EBOLA VIRUS DISEASE - UGANDA (30): (LUWEERO) WORLD HEALTH ORGANISATION UPDATE

Date: Fri 30 Nov 2012

Source: World Health Organisation (WHO), CSR, disease Outbreak News [edited]

http://www.who.int/csr/don/2012_11_30_ebola/en/index.html





Ebola in Uganda - update


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As of Wed 28 Nov 2012, the Ministry of Health in Uganda reported 7 cases (6 confirmed, 1 probable) with Ebola haemorrhagic fever [Ebola virus disease] in the Luweero and Kampala districts. Of these cases, 4 died. [WHO Note: The total number of cases reported on 23 Nov 2012 was 10 (6 confirmed, 4 probable) Probable cases that tested negative for Ebola have been classified as Non-Cases and excluded from the case counts.]



Field teams continue to investigate cases alerted to them from the communities. The major challenge faced in some communities is the belief that witch-craft and not Ebola [virus] was the cause of deaths, despite ongoing intensive awareness campaigns. Social mobilization teams are working closely with traditional healers and religious leaders to raise awareness on prevention and control of the disease.



The WHO and partners, including the US Centers for Disease Control and Prevention (CDC), Medecins Sans Frontieres (MSF), the Uganda Red Cross (URCS), African Field Epidemiology Network (AFENET) and Plan Uganda continue to support the national authorities in the response to the outbreak. Through the WHO, an expert on infection prevention and control has been deployed to the field.



With respect to this event, the WHO does not recommend that any travel or trade restriction be applied to Uganda.



--

Communicated by:

ProMED-mail Rapporteur Marianne Hopp

[This update does not report any new confirmed cases in this outbreak since the previous WHO update dated 23 Nov 2012, and reproduced as ProMED-mail post: Ebola virus disease - Uganda (29): (LO) WHO update 20121123.1422071. This new update reports that 3 of the 4 probable cases identified in the previous update have not been confirmed, and the case count returns to 7 (6 confirmed and one probable). It appears that the outbreak in the Luweero and Kampala districts, for the moment, has been contained.

Bird flu kills 4,000 wild ducks in Russia

MOSCOW — Around 4,000 wild ducks have been found dead in Russia's southern Krasnodar region, officials said on Friday, blaming H5 bird flu for the mass deaths.

"This is the H5 virus, the strain is being confirmed," a spokeswoman for the Krasnodar region branch of Russian agriculture watchdog Rosselkhoznadzor told AFP.

The birds' remains were now being tested, she added.

The dead birds have been found on lakes near the Black Sea resort town of Anapa.

The region has gone on high alert, with poultry and humans now being vaccinated.

"All of these are protective measures, it's better to be on the safe side," the spokeswoman added.    http://www.google.com/hostednews/afp/article/ALeqM5hkclP5htvyU9uItLrfoLukWP6KJw?docId=CNG.a7d2f8d949f2ecbfd7611ccf89934f70.21

Monkey fever:Forest watcher hospitalized

Forest watcher hospitalized

TNN | Dec 1, 2012, 06.47 AM IST

MYSORE: Two days after a forest watcher was hospitalized, another watcher fromAlegowdanakattte anti-poaching camp in Maddur forest range of Bandipura tiger Reserve, got admitted to Gundlupet General Hospital on Friday. 

Pradeep Kumar, 46, came to hospital with complaints of body pain, headache and eye burn, said hospital chief medical officer Dr R Srinivas. "We have put him on drips," the officer said. 

Four other watchers, who were working at the anti-poaching camp, are fine. 

On Wednesday, Chikkakariaiah, a 42-year-old watcher, was hospitalized following tiredness. He is recuperating. He, however, continues to be under observation. Chikkakariaiah is likely to be discharged on Saturday. 

