New coronavirus cases suggest source may be more widespread, WHO says

Helen Branswell, The Canadian Press  Nov 27, 2012 04:00:00 AM

Clues gleaned from the most recent infections with the new coronavirus are behind the World Health Organization's decision to warn countries to broaden their surveillance for cases, an expert with the agency says.

The Geneva-based global health body now believes the risk of exposure to the new virus may exist beyond Saudi Arabia and Qatar, so telling countries they need only look for sick people with travel or residency links to those countries may be misleading and counterproductive.

It's not that the WHO has proof of infections from elsewhere. The issue is rather that its disease experts can think of no reason why a virus that has popped up in different parts of Saudi Arabia and in Qatar would be limited to those two countries.

"It's impossible to know at this point because of the limited amount of testing just how widespread this problem is," says Dr. Anthony Mounts, the WHO's technical point person for the outbreak.

"But it just seems inappropriate to continue to focus on two countries in the region when there's really not much that would lead you to suppose that those were the only two countries affected. ... We have to widen the net a little bit to try and find out how big a problem this is."

On Friday the WHO reported that four additional infections with the new virus — a cousin of the coronavirus that caused SARS — had been found in Saudi Arabia and Qatar. They bring to six the total of confirmed cases since this virus was first spotted in June.

In that time, four cases have been reported by Saudia Arabia. As well, two relatives of two of the Saudi infections are considered probable cases; they all lived in the same household and were sick with similar symptoms at about the same time.

While one of the probable cases tested negative, not even the Saudi government is confident that is a true negative, Mounts says.

To date there is no validated blood test to confirm infection, so diagnosis relies on PCR — short for polymerase chain reaction — tests that look for pieces of virus in sputum specimens or on swabs poked into nasal cavities. The reliability of testing in such cases depending on when and how well those samples were taken.

"With PCR especially, a negative isn't as revealing as a positive," Mounts says. "With a negative, you just always have to question whether you just didn't get a good enough swab."

The WHO's Friday statement said countries should consider testing people with unexplained pneumonia for the virus, even if the patients don't have links to the two countries.

It also said countries should investigate clusters of severe respiratory infections — especially in health-care workers — regardless of where they happen in the world. Health-care workers can be sentinels in disease outbreaks because they get exposed by caring for sick people.

The WHO is in the process of further revising its guidance to countries; it may post the new advice on its website as early as today. Mounts suggests the goal is to try to strike an balance between looking hard enough to see what's really going on and not swamping health-care systems.

"We don't want to overburden everybody," he says. "We don't think that it's necessary at this point for every unexplained pneumonia case in the world to be tested for this virus."

There have already been concerns raised that the agency missed the mark with the advice issued Friday.

In a statement posted on its website Monday, the European Centre for Disease Control said testing all patients with unexplained pneumonias would place a heavy burden on hospitals in the European Union.

The ECDC estimated EU hospitals treat about 750,000 patients a year with pneumonias for which a cause is not identified. It said it may come up with more targeted advice on testing for EU countries.

In the meantime, the ECDC said health-care workers should be on the lookout for patients with severe respiratory illnesses who have travelled to or are residents of the Middle East.

Mounts says when the first two infections with this virus were spotted, in June and then September, both men had been in Mecca, Saudia Arabia, before they got sick. As such the chance existed that the source of infection — which is currently unknown — was only found there.

But the newest infections show that isn't possible. Some of the Saudi cases had not been to Mecca before they got sick. They live in and fell ill in Riyadh, the capital. And the most recent case from Qatar lives in Doha and had not recently travelled outside the country.

With people falling ill in different places, it seems unlikely that the risk of infection exists only in Saudi Arabia and Qatar, WHO experts believe.

As well, two of the more recent cases were not as sick as the first cases, Mounts notes. They were seriously sick — they needed mechanical help breathing for a time — but they didn't experience the kidney failure seen in the first two cases.

"So that indicates to us that there is a milder form of the disease. It doesn't always involve multi-organ failure and so on," Mounts says.

"But how mild it could be is unknown. And you know, that's basically because where we look for this is in hospitals. And people have not yet started to test milder cases in the area."

Bats have been named as a possible source of the virus, because its genetic sequence is most like that of other coronaviruses that come from bats. Mounts cautions, though, that at this point the evidence is only suggestive.

But even if that's true, it's not clear how the virus got from bats to people — and there are a number of possible routes. Bats could pass the virus to other animals, which in turn somehow infect humans. People could come in contact with bat guano, or dust from it, or bat urine.

Another possible source is contaminated fruit, Mounts notes. It's known that in Nipah virus outbreaks in Asia, date palm sap and fruit contaminated with bat saliva have been the source of disease. (In some countries date palms are tapped like maple trees. The sap that flows is a popular drink. But bats like it too.)

Saudi Arabia and Qatar import a lot of food and animals from other countries, both within the region and beyond. Mounts says the WHO is trying to figure out what connections might be important so it can better advise countries on how to remain alert for infected people.

