SARS & Beta2c nCoV Similar Histories

SARS & Beta2c nCoV Similar Histories 
Recombinomics Commentary 20:00
March 8, 2013

This recent cluster provides the first clear evidence of human-to-human transmission of this novel coronavirus, coinfection of this novel coronavirus with another pathogen (influenza A), and a case of mild illness associated with this novel coronavirus infection. In light of these developments, updated guidance has been posted on the CDC coronavirus website
The above comments in a CDC early release MMWR describe the recent beta2c novel coronavirus cluster in the UK.  The difference between the above cluster and earlier clusters in Jordan and Saudi Arabia is one of circumstances. In the UK cluster the index case developed symptoms while performing Umrah in Saudi Arabia, while family members developed symptoms in the UK.  Since the family members had no recent travel outside of the UK, H2H transmission was demonstrated. However, the earlier cluster in Jordan had more symptomatic cases and the number of confirmed/probable cases was 12, which included two confirmed deaths. That cluster was largely composed of health care workers (7 nurses and 2 doctors) from the same ICU, and the deaths were one nurse (45F) and one doctor/intern (25M). Although disease onset dates were not released, the dates of death were 1 week apart, and family members of the HCWs were also symptomatic.  The other cluster was a familial cluster in Riyadh involving 4 cases.  Two died and were confirmed as was a survivor. The 4th case was classified as probable and disease onset dates fully supported H2H transmission in the family.

Thus, although clear evidence existed for H2H transmission in the clusters, the circumstances unique to the UK cluster clearly demonstrated the transmission as well as the import of the virus into the UK via commercial airline, followed by clear transmission, which was a hallmark of the SARS CoV international spread in 2003.  Moreover, the SARS spread in 2003 was similar to the Jordan cluster, which involved a large number of HCW’s who developed severe pneumonia leading to the death of two relatively young HCWs (45F and 25M).  In 2003 a high percentage of HCWs were infected because SARS CoV grew well in the lower respiratory tract, so transmission was limited, but dramatic in “super spreaders” which frequently caused HCW infections.

This effect was clearly seen in the 2002/2003 SARS spread.  Initially the virus was largely confined to Guangdong Province, adjacent to Hong Kong.  Reports of a “mystery disease” were being cited by ProMED, which also noted the associate with severe pneumonia and death.  However, details were sketchy and China insisted that the situation was resolving, which dramatically changed in March, due to events in February.  A physician treated patients travelled to Hong Kong for a wedding and checked into room 911 at the Metropole Hotel for a 1 night stay on February 21.  There was at least one super spreading event (vomiting in hall on the 9th floor) which led to the infection of at least a dozen guests with rooms on the 9th floor.  At least four of these infections led to super spreading events involving health care workers in Hong Kong, Singapore, Hanoi, and Toronto.

This international spread led to significant scientific cooperation, as well as media coverage, because the infections were killing middle age patients and infecting large numbers of HCWs and the etiological agent was still a mystery.  However, the agent was quickly identified as a novel coronavirus that was in group 2 (betacornavirus), but distinct from the only known human betacornavirus, OC43, which had been identified decades earlier as a human cold virus (in addition to a group 1, alphacornavirus, which had also been identified decades earlier, 229E, and also caused human colds. 
 The novel virus was called SARS (Sudden Acute Respiratory Syndrome), and was subsequently classified as 2b.  SARS was most easily identified in samples from the lower respiratory tract, which were readily available in the severe and fatal cases.  The SARS outbreak also gave rise to a sequence database of bat coronaviruses, because the sequences from exotic animals found in live markets in Guangdong Province and Hong Kong had sequences which were virtually identical to each other and the early human cases. 
 The search for a natural reservoir (which used the same PCR primer set used to identify the first two human nCoV cases) found that bats were frequently infected with a wide range of coronaviruses (which were in guano and easily accumulated in bat caves), which included beta2a sequences related to SARS CoV, as well as other beta sub-clades designated as beta2c and beta 2d.

