Patients in Curuçá be transferred to Castlebay

Updated 04/12/2012 20h19

Municipal Hospital Curuçá will undergo disinfection after death. 
Causes of the disease is remaining unknown.

Six employees of the Municipal Hospital Curuçá who are hospitalized in the city will be transferred on Wednesday (5) to Castlebay, northeast of the state. They are hospitalized since last Nov. 23, after they began to exhibit symptoms such as fever, shortness of breath, oliguria (reduced urine volume), hypotension, hypoglycemia, bradycardia (slow heart rate) and hemorrhagic manifestations in the digestive system.

According to the State Department of Health (Sespa), the transfer will occur so that the hospital Curuçá be disinfected. Still no confirmation on the exact disease that affects 19 employees. A 17 year old died in the ICU of Santa House on the evening of Saturday (01). The results of tests performed on patients must leave in 15 days.

Only test results for common viruses like Influenza, including Influenza A (H1N1), was released.The analysis was negative. Samples were collected nasal and pharyngeal patients, as well as blood to a series of laboratory tests such as blood culture and research of various viruses.

According to director of the Department of Endemic Disease Control, Bernardo Cardoso, is likely to be patients with poisoning and contamination by bacteria, viruses and fungus. For investigation of possible intoxication, Toxicology Laboratory, Federal University of Pará (UFPA) examine spilled accidentally in Curuçá Municipal Hospital, originally named as causing the problem.

The cases are being followed up by the Epidemiological Monitoring of Sespa in conjunction with the 3rd Regional Center for Health in Castlebay, the Municipal Health Curuçá, Central Laboratory of the State (Lacen), Centre for Skills Scientific Renato Chaves (CPC) and Instituto Evandro Chagas.

Last Sunday (2), five other patients who have symptoms more delicate were transferred to Bethlehem Patients are admitted to the unit of Meningitis Diagnosis (UDM), the University Hospital João de Barros Barreto, under monitoring of infectious disease.

Understand the case
Between 23 and 24 November, 19 people were diagnosed with respiratory syndrome in Curuçá Municipal Hospital. According to Sespa at first was suspected contamination by radioactive material.

As the evolution of the process of investigation, however, the main suspicion is that employees are with an infection caused by viruses, bacteria or fungus.

The investigations and assistance to patients and families is being coordinated by Sespa (Central and Regional Level) with the participation of the Municipal Health Department, Instituto Evandro Chagas and Scientific Skills Center Renato Chaves.  http://g1.globo.com/pa/para/noticia/2012/12/pacientes-internados-em-curuca-serao-transferidos-para-castanhal.html

Brazil outbreak news

Bernardo Cardoso (c) told reporters that the scans ruled out contamination by virus Influenza, including influenza A (H1N1)

Flu season expected to be worst in almost a decade

Dec 04, 2012 11:53 AM EST

LOUISVILLE, Ky. (WDRB) -- Don't let the warm weather fool you.

This year's flu season is starting earlier and hitting harder than it has in almost a decade.

The Metro Health department says it has already seen its first reports of the flu this season.
And nationwide, the Centers for Disease Control says the strain circulating this year is more severe.

The good news is that this year's flu vaccine is a 90 percent match for circulating strains.
The prime flu season runs from October through April.

http://www.wdrb.com/story/20257184/flu-season-expected-to-be-worst-in-decade

UNDIAGNOSED RESPIRATORY DISEASE - BRAZIL: (PARA) REQUEST FOR INFORMATION

Published Date: 2012-12-04 11:18:09
Subject: PRO/AH/EDR> Undiagnosed respiratory disease - Brazil: (PA) RFI 
Archive Number: 20121204.1436678

UNDIAGNOSED RESPIRATORY DISEASE - BRAZIL: (PARA) REQUEST FOR INFORMATION
************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Sun 2 Dec 2012

Source: Para Government press release [in Portuguese, trans. Mod.MPP, edited]

http://www.pa.gov.br/noticia_interna.asp?id_ver=113000





Patients with respiratory syndrome are transferred from Curuca to Belem


----------------------------------------------------------------------


The State Department of Public Health (Sespa) decided to transfer 5 patients in serious clinical condition from Curuca Municipal Hospital to Belem, with symptoms of an acute respiratory syndrome with as yet undiagnosed etiology. The purpose of the transfer is to assure better care of the patients, cases which are still under investigation by the Sespa Epidemiologic Surveillance unit in conjunction with the 3rd Regional Center for Health in Castanhal, the Curuca Municipal Health Secretariat, the State Central Laboratory (Lacen), the Renato Chaves Center of Scientific Expertise (CPC), and the Evandro Chagas Institute.



The patients that were transferred to the capital [Belem is the capital of Para State] will be admitted to the Meningitis Diagnostic Unit (UDM), of the Joao de Barros Barreto University Hospital, under the care [monitoring] of the Infectious Disease physicians. In addition to these 5 people, another 14 [individuals] showed symptoms of the disease since the beginning of the outbreak in the Municipal Hospital of Curuca, where a 17 year old female died in the ICU of Santa Casa, on the evening of Sat 1 Dec 2012.