The two cases from Qatar illustrate one possible route by which the virus might move from wherever it is to further afield.

After they fell ill, both Qatari men flew out of the country to Europe for treatment — one went to London, the other to Germany. In both cases the European facilities did not know their new patients were infected with the new virus when they admitted them.

Wealthy Middle Easterners often seek care in Europe. That is factored in to the ECDC guidance, which urges hospitals to test patients with acute respiratory infections who are transferring in from the Middle East.

Mounts says the WHO guidance will also instruct hospitals accepting patients like these to take the type of precautions they would take for other respiratory infections to protect their staff and other patients.

http://www.570news.com/news/world/article/425727--new-coronavirus-cases-suggest-source-may-be-more-widespread-who-says

Latest coronavirus cases prompt WHO call for vigilance

Robert Roos  News Editor

Nov 26, 2012 (CIDRAP News) – The reporting of four more novel coronavirus infections in recent weeks, raising the total to six, has prompted the World Health Organization (WHO) to suggest that governments consider a major escalation of testing for the virus, a potentially burdensome undertaking.

In a Nov 23 statement, the WHO reported three new cases, with one death, in Saudi Arabia and one new case in Qatar. The latest Saudi Arabian cases included two in the same household, but it was not known if person-to-person transmission was involved.

The global case count since the virus emerged in June has reached six, of which two were fatal. The latest cases noted by the WHO apparently include two that were reported earlier by Saudi health officials and the news media.

Until more is known, the WHO statement said, "It is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases. Member States should consider testing of patients with unexplained pneumonias for the new coronavirus even in the absence of travel or other associations with the two affected countries."

The European Centre for Disease Prevention and Control (ECDC), in a risk assessment released today, said it was considering the implications of the WHO recommendation and commented that increasing testing to that extent would probably be burdensome for European countries.

The novel coronavirus, a relative of the SARS (severe acute respiratory syndrome) virus, emerged in June, but it was not publicly announced until late September.

The first case was in a 60-year-old Saudi Arabian man who died in a Jeddah hospital Jun 24. The second case struck a Qatari man who fell ill in early September and was flown to London, where he apparently remains hospitalized. Both patients had pneumonia and acute renal failure.

A Saudi health official reported the third case on Nov 4, in a Saudi man in Riyadh who had been critically ill but was recovering. The fourth case, as reported Nov 21 by a Saudi newspaper quoting government sources, involved another Saudi man who was hospitalized in Riyadh and was said to be improving.

The Nov 23 WHO statement gave few details on the latest four cases, but it said two of the patients came from the same family and household and had similar symptoms. One of the patients died and the other recovered, the agency said.

Further, two more members of the same family were sick with similar symptoms, and one of them died, the WHO said. Test results for the deceased family member are pending, and the other patient, who is recovering, tested negative.

Investigations concerning the source of infection, the route of exposure, and the possibility of human-to-human transmission are ongoing, the WHO said.

The latest Qatari patient got sick in October and was flown to Germany, where he was hospitalized and received intensive care but eventually recovered and was discharged this week, according to Germany's Robert Koch Institute.

In a Nov 23 statement, the institute said the patient was treated for 4 weeks at a hospital in North Rhine–Westfalia. No illnesses have been reported among hospital personnel, though an investigation of the patient's contacts is ongoing.

The institute said samples taken while the patient was still in Qatar were tested in the United Kingdom and found to be positive.

The WHO in its statement did not list specific reasons for its suggestion that the novel virus may exist in countries other than just Saudi Arabia and neighboring Qatar.

In response to a query on the topic today, WHO spokesman Glenn Thomas told CIDRAP News via e-mail, "This is based on the fact that the cases confirmed to date are geographically far apart, and that investigations are still ongoing into the characteristics of this novel coronavirus."

The ECDC, in its statement today, noted that the possibility of person-to-person transmission in the Saudi Arabian family case cluster has not been excluded. It added, "There is indication that some cases had a history of visits to farms prior to illness, but no details are available concerning the kind of farms or related animal contact."

The agency said healthcare workers who treat people from the Middle East who have severe respiratory infections may be at risk for infection with the novel virus. It's possible, though, that the infections are more widespread, as suggested by the WHO, and seroepidemiologic studies are needed to investigate the possibility of mild and asymptomatic cases, the EU agency said.

"The fact that there have not been any expanding clusters of cases indicates that currently the risk for EU citizens to acquire these infections has not increased and remains very low, based on the current information," the ECDC said.

The ECDC statement evidenced some wariness about the WHO suggestion to consider testing patients with unexplained pneumonia even if they have no ties to Saudi Arabia or Qatar. The ECDC said it is considering the recommendation in relation to the potential burden of testing and the possibility of false-positive results.