In the fall of 2012 a fatal case (60M) from Bisha, Saudi Arabia, presented with SARS-like symptoms (at a hospital in Jeddah) and died.  Testing for SARS and other human respiratory viruses was negative, which led to testing using the set of universal coronavirus primers, which produced a positive (designated EMC/2012 for the Emaras Medical Center, which generated the sequence).  Sequencing led to the identification of a novel coronavirus, which had not been previously reported in humans and was most closely related to the bat beta2c sequences from Guangdong Province (series HKU4 and HKU5).  Those primers were then used samples from a case from Qatar (49M) who had been transported by air ambulance to the UK for treatment with SARS-like symptoms.  He also tested positive, and the 206 BP insert was sequenced and found to differ from EMC/2012 at only one position (99.5% identity). 
 In contrast, the closet bat sequence had 35 differences (82.5% identity) clearly demonstrating that the two human cases were infected with a novel human virus.  A short partial sequence from a 2008 collection from a bat in the Netherlands was somewhat higher, so samples collected from bats in Europe and Africa were retested with probes targeting beta2c, which confirmed that European bats had an identity of 89% (using a conserver region of the polymerase gene), which was closer than bat sequences from Asia or Africa, but well short of the identities in the human sequences.  A full sequence from the Qatar case (designated England 1since it was generated by the Health Protection Agency, HPA, in London) showed that the full sequence (over 30,000 BP) was also 99.5% identical to EMC/2012. 
 The HPA also released the full sequence for the index case (60M) for the UK cluster.  That sequence, England 2, allowed for the generation of a consensus sequence for the full beta2c genome (30,118 BP), which showed that England 1 only had 17 differences, in addition to a 6 BP deletion.  Similarly, England 2 only had 23 differences, indicating each sequence was more than 99.9% identical to the consensus, while the identity for EMC/2012 was just under 99.8%.  In contrast, the most closely related bat sequence had an identity of 89% for a highly conserved region of the polymerase gene.  Partial sequences for the first case from Riyadh (45M) were identical to the consensus, while the two sequences for the Qatari treated in Germany (Essen) had no differences for one region and only one difference for the other, clearly demonstrating that all five patients had sequences virtually identical to each other and easily distinguished from all bat sequences.

The sequences allowed for PCR testing that would specifically identify the novel beta2c sequence s in clinical samples.  However, the low level of RNA in the upper respiratory tract produces false negatives, which grossly under estimate the transmission of the novel beta2c coronavirus.

CDC Issues Novel Beta2c Coronavirus Health Alert

Recombinomics Commentary 21:30
March 8, 2013

Notice to Health Care Providers: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated with a Novel Coronavirus

Distributed via the CDC Health Alert Network

The above title of the CDC Health Alert is similar to yesterday’s early release MMWR which provides background and new guidelines for reporting suspect cases of beta2c nCoV to the CDC, as well as requests for samples.

The novel coronavirus has striking similarities to the SARS CoV that spread internationally almost exactly 10 years ago.  The international spread was seeded on February 21, 2003, but the effects of that spread began toi be reported in early March, which marked the beginning of the dramatic increase in cases which h last until mid-May.

The recent cluster in the UK had clear evidence of human to human transmission, which included detection of a mild case via testing of a sputum sample.  This mild case raised concerns that detection of the virus may be largely limited to samples from the lower respiratory tract, and claims of a lack of onward transmission may be compromised by false negatives for samples collected from the upper respiratory tract. 

This preference has striking similarities with SARS, as did the spread from Saudi Arabia to the UK via commercial airline.  Similarly, the large cluster of cases involving health care workers linked to an ICU in Jordanlast April also mimic the effects of SARS 10 years ago and raise concerns that a spike in cases may be reported in the near term.

The new guidelines focus on cases originating from the Arabian Peninsula and encompass all countries in the Middle East.

Distributed via the CDC Health Alert Network
March 8, 2013, 12:00 ET (12:00 PM ET)
CDCHAN-00343

Notice to Health Care Providers: Updated Guidelines for Evaluation of Severe Respiratory Illness Associated with a Novel Coronavirus

Summary

The Centers for Disease Control and Prevention (CDC) is working closely with the World Health Organization (WHO) and other partners to better understand the public health risk posed by a novel coronavirus that was first reported to cause human infection in September 2012.  The purpose of this HAN Advisory is to provide guidance to state health departments and health care providers in the evaluation of patients for novel coronavirus infection.  Please disseminate this information to infectious diseases specialists, intensive care physicians, internists, infection preventionists, as well as to emergency departments and microbiology laboratories.

