia was low in most countries. Both influenza A(H1N1)pdm09 and A(H3N2) viruses were reported in this area. Since early July 2013, an increase in influenza transmission was seen in Hong Kong Special Administrative Region (SAR), China. The influenza transmission in Hong Kong SAR was predominated by influenza A(H3N2) virus. This increased transmission was also seen in the influenza associated hospital rates in this region; mainly the rates among 0-4-year-old patients increased over the past month. In the south of China, influenza activity remained at an interseasonal level. However, the number of influenza virus detections has been higher in this year's [2013] interseasonal period compared to the previous year.
Countries in the temperate zone of the southern hemisphere
-----------------------------------
Temperate countries of South America
In the temperate countries of South America, ARI activity was reported at expected levels for the time of year, and RSV continued to be the most common respiratory virus detected in Argentina and Chile, although cases had largely decreased. In Argentina, ILI activity continued its decreasing trend since its peak in June and July of this year [2013]. In Chile, the proportion of SARI-associated hospitalizations continued to decrease. In Paraguay, the ILI consultation rate was higher than expected for the time of year but with decreased influenza and respiratory virus detection. In Uruguay, the proportion of SARI-associated hospitalizations increased from levels reported in the previous week, but proportions of ICU admissions continued to decline.
Temperate countries of Southern Africa
After a peak in influenza activity in South Africa due to influenza A(H1N1)pmd09 in June 2013, a small 2nd peak was observed in the last few weeks due to increased influenza A(H3N2) and influenza B circulation.
Overall, in Australia, New Zealand, and the Pacific Islands, influenza activity seemed to have peaked.
In Australia, during the period from 30 Aug to 13 Sep 2013, the distribution of influenza types and subtypes was variable across jurisdictions. In Western Australia, influenza A(H3N2) remained the predominant virus subtype; however, the proportion of A(H1N1)pdm09 increased. Influenza type B continued to represent over half of Victoria's influenza notifications. In recent weeks, there have been increasing proportions of influenza B virus in Queensland and South Australia. Influenza positivity levels ranged from 15 percent (309/2114) in the national sentinel laboratory surveillance to 28.1 percent (56/199) in the Australian Sentinel Practices Research Network (ASPREN). The Influenza Complications Alert Network (FluCAN) sentinel hospital surveillance system reported that the rate of influenza associated hospitalisations had been relatively stable since mid-August 2013. Almost 15 percent of influenza associated hospitalisations were admitted directly to the ICU. The age distribution of hospital admissions showed peaks in the 0-9 and over 60 years age groups.
In New Zealand, ILI activity was almost at the baseline threshold in early September 2013 but decreased since then. Out of 303 samples received in the last week, 161 were positive for influenza (53 percent): 49 were influenza B, 16 were influenza A(H3N2), 22 were influenza A(H1N1)pdm09, and 74 were influenza A (not subtyped). In Auckland and Counties Manukau District Health Boards, decreased influenza activity was reported in community surveillance and hospital surveillance.
http://www.promedmail.org/direct.php?id=20131015.2003667
#MERS #Coronavirus WHO Update October 14, 2013
14 October 2013 -
WHO has been informed of an additional two
laboratory-confirmed cases of Middle East respiratory syndrome
coronavirus (MERS-CoV) infection in Saudi Arabia.
The patients, both men, aged 55 and 78, were from Riyadh region. They became ill at the end of September 2013 and died in the beginning of October 2013. Both the patients were reported to have had no contact to a known laboratory-confirmed case with MERS-CoV.
Globally, from September 2012 to date, WHO has been informed of a total of 138 laboratory-confirmed cases of infection with MERS-CoV, including 60 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.
Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.
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.
http://www.who.int/csr/don/2013_10_14/en/index.html
The patients, both men, aged 55 and 78, were from Riyadh region. They became ill at the end of September 2013 and died in the beginning of October 2013. Both the patients were reported to have had no contact to a known laboratory-confirmed case with MERS-CoV.
Globally, from September 2012 to date, WHO has been informed of a total of 138 laboratory-confirmed cases of infection with MERS-CoV, including 60 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.
Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.