For European countries, following the WHO testing suggestion probably would mean a "high" burden, the ECDC said. It estimated that EU countries have roughly 750,000 cases of community-acquired pneumonia of unknown cause each year.  http://www.cidrap.umn.edu/cidrap/content/other/sars/news/nov2612corona.html

The risk of a new SARS- Vietnam on watch

According to the World Health Organization, there were six cases similar to the SARS epidemic in the Middle East, including one death. Surveillance at airports and seaports. 

Wearing masks in public is one of the measures to prevent the new Corona virus. Photo: HTD

26-11, Dr. Nguyen Hoai Nam, Head of Professional Health, Department of Health City, said an official letter sent to all health facilities in the area prompted to strengthen the examination, diagnosis and detection of patients with SARS-like symptoms (new Corona virus) to timely treatment.

New viruses

In addition, the preventive medicine centers prepare manpower, chemicals for processing cases, the environment, if any. International Health Quarantine Center has also implemented measures to control the disease entering Vietnam by air and seaports.

Earlier, Deputy Minister of Health Nguyen Thi Xuyen signed Decision promulgating guide diagnosis and treatment of viral diseases new Corona.

According to the Ministry of Health, Corona virus often causes the pathological expression of the upper respiratory tract, the gastrointestinal tract in humans and some animals. In humans, this virus causes the common cold. Virus infection through direct contact with respiratory secretions of an infected person. The disease usually occurs in the winter and early spring.

Corona viruses are pathogenic said most SARS-CoV causes SARS (800 deaths in the world in 2002). Pathogenic virus outside the upper respiratory tract, but also lower respiratory and inflammation of the stomach and intestines.

Latest Corona virus is detected (human coronavirus beta 2c-HCoV-EMC) may cause severe respiratory tract infection, together with kidney failure.

No cure

Ministry of Health, said people traveling to endemic areas with Corona virus returned, then the expression of acute respiratory tract infections, fever over 38oC, cough, shortness of breath, lung damage or distress syndrome acute respiratory syndrome accompanied by acute renal failure; not explained by tests of infection or other causes ... are suspected with new Corona viruses, including contact with people who have symptoms.However, the Ministry of Health also noted that it is necessary to distinguish influenza A/H1N1, A/H5N1, atypical pneumonia, sepsis caused renal failure and respiratory failure, hand-foot-mouth disease complicated respiratory failure and renal failure.

The new virus, depending on the level of severity that have different handling. But not cure disease, so mainly treat the symptoms, detection and timely treatment of respiratory failure, renal failure. If after five days of treatment, the fever, pulse, blood pressure, chest X-ray improved renal function returned to normal, you can leave the hospital. However, after returning home, patients should self monitor 12-hour temperature / time, if the temperature is higher than 38oC fever in two consecutive measurements or other unusual signs, must visit at places where it treatment.

Surveillance at airports, ports

Dr.-BS Nguyen Van Vinh Chau, director of HCMC Tropical Disease Hospital, said up to this point in the BV has not discovered any cases suspected new Corona virus. The control carrier no symptoms from the region are new virus (Middle East) to move to other countries is very difficult, especially in the incubation period after contact with the source of infection.Therefore today Close monitoring of cases of contact with the initial case is extremely important. The World Health Organization (WHO) is working closely with the government of Saudi Arabia, Qatar - countries with virus circulation to track all cases of respiratory manifestations and associated with six cases have determined to timely diagnostic isolation.

In Vietnam, but not detected cases, but under the guidance of the Ministry of Health, hospitals focused watchful for timely case detection and isolation, thorough handling, online community spread. Especially, monitoring airport ca clinical symptoms come from epidemic areas to timely detection and isolation.

To prevent new viral Corona, Ministry of Health recommends that people should wash their hands with soap regularly, wear a mask when you go out, when to crowded places and examination when the e ... Patients with respiratory symptoms deaths have been shrouding in place, the chemical disinfection Chloramin B, Formalin. Corpse to be buried or cremated within 24 hours, it is best cremation. 

http://www.xaluan.com/modules.php?name=News&file=article&sid=505134

Ebola outbreak in DR Congo has ended

byAFP 

NOVEMBER 26, 2012Congo: The latest outbreak of Ebola in the Democratic Republic of Congo has ended after claiming 34 lives, Health Minister Felix Kabange Numbi said Monday. According to revised figures, 62 people are believed to have been infected during the latest epidemic, which was declared in mid-August in the northeastern Orientale Province and which officially ended on Friday, he said...

http://www.timesofoman.com/News/Article-2334.aspx?

New SARS outbreak on the horizon

November 23rd, 2012

by Treyfish

 Take heed all you doomers, preppers and disease reporters.