Background

Novel coronavirus is a beta coronavirus that was first described in September 2012, when it was reported to have caused fatal acute lower respiratory illness in a man in Saudi Arabia.  As of March 8, 2013, 14 laboratory-confirmed cases of novel coronavirus infection have been reported to WHO—seven from Saudi Arabia, two from Qatar, two from Jordan, and three from the United Kingdom (UK). Illness onsets were from April 2012 through February 2013. Of the 14 cases, eight were fatal.  One of the 14 persons with novel coronavirus infection experienced a respiratory illness not requiring hospitalization. Diagnoses rely on testing with specific polymerase chain reaction (PCR) assays.  Genetic sequence analyses have shown that this new virus is different from other known human coronaviruses, including the one that caused severe acute respiratory syndrome (SARS).  There is no specific treatment for novel coronavirus infection; care is supportive. To date, no cases have been reported in the United States.

The three confirmed cases in the UK were reported in February 2013 as part of a cluster within one family; only the index patient had a history of recent travel outside the UK (to Pakistan and Saudi Arabia). This index patient is receiving intensive care treatment and tested positive for both novel coronavirus and influenza A (H1N1) virus. The other two patients became ill after contact with the index patient; one died, and one has recovered from mild illness. This cluster of illnesses is still under investigation by the UK Health Protection Agency, but provides the first clear evidence of human-to-human transmission of this novel coronavirus, co-infection of this novel coronavirus with another pathogen (influenza A), and a case of mild illness associated with this novel coronavirus infection.  Additional details can be found in the March 7, 2013 MMWR Early Release (http://www.cdc.gov/mmwr/preview/mmwrhtml/mm62e0307a1.htm?s_cid=mm62e0307a1_e).

Recommendations

In light of these developments, updated guidance (http://www.cdc.gov/coronavirus/ncv/case-def.html) has been posted on the CDC coronavirus website.  Persons who develop severe acute lower respiratory illness within 10 days after traveling from the Arabian Peninsula or neighboring countries* should continue to be evaluated according to current guidelines.  In particular, persons who meet the following criteria for “patient under investigation” (PUI) should be reported to state and local health departments and evaluated for novel coronavirus infection:

• A person with an acute respiratory infection, which may include fever (≥ 38°C , 100.4°F) and cough; AND
• suspicion of pulmonary parenchymal disease (e.g., pneumonia or acute respiratory distress syndrome based on clinical or radiological evidence of consolidation); AND
• history of travel from the Arabian Peninsula or neighboring countries* within 10 days; AND
• not already explained by any other infection or etiology, including all clinically indicated tests for community-acquired pneumonia† according to local management guidelines.

CDC requests that state and local health departments report PUIs for novel coronavirus to CDC.  To collect data on PUIs, please use the CDC Novel Coronavirus Investigation Short Form. State health departments should FAX completed investigation forms to CDC at 770-488-7107 or attach in an email to eocreport@cdc.gov (subject line: NCV Patient Form).

In addition, the following persons may be considered for evaluation for novel coronavirus infection:

• Persons who develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula or neighboring countries* but who do not respond to appropriate therapy; OR
• Persons who develop severe acute lower respiratory illness who are close contacts† of a symptomatic traveler who developed fever and acute respiratory illness within 10 days of traveling from the Arabian Peninsula or neighboring countries.*

Testing of specimens for the novel coronavirus will be conducted at CDC.  Recommendations and guidance on the case definitions, infection control (including use of personal protective equipment), case investigation, and specimen collection and shipment for testing, are available at the CDC coronavirus website (http://www.cdc.gov/coronavirus/ncv/case-def.html). Additional information and potentially frequent updates will be posted on the CDC coronavirus website. State and local health departments with questions should contact the CDC Emergency Operations Center (770-488-7100).

* Countries considered to be on or neighboring the Arabian Peninsula include Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Palestinian territories, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE), and Yemen.

† Examples of respiratory pathogens causing community-acquired pneumonia include influenza A and B, respiratory syncytial virus, adenovirus, Streptococcus pneumoniae, and Legionella pneumophila.

‡ Close contact is defined as 1) any person who provided care for the patient, including a health-care worker or family member, or who had other similarly close physical contact, or 2) any person who stayed at the same place (e.g., lived with or visited) as the patient while the patient was ill.