Dr Srinivas told TOI that they are awaiting reports from experts working in Kyasanur forest of Shimoga to confirm the disease. Blood samples of six watchers and viscera of primates have been sent to National Institute of Virology (Pune).   http://timesofindia.indiatimes.com/city/mysore/Forest-watcher-hospitalized/articleshow/17436530.cms

Pacific: A patient with suspected H5N1

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To the Provincial Hospital in a state of continuous high fever, cough, sore throat, shortness of breath ... the usual treatments for patients who do not yield results, the doctor suspected H5N1-infected patients should be moved Tropical diseases hospital treatment

Nguồn đọc thêm: http://www.xaluan.com/modules.php?name=News&file=article&sid=507308#ixzz2DlTn8zQM
http://www.xaluan.com/

Vietnam-A patient with suspected H5N1

Saturday, 01/12/2012 - 06:

(Reuters) - By Provincial Hospital in a state of continuous high fever, cough, sore throat, shortness of breath ... the usual treatments for patients who do not yield results, the doctor suspected patients H5N1 infection should be referred to hospital for Tropical diseases treatment.

Cases suspected of being infected with the virus aforementioned risk patients Nguyen Van Sang (42 years old, live in Kien Giang). Known, Mr Sang is made in the town of Thuan An, Binh Duong. Before admission, he visited the home in Kien Giang, his family had a flock of ducks, but are dying.Unfortunately, he brought 3 to Binh Duong disease ducks eating meat.

On 26/11, Mr. Sang began to appear symptoms of high fever, sore throat, cough, shortness of breath ... despite taking multiple medications, but the condition is not relieved. On 27/11 a friend took him to a Hospital Binh Duong visit. Here, the X-ray results recognized in patients with large cardiac shadow, pleural effusion associated with clinical symptoms doctors suspected H5N1-infected patients should be transferred to the Hospital for Tropical Diseases to continue treatment .

Immediately after receiving the notification of cases of suspected influenza, preventive medicine center in Binh Duong province has carried out disinfection in patients boarding area and the surrounding area. Hospital for Tropical Diseases and the Pasteur Institute in Ho Chi Minh City is conducting the necessary tests to be the most accurate conclusion to this case. 

  http://dantri.com.vn/suc-khoe/mot-benh-nhan-nghi-nhiem-cum-h5n1-668782.htm

Identical Novel Beta Coronavirus Sequences Signal H2H

Recombinomics Commentary 21:00
November 30, 2012

A paper “Recovery from severe coronavirus infection” published in the Saudi Med J by Dr Ziad Memesh and colleagues describes the third confirmed novel betacornavirus case (45M), which was announced by the Kingdom of Saudi Arabia Ministry of Health on November 4, the date of discharge.
 
The case is a gym-teacher from Riyadh, Saudi Arabia who developed symptoms on October 9. His conditioned worsened and he visited the emergency room on October 10 and 12. His conditioned continued to worsen and was intubated for mechanical ventilation on October 13 and transferred to the ICU. Kidney failure led to hemodialysis between October 15-23.
 
The novel betacornavirus was detected in respiratory samples using PCR tests for the upstream region of the E gene as well as ORF1B and N genes. The paper included two sets of sequences for two regions, a 311 Bp fragment of ORF1B (positions 18105-18414) and a 409 BP fragment of E (positions 27278-27868).  These sequences were from samples collected from case 1 (60M businessman from Bisha, treated in Jeddah, confirmed at Erasmus Medical Center in the Netherlands) and case 3 described above. The two sets of sequences were identical to the updated public sequence for case 1 (JX869059.2) as well as case 2 (49M businessman from Doha, Qatar and treated in London).
 
The identity of the two regions in all three cases once again indicates these cases were not infected by an animal source.  Media reports continue to cite the relatedness to bat coronaviruses, which were identified under an enhanced surveillance program to identify the natural reservoir for SARS CoV.  Bats were found to host a wide variety of coronaviruses including the two members of class 2c found in Guangdong Province, China (HKU4 and HKU5).  These cases were identified using the same pan-coronavirus PCR tested used to identify the first two recent human cases.  However, for the two regions above the three cases from widely separated areas in two countries (Bisha, Doha, Riyadh) were identical, yet had more than 20% mismatches for the most closely related bat class 2c coronaviruses (HKU4 and HKU5).
 