The World Health Organization finally found the time to tell us of some new coronavirus patients in the Middle east. Seems the whole family has been infected and showed symptoms, some severe. This new SARS like respiratory killer, was supposedly not infectious between humans and has been downplayed bigtime.
I don’t profess to be a fearmonger, but I am warning you to keep an eye on this developing situation. If they can withhold this info for a month..
Because they only admit to 6 lab confirmed cases, yet ARE REPORTING others, This should be a wake up call for hidden unreported cases they aren’t telling us about. This is a common practice they employ to fudge the actual numbers and current situation, kind of like the current U.S Administration.

The WHO is currently run by China and the U.S. more than any other country, but It is not hard to notice Saudi Arabia and close by countries like Quatar hold major money over their heads.

When the shit does get going, you will have major problems, that were barely contained in 2003. The big problem we are having now is timely information.
Keep your guard and preps up to date.

Novel coronavirus infection – update
23 NOVEMBER 2012 - WHO has been notified of four additional cases, including one death, due to infection with the novel coronavirus. The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case). This brings the total of laboratory confirmed cases to 6.
Investigations are ongoing in areas of epidemiology, clinical management, and virology, to look into the likely source of infection, the route of exposure, and the possibility of human-to-human transmission of the virus. Close contacts of the recently confirmed cases are being identified and followed-up.
So far, only the two most recently confirmed cases in Saudi Arabia are epidemiologically linked – they are from the same family, living in the same household. Preliminary investigations indicate that these 2 cases presented with similar symptoms of illness. One died and the other recovered.
Additionally, 2 other members of this family presented with similar symptoms of illness, where one died and the other is recovering. Laboratory results of the fatal case is pending, while the case that is recovering tested negative for the novel coronavirus. <<WHO continues to work with the governments of Saudi Arabia, Qatar and ot..

http://www.who.int/csr/don/2012_11_23/en/index.html

http://swineflumagazine.blogspot.com/2012/11/novel-coronavirus-infection-update.html

Read more at http://investmentwatchblog.com/new-sars-outbreak-on-the-horizon/#khYSPaqkL3CM0yBu.99 

Urgent action to address the Corona virus

Flag in response to published Sunday .. Health Council:

D. Hajri: Import analysis techniques soon and laboratory staff training

Clinical and laboratory monitoring of the virus

Field visits and epidemiological cut all contacts

Prompt reporting of suspected cases of the disease in government and private hospitals

Invite a delegation from the World Health to assist in the investigation of the field of the disease

In response to published flag Sunday on citizens' demands to tighten the mechanism of surveillance and medical examinations of suspected illness Corona prevented from increasing cases of patients after the announcement of the discovery of a second case infected .. contract Supreme Council of Health meeting to discuss the latest developments on HIV Coruna new after registration second infection with the virus in the state‎.

Dr. Mohammed Al Hajri, Director Health Protection and Disease Control transitional Supreme Council of Health said the meeting included all the relevant departments of the Council and representatives from the Hamad Medical Corporation to discuss the second case recently discovered and which are currently subject to treatment were also discussed all matters related to illness,

He indicated that it was decided during the meeting that the concerned authorities to disclose clinical and laboratory surveillance and conduct field visits and do Epidemiological Investigation of all contacts in the public health sector and private communication with the relevant authorities to participate in the investigation‎.

Dr. Al-Hajri that the Supreme Council of Health expressed keen interest to pursue all aspects of the disease and work to تقصيه and limit the spread of cooperation with all organizations and experts at the global level, where the Council, in cooperation with HMC to tighten surveillance of such cases, check and send samples for each suspect their competent centers globally. The Council has also recently invited a delegation of experts from the World Health Organization (WHO) for consultation and assistance in the field investigation procedures.

He added that he was also communicate directly with the health sectors in the country against a government and a special emphasis on the need immediate reporting of any suspected case and confirmation work protocol prepared for this purpose, pointing to HMC working to get as soon as possible on such tests new staff training laboratory with the knowledge that current work guaranteed to get the result within a week and by dealing with a competent laboratories in Britain.

The Supreme Council of Health announced Friday evening discovered cases of a second virus Coruna new after confirmation of laboratory tests for the virus, while continuing communication and coordination between the Council and the World Health Organization since reporting the discovery of this case on November 21, 2012 to consult and stand on various aspects of the disease and follow-up developments at the global level‎.

He called Citizens of the Supreme Council of Health to the need to provide and import all laboratories and examination techniques and treatment that will help in the discovery of the disease and training doctors hospitals HMC and health centers and hospitals on how to suspicion of infected cases, especially with the entry of the winter season and the increase in cases infected with influenza are similar in their symptoms of HIV Coruna.

They pointed out that there is a state of anxiety and anticipation among citizens after the announcement of the discovery of the second case infected with Corona in a period not exceeding two months from the first case of injury.