For more information:

For additional information, please consult the CDC coronavirus website at:http://www.cdc.gov/coronavirus/ncv 
State and local health departments with questions should contact the CDC Emergency Operations Center (770-488-7100).

---

The Centers for Disease Control and Prevention (CDC) protects people's health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations.

http://emergency.cdc.gov/HAN/han00343.asp

Release of Severe Acute Respiratory Syndrome Coronavirus Nuclear Import Block Enhances Host Transcription in Human Lung Cells

ABSTRACT

The severe acute respiratory syndrome coronavirus accessory protein ORF6 antagonizes interferon signaling by blocking karyopherin-mediated nuclear import processes. Viral nuclear import antagonists, expressed by several highly pathogenic RNA viruses, likely mediate pleiotropic effects on host gene expression, presumably interfering with transcription factors, cytokines, hormones, and/or signaling cascades that occur in response to infection. By bioinformatic and systems biology approaches, we evaluated the impact of nuclear import antagonism on host expression networks by using human lung epithelial cells infected with either wild-type virus or a mutant that does not express ORF6 protein. Microarray analysis revealed significant changes in differential gene expression, with approximately twice as many upregulated genes in the mutant virus samples by 48 h postinfection, despite identical viral titers. Our data demonstrated that ORF6 protein expression attenuates the activity of numerous karyopherin-dependent host transcription factors (VDR, CREB1, SMAD4, p53, EpasI, and Oct3/4) that are critical for establishing antiviral responses and regulating key host responses during virus infection. Results were confirmed by proteomic and chromatin immunoprecipitation assay analyses and in parallel microarray studies using infected primary human airway epithelial cell cultures. The data strongly support the hypothesis that viral antagonists of nuclear import actively manipulate host responses in specific hierarchical patterns, contributing to the viral pathogenic potential in vivo. Importantly, these studies and modeling approaches not only provide templates for evaluating virus antagonism of nuclear import processes but also can reveal candidate cellular genes and pathways that may significantly influence disease outcomes following severe acute respiratory syndrome coronavirus infection in vivo... http://jvi.asm.org/content/87/7/3885.short?rss=1

Egypt-Aswan health" the emergence of symptoms similar to "SARS have not received any warning from the Ministry bulletins":

Dr. Magdy Hegazy and Undersecretary of the Ministry of Health in Aswan that he did not appear at the level of cities and villages to maintain any special cases the disease like SARS. pointed out that there were no bulletins from the health world or the Ministry of Health regarding willingness to face similar SARS, which is a kind of disease respiratory and procedures preventive Kalagraouat usual to face diseases other epidemic. said that the Department of Health lifted the maximum readiness to counter any epidemic diseases and through the implementation of cleaning operations continuing and sterilization, explaining that such diseases need ventilation continuing if his appearance, in addition to exposure patient for ventilation as well.

Is the Middle East brewing the perfect storm for a health epidemic?

Published March 08, 2013

The turmoil in the Middle East is not just creating human tragedy, where the indiscriminate use of force by terrorists and dictators is causing a huge displacement of families and destroying cities and neighborhoods.  

To me, the scariest aspect of this region is that it could be brewing a catastrophic event of global proportions.  I’m talking about infectious disease outbreaks, which can spread throughout the world.

The Centers for Disease Control and Prevention warned U.S. health officials Thursday of a deadly new virus originating in the Middle East.  This virus is in the coronavirus family, and it seems to be creating severe respiratory distress, similar to that of the severe acute respiratory syndrome (SARS) virus, which first emerged in Asia in 2003.  

Symptoms of the infection include severe acute respiratory illness with fever, cough and shortness of breath.  Perhaps the most worrisome aspect of this virus is that of the 14 people so far infected, eight have died.  

We have been reporting over the last several years how even in developed nations, we’re losing the battle against viruses and bacteria.  Scientists have been warning us for years, and now we see that simple bacteria, which was easily treatable in the past are now almost impossible to treat.

More problematic, however, is the mutation of these viruses.  Over the last several years, we have seen multiple viruses that have mutated from animals to people and have created an international scare because of their potentially deadly effects.