The case of the young woman [the 17 year old] is being investigated because she was a resident of Curuca and a cousin of a nursing technician in the Municipal Hospital, who also presented with symptoms of this disease. The young woman was pregnant and lost the baby after being infected. Although the body was released for burial and taken to Curuca, the Sespa team contacted the family and asked permission for an autopsy, which will be performed at the Center for Scientific Expertise in Belem.



The initial suspicion was that the patients had been victims of radioactive contamination and then by a chemical product used in developing the radiographs. [This hypothesis] was discarded as a function of the presenting symptoms -- low fever, shortness of breath, oliguria (reduced urine volume), hypotension, hypoglycemia, bradycardia (slow heart rate), and hemorrhagic manifestations in the digestive system, among others. The working hypothesis of Sespa is now a viral, bacterial, or fungal infection.



To discover the causative agent of the disease nasopharyngeal secretions of the patients were collected, as well as blood for a series of laboratory tests that are underway in Lacen [State Laboratory] and the Evandro Chagas Institute, including, blood cultures and studies for various viruses, including H1N1 and hantavirus. The patients were [empirically] treated with ciprofloxacin and Tamiflu even in the absence of test results, but they did not show any improvement.



The State Laboratory also collected samples of the water supply of Curuca City Hospital because of a suspicion that the causative agent might me found there. According to the director of the Sespa Health Surveillance Unit, Rosiana Nobre, in addition to the investigation and medical attention of the patients, it was necessary to provide assistance to the families and professionals supposedly exposed [to the source of the infection], as well as to disinfect the Municipal Hospital in order to eliminate the possible sources of infection and provide the Municipal Hospital of Curuca with medicines, supplies, and personal protective equipment (PPE).



Nobre also said they were developing an orientation guide for the Curuca population, hospital workers, and family members on preventive measures to avoid the emergence of new cases pending laboratory results and the identification of more specific measures for disease prevention.



[Byline: Roberta Vilanova, Sespa]



--

Communicated by:

ProMED-mail



[An initial reaction one has upon reading the introductory paragraphs describing the outbreak of an acute severe respiratory illness associated with reduced urinary output was to wonder if this might be another new location for a nosocomial outbreak of the novel coronavirus described in the Eastern Mediterranean countries of Saudi Arabia, Jordan, and Qatar. As one reads more of the official announcement, this seems to be less and less a possible explanation for this outbreak.



A curious symptom described in the clinical presentations above is the relative bradycardia. Usually when there is respiratory distress (due to hypoxia -- low blood oxygen concentrations) or when there is a fever, it is often accompanied by a tachycardia (fast heart beat). Diseases that are known to present with a relative bradycardia (slow heart beat in the face of other symptoms) include typhoid fever, legionnaires' disease, psittacosis, typhus, leptospirosis, malaria, babesiosis, dengue fever, and viral hemorrhagic fevers (see refs 1,2,3 below). With respect to the presentation of hypoglycemia, Mod. ML mentioned that hyperglycemia is the most common blood glucose abnormality seen early in the course of bacterial sepsis. Profound hypoglycemia may occur late in the course of sepsis. Hypoglycemia with cardiovascular collapse is seen in patients with adrenal insufficiency.



In another newswire, there is mention there had been 19 cases with respiratory symptoms reported from the Hospital in Curuca during the period 23-24 Nov 2012. Further investigation revealed a predominance of hypoglycemia, bradycardia, and gastrointestinal hemorrhagic symptoms (see http://g1.globo.com/pa/para/noticia/2012/12/tecnicos-de-hospital-de-curuca-sao-transferidos-para-belem.html in Portuguese).



When one reads the paragraphs towards the end of the press release discussing the concerns that there was exposure to the etiologic agent through a water source of the hospital, this moderator wondered about legionellosis as one of the diseases under suspicion.



There is clearly much room for speculation, with many questions -- what is the apparent transmission? Is a common source exposure suspected? (while the newswire mentions that 19 cases were reported during a 24-48 hour period, it doesn't mention if that reflected the dates of onset of the illnesses, but does seem to suggest there may have been a common source exposure, as did the initial working hypothesis of a possible radiation exposure). What is the suspected incubation period? Is there evidence for person-to-person transmission? What does the epidemic curve look like? (number of cases by date of onset of illness). What is the distribution of the symptom complex (what is the frequency of the symptoms in the affected group of individuals)?



More information on the results of the investigations to date as well as laboratory results when available would be greatly appreciated.



For a map of the state of Para in Brazil, see http://www.v-brazil.com/graphics/para.gif. Belem is to the northeast of the state, with Castanhal to the northeast of Belem.

For a map of Brazil showing the location of Curuca, seehttp://www.maplandia.com/brazil/para/curuca/. It is further northeast of both Castanhal and Belem.

For the HealthMap/ProMED-mail interactive map of Brazil see http://healthmap.org/r/4oYc.

Bird Deaths in Russia Are Being Blamed on ‘Low Pathogenic Flu’

By Marina Sysoyeva on December 04, 2012

\

The H5N1 avian flu didn’t cause deaths of wild birds in Russia’s southern Krasnodar region last week, the government’s food safety agency said.