The citizens demanded those responsible health quickly launch an awareness campaign among all citizens and residents about Corona disease and how to prevent it and symptoms that are suspected in relation to the disease and tighten surveillance mechanism and medical examinations for suspected of 

having the disease in order to prevent the increasing incidence of infected

http://www.raya.com/news/pages/b52cc156-ac98-4119-ae33-f3ff11e7d0de

Curious Coronavirus Comments By Saudi Arabia MoH

Recombinomics Commentary 23:55
November 26, 2012

We do trust ProMED-mail's editors and moderators will remember that our Ministry of Health bears ultimate responsibility for managing contagious disease within and even outside our boundaries. We take seriously our responsibilities to our citizens and our guests. This time of year, we assume an enormous responsibility to our Hajj pilgrims visiting Mecca, and then to the world community as our guests return home.We invite our friends and colleagues to stay tuned; we invite ProMED-mail to collaborate with us to balance public health reporting. As of now, the full story has yet to be told.

The above comments are from an October 22, 2012 ProMED letter from Ziad Memish, who is Deputy Minister of Public Health for the Kingdom of Saudi Arabia (KSA) as well as Director WHO Collaborating Center for Mass Gatherings.

His letter was in response to the ProMED September 20 publication of a September 15 letter from Ali Zaki, Professor of Microbiology at the Dr Kakeeh Hospital in Jeddah, Saudi Arabi.  His letter described a Jeddah patient who was fatally infected with a novel coronavirus which was identified with a pancornavirus PCR test and subsequently sequenced in collaboration with Ron Fouchier at the Emarasus Medical Center in The Netherlands.  The patient had died in June and the novel coronavirus was reportable under International Health Regulations (IHR).

In the letter Dr Memesh complained that the reporting of the case had not gone through proper channels, which may have caused unnecessary collateral economic damage due to an over-reaction to the news.  However, the complaint was made well after the case and virus were described in multiple independent sources, along with additional case(s).

The time line of the events surrounding the curious complaint  are instructive and raise transparency and credibility concerns for the KSA Ministry of Health as well as WHO.

The Zaki letter was written almost four months after the patient died from an IHR reportable agent (a novel cornavirus). The ProMED report was on September 20, and two days later the full sequence of the coronavirus(EMC/12) was submitted to Genbank, a public sequence database.  The letter was also linked to testing of the Health Protection Agency (HPA) of a severe case who like the above fatal case had been placed on life support after renal failure.  A sample was tested with the pancornavirus PCR test described in the Zaki letter, and the case, who was a Qatari National (49M) who had traveled to Saudi Arabia.

The following day the Saudi Arabia Ministry of Health acknowledged the two confirmed cases as well as another fatal case who was a Saudi who died in England after seeking advanced medical care.  The case had similar symptoms but was not tested for the novel coronavirus.  On September 23 the WHO also acknowledged the two confirmed cases.

The following day the HPA released the sequence of the 206 BP insert from the PCR test of the Qatari case.  That sequences had 35 mismatches with the most closely related sequences at Genbank, bat sequences (HKU4 series and HKU5 series) from Guangdong Province in China, but there was only 1 mismatch (99.5% identity), with they EMC sequence from the fatal Saudi case from June (June 22 collection date).  The phylogenetic analysis placed the sequences in group 2c adjacet to SARS CoV sequences in group 2a.

On September 27 the full sequence from the fatal case was made public, and a revised sequence was made public on October 16, which was followed the next day by the publication of a New England Journal of Medicine report on the fatal Saudi case.

Thus, the Memesh complaint on October 22 was written after the Qatari case was confirmed in England and the two confirmed cases were described by the KSA MoH (in addition to the suspect fatal case who was not tested) as well as WHO.

The letter noted that the full story had not been told and subsequent reports by the KSA MoH and WHO raised serious concerns.

On November 4 the KSA MoH announced a third confirmed case.  The report noted that the case was treated at a Riyadh hospital and was recovering, but the age of the case ,as well as associated dates (disease onset and hospitalization) were withheld.

On November 19 the KSA MoH announced a fourth confirmed case.  Like the earlier report the case was treated at a Riyadh hospital and was recovering, but the age/gender as well as key dates were withheld.  The KSA did not describe relatives with the same symptoms, including two who had been PCR confirmed or the fact that two of the relatives had died.  Instead the KSA MoH noted an absence of serious outcomes.

On November 23 a fifth confirmed case was described on the Robert Koch Institute (RKI) website.  This case was another Qatari who had also gone to Europe (Germany) for treatment and was recovering from an October infection.

  The description of three of the cases matches those disclosed by the KSA MoH or RKI, while the sixth case was the confirmed fatal case.  The two epidemiologically linked cases were from the same family and lived in the same house.  However, there were two additional family members who were symptomatic, including one who had died.  The surviving symptomatic family member tested negative for the novel coronavirus. Like the KSA MoH reports, the WHO update gave no age or gender for the six confirmed or suspect cases and also failed to give any dates.