Right now, the Middle East is the perfect storm for such an outbreak.  With crowded refugee camps, limited running water in many areas, the destruction of sanitary infrastructures, and limited access to physicians,  this region’s hospitals and governments presently don’t have the tools to monitor infectious outbreaks and alert the rest of the world.  

I recently spoke to Dr. Abdulla Al-Khan, an international health consultant and director of the Center for Abnormal Placentation at Hackensack University Medical Center in New Jersey, about how this coronavirus may impact the country of Bahrain.

“In Baharain there (have) not been any documented cases, but I have heard that there has been over the last couple of weeks two mortalities from influenza-like illness,” Al-Khan said. “Whether that was the SARS (virus) or whether it was the corona variant virus of it, I'm not too sure. But I think this is why it is important for the country and the people to understand: Let's focus on important things. Let's focus on issues that are more important to the children of Baharain, to the region, as opposed to these political issues. Because ultimately politics and medicine, in a way we don't want it to mix, but it ultimately does, because it all has a domino effect.”

And the domino effect doesn’t stop overseas. The days where health outbreaks abroad were an anecdote in a scientific journal are long gone.  What could happen in one part of the world in the morning could be spreading to our shores in the evening.

Read more: http://www.foxnews.com/health/2013/03/08/is-middle-east-brewing-perfect-storm-for-health-epidemic/#ixzz2Mz18qFyS

Found in poultry markets positive for H5N1

Found in poultry markets positive for H5N1

09/03/2013 3:10

On 8.3, Dong Thap province requires branches and localities to closely examine the situation of avian influenza are at risk of outbreak, quickly dealing with the outbreak, not to spread ...

As reported by the provincial Department of Agriculture and Rural Development, through testing 72 samples of poultry sold in the town market Tram Chim (Agriculture H.Tam), fair An Thanh (Ngu TX.Hong) and a number of markets in TP.Cao Consul, found 24 poultry samples tested positive for the H5N1 flu.

On 7.3, the Ministry of Agriculture and Rural Development has sent urgent provinces of An Giang, Dong Thap, Kien Giang ...required to strengthen control the transport, trade and consumption of poultry and poultry products in the border areas bordering Cambodia.  http://www.thanhnien.com.vn/pages/20130309/phat-hien-gia-cam-o-cho-duong-tinh-voi-h5n1.aspx

US WARNING: the the new coronavirus fear human-to-human transmission

2013.03.08 02:55 pm

For Disease Control and Prevention (CDC) today issued a warning to remind the the new coronavirus fear of human-to-human transmission, the Department of Health, Centers for Disease Control, Deputy Secretary Jih-Haw Chou, of course, possible human-to-human transmission, the CDC chances will strengthen border monitoring. Up until now, has been testing the 109 returning from the Middle East and the risk of unexplained pneumonia patient specimens, and fortunately are generally flu. Jih-Haw Chou pointed out that the epidemic reported according to the latest EU health units, new coronavirus is indeed diffusing risk, but the possibility of large-scale infection is quite low, people should be cautious, but not panic. The new coronavirus infection resulting in 14 people, eight people were killed. Jih-Haw Chou routes of infection are of close contact, such as the close interaction between family members, the hospital, the doctor-patient contact, new cases of coronavirus infection by strangers in public places is yet to come. Comparison, the powerful and the spread of the SARS the new coronavirus infectivity seems to be limited. Jih-Haw Chou reminded that any virus has changed, and the possibility of evolution. Jih-Haw Chou stressed, has asked the first-line physicians deal with rapid course of the disease for patients with unexplained pneumonia to be careful and immediately informed. Health care workers, such as pneumonia, also need to be classified as the observed object. Physician if unexplained pneumonia patients treated, the patient denied a history of going abroad, even recently traveled to Qatar and other Middle East, but also to further clarify the type of virus, and immediately isolate patients up communications. http://udn.com/NEWS/HEALTH/HEA1/7745339.shtml

FAO warns Jordan, Egypt and Israel of locust threat

- Student Prediction Center of the Food and Agriculture Organization «FAO», in an official report to him, Thursday, »Egyptian governments, Jordanian and Israeli make every effort to follow up and begin to fight, if necessary, while prepared the General Administration of lobster preparations to face any emergency unexpected through its committees deployed in Cairo and bases nearby fully equipped to combat any gatherings or swarms appear in the skies of Cairo, but for the Red Sea coast and the Sinai or any other places, you will working committees of the existing rules that immediate places to deal with what will appear from flocks.  http://www.gerasanews.com/index.php?page=article&id=101376

Thailand on high alert against possible avian flu spread from Cambodia

Public Health Ministry on high alert against possible avian flu spread from Cambodia

Friday, 08 March 2013

BANGKOK, 6 March 2013 The Public Health Ministry is on high alert against the possible spread of avian flu into the country, after a number of people have been reportedly killed by H5N1 virus in neighboring Cambodia.