Lab tests proved a “low-pathogenic flu,” not H5N1, killed hundreds of wild ducks in coastal lakes in the Anapa and Temryuk districts in the Krasnodar region last week, said Alexei Alekseenko, spokesman for Rosselkhoznadzor.

No poultry for human consumption was infected, Krasnodar’s administration said on its website Nov. 30. Governor Alexander Tkachev ordered a quarantine of areas and banned hunting there to keep the virus from spreading, the press service said.

Most bird viruses don’t infect humans, according to the World Health Organization. The disease can be spread by wild water fowl, the WHO says.

Rosselkhoznadzor will eliminate dead birds from the area and will not cull other ducks, Alekseenko said. There were about 12,000 wild ducks in the Krasnodar areas last week, according to Rosselkhoznadzor data.

http://www.businessweek.com/news/2012-12-04/bird-deaths-in-russia-are-being-blamed-on-low-pathogenic-flu

China-unexplained pneumonia to be reported within 12 hours of consultation

I think this says , any unexplained pneumonias are to be reported to the county within 12 hrs and to the state within 24 hrs and on to the chinese CDC if it can't be determined what it is.


Found unexplained pneumonia within 12 hours of consultation, reporting


... To strengthen the monitoring and troubleshooting of unexplained pneumonia cases, standardize the diagnosis of unexplained pneumonia cases, report, reporter learned yesterday, the Provincial Health Department has issued a notice requiring all levels of the medical staff of the various medical institutions found to comply with the unexplained pneumonia definition cases, the organizational unit within 12 hours of expert consultation to troubleshoot and direct reporting network. It is reported that the province found no reports of unexplained pneumonia cases.

　　To the discovery of cases within 12 hours of consultation troubleshoot

　　Provincial Health Department recently issued a "further strengthen the diagnosis of unexplained pneumonia cases, reporting and disposal work notice" at all levels, the medical staff of the various medical institutions found to meet the definition of unexplained pneumonia cases should be immediately reported to the relevant departments of medical institutions within 12 hours by medical institutions and organize the group of experts for consultation and to troubleshoot. The county-level disease control institutions received a telephone report should immediately direct reporting network.

　　Unexplained pneumonia cases found, township, community and primary health care institutions do not have the appropriate diagnosis and treatment of conditions should immediately go to the county level and above hospitals for diagnosis and treatment by hospitals receiving cases of unexplained pneumonia cases direct reporting network.

　　Disease control institutions at all levels in the ordinary course of the epidemic monitoring, proactive monitoring and data analysis of online reporting unexplained pneumonia cases daily to analyze the same time, space, or occupation-specific clusters of unexplained pneumonia cases....

Received unexplained pneumonia cases in the report, the county health bureau should be organized within 24 hours at the county level expert group consultation. County level expert group consultation of unexplained pneumonia cases still can not be ruled out SARS and avian flu, county-level disease control agencies and medical institutions of the cases admitted to closely cooperate with related clinical samples collected cases, as soon as possible sent to conditional laboratory, SARS and avian flu pathogen detection.

　　In addition, clusters of unexplained pneumonia cases, can not confirm the diagnosis by the provincial team of experts examined the provincial disease control agencies to specimens sent to China CDC for testing. If necessary, the provincial disease control institutions in accordance with the requirements of the Chinese Center for Disease Control, the provincial level and below expert consultation has been made clear diagnosis of unexplained pneumonia cases specimens were sent to CDC conducted a review of detection...http://news.hexun.com/2012-12-04/148656758.html

Hong Kong-Update on Global Situation of Severe Respiratory Disease associated with Novel Coronavirus

Update on Global Situation of Severe Respiratory Disease associated
with Novel Coronavirus
3 December 2012 
Dear Doctor, 

Further to our letter to you dated 26 November, 2012, we would like to
update you with the latest development on severe respiratory disease associated
with novel coronavirus. As of 30 November, the World Health Organization
(WHO) has reported nine  confirmed cases of human infection with novel
coronavirus from Qatar (two cases), Saudi Arabia (five cases) and Jordan (two
cases). All patients were severely ill and five of them died.

According to WHO, 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 them died. Three other confirmed cases are
epidemiologically linked and occurred in one family living  within the same
household; two of them died. One additional family member in this household
also developed symptoms similar to those of the confirmed cases. This person
has recovered and was tested negative for the virus.

In addition, two confirmed cases have been reported in Jordan. Both of
them died. These cases were discovered through testing of stored samples from a
cluster of pneumonia cases that occurred in April 2012.
The two clusters from Saudi Arabia and Jordan raise the possibility of 
limited human-to-human transmission or, alternatively, exposure to a common 
source. Ongoing investigation is underway to distinguish between these 
possibilities.