Subsequent media reports contained additional information, which raised serious concerns.  All six cases were male, and the unconfirmed fatal case (who died from renal failure complications) was 70 years of age and the father of the other fatal case (who died from complications linked to multi-organ failure) in the cluster, which developed in October, but reported on November 23.  Moreover, the fatally infected son was hospitalized four days after his father died, suggesting a significant time gap in disease onset dates for the father and son, which would strongly support human to human transmission.  Another media report quoted a WHO spokesperson, who also alluded to the time gap in disease onset dates for the cluster, which supported H2H transmission.

Thus, the recent WHO update raised concerns about the absence of reports on the cluster by the KSA-MoH as well as the withholding of age and onset dates by the KSA-MoH and WHO.  Media reports suggested that all 6 of the recently described confirmed and suspect cases were from October, but reported in November, including the November 23rd report which announced the cluster, which including a failure to detect the novel coronavirus in one of the surviving symptomatic family members.

These recent reports raise serious questions regarding the delays in reporting these cases as well as the withholding key information including age and disease onset dates supporting human to human transmission.  The cases were active in October  during peak Hajj activity, and now theWHO is suggesting more widespread testing.  http://www.recombinomics.com/News/11261201/Betacoronavirus_Curious_Saudi.html?

WHO says virus not more widespread

The World Health Organisation has dismissed a suggestion that the illness caused by a novel corona virus is more widespread than previously thought. http://rthk.hk/rthk/news/englishnews/20121126/news_20121126_56_885443.htm

Again, AI Attack Duck in Winton, 200 Tail Off

Monday, November 26, 2012 16:18 PM | 

WONOGIRI - Cases of avian influenza (AI) aka bird flu at a duck or ducks occurred again in Winton. The virus infects 700 ducks in Hamlet Ngelo, Semin Village, District Nguntoronadi and 200 tails of them died.

Animal Husbandry Department of Fisheries and Marine Resources (Disnakperla) Winton has conducted a rapid test (rapid test) against two ducks that died in the village on Thursday (11/22/2012) and the results were positive.  http://www.solopos.com/2012/11/26/lagi-ai-serang-bebek-di-wonogiri-200-ekor-mati-350978

Three discharged from Ebola isolation centres in Luweero

Three people admitted to Bombo Military Hospital and Nyimbwa Health Centre IV with symptoms similar to Ebola virus have been discharged from the isolation units after recovering and being counselled by health officials.

Dr Agaba Byamukama, the case management and surveillance coordinator for the Ebola task force in Luweero District, told the Daily Monitor at the weekend that two of the discharged people were from the isolation unit at Bombo Military Hospital and one was from Nyimbwa Health Centre IV.

“We have discharged three people who have been undergoing treatment. They are free to go back to the community because they have been treated and counselled by our staff,” Dr Agaba said.

He said they were also given packages such as a mattress, clothes, some food, shoes, a jerrican, among other essential items, because some of their property was destroyed as a precautionary measure against further spread of the disease.

Meanwhile, the surveillance teams have indicated that a confirmed Ebola case at Bombo Military Hospital is recovering and that no new cases have been admitted at the isolation facilities at Nyimbwa Health Centre and Bombo Military Hospital.

However, the medical teams continue to monitor 77 who came into contact with Ebola patients as a precautionary measure. He said the ministry was concentrating on training health workers, assessing infection prevention and control practices in health facilities and sensitisation of the communities.

Meanwhile, 12 people believed to have come into contact with the first suspected case on November 7 have completed the 21 days of monitoring and have been pronounced to be Ebola free, according to Dr Ester Namukose, an Epideomologist from the Ministry of Health.  http://www.monitor.co.ug/News/National/Three-discharged-from-Ebola-isolation-centres-in-Luweero/-/688334/1628922/-/iyp956/-/index.html?

BC doctors on the lookout for SARS-like virus from the Middle East

11/26/2012 

BC hospitals are on heightened alert after a new SARS-like virus has killed two people in the Middle East.

Dr. Perry Kendall, the province's Chief Medical Health Officer, says doctors received a memo from the world health organization.

"If they have concerns because there may be a linkage to someone who's travelled to Saudi Arabia or Qatar, they're asked to send respiratory secretions to the BCCDC lab so that they can be examined to be quite sure they don't have the corona virus which is linked to SARS."

There have been six confirmed cases of the virus since April.  http://www.cknw.com/news/vancouver/story.aspx/story.aspx?ID=1826364

Tuberculosis vaccine sickens 115 Romanian children; 50 hospitalized

NOVEMBER 25, 2012
Romania - On Friday, the Stockhom-based European Centre for Disease Prevention and Control said that 115 children inRomania have been sickened by a tuberculosis vaccine made in Denmark according to Businessweek.com. The children had symptoms including swollen lymph nodes and abscesses, and 50 have been hospitalized since March. In a televised address on November 22,Romanian Health Minister Raed Arafatsaid that TB vaccinations would stop until the cause of the side effects is determined...  http://www.examiner.com/article/businessweek-com-115-children-ill-from-tuberculosis-vaccine-50-hospitalized