Permanent Secretary for Public Health Dr. Narong Sahametapat said that Thailand is now on alert to prevent the outbreak of avian flu even though the country has not found a single patient during the past 7 years. 

Dr. Narong’s comment was made after the World Health Organization (WHO) reported that there have been 7 bird-flu patients in Cambodia, 2 in China and 1 in Egypt, during January 1 and February 15, 2013. Out of this, 7, including 6 in Cambodia, died.

The Permanent Secretary for Public Health stated that the H5N1 outbreak in the neighboring country has put Thailand on high alert and the ministry has already instructed all related provincial health offices, particularly in Sa Kaeo Province, which borders Cambodia, to watch out for any possible spread of the virus.

He added the alert is applied to both poultry and human while related provincial livestock offices were ordered to be ready to control the spread of the avian flu, if the virus is ever found.

In addition, all hospitals under the ministry have been advised to stock up Oseltamivir, an anti-viral drug and to conduct thorough diagnosis on patients suspected to have contracted the virus.

The Public Health Ministry also warned the public to only consume completely-cooked poultry and eggs, to never include sick poultry in any cooking, and to report any suspected case of avian influenza to the nearest livestock or public health offices as soon as possible. http://www.pattayamail.com/news/public-health-ministry-on-high-alert-against-possible-avian-flu-spread-from-cambodia-23092

Urgent work of the Ministry of Agriculture and Rural Development: Beware the risk of A/H5N1 flu spread to poultry and humans

Last Updated on: 08/03/2013 06:16:59

Prohibits the movement of poultry originating from Cambodia to Viet Nam to pasture, fields and vice versa (BTNO) - Ministry of Agriculture and Rural Development has just the urgent request Tay Ninh provinces bordering Cambodia such as Long An, Dong Thap, An Giang, Kien Giang, Binh Phuoc strengthen the prevention of avian influenza . Ministry of Agriculture and Rural Development said, as notified by the Cambodian Ministry of Health and the World Health Organization (WHO), since the beginning of 2013 in this country appeared 09 cases of A/H5N1 flu, of which there were 8 deaths. At the same time, the last day 20.2, WHO informed the virus is pathogenic for poultry and Cambodian H5N1 branch 1.1. Epidemiological investigation results showed that all patients had a history of contact with poultry. Among the avian influenza outbreak occurred in some provinces of Cambodia, Takeo Province, Kampong Cham border with Vietnam. Therefore, the risk of spread of avian influenza to poultry and to humans in Vietnam is very high. To quickly extinguish the outbreak of bird flu at present, actively prevent the effective spread strain of influenza from Cambodia to Vietnam, not to spread germs, MARD proposed Chairman of the provincial border borders with Cambodia urgently direct prohibits all forms of transport, trade and consumption of poultry and poultry products across the border with Cambodia, including form of donation poultry and products poultry across the borders of organizations, individuals and residents of border areas.Prohibits the movement of poultry originating from Cambodia to Viet Nam to pasture, fields and vice versa. Urgently organized vaccination bird flu vaccine for the entire poultry population eligible for vaccination in the border districts and areas with high risk locally; strain vaccine vaccination using under the guidance of the Department of Animal Health. MARD also proposed Chairman of the border provinces to organize and direct supervision in the villages, hamlets, early detection when poultry show unusual and thoroughly treated, limiting spread poultry diseases and infectious. Enhance the propagation effects of avian flu; mobilizing farmers declare veterinary staff, local authorities found suspected bird flu or unusual deaths; performance captivity holding and application of sanitary measures, regular disinfection; observance of the flu vaccine; trade, transport and use of poultry and poultry products of unknown origin, only use poultry products processed cooked.