Moreover, WHO has now reported two confirmed cases from an ICU outbreak in Zarka, Jordan in April.  The novel betacornavirus spread throughout the unit and infected at least seven nurses and a doctor as well as the brother of a fatally infected nurse.  The ECDC report cited one fatality, but WHO has already confirmed two fatalities.
 
Release of sequences from the Jordan outbreak would be useful.

http://www.recombinomics.com/News/11301203/Betacoronavirus_Seq_3.html

SARS-Like Virus Found In Jordan, Hunt Is On For Other Cases

By RICHARD KNOX

The World Health Organization says a new Arabian coronavirus has killed two people in Jordan — the third country where the novel microbe has been traced.

That brings lab-confirmed cases to nine, with five fatalities.

The latest cases are actually the oldest known so far. They push the SARS-like virus's timeline three months back from the first reported case involving a 60-year-old man who died in Jedda, Saudi Arabia, last June.

Jordan's cases were found through new testing of blood and tissues samples from patients in a cluster of pneumonias of unknown origin that occurred last April at a hospital in Zarqa, near Jordan's capital of Amman.

Until now known cases have occurred further south in Qatar and Saudi Arabia.

The newly identified cases are also significant because they're part of an 11-person pneumonia cluster that involved seven nurses and a doctor.

It's unclear whether either of the two new cases involved health care workers, or whether the new coronavirus has been ruled out yet as the cause of the other pneumonias in that outbreak.

But whenever disease-trackers see clusters of infection involving caregivers, that raises their suspicion that a microbe has spread from person to person — most likely from patient to caregiver.

It doesn't have to mean that. Health care workers and patients could have acquired the infection from a shared environmental source.

But if the new virus is able to spread from person to person, even if inefficiently, that raises the possibility it can become more mobile, moving through human populations.

"Even if the cases in Jordan were human-to-human spread — and we don't know that — it wasn't sustained," WHO spokesman Gregory Haertl told the Canadian Press.

The possibility of person-to-person spread is also suggested by a cluster of coronavirus pneumonias reported on November 23 involving members of the same household in Riyadh, Saudi Arabia. Four men in that family fell ill with respiratory symptoms and two tested positive for the new coronavirus. The two others, one of whom died, are considered probable cases.

No one thinks that the new coronavirus is as big a threat as its notorious cousin, the one that precipitated the SARS epidemic in 2003 that quickly spread around the world and killed 916 people.

For one thing, health officials haven't found any cases of the new coronavirus among the millions of pilgrims who attended this fall's annual Hajj in Mecca, near the place where the Saudi man died in June.

On the other hand, nobody knows how big a problem the Arabian coronavirus may be — or even whether it is likely to be restricted to Arabia.

The WHO is urging medical and public health workers around the world to investigate clusters of unexplained pneumonia for a possible link to the new virus. It isn't calling for individual cases to be tested.

The agency "is convinced that whatever the source of the virus is, it is probably not unique to those countries," science journalist Helen Branswell writes in Scientific American.

Genetic testing suggests that the new virus is most closely related to one in bats. But that doesn't necessarily mean all human cases had direct contact with bats. There may be an intermediate carrier, and victims might have eaten food contaminated with dust, urine or feces from an infected animal.

At this point, it appears that researchers will find more human cases of the new virus. Each case, or cluster of cases, increases the chance that the source and mode of transmission will be found.

That effort will be accelerated by the development of a blood test for the virus, which Branswell reports may come in the next month or so. Right now diagnosis relies on a gene-amplification test called PCR which is cumbersome and sometimes hard to interpret. And it can't tell if someone had been exposed to the virus in the past but recovered.   http://www.wknofm.org/post/sars-virus-found-jordan-hunt-other-cases

Two people in Jordan died from SARS-like coronavirus: WHO

By Stephanie Nebehay

GENEVA (Reuters) - Two people who died in Jordan in April have been found to have been infected with the new virus from the same family as SARS which sparked a global alert in September, the World Health Organization (WHO) said on Friday.

The coronavirus, previously unknown in humans, has now been confirmed in a total of nine people in three countries in the Middle East region, including a Saudi who had severe acute respiratory illness last month, the United Nations agency said.