According to WHO, the current understanding of this novel virus is that
it can cause a severe, acute respiratory infection presenting as pneumonia.  - 2 -
Acute renal failure has also occurred in five cases.
In view of the latest development, please consider testing for novel 
coronavirus for unexplained pneumonia after exclusion of common causative 
agents, regardless of the travel history. Laboratory testing of novel coronavirus is
available in Public Health Laboratory Centre (PHLC) of the Centre for Health
Protection (CHP) and please contact the Virology Division of PHLC for
necessary arrangement.

We understand that WHO is currently reviewing the case definition and
other guidance related to the novel coronavirus. While the existing reporting
criteria remains unchanged, please kindly be informed that we have included
Jordan as one of the affected areas
(http://www.chp.gov.hk/files/pdf/novel_coronavirus_affected_areas.pdf).
 To
detect suspected cases early, medical  practitioners are reminded to notify the
Department of Health any suspected  cases of severe respiratory disease
associated with novel coronavirus fulfilling the reporting criteria
(https://chpceno.chp.gov.hk/casedef/casedef.pdf) to  the Central Notification
Office (CENO) of CHP via fax (2477  2770), phone (2477 2772) or CENO
On-line (http://ceno.chp.gov.hk/). Please also call our Medical Control Officer at
7116 3300 a/c 9179 outside office hour for prompt investigation.

CHP is closely communicating with WHO and relevant overseas health
authorities to obtain more  information about the recently confirmed cases and
will update you with the latest information.
Thank you for your ongoing support in combating communicable
diseases.
Yours faithfully,
(Dr. S K Chuang)
for Controller, Centre for Health Protection
Department of Health

Flu Season Arrives Early, and Could Be Bad

Reported by Dr. Lauren Browne:

Flu season arrived early this year. And according to the U.S. Centers for Disease Control and Prevention, it’s shaping up to be a bad one.

CDC director Dr. Thomas Frieden announced today that Tennessee, Mississippi, Alabama, Louisiana and Texas have reported enough seasonal flu cases to officially mark the beginning of the flu season.

“We’re seeing the beginning of the uptick start at least a month before we’d generally see it,” Frieden said, explaining that flu rates typically start to rise in early January.

Click here to see 12 flu myths debunked.

Missouri and Georgia are also well on their way to meeting the critical threshold number of cases. And as the season progresses, the infection is expected to spread across the nation.

“It looks like it’s shaping up to be a bad flu season,” Frieden said, explaining that the predominant flu subtype being passed around — H3N2 — is known to cause more severe il..

http://abcnews.go.com/blogs/health/2012/12/03/flu-season-arrives-early-and-could-be-bad/

Monkey fever confirmed

Gundlupet, (Chamarajanagar dist), Dec 3, 2012, DHNS :

A medical report from the National Institute of Virology in Pune has confirmed that the recent death of monkeys in the Bandipur National Park limits was due to ‘kyasanur forest disease’ (KFD). 

The blood samples were sent to the centre soon after 12 monkeys died of the suspected fever at Alegowdanakatte camp in Maddur division, said Pushkar, the tiger reserve project director.

The daily wage workers of the Forest department too were affected by the epidemic.

Following the report confirming the prevelance of the KFD virus, a meeting of the veterinarians and the officials of the Forest department has been convened to discuss preventive measures. 

Soon, the residents in the surrounding villages will be administered a vaccine to check the spread of the infectious disease, he added.   http://www.deccanherald.com/content/296184/monkey-fever-confirmed.html

Have not found the culprit cause of death in patients with H5N1 influenza-like expression

Refer to hospital with H5N1 influenza-like illness close, despite being dedicated doctors cure, but the patient did not pass of danger. It is worth mentioning, the test results at the Pasteur Institute showed that the patient is not infected with the dangerous flu.

Earlier, on 26/11 NVS patients (42 years, staying at Thuan An, Binh Duong) exhibit high fever, sore throat, cough, shortness of breath ... should be taken to the General Hospital in Binh Duong province examination and treatment. Here, the X-ray doctors recorded patients with large cardiac shadow, pleural effusion. Exploitation of known medical history from the patient sick duck brought from home to eat meat.

Combining physical examination with the diagnosis and cause of the condition, the doctor suspected A/H5N1 flu patients should have moved Mr. S. to the Tropical Disease Hospital treatment. Patient samples were also sent to the Pasteur Institute in Ho Chi Minh City to tests, the results showed that patients negative for the H5N1 virus.

In the course of treatment at the Hospital for Tropical Diseases, the patient's progress on a bad, even if your doctor has dedicated his rescue but S. can not pass a critical attack over the weekend. Epidemiological factors and the first manifestation of the disease like influenza A/H5N1 patients not infected with this virus. The cause of death of this patient is unknown.http://www.xaluan.com/modules.php?na...cle&sid=508589

Suspected cases influenza A/H5N1 died of pneumonia

Tuesday, 04/12/2012, 06:23 (GMT +7)