Hong Kong suspends poultry eggs imported from Taiwan, Penghu County and Chiayi County

Time: 2012-11-25 10:36 Source: People's Daily Online - Hong Kong and Macao channels of: According to the Central Evaluation Agency

The People's Daily, November 24, according to the assessment agency reported, the Hong Kong Government Information Services announcement, Penghu County and Chiayi County found that H5N2 avian flu, the Taiwan authorities announced that the Hong Kong SAR Government, the Food and Environmental Hygiene Department spokesman for the Centre for Food Safety said, instant suspend imports of poultry and eggs from Penghu County and Chiayi County. 　　The spokesman said no live poultry and poultry meat imports from Taiwan, but there are a small number of eggs imported. For the record, in the first three quarters of this year from Taiwan, Hong Kong imported about 7.7 million eggs. 　　The spokesman said Hong Kong will pay close attention to the World Organization for Animal Health (OIE) issued on the news of the outbreak of avian flu in Taiwan and local development of the epidemic, and eggs with Hong Kong's main importers, distributors and supermarket retailers to maintain close contact. http://www.hinews.cn/news/system/2012/11/25/015164638.shtml

New SARS poison like H5N1 tour to the Middle East not to eat game

2012-11-26

World's Department of Health Organization announced four additional new coronavirus infections, one people were killed, has accumulated six infections and two deaths, the mortality rate of up to one-third. Hong Kong medical experts have warned the new coronavirus toxicity comparable H5N1 avian influenza, called on Hong Kong people not to eat venison, outbound travelers do not touch the camels and other animals, in order to avoid the poisoned.        

 The World  announced four new coronavirus infections, three from Saudi Arabia, two of which are from the same family, one person was killed, one rehabilitation. HKU Department of Microbiology, Chair Professor Yuen Kwok-yung (inset), two cases from the same family, but was unable to determine whether the virus is human-to-human transmission, there may be two patients at the same time contact with the source of experts will know whether infected after contact with animals, and take care of their health care is not infected, and therefore there is no evidence the virus is contagious.         He was referring, similar to the virus and SARS, but one of the symptoms of SARS belly defecate According display six new coronavirus infection cases, the symptoms of the patients had no belly defecate. In patients with one third of death, showing the the new coronavirus fatal high, comparable to the H5N1 avian influenza.        

 Yuan Yong added that the scientists of Saudi Arabia has done nearly a thousand individual Class A common serum test, the serum can not find all the antibodies, to prove that this is a new virus. He refers to, there is reason to believe that the virus is still concentrated in Saudi Arabia, Qatar, appealed to the public not to panic, but to do the the border medical reporting measures, to strengthen the monitoring of travelers from the Middle East, in addition to eat "game", do not touch camels, as well as in contact with animals After remember to wash your hands.      

   EGL executive director Huen Kwok-chuen, said the company does not have tours to Saudi Arabia and Qatar, but still tour group departure to Egypt and Turkey, earlier due to security issues, has been canceled camel ride links.   http://news.hkheadline.com/dailynews/content_hk/2012/11/26/216286.asp

Hong Kong-Testing stepped up as more hit by SARS-like virus

Mary Ann Benitez
Monday, November 26, 2012
Residents and tourists with unexplained pneumonia, not only those from Saudi Arabia and Qatar, will be tested for a new SARS-like virus.
Secretary for Food and Health Ko Wing-man called yesterday for enhanced vigilance after four more cases of "severe acute respiratory infection" in Saudi Arabia and Qatar were confirmed by the World Health Organization.
Patients with no history of travel to the two Middle Eastern countries but who develop symptoms of the novel coronavirus may need to be tested, Ko said.
While there is no cause to raise the alert level for SARI, he said new cases highlight the need to enhance surveillance measures in hospitals and border control points.
The WHO was notified on Friday of four additional SARI cases - three from Saudi Arabia and one in Qatar - bringing total confirmed cases of the novel coronavirus to six, with two deaths, in the past two months.
Two of the latest cases in Saudi Arabia are from the same family living in the same household. One died and the other recovered.
The health agency urged all member states to continue their surveillance for SARI. It is reviewing the case definition and other guidelines.
"Until more information is available, it is prudent to consider that the virus is likely to be more widely distributed than just the two countries that have identified cases," it said.
The WHO expressed concern because a novel coronavirus spawned the global outbreak of severe acute respiratory syndrome in 2003, with it spreading from Hong Kong.
Of the nearly 900 who died, 299 came from Hong Kong. About 8,500 people worldwide were infected.
Yuen Kwok-yung, University of Hong Kong microbiology professor, said the genetic makeup of SARI is similar to SARS and both come from bats.
Yuen said the chance of person-to- person transmission is not very high for the new infection because none of the health workers who cared for patients has been infected.
The International Society for Infectious Diseases said increased surveillance of patients even without travel history to Saudi Arabia or Qatar is prudent advice.
"The presence of cases in the same family can either be a sign of human-to- human transmission or may be related to exposure of the family members to a common source such as farm animals or bat excreta or other bat bodily fluids," the society said. http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=128660&sid=38319665&con_type=1&d_str=20121126&fc=10

UAE well-prepared for Sars-like virus after outbreak in Gulf

The UAE is well prepared to deal with outbreaks of deadly viruses, experts said, after further cases of a new, Sars-like virus were reported in the region and the death toll rose to two.