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.
http://www.who.int/csr/don/2013_10_14/en/index.html
Monday, October 14, 2013
Adaptive evolution of bat dipeptidyl peptidase 4 (dpp4): implications for the origin and emergence of Middle East respiratory syndrome coronavirus
Virology Journal 2013, 10:304 doi:10.1186/1743-422X-10-304
Published: 10 October 2013
Published: 10 October 2013
Abstract (provisional)
Background
The newly emerged Middle East respiratory syndrome coronavirus (MERS-CoV) that first
appeared in Saudi Arabia during the summer of 2012 has to date (20th September 2013)
caused 58 human deaths. MERS-CoV utilizes the dipeptidyl peptidase 4 (DPP4) host cell
receptor, and analysis of the long-term interaction between virus and receptor provides
key information on the evolutionary events that lead to the viral emergence.
Findings We show that bat DPP4 genes have been subject to significant adaptive evolution,
suggestive of a long-term arms-race between bats and MERS related CoVs. In particular,
we identify three positively selected residues in DPP4 that directly interact with
the viral surface glycoprotein.
Conclusions
Our study suggests that the evolutionary lineage leading to MERS-CoV may have circulated
in bats for a substantial time period.
The complete article is available as a provisional PDF. The fully formatted PDF and HTML versions are in production.
http://www.virologyj.com/content/10/1/304/abstract
Thursday, October 10, 2013
#MERS #Coronavirus Saudi Arabia Announces Absense of Virus among Pilgrims
Al-Riyadh newspaper quoted Rabiah as saying that the health status of pilgrims "reassuring as it is not registered any case of epidemic or Mahgria including the Corona virus."
He stressed that "the ministry is very keen to follow up on the epidemiological situation in the countries of the world, in coordination with the World Health Organization and put crack down this year with a virus Corona, and give workers strict instructions to isolate any suspected case out and conduct the necessary tests to ensure their safety."
Rabiah said that there is a team of 600 employees of the ministry in the King Abdul Aziz Airport provide curative and preventive services in full coordination with the parties participating in the pilgrimage all.
And puts workers at Jeddah airport masks for Okabh of the Corona virus, which killed 58 victims in the world so far, including 49 in Saudi Arabia, where he appeared for the first time.
The World Health Organization announced last Friday that the number of people infected with the virus of 136 people, including 117 in Saudi Arabia.
And overshadowed by fears of the spread of Corona during the pilgrimage season, the largest religious gathering of Muslims in the world.
However, the Minister of Health was expressed optimism gap in the pilgrimage season of the virus in the absence of any registration injury Umrah season.
But he called the elderly, the infirm and people with chronic illnesses to avoid coming to the pilgrimage this year.
Wednesday, October 9, 2013
#MERS #Coronavirus Saudi Arabia MOH Update 10/9/13
October 9, 2013
Translation
Translation
In the framework of the epidemiological investigation and ongoing follow-up carried out by the Ministry of Health for HIV (Corona) new syndrome that causes
Middle East of MERS-CoV respiratory ministry announces the registration of two cases in the Riyadh region.
First of a citizen at the age of 78 years old, suffers from several chronic diseases, has died of God's mercy.
The second case to another citizen at the age of 55 years old and suffering from chronic diseases, has died God's mercy.
http://www.moh.gov.sa/CoronaNew/PressReleases/Pages/mediastatemenet-2013-10-09-001.aspxMonday, October 7, 2013
Pandemic Preparedness: Taking Our Cue From The Experts
A very good read full of resources, from Avian Flu Diary:
http://afludiary.blogspot.com/2013/10/pandemic-preparedness-taking-our-cue.html
http://afludiary.blogspot.com/2013/10/pandemic-preparedness-taking-our-cue.html
ProMED: CHINA, H7N9 LOW TRANSMISSION POTENTIAL
Published Date: 2013-10-05 13:28:47
Subject: PRO/AH> Avian influenza, human (118): China, H7N9 low transmission potential
Archive Number: 20131005.1982621
Date: Wed 2 Oct 2013
Source: University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) [edited]
http://www.cidrap.umn.edu/news-perspective/2013/10/flu-scan-oct-02-2013
Researchers who used a sophisticated modeling approach incorporating H7N9 case data from China found hints that the virus has low transmission potential and that the pace of infection slowed in April [2013] after officials closed live-bird markets. The study, published in BMC Medicine today [2 Oct 2013], was conducted by a team from the National Institutes of Health, Arizona State University, and George Washington University.