(SGGP). - Dinner at 3-12, Dr.-BS Nguyen Van Vinh Chau, director of the Hospital for Tropical Diseases Ho Chi Minh City, said suspected cases of avian influenza A/H5N1 died after being treated here. That NVS patients (42 years old, live in Kien Giang) is transferred from the hospital in Binh Duong to the Hospital for Tropical Diseases Ho Chi Minh City over the weekend in a state of high fever, cough, sore throat, shortness of breath ... X-ray results reported patients with large cardiac shadow, pleural effusion associated with clinical symptoms doctors suspected of being infected with influenza virus A / H5N1. HCMC Hospital for Tropical Diseases and the Pasteur Institute in Ho Chi Minh City have taken swabs from molecular biological tests but showed negative results for influenza A/H5N1 virus. After 5 days of active treatment, patients with S. died of severe pneumonia, acute respiratory distress ... Mr. S. are working women in the town of Thuan An, Binh Duong. Before admission, he visited the home in Kien Giang and eat ducks die from farming families. http://www.sggp.org.vn/ytesuckhoe/2012/12/305799/

Like bird flu deaths

Monday, 12.03.2012, 10:31 GMT +7
Like bird flu deaths
42-year-old male patient with acute respiratory suspected H5N1 flu death last weekend in HCMC Hospital for Tropical Diseases.

Contact with infected poultry susceptible to the flu. Artwork: Heaven Chapter.
Doctors Hospital for Tropical Diseases Ho Chi Minh City, said the patient was transferred up from Binh Duong Hospital in critical condition.

"Patients with severe pneumonia, acute respiratory distress. Emergency We have positive but he has not recovered," a doctor said.

According to medical reports, patients with symptoms consistent with the H5N1 avian influenza infection, such as sore throat, prolonged fever, shortness of breath and fluid. Before getting sick, I have been in contact with influenza duck and duck meat.

"The epidemiological factors and disease manifestations are made ​​doctors think of the H5N1 bird flu. Yet tests at the hospital and the Pasteur Institute in Ho Chi Minh City were negative," said Dr. Le Manh Hung, deputy director of the disease hospital for Tropical Diseases Ho Chi Minh City said.

According to the patient, before you get sick, you can go home in Kien Giang play. Here you contact with infected ducks and duck meat. When back to the Pacific, he began to feel tired, sore throat and fever that lasts.  http://vnexpress.net/gl/suc-khoe/2012/12/ca-tu-vong-giong-nhiem-cum-gia-cam/

Unknown disease outbreak kills 2 people in Baghlan

According to reports at least 2 people have died following an unknown disease outspread in northern Baghlan province of Afghanistan.

At least 5 more people have been affected in Deh-Sala area at Deh-Salah district in this province.

Local residents are saying that the unknown disease spread in Uruzngan village a week ago and a shor shiver has been noted in affected indivuals which kills in less than 10 minutes.

They are saying at least 2 people have died and five others have been affected who have been taken to hospitals for the treatment purposes.

A local villager who lost one his relative said, “One of my relative died after receiving a short shiver and another neighbor died within 10 minutes from the same disease. Two people have died and 5 others have been affected in our village during the past one week.”

Residents in Uruzngan village at Deh-Salah district are seriously concerned of the disease and have urged the Afghan government to take immeidate actions in this regard.

Provincial public health chief Dr. Mohammad Salim Rassouli confirming the report said they have sent a team in the area to investigate the outspread of the disease.

He said they are able to take preventive actions in order to stop the disease if any positive signs of virus was detected during the inspection.

  http://www.khaama.com/unknown-disease-outbreak-kills-2-people-in-baghlan-1052

HATTIP DUTCHY

New polio strain from Pakistan hits Afghanistan

By Sehrish Wasif

Published: December 2, 2012

Officials say newly-discovered Sabin Like (2) poliomyelitis originated in Balochistan.

ISLAMABAD: 

With the Independent Monitoring Board recommending travel restrictions on polio endemic countries, reports of the transmission of a newly-discovered poliovirus strain from Pakistan to Afghanistan is likely to complicate an already tough situation for Islamabad.

Two Afghan children, living close to the border with Pakistan, have been paralysed by the Sabin Like (2) poliomyelitis, officials in the Polio Programme told The Express Tribune. The cases were reported from Afghanistan’s Kandahar province two days ago – one in Panjwai district and the other in Spin Boldak, they added. The World Health Organisation (WHO) has confirmed the two new cases.

According to the officials, genetic sequencing has confirmed the new polio strain originated in Balochistan’s Killa Abdullah district. They said Sabin Like (2) poliomyelitis develops in children with an extremely poor record of routine immunisation – a situation rampant in Balochistan.

Since 2006, polio vaccination teams have repeatedly missed an estimated 50,000 children in Killa Abdullah, derailing efforts to eradicate the virus in the country.

This is not the first case of poliovirus transmission from Pakistan to a neighbouring country either. Last year, 16 children in China’s Xinjiang province were paralysed after being infected by a polio strain originating in Pakistan.

“The paramedic association and health department of Balochistan continues to hold the polio-eradication campaign hostage in Killa Abdullah through unfair demands … It has now resulted in embarrassment for Pakistan before the world community,” an official of the Expanded Programme on Immunisation (EPI) told The Express Tribune on condition of anonymity.

WHO senior coordinator for polio eradication Dr Elias Durry said the organisation was monitoring the situation in Balochistan closely.

