Novel (New) Coronavirus in the Arabian Peninsula and United Kingdom

This information is current as of today, May 02, 2013 at 17:26 EDT

Updated: May 02, 2013

What Is the Current Situation?

As of May 2013, a total of 24 people in Saudi Arabia, Qatar, Jordan, the United Kingdom (UK), and the United Arab Emirates were confirmed to have respiratory illness caused by a novel (new) coronavirus. Sixtenn of these 24 people died.

In the UK, an infected man likely spread the virus to two family members. He had recently traveled to Pakistan and Saudi Arabia and got sick before returning to the UK. This cluster of cases provides the first evidence of person-to-person transmission. The UK’s Health Protection Agency is continuing to investigate this. Also, clusters of cases in Saudi Arabia and Jordan are being investigated. For more information, see CDC’s novel coronavirus update.

CDC does not recommend that anyone change their travel plans because of these cases of the novel coronavirus. CDC recommends that US travelers to countries in or near the Arabian Peninsula* monitor their health and see a doctor right away if they develop fever and symptoms of lower respiratory illness, such as cough or shortness of breath. They should tell the doctor about their recent travel.  

What Is a Coronavirus?

Coronaviruses are a cause of the common cold. A coronavirus also was the cause of the severe respiratory illness called SARS (severe acute respiratory syndrome). SARS caused a global epidemic in 2003, but there have not been any known cases of SARS since 2004. This novel coronavirus is not the same coronavirus that caused SARS.

What Is Known About Novel Coronavirus?

The novel coronavirus is different from any other coronavirus that has been previously found in people. In the UK, the virus likely spread from an infected person to two family members. Symptoms of novel coronavirus