The investigators used a Bayesian modeling technique [see http://en.wikipedia.org/wiki/Bayesian_statistics] to assess if the outbreak had a reproduction (R) number consistent with unsustained human transmission and if interventions reduced transmission. They compared their estimates with other zoonotic pathogens, including H5N1 avian influenza, variant H3N2 (H3N2v) influenza flu, and Nipah virus. Based on 130 lab-confirmed cases reported in China from March through 20 May 2013, their analysis found that transmission was low in Shanghai and Zhejiang province, and at 0.6 the R was well below the 1.0 level needed to sustain transmission. Researchers also found that the growth rate slowed in mid April [2013], which coincided with the closure of live-bird markets in large Chinese cities in early April. Compared with other zoonotic threats, the transmission threat from H7N9 was lower.
The authors said that, although the findings were based on a small number of cases and need to be confirmed, the modeling technique could be useful for measuring outbreak progression and the impact of control measures in the months ahead and provides a tool for monitoring pandemic potential in near real-time.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The reference for the BMC Medicine paper is: Transmission potential of influenza A/H7N9, February to May 2013, China; by Gerardo Chowell, Lone Simonsen, Sherry Towers, Mark A Miller and Cecile Viboud; in BMC Medicine 2013, 11:214 doi:10.1186/1741-7015-11-214; http://www.biomedcentral.com/1741-7015/11/214/abstract. The Abstract follows.
"Background: On 31 Mar 2013, the 1st human infections with the novel influenza A/H7N9 virus were reported in Eastern China. The outbreak expanded rapidly in geographic scope and size, with a total of 132 laboratory-confirmed cases reported by 3 Jun 2013, in 10 Chinese provinces and Taiwan [imported from mainland China]. The incidence of A/H7N9 cases has stalled in recent weeks, presumably as a consequence of live bird market closures in the most heavily affected areas. Here we compare the transmission potential of influenza A/H7N9 with that of other emerging pathogens and evaluate the impact of intervention measures in an effort to guide pandemic preparedness.
Methods: We used a Bayesian approach combined with a SEIR (Susceptible-Exposed-Infectious-Removed) transmission model fitted to daily case data to assess the reproduction number (R) of A/H7N9 by province and to evaluate the impact of live bird market closures in April and May 2013. Simulation studies helped quantify the performance of our approach in the context of an emerging pathogen, where human-to-human transmission is limited and most cases arises from spillover events. We also used alternative approaches to estimate R based on individual-level information on prior exposure and compared the transmission potential of influenza A/H7N9 with that of other recent zoonoses.
Results: Estimates of R for the A/H7N9 outbreak were below the epidemic threshold required for sustained human-to-human transmission and remained near 0.1 throughout the study period, with broad 95 percent credible intervals by the Bayesian method (0.01 to 0.49). The Bayesian estimation approach was dominated by the prior distribution, however, due to relatively little information contained in the case data. We observe a statistically significant deceleration in growth rate after 6 Apr 2013, which is consistent with a reduction in A/H7N9 transmission associated with the preemptive closure of live bird markets. Although confidence intervals are broad, the estimated transmission potential of A/H7N9 appears lower than that of recent zoonotic threats, including avian influenza A/H5N1, swine influenza H3N2sw and Nipah virus.
Conclusion: Although uncertainty remains high in R estimates for H7N9 due to limited epidemiological information, all available evidence points to a low transmission potential. Continued monitoring of the transmission potential of A/H7N9 is critical in the coming months as intervention measures may be relaxed and seasonal factors could promote disease transmission in colder months."
This analysis is consistent with independent studies, and a resurgence of disease should not occur unless there is some significant modification of the genetic properties of the H7N9 virus, or relaxation of the restrictions introduced to control access to poultry markets. - Mod.CP]
http://www.promedmail.org/direct.php?id=20131005.1982621
Subject: PRO/AH> Avian influenza, human (118): China, H7N9 low transmission potential
Archive Number: 20131005.1982621
Date: Wed 2 Oct 2013
Source: University of Minnesota Center for Infectious Disease Research and Policy (CIDRAP) [edited]
http://www.cidrap.umn.edu/news-perspective/2013/10/flu-scan-oct-02-2013
Researchers who used a sophisticated modeling approach incorporating H7N9 case data from China found hints that the virus has low transmission potential and that the pace of infection slowed in April [2013] after officials closed live-bird markets. The study, published in BMC Medicine today [2 Oct 2013], was conducted by a team from the National Institutes of Health, Arizona State University, and George Washington University.