But the two fatal cases in Jordan, confirmed in samples just retested by a WHO collaborating laboratory in Egypt, do not change WHO's assessment that the virus does not appear to spread easily between people, if at all, spokesman Gregory Hartl said.

"These Jordan cases don't change our risk assessment at the moment. We haven't seen any new pattern. These are old cases," Hartl told Reuters.

In a statement, the Geneva-based WHO said: "Two fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to nine."

Initially, the samples had tested negative for known coronaviruses and other respiratory viruses in April.

"As the novel coronavirus had not yet been discovered, no specific tests for it were available," the agency said.

The new virus shares some of the symptoms of SARS, or Severe Acute Respiratory Syndrome, which emerged in China in 2002, spread easily among people and killed around a tenth of the 8,000 people it infected worldwide.

"Based on current information, it does not appear to transmit easily between people, unlike theSARS virus," WHO said.

The new virus can appear to be pneumonia and acute kidney failure has occurred in five cases, the WHO said.

In all, five cases of the new virus, including three deaths have been confirmed in Saudi Arabia, including three patients in one family, it said. Two cases have been confirmed in Qatar, and both are recovering, while both cases in Jordan were fatal.

LINK

The Jordan cases were among a total of 12 cases of severe acute respiratory illness that erupted last April linked to a hospital in Zarqa some 40 kilometers (24 miles) outside Amman, Hartl said. Most were health workers, he added.

"The link is the hospital. It could be some environmental thing or human-to-human transmission," he said.

"The main thing is the fact that even if it were human-to-human transmission, which we don't know, it doesn't seem to spread very well or efficiently," Hartl said.

The two so-called "clusters" of cases, in Saudi Arabia and Jordan, raised the possibility of "limited human-to-human transmission", or exposure to a common source, the WHO said.

"Ongoing investigation may or may not be able to distinguish between these possibilities," it said, noting some viruses are transmitted within families but are not transmissible enough to cause large community outbreaks.

The WHO urged health authorities in its 194 member states to continue surveillance for the new virus and investigate any unusual patterns.

"Testing for the new coronavirus of patients with unexplained pneumonias should be considered, especially in persons residing in or returning from the Arabian peninsula and neighboring countries," it said.   http://news.yahoo.com/two-people-jordan-died-sars-coronavirus-195501996.html?utm_medium=twitter&utm_source=twitterfeed

Coronavirus caused infections as early in April, tests show

Helen Branswell, The Canadian Press 

Published Friday, Nov. 30, 2012 2:39PM EST 

TORONTO -- The World Health Organization has reported two additional cases of infection with the new coronavirus, the earliest on record.

The agency says retrospective testing of stored samples show two people who died in Jordan in April were infected with the virus, which is from the same virus family as SARS.

Prior to this the first known case had been a man from Jeddah, Saudi Arabia, who fell ill and died in June.

The new report from the WHO brings to nine the number of confirmed infections with the new virus, of which five cases have been fatal.

When it came to light that a new coronavirus was causing severe human illnesses in the Middle East, questions were raised about an outbreak of severe pneumonia cases that had occurred in Jordan in April.

At the time health officials were not able to diagnose what was causing the illnesses, but stored samples from two of the patients tested positive recently for the new coronavirus.

In a statement issued Friday, the WHO says Jordan's ministry of health has asked the global health agency for assistance in investigating the infections.

A team from WHO's Eastern Mediterranean Regional Office and from WHO headquarters arrived in the Jordanian capital, Amman on Wednesday to help with studies aimed at trying to trace the source of infection and strengthen capacity to spot new cases.

A potentially worrisome aspect of the Jordanian outbreak is that it involved health-care workers. Health-care workers can be unwitting sentinels in disease outbreaks, picking up infections from patients that they treat. If health-care workers become infected, that can often -- though not always -- be a sign a pathogen can spread from person to person.

To date there has been no sign of sustained person-to-person spread of the virus,??.. though there was a recent cluster of three and possibly four family members who got sick in Riyadh, Saudi Arabia. Two of them died.