“We are seriously concerned about the new poliovirus strain and are recommending urgent steps to the provincial government to contain the outbreak,” said Dr Durry. The only way to contain the spread of the virus is by conducting three to four high-quality polio vaccination rounds in the infected districts and their nearby areas, he said.

Meanwhile, a special WHO delegation, led by internationally acclaimed polio eradication expert Dr Mohammed Mohammedi, has reached Balochistan and is holding indepth discussions with the provincial government over ways to combat the outbreak.

“We have asked the provincial government to hold three emergency polio campaigns each in Quetta, Killa Abdullah and Pishin districts during a span of 30 days to control the spread of the virus to other parts of the country,” said Dr Mohammedi, adding that the first campaign in the three districts was scheduled for December 10.

Pakistan has reported a total of 56 polio cases this year so far. A massive 181 cases were reported in 2011.

Published in The Express Tribune, December 2^nd, 2012. 

Patients with suspected H5N1 flu death

PN - TS-BS Le Manh Hung, deputy director of the hospital (BV) for Tropical Diseases Ho Chi Minh City, said patients (patients) with suspected influenza H5N1 by BV Locked Binh Duong moved to 28/11, has mortality.

According to medical records, patients admitted to the hospital in a state of continuous high fever, cough, sore throat, shortness of breath, chest X-ray shadow big heart, pleural effusion. Due to the usual treatment for patients not yield results, the doctors suspected H5N1 infected patients and transferred to the Hospital for Tropical Diseases.

 However, the test results of the Hospital for Tropical Diseases Ho Chi Minh City and Ho Chi Minh City Pasteur Institute showed that patients negative for the H5N1 flu, although the illness is very similar to the H5N1 flu. Doctors are continuing to study the cause of death for patients. Known, BN Nguyen Van S. (42 years old, resident of Kien Giang province), as an additive in the town of Thuan An, Binh Duong Province. Before admission, the patient had contact with infected ducks in Kien Giang and family eating duck meat.  http://phunuonline.com.vn/xa-hoi/y-te/benh-nhan-nghi-nhiem-cum-h5n1-da-tu-vong/a80688.html

NIAID Scientists Begin Study of New Coronavirus

Last Updated December 03, 2012

In September, just days after receiving reports that a newly identified coronavirus had claimed the life of a person in Saudi Arabia, NIAID and its international partners began discussing potential studies of the virus. Their plans took on greater urgency eight days later when the United Kingdom reported treating the same viral infection in a man who had recently traveled in Saudi Arabia. This patient survived.

These first two cases sparked fears among scientists of a new SARS-like outbreak. SARS—severe acute respiratory syndrome—also is caused by a coronavirus, which in 2003 spread rapidly from person to person, sickening more than 8,000 people and killing more than 900 worldwide. Until SARS, most scientists viewed coronaviruses as relatively harmless causes of the common cold.

In late November 2012, after a lull that made scientists optimistic, the case count climbed to nine people, including five deaths.

Seeking the Best Animal Model

In response to the outbreak, Drs. Heinz Feldmann and Vincent Munster at NIAID Rocky Mountain Laboratories (RML) in Hamilton, Montana, began studies of the novel coronavirus in Syrian hamsters and rhesus macaques. Their partners at Erasmus University in The Netherlands are conducting similar tests in ferrets and cynomolgus macaques. The groups are coordinating their work to determine which species may be the most suitable to study as a model of human infection. The same four animal species are used to study other human respiratory diseases, most notably SARS, influenza, and hantavirus.

The new coronavirus is closely related to coronaviruses isolated from bats, suggesting that these animals might be its natural carrier. The RML Virus Ecology Unit conducts research on viruses that originate from bats, such as Ebola and Nipah, and this new coronavirus underscores the need for NIAID research on infectious disease ecology and natural carriers, or reservoirs, of infectious agents.

Responding to an Emerging Virus

“The virus appears to cause severe lung and kidney damage,” said Feldmann, who in 2003 was among a group of scientists who tracked the spread of the SARS virus from its origin in southern China to a Hong Kong hotel, where it affected several guests.

“We want to mimic human infection in an animal model to understand how this novel coronavirus causes disease and whether there is a potential for transmission of the virus among humans.”

Once the scientists learn how the virus spreads in an animal model, they will begin working on countermeasures such as antiviral treatment and vaccines to assist preparedness efforts.

“Several weeks passed between the cases, so we still are not sure whether there is potential for this new coronavirus to infect more people,” said Munster, who heads the Virus Ecology Unit at RML. “Our studies will provide valuable knowledge that should help us if this disease is indeed similar to SARS.”   http://www.niaid.nih.gov/topics/emerging/Pages/coronavirus.aspx

In the Kuban vaccinations for both people and birds

While no cases of bird flu in the region is not registered
At the end of last week in Anapa and Temryuk district residents discovered hundreds of dead carcasses of wild birds - coots . Birds died just one day. Analyses showed all his fault influenza strain H5N1. He's a notorious bird flu, which claimed 64 lives during the epidemic of 2005 in Southeast Asia. This means that the danger is not only to poultry, but all residents of the Kuban. As described in the Regional Ministry of Health, from human to human infection is not transmitted, but you can get infected from sick birds, and even while cutting its carcass. Therefore, on Friday to address the governor of the region Alexander Tkachev in Anapa and Temryuk imposed quarantine and banned hunting .