Vietnam-prohibit all forms of transport, trade and consumption of poultry with Cambodia

Prevent bird flu from Cambodia

Friday, 08.03.2013, 07:10 (GMT +7)

(SGGP). - On 7-3, the Ministry of Agriculture and Rural Development has sent urgent Chairman 6: Tay Ninh, Binh Phuoc, Long An, Dong Thap, An Giang, Kien Giang and ministries member of the National Steering Committee HPAI prevention urgent requirements prohibit all forms of transport, trade and consumption of poultry and poultry products across the border with Cambodia; organized vaccination vaccine AI for the entire poultry population eligible for vaccination in the districts bordering Cambodia and other high-risk areas.  http://www.sggp.org.vn/ytesuckhoe/2013/3/312930/

Hong Kong Prison Homes Spur Virus Risk Decade After SARS

By Natasha Khan - Mar 7, 2013 11:00 AM ET

Daniel J. Groshong/Bloomberg

Members of the World Health Organization's Environmental Health Team walk out of the Amoy Gardens housing estate in Hong Kong on April 30, 2003. More than 40 residents of Amoy Gardens died and 329 were infected.

Chan Sung-ming says the coughs and sneezes echoing through the plywood walls of his windowless, 60- square foot Hong Kong apartment get him thinking: is there a bug going around and could it be deadly?

Enlarge image

The bathroom, right, and kitchen which Chan shares with his neighbors in Hong Kong. Photographer: Jerome Favre/Bloomberg

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A bed and an chair sit in Chan's subdivided flat in Hong Kong. Photographer: Jerome Favre/Bloomberg

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A woman crosses a busy road wearing a mask to protect against the severe acute respiratory virus in Hong Kong on April 18, 2003. When a fast-spreading germ takes hold in Hong Kong, the consequences for the city -- and the world -- can be devastating. Photographer: Peter Parks/AFP/GettyImages

Enlarge image

Masked commuters disembark from harbor ferry in Hong Kong on April 10, 2003. SARS infected 1,755 people in Hong Kong, killing 300, and caused economic losses totaling HK$3.8 billion ($490 million) in two months alone as tourist arrivals dwindled and businesses from restaurants to taxi cabs slumped. Photographer: Daniel Groshong/Bloomberg

Enlarge image

People head to the immigration counters at the Lo Wu border crossing between Hong Kong and mainland China wearing masks to protect against SARS on April 22, 2003. “Hong Kong acts as a transit point from China to Hong Kong, and Hong Kong to the world,” said Guan Yi, professor of virology at the University of Hong Kong. Photographer: Peter Parks/AFP/Getty Images

Enlarge image

A worker wearing protective dress participates in the slaughtering of approximately 2,700 chickens at a market in the Kowloon district of Hong Kong on June 7, 2008. Hong Kong detected the H5N1 bird flu virus in a live poultry market in Kowloon, and stopped importing poultry from mainland China. Photographer: Jerome Favre/Bloomberg

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A passenger has her temperature taken at Chek lap Kok Airport on April 17, 2003. Last year, 56.5 million people transited the city’s airport-- 65 percent more than in 2002. By the time SARS petered out in August 2003, the virus had spread to more than two dozen countries and three regions, causing 8,096 cases and 774 deaths. Photographer: Christian Keenan/Getty Images

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A decade after SARS began a lethal odyssey via Hong Kong, which has the world's most-densely populated urban areas, Chan says his apartment -- one of eight in a space about the size of a squash court -- makes him feel more prone to airborne germs.

Even as the city spends HK$1.6 billion ($206 million) a year on a disease-tracking center to prepare for future contagions, a tripling in the price of homes in the past decade have forced its 7.2 million residents closer together. That’s stoking the potential for a rapid rise of bugs like the severe acute respiratory virus that exploded there in early 2003.

“In Hong Kong, we live vertically, not horizontally,” said Sian Griffiths, director of the Chinese University of Hong Kong’s school of public health. “It’s as if we’ve turned a village street on its end. People are so close together here, the risk of transmission is greater.”

Chan’s apartment is smaller than some of the city’s prison cells. The 36-year-old electricia...  http://www.bloomberg.com/news/2013-03-07/hong-kong-prison-homes-spur-virus-risk-decade-after-sars.html

CDC Issues New Beta2c Coronavirus Guidance

Recombinomics Commentary 21:00
March 7, 2013

The CDC has put out an early release MMWR which updates the current situation for nCoVs.  Associated with the MMWR are guidance including a new case definition and travel updates.  These updates highlight the concentration of cases in the Middle East and request notification of PUI’s (person under investigation).