The Jordanian cases may signal spread from patients to health-care workers happened there. But it's too soon to conclude that, said WHO spokesperson Gregory Hartl, who noted the health-care workers and the patients could have been infected for a common -- and as yet unidentified -- source.

"Even if the cases in Jordan were human-to-human spread -- and we don't know that -- it wasn't sustained," Hartl said in an interview from Geneva. He noted that there has been no sign of spread to health-care workers in Saudia Arabia or Qatar, the two other countries that have had cases, nor in London or Germany, where two of the cases have been treated.

Hartl said with cases popping up over large distances in three different countries, and over months, much work remains to be done to figure out what is going on. "There are a lot of holes still to be filled in," he said.

The WHO has asked countries to be on the lookout for possible cases in people with unexplained severe infections who have recently returned from or lived in countries in the Arabian Peninsula, or surrounding countries.

To date the case count is as follows: Jordan, two, both fatal; Saudi Arabia, five, three fatal and Qatar, two.

A report on the outbreak -- noted in a weekly disease report from the European Centre for Disease Control in May -- said seven nurses and a doctor were among 11 cases identified in the outbreak at a hospital in Zarqa, Jordan.  http://www.ctvnews.ca/health/coronavirus-caused-infections-as-early-in-april-tests-show-1.1060942

Jordan Fatal Novel Beta Coronavirus Cluster Confirms H2H

Recombinomics Commentary 19:00
November 30, 2012

In addition to the fatal case of novel coronavirus in Saudi Arabia reported to WHO on 28 November, two fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to nine.

The two cases from Jordan occurred in April 2012. At that time, a number of severe pneumonia cases occurred in the country and the Ministry of Health (MOH) Jordan promptly requested a WHO Collaborating Centre for Emerging and Re-emerging Infectious Diseases (NAMRU – 3) team to immediately assist in the laboratory investigation.

The above comments are from a WHO update confirming two of the pneumonia cases in an ICU ward in Zarqa, Jordan in April, 2012 were due to the novel betacornavirus currently circulating in Saudi Arabia and Qatar.  This outbreak involved at least seven nurses and a doctor among the 11 cases cited.  Media reports indicated the actual number was larger than the numbers cited in an ECDC report, which noted the death of one of the nurses.

The failure of NAMRU-3 to detect this outbreak last spring raises concerns, since the pan-coronavirus PCR test has been known since 1999.

The ICU cluster clearly demonstrates that this novel betacoronavirus transmits human to human (H2H) and has striking similarities to the SARS CoV outbreak in 2003.

http://www.recombinomics.com/News/11301202/Betacoronavirus_Jordan_H2H.html?

ECDC Epidemiological update: novel coronavirus

30 Nov 2012

ECDC
On 30 November WHO updated the number of confirmed cases of pneumonia caused by the novel coronavirus which has been temporarily named hCoV-EMC. Between April 2012 and 30 November 2012, nine confirmed cases of infection with the novel coronavirus (of whom five died) have been reported to WHO, according to its case definitions. Severe acute respiratory disease was the common presentation of all cases.

Five of the confirmed cases reside in Saudi Arabia (including three fatalities) two in Qatar and two in Jordan. Three of the confirmed cases from Saudi Arabia are from the same family household and there is also a fourth probable case. The second cluster with two confirmed cases (both fatal) has been retrospectively identified among eleven persons who became ill with acute respiratory disease in Jordan already in April 2012.
Two of the cases were diagnosed after being transferred to Europe for further medical care.

The reservoir and route of transmission of this virus has not been identified but all cases were reported from the Arabian Peninsula. 
The detection of two clusters could indicate limited person-to-person transmission or exposure to a common source. However, only careful investigation can help to distinguish between those two.

On 26 November 2012, ECDC updated the Rapid Risk Assessment on severe respiratory disease associated with the novel coronavirus. The updated information from WHO at present does not change the conclusions of this assessment.
ECDC conducted a survey on the laboratory capacity testing in EU/EEA member states in coordination with WHO Regional Office for Europe and the results are expected to be available next week.