- The experience we have - reminded Tkachev. - Five years ago, the edge in a short time managed to fully cope with the spread of the virus. Then there was a flash on a large poultry farm in Bryukhovetskiy area. Poultry had to completely destroy, introduced strict controls on the roads as well as in enterprises. As a result, to prevent new outbreaks. No human bird flu while ill.
In the same way there are today. While some experts bypass hunting grounds and ponds in search of dead birds, others inspect hens and geese, and questioned their owners, whether they have symptoms. At the same time, the edge of the poultry should go to the private mode, and poultry banned "to go out." Experts believe that the virus got into the Kuban with migratory birds, which means that poultry should be possible to isolate.
Veterinarians offer poultry owners to vaccinate. Procedure is free no matter how many birds you "will lead to the reception." Where the vaccination - please call "hot" line of the 8 (861) 268-33-09, 268-34-05.
The rest of the Kuban management specialists veterinarians recommend to stick to simple rules: no contact with either the home or with wild birds and not to buy meat and eggs with it.
- Since then, as the Kuban appeared avian influenza each year vaccinate everyone who lives in the 3 km of the bird production - said the spokesperson of the regional Rospotrebnadzor Irina Voronkov.
Vaccination against influenza, which was to end on December 1, extended, and a mandatory vaccination will make poultry workers. In Anapa and Temryuk district podvorovye rounds conducted 25 medical teams.
- Those who have already been vaccinated against the "human" flu (in the region of 1.7 million people), do not worry. Because the vaccine is the same, it contains several strains of the virus, including H5N1, - explain in the regional Rospotrebnadzor.
All those wishing to make the vaccine for free. You just have to go to a clinic in the community.

REFERENCE "KP"
- Bird flu refuses to feed and water, does not respond to external stimuli such as "Enchanted" goes around, twists his head. I feathered skin turns blue, you can see the curvature of the neck, - warn the State Veterinary Department of the Krasnodar Territory. - However, the final diagnosis is only in the veterinary laboratory.

BTW
First bird flu found Italian veterinarians over a hundred years ago. However, the first person infected by birds only in 1997. Then ill 18 people in Hong Kong, six of them died.

http://kuban.kp.ru/daily/25994.5/2923835/

Gujarat: 38 cranes dead; avian flu back?

Ahmedabad: The sudden death of 38 cranes in the wetlands (salt pans) close to Victor village in Rajula range of Amreli district has raised fears of a return of the deadly bird flu virus. The matter first came to light when a bird lover informed forest officials about the death of five birds on Saturday.

Sunday saw the death of 30 more birds while a few others were found to be extremely ill. Of the ill birds, three more died taking the toll to 38. Incidentally, two eagles, believed to have feasted on the dead cranes were also found dead. 

Cranes migrate to the wetlands in this part of Gujarat from Siberia during the four months of winter. The salt pans belong to GHCL, a company involved in the production of salt.

Mangubhai Thapa, a bird lover and resident of a nearby village was the first to be told about death of five birds. He said that there had been sporadic incidents of bird deaths for the last one week. 

“A fortnight ago we found 15 dead birds but thought it was the handiwork of dogs. It was only when villagers informed me of the death of five birds that an alarm was raised. We informed the forest officials who sent the birds’ remains for a post-mortem,” said Thapa. 

Dinesh Goswami of Kodinar Nature Club, who rushed to the two wetlands (salt pans filled with water), said that on Sunday he had counted 30 dead birds. “It could be bird flu although we can’t be sure. Some of the cranes seemed extremely ill. Two eagles who might have feasted on the dead birds, also died while another is in a critical condition,” said Goswami.

DFO, social forestry, JK Makwana, when contacted said that the post-mortem of the birds will be done on Monday. Regarding the post-mortem report of the five birds who died earlier, he said that the reports showed that they had died due to respiratory troubles. As for the possibility of a return of avian flu, he said nothing could be said without proper investigation. “The forest department may send samples to Junagadh or Bhopal to know more details about the bird deaths,” said Makwana.

A team of veterinary doctors from Amreli is also likely to visit the place on Monday to collect samples.

Director, Bombay Natural History Society (BNHS), Assad Rahmani, said there is a need to investigate. “Nothing can be said without proper investigation. The blood samples of the birds should be scientifically collected and sent to Bhopal for investigation. Then only will we know what caused the birds’ death,” said Rahmani. 

He also said that stomach samples of the birds should be sent to know if they died due to unintentional pesticide poisoning or avian flu.

Another source in the department said that paralysis, as displayed by the birds, is a symptom of viral infection. Principal secretary, forest and environment department, HK Dash, could not be reached for his comment.  http://daily.bhaskar.com/article/GUJ-AHD-gujarat-38-cranes-dead-avian-flu-back-4097826-NOR.html

Frequently Asked Questions on novel coronavirus

2 December 2012

What is the novel coronavirus?