The investigators used a Bayesian modeling technique [see http://en.wikipedia.org/wiki/Bayesian_statistics] to assess if the outbreak had a reproduction (R) number consistent with unsustained human transmission and if interventions reduced transmission. They compared their estimates with other zoonotic pathogens, including H5N1 avian influenza, variant H3N2 (H3N2v) influenza flu, and Nipah virus. Based on 130 lab-confirmed cases reported in China from March through 20 May 2013, their analysis found that transmission was low in Shanghai and Zhejiang province, and at 0.6 the R was well below the 1.0 level needed to sustain transmission. Researchers also found that the growth rate slowed in mid April [2013], which coincided with the closure of live-bird markets in large Chinese cities in early April. Compared with other zoonotic threats, the transmission threat from H7N9 was lower.
The authors said that, although the findings were based on a small number of cases and need to be confirmed, the modeling technique could be useful for measuring outbreak progression and the impact of control measures in the months ahead and provides a tool for monitoring pandemic potential in near real-time.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[The reference for the BMC Medicine paper is: Transmission potential of influenza A/H7N9, February to May 2013, China; by Gerardo Chowell, Lone Simonsen, Sherry Towers, Mark A Miller and Cecile Viboud; in BMC Medicine 2013, 11:214 doi:10.1186/1741-7015-11-214; http://www.biomedcentral.com/1741-7015/11/214/abstract. The Abstract follows.
"Background: On 31 Mar 2013, the 1st human infections with the novel influenza A/H7N9 virus were reported in Eastern China. The outbreak expanded rapidly in geographic scope and size, with a total of 132 laboratory-confirmed cases reported by 3 Jun 2013, in 10 Chinese provinces and Taiwan [imported from mainland China]. The incidence of A/H7N9 cases has stalled in recent weeks, presumably as a consequence of live bird market closures in the most heavily affected areas. Here we compare the transmission potential of influenza A/H7N9 with that of other emerging pathogens and evaluate the impact of intervention measures in an effort to guide pandemic preparedness.
Methods: We used a Bayesian approach combined with a SEIR (Susceptible-Exposed-Infectious-Removed) transmission model fitted to daily case data to assess the reproduction number (R) of A/H7N9 by province and to evaluate the impact of live bird market closures in April and May 2013. Simulation studies helped quantify the performance of our approach in the context of an emerging pathogen, where human-to-human transmission is limited and most cases arises from spillover events. We also used alternative approaches to estimate R based on individual-level information on prior exposure and compared the transmission potential of influenza A/H7N9 with that of other recent zoonoses.
Results: Estimates of R for the A/H7N9 outbreak were below the epidemic threshold required for sustained human-to-human transmission and remained near 0.1 throughout the study period, with broad 95 percent credible intervals by the Bayesian method (0.01 to 0.49). The Bayesian estimation approach was dominated by the prior distribution, however, due to relatively little information contained in the case data. We observe a statistically significant deceleration in growth rate after 6 Apr 2013, which is consistent with a reduction in A/H7N9 transmission associated with the preemptive closure of live bird markets. Although confidence intervals are broad, the estimated transmission potential of A/H7N9 appears lower than that of recent zoonotic threats, including avian influenza A/H5N1, swine influenza H3N2sw and Nipah virus.
Conclusion: Although uncertainty remains high in R estimates for H7N9 due to limited epidemiological information, all available evidence points to a low transmission potential. Continued monitoring of the transmission potential of A/H7N9 is critical in the coming months as intervention measures may be relaxed and seasonal factors could promote disease transmission in colder months."
This analysis is consistent with independent studies, and a resurgence of disease should not occur unless there is some significant modification of the genetic properties of the H7N9 virus, or relaxation of the restrictions introduced to control access to poultry markets. - Mod.CP]
http://www.promedmail.org/direct.php?id=20131005.1982621
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