On 28 November, WHO updated the Interim surveillance recommendations for human infection with novel coronavirus.
Healthcare professionals should be aware of the possibility of seeing patients matching the WHO case definition. Any probable or confirmed case being diagnosed in the EU/EEA area should be reported to the national authorities and then through the Early Warning Response System (EWRS) also to the Event Information Site of the WHO International Health Regulations.ECDC will continue to closely follow developments.

Read more on ECDC website:

Rapid Risk Assessment: Severe respiratory disease associated with a novel coronavirus, 26 September 2012
Epidemiological update on third confirmed case of novel coronavirus, 6 November 2012
Rapid Risk Assessment: Severe respiratory disease associated with a novel coronavirus of 24 Sep 2012
External websites:
RKI: Press Release on a case of Novel Coronavirus diagnosed in Germany 
WHO: Novel Coronavirus; Novel coronavirus infection - update
UK: Genetic sequence information for scientists about the novel coronavirus 2012 
Recent Eurosurveillance article:
The United Kingdom public health response to an imported laboratory confirmed case of a novel coronavirus in September 2012

http://ecdc.europa.eu/en/press/news/...ews/Lists/News

Interim Local Health Departments Novel Coronavirus (NCV) Investigation Short Form

. For NCV patients under investigation (PUI), fill out the form below and send to eocreport@cdc.gov (subject line: NCV Patient
Form) or fax to 770-488-7107.  If information is incomplete, please send any information you have as soon as possible then send
an updated form when you obtain more information.
Case Definition: see Interim Guidance for State & Local Health Departments.

http://www.cdc.gov/coronavirus/ncv/downloads/Interim-NCV-investigation-short-form.pdf

Background and summary of novel coronavirus infection – as of 30 November 2012

Over the past two months, WHO has received reports of nine cases of human infection with a novel coronavirus. Coronaviruses are a large family of viruses; different members of this family cause illness in humans and animals. In humans, these illnesses range from the common cold to infection with Severe Acute Respiratory Syndrome (SARS) coronavirus (SARS CoV).

Thus far, the cases reported have come from Qatar, Saudi Arabia and Jordan. All patients were severely ill, and five have died.

The two Qatari patients are not linked. Both had severe pneumonia and acute renal failure. Both are now recovering.

A total of five confirmed cases have been reported from Saudi Arabia. The first two are not linked to each other; one of these has died. Three other confirmed cases are epidemiologically linked and occurred in one family living within the same household; two of these have died. One additional family member in this household also became ill, with symptoms similar to those of the confirmed cases. This person has recovered and tested negative, by polymerase chain reaction (PCR) tests, for the virus.

Two confirmed cases have been reported in Jordan. Both of these patients have died. These cases were discovered through testing of stored samples from a cluster of pneumonia cases that occurred in April 2012.

The two clusters (Saudi Arabia, Jordan) raise the possibility of limited human-to-human transmission or, alternatively, exposure to a common source. Ongoing investigation may or may not be able to distinguish between these possibilities.

The current understanding of this novel virus is that it can cause a severe, acute respiratory infection presenting as pneumonia. Acute renal failure has also occurred in five cases.

WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with SARS. Although this novel coronavirus is distantly related to the SARS CoV, they are different. Based on current information, it does not appear to transmit easily between people, unlike the SARS virus.

WHO has closely monitored the situation since detection of the first case and has been working with partners to ensure a high degree of preparedness should the new virus be found to be sufficiently transmissible to cause community outbreaks. Some viruses are able to cause limited human-to-human transmission under condition of close contact, as occurs in families, but are not transmissible enough to cause larger community outbreaks.

Actions taken by WHO in coordination with national authorities and technical partners include the following:

Investigations are ongoing to determine the likely source of infection and the route of exposure. Close contacts of confirmed cases are being identified and followed up. 
An interim surveillance recommendation has been updated to assist clinicians to determine which patients should undergo laboratory testing for the presence of novel coronavirus.
Laboratory assays for the virus have been developed. Reagents and other materials for testing are available, as are protocols, algorithms and reference laboratory services. WHO has activated its laboratory network to assist in testing and other services. WHO has also issued preliminary guidance for laboratory biorisk management.
Guidance is available for infection control.