This is a new strain of coronavirus that has not been previously identified in humans.
Coronaviruses are a large family of viruses that are known to cause illness in humans and animals. In humans, this large family of viruses are known to cause illness ranging from the common cold to Severe Acute Respiratory Syndrome (SARS).

What are the symptoms of novel coronavirus?

In confirmed cases of illness in humans, common symptoms have been acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties. Based on current clinical experience, the infection generally presents as pneumonia. It has caused kidney failure and death in some cases. It is important to note that the current understanding of the illness caused by this infection is based on a limited number of cases and may change as more information becomes available.

Can it be transmitted from person to person?

This is not known with certainty at this time. The cases occurring in the same family raises the possibility of limited human-to-human transmission. Alternatively, it is possible that the infected family members were exposed to the same source of infection, for example, in a household or workplace.

How could I become infected with this virus?

To date, we do not know how humans have become infected with this virus. Investigations are underway to determine the virus source, types of exposure that lead to infection, mode of transmission and the clinical pattern and course of disease.

Is there a vaccine for the novel coronavirus?

There is no vaccine currently available.

Is there a treatment for the novel coronavirus?

There is no specific treatment for disease caused by novel coronavirus. However, many of the symptoms caused by this virus can be treated and therefore treatment should be based on the symptoms of the patient.

What can I do to protect myself?

Exactly how people become infected with this virus is not known at this time. However, some general measures that would be prudent and help prevent the acquisition of any respiratory illness are to avoid close contact, when possible, with anyone who shows symptoms of illness (coughing and sneezing), and to maintain good hand hygiene.

How many people have been infected by the novel coronavirus?

WHO is closely monitoring the situation and regularly publishes information about the disease. For more go to http://www.who.int/csr/disease/coronavirus_infections/en/

How widespread is the novel coronavirus?

It is unknown how widespread this virus may be. 
WHO is encouraging Member States to continue to closely monitor for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia. WHO will continue to share information as it is made available.

Are health workers at risk from the novel coronavirus?

Health care workers come into contact with patients with many different infectious illnesses more often than the general public. Therefore WHO recommends that health care workers consistently apply appropriate infection prevention and control measures.
http://www.who.int/csr/disease/coronavirus_infections/prevention_control/en/index.html

Is the novel coronavirus like SARS?

SARS is a coronavirus that was identified in 2003 and belongs to the same large family of viruses as the novel coronavirus. Therefore, SARS and the novel coronavirus are distantly related. Both viruses are capable of causing severe disease. However, they have important differences based on current information. Most importantly, the novel coronavirus does not appear to transmit easily between people while the SARS virus was much more transmissible.

Is it true that this novel coronavirus originated from bats?

This is one possibility but the origin of the virus has not yet been established.

Can humans become infected with novel coronavirus from animals? If so, which ones should we be concerned about?

WHO is closely monitoring the situation to identify how people are being exposed. There is currently no direct evidence that the human cases were exposed through direct contact with animals.

How is WHO responding to the emergence of this novel coronavirus?

Since the emergence of this virus, WHO has been working under the International Health Regulations to provide information to Member States. WHO is also working with involved countries and international partners to coordinate the global health response, including the provision of updated information on the situation, guidance to health authorities and technical health agencies on interim surveillance recommendations, laboratory testing of cases, infection control, and clinical management, based on the current understanding of the novel virus and the disease in humans.
WHO will continue to work with Member States and international health partners and share updated information as it is made available.

What is WHO recommending countries do?

WHO encourages all Member States to enhance their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia cases.
WHO urges Member States to notify or verify to WHO any suspected or confirmed case of infection with novel coronavirus.

Has WHO recommended any travel or trade restrictions related to this new virus?

No. WHO does not recommend any travel or trade restrictions with respect to this event. WHO will continue to provide updated information as it is available.

http://www.who.int/csr/disease/coronavirus_infections/faq_dec12/en/index.html

EMERGING DISEASES LIKE NEW CORONAVIRUS BEING MONITORED CLOSELY IN OMAN: WHO

Madhuparna Bhattacharjee

01/12/2012 9:18 am

The World Health Organization (WHO) office in Muscat has said that emerging diseases like the new Severe Acute Respiratory Syndrome (SARS)-like virus outbreak are being constantly monitored in Oman. 

The surveillance system in the sultanate is capable finding cases (if any), which includes the latest coronavirus that affected two GCC countries.

Dr Abdullah Saleh Assaedi, the WHO representative in Oman, said, “Monitoring any emerging disease is a very crucial task and we are doing it.”

He said that monitoring is done through International Health Regulations (IHR). “The country’s Ministry of Health reports it to IHR, which in turn reports to WHO.” He added that WHO encourages all member states to continue their surveillance on Severe Acute Respiratory Infections (SARI) and is currently reviewing the case definition related to the novel coronavirus...

http://www.muscatdaily.com/Archive/Oman/Emerging-diseases-like-new-coronavirus-being-monitored-closely-in-Oman-WHO-1ve8