The World Health Organisation (WHO) issued a warning on Friday over a type of coronavirus that was unknown in humans before two cases were identified in late September.

One was in Saudi Arabia, where the victim died, and the other in Qatar.

The latest outbreak has affected another four people.

One of the new cases was in Qatar and the other three were in Saudi Arabia, where one of the patients died. WHO said two of the latest Saudi cases were in the same family.

The UAE does not need to go beyond the basic precautionary measures already in place, said Dr Mansour Al Zarouni, a consultant medical and molecular microbiologist, and the head of pathology and laboratory medicine for Sharjah Medical District.

“We should be aware of this but, at the same time, be inactive,” Dr Al Zarouni said. “If anything is going to happen it’s going to happen now ... there is nothing to be done except very basic precautions that we take anyway.”

Coronaviruses are a large family of viruses that range from those that cause the common cold to more severe strains such as severe acute respiratory syndrome, or Sars, said Dr Fatma Al Attar, head of preventive services at Dubai Health Authority.

As in September, when the first cases emerged, the authority is working with the Ministry of Health and following instructions from WHO and the US Centres for Disease Control and Prevention, Dr Al Mattar said.

While no cases have been reported in the UAE, hospitals have policies in place to deal with outbreaks, said Dr Mohamed Hamad, the infection-control chief at Lifeline Hospital, in Abu Dhabi.

“We have our own plan, which is based on the instruction of the Health Authority Abu Dhabi,” he said.

“They have instructed us to create a policy on this, in general.”

There are several methods by which authorities can determine whether there is an outbreak, and how extensive it is, Dr Hamad said.

“If two or more cases are found, the authorities will begin to investigate whether or not it can be classed as an outbreak,” he said.

“They [the cases] will be isolated and treated accordingly.

“They will then go for further investigation to know what type of influenza has been found and whether it is coronavirus or not.”

Investigations into the source of the Saudi and Qatar cases and how the infections spread are continuing, WHO said.  http://www.thenational.ae/news/uae-news/health/uae-well-prepared-for-sars-like-virus-after-outbreak-in-gulf?

SARS-like virus concerns WHO

The World Health Organization urges special tests for all unexpected pneumonias after another disturbing illness

A patient from Qatar has been confirmed with a new virus related to SARS, while health officials are investigating whether it may have spread between humans after close contact in Saudi Arabia.

Germany’s Robert Koch Institute said Friday that the Qatari patient fell ill in October with severe respiratory problems. He was brought to Germany for treatment in a specialty clinic, recovered after a month and was released this week.

As a precaution, the World Health Organization advised medical authorities around the world to test any patients with unexplained pneumonias for the new coronavirus, from a family of viruses that cause the common cold as well as SARS. Previously, WHO had only advised testing patients who had been to either Qatar or Saudi Arabia, the two countries with all six reported cases.

“Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the two countries which have identified cases,” WHO said.

WHO reported a cluster of four cases in October in a family living in the same household in Saudi Arabia, in which a father and son both fell ill with symptoms including pneumonia, fever and respiratory problems. The father, 70, died after developing renal failure. His son was hospitalized shortly afterwards and died four days later after multi-organ failure. The son was confirmed with the coronavirus while the father’s results are pending.

Two other people in the same family got sick but both recovered. One was confirmed with the coronavirus while the other tested negative.

Health officials always keep a close eye on any clusters of unusual viruses within families, since they may suggest the possibility of human-to-human spread. Still, that is usually due to close contact in which family members are looking after sick loved ones and does not suggest the virus can be easily transmitted.

Experts aren’t sure how the virus is spreading but suspect it may be jumping directly to humans from animals like bats, camels or goats. In the latest case from Qatar, however, the patient had no known links to animals.

WHO said Saudi officials were currently examining how its last cases got infected. “Investigations are ongoing to look at all sorts of exposure, including the possibility of human-to-human transmission,” said spokeswoman Fadela Chaib. So far, there is no evidence the virus can spread easily between people.

The Koch institute says there is no evidence the Qatari patient treated in Germany infected anyone else in the country. “The Robert Koch Institute’s assessment of the risk remains that the possibility of becoming infected in Germany is very low,” the institute said.

About 8,500 people worldwide were affected by SARS, or Severe Acute Respiratory Syndrome, in 2003 and about 900 died. http://www.salon.com/2012/11/25/sars_like_virus_concerns_who/