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.
Further, testing for the new coronavirus of patients with unexplained pneumonias should be considered, especially in persons residing in or returning from the Arabian peninsula and neighboring countries. Any new cases should be promptly reported both to national health authorities and to WHO.

In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated, regardless of where in the world they occur. These investigations will help determine whether the virus is distributed more widely in the human population beyond the three countries that have identified cases.

WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.
WHO continues to work with Member States and international health partners to gain a better understanding of the novel coronavirus and the disease in humans and will continue to provide updated information. As the situation evolves, WHO will reassess its guidance and revise it accordingly.http://www.who.int/csr/disease/coron...e_20121130/en/

WHO confirms 2 more fatal cases of new virus in Jordan, possible virus spread between peopl

By: Maria Cheng, The Associated Press
LONDON - International health officials have confirmed two more fatal cases of a mysterious respiratory virus in the Middle East.
The virus has so far sickened nine people and killed five of them. The new disease is a coronavirus related to SARS, which killed some 800 people in a global epidemic in 2003, and belongs to a family of viruses that most often causes the common cold.
The two cases date back to April and are part of a cluster of a dozen people, mostly health workers, who fell sick in an intensive care unit at a hospital in Zarqa, Jordan. Officials are investigating whether the 10 other people who grew sick in Zarqa also were infected and how the virus might have spread.
"It's too early to say whether human-to-human transmission occurred or not, but we certainly can't rule it out," said WHO spokesman Gregory Hartl.
One of the Jordanian cases was a 40-year-old female. All of the other patients to date have been men. The new virus has so far been identified in patients from Saudi Arabia and Qatar.
Scientists haven't found any links between the sporadic cases of the coronavirus so far, first detected in September. "We don't know how the virus gets around and there are more questions than answers right now," Hartl said.
Several of the patients sickened by the new coronavirus have had rapid kidney failure and others have suffered severe pneumonia and respiratory illnesses. The virus is most closely related to a bat virus and scientists are also considering whether bats or animals like camels or goats are a possible source of infection.
Scientists are also considering whether fruit contaminated by animal droppings may have spread the virus.
Still, not all of the cases had contact with animals and WHO said it was possible the virus was spread between humans in the Jordan hospital and in a cluster of cases in Saudi Arabia, where four members of the same family fell ill and two died.
WHO says the virus is probably more widespread than just the Middle East and recommended that countries test any people with unexplained pneumonia.
http://www.winnipegfreepress.com/bre...181561141.html

WHO: 2 MORE CASES OF NEW VIRUS IN JORDAN

LONDON (AP) -- International health officials have confirmed two more fatal cases of a mysterious respiratory virus in the Middle East.

The virus has so far sickened nine people and killed five of them. The virus is related to SARS, which killed some 800 people in a global epidemic in 2003.

The two cases date back to April and are part of a cluster of a dozen people who fell sick in Zarqa, Jordan. Officials are investigating whether the 10 other people sick in Zarqa also were infected and how it might have spread. Other cases of the virus have been spotted in Saudi Arabia and Qatar.
WHO doesn't know exactly how the virus spreads but said it couldn't exclude the possibility it was being transmitted from person to person.

http://hosted.ap.org/dynamic/stories...MPLATE=DEFAULT

WHO confirms 2 more fatal cases of new virus in Jordan, possible virus spread between people

..The two cases date back to April and are part of a cluster of a dozen people who fell sick in Zarqa, Jordan. Officials are investigating whether the 10 other people sick in Zarqa also were infected and how it might have spread. Other cases of the virus have been spotted in Saudi Arabia and Qatar.

WHO doesn’t know exactly how the virus spreads but said it couldn’t exclude the possibility it was being transmitted from person to person.

http://www.washingtonpost.com/world/...80_story.html?

New SARS-related coronavirus claims a third life

Jennifer Yang

Three people have now died from the new coronavirus in the Middle East — two of whom were relatives from the same Saudi Arabian household, the World Health Organization confirmed Friday.