The new guidelines highlight symptomatic cases with recent travel to the Arabian Peninsula. 

It is worth noting that this notice coincides with the timing of the SARS-CoV international outbreak 10 years, which began at the Metropole Hotel on February 21, but the confirmation of the outbreak happened in March, as guests began appearing at hospitals in Hong Kong, Singapore, Hanoi, and Toronto.  That initial spread was followed by the spike in reported cases from mid-March through mid-May.
Although the current nCoV is beta2c and SARS CoV is beta2b, the similarities in the disease presentations are striking as is the high case fatality rate for adults age 40 and above.  http://www.recombinomics.com/News/03071302/nCoV_CDC_Update.html

cdc- Update: Severe Respiratory Illness Associated with a Novel Coronavirus — Worldwide, 2012–2013

Update: Severe Respiratory Illness Associated with a Novel Coronavirus — Worldwide, 2012–2013

Early Release

March 7, 2013 / 62(Early Release);1-2

CDC continues to work closely with the World Health Organization (WHO) and other partners to better understand the public health risk posed by a novel coronavirus that was first reported to cause human infection in September 2012 (1–3). Genetic sequence analyses have shown that this new virus is different from any other known human coronaviruses, including the one that caused severe acute respiratory syndrome (SARS) (2). As of March 7, 2013, a total of 14 confirmed cases of novel coronavirus infection have been reported to WHO, with eight deaths (4). Illness onsets have occurred from April 2012 through February 2013 (4,5). To date, no cases have been reported in the United States.

Three of the confirmed cases of novel coronavirus infection were identified in the United Kingdom (UK) as part of a cluster within one family (6). The index patient in the cluster, a man aged 60 years with a history of recent travel to Pakistan and Saudi Arabia, developed respiratory illness on January 24, 2013, before returning to the UK on January 28 (5,7,8). He was hospitalized on January 31 with severe lower respiratory tract disease and has been receiving intensive care (5,7,8). Respiratory specimens from this patient taken on February 1 tested positive for influenza A (H1N1) virus and for novel coronavirus infection (8). The second patient was an adult male household member with an underlying medical condition who became ill on February 6, after contact with the index patient, and received intensive treatment but died with severe respiratory disease (5,9). This patient's underlying illness might have made him more susceptible to severe respiratory infection. The third patient is an adult female who developed a respiratory illness on February 5, following contact with the index patient after he was hospitalized (5,10). She did not require hospitalization and had recovered by February 19 (5,6). Only the index patient had traveled recently outside the UK. Based on their ongoing investigation of this cluster of illnesses, the UK Health Protection Agency has concluded that person-to-person transmission likely occurred in the UK within this family (6).

This recent cluster provides the first clear evidence of human-to-human transmission of this novel coronavirus, coinfection of this novel coronavirus with another pathogen (influenza A), and a case of mild illness associated with this novel coronavirus infection. In light of these developments, updated guidance has been posted on the CDC coronavirus website (http://www.cdc.gov/coronavirus/ncv). Persons who develop severe acute lower respiratory illness within 10 days after traveling from the Arabian Peninsula or neighboring countries* should continue to be evaluated according to current guidelines. Persons whose respiratory illness remains unexplained and who meet criteria for "patient under investigation" should be reported immediately to CDC through state and local health departments. Persons who develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula or neighboring countries but who do not respond to appropriate therapy may be considered for evaluation for novel coronavirus infection. In addition, persons who develop severe acute lower respiratory illness who are close contacts†of a symptomatic traveler who developed fever and acute respiratory illness within 10 days of traveling from the Arabian Peninsula or neighboring countries may be considered for evaluation for novel coronavirus infection. Testing of specimens for the novel coronavirus will be conducted at CDC.

Recommendations and guidance on case definitions, infection control (including use of personal protective equipment), case investigation, and specimen collection and shipment for testing, are available at the CDC coronavirus website. Additional information and potentially frequent updates will be posted on the CDC coronavirus website. State and local health departments with questions should contact the CDC Emergency Operations Center (770-488-7100).