There are now a total of seven confirmed cases, which is up one from last week. An eighth case has been deemed “probable” but confirmation of infection may not be possible, according to WHO spokesperson Glenn Thomas, who said tests are still underway.

So far, this new virus — which is genetically related to the virus that caused SARS — has been popping up in three regions: Doha, Qatar, where two citizens have been infected, and the Saudi Arabian cities of Jeddah and Riyadh, which are approximately 850 kilometres apart.

The first case was a 60-year-old Saudi Arabian man who was hospitalized in Jeddah on June 13.

“The newly reported cases demonstrate that the virus has persisted over a period of at least 5 months and is geographically distributed over a wider area than was evidenced by the first two cases,” the WHO said in a Nov. 28 surveillance recommendation report.

“Given that the exact extent of the distribution is unknown, WHO is taking the precaution of recommending an expansion of surveillance to monitor for the appearance of the virus in other countries.”

All of the victims have been male but “the significance of this is unknown,” the release said.

The WHO said it still does not know the source of the virus or its mode of transmission but the family cluster of cases has raised questions over whether the virus might be transmitting from person to person — as was the case with SARS.

Three members of the same Saudi Arabian family have now been infected, two fatally. A fourth relative is the probable case. All were treated in Riyadh, according to Thomas.

But last week, WHO spokesperson Fadéla Chaid cautioned that it is difficult to know if the family members may have infected each other or simply been exposed to the same environmental source, since they all lived in the same household.

Early investigations show that the coronavirus is closely related to one found in bats, but the WHO said there is no proof yet that bats are the animal reservoir. It is not known whether the family members who have been infected worked with animals.

“The timing of the cases in the Saudi cluster does raise that concern (of human-to-human transmission),” Chaib said last week. “But when a cluster occurs in a setting such as a household, where everyone has similar environmental exposures, it can be very difficult to separate out exposure to the same environmental source versus spread from one person to another.”

There has been some inconsistency around the number of cases and the way in which new cases have been publicized.

The first case, the 60-year-old Saudi Arabian man, died in mid-June but information about his death and the novel coronavirus was not widely disseminated until late September, when a Jeddah hospital microbiologist investigating his case posted an email on ProMed, an infectious disease reporting website.

The second case came to light after microbiologists in the United Kingdom’s Health Protection Agency noticed the ProMed posting — at the time, they were looking into a case involving a Qatari patient who had been airlifted to a London hospital with serious respiratory problems. He was quickly confirmed as the second case.

A third case was publicized by the Saudi Arabian Ministry of Health in early November in a news release. Then on Nov. 23, the WHO announced the total of cases as six, with two confirmed deaths — that same day, Germany’s national health institute published a news release confirming that a German clinic had been treating a Qatari citizen with the novel coronavirus, who had recovered and been released.

The WHO announcement said at the time that two of the confirmed cases were from the same family, one of whom had died; two other relatives had also sickened but one tested negative and the other, who passed away, still had laboratory tests pending.

On Nov. 28, the WHO published its interim surveillance recommendations for the novel coronavirus and included an update that brought the case total up to seven, with one probable case. It did not directly state the total number of deaths but said four patients had “developed acute renal failure; one of these has died.”

The recommendations were revised two days later to say that five of the seven confirmed cases had “developed acute renal failure and three of these died.”

According to Thomas, the surveillance recommendations are in the process of being updated with clarifications on the number of cases. “Significant information” about the novel coronavirus will be announced on the WHO’s website, under the Disease Outbreak News section, Thomas said in an email Friday morning.

The WHO recommendations describe the clinical picture of the new coronavirus as an acute respiratory infection. All of the confirmed cases showed signs of pneumonia.

The coronavirus is named for its crown-like appearance under the microscope and prior to 2002, there were only two known coronaviruses, both associated with the common cold. SARS was the third known coronavirus and caused an outbreak in 2003 that swept across 30 countries and killed approximately 800 people, including 44 Torontonians.  http://www.thestar.com/news/world/article/1295819--new-sars-related-coronavirus-claims-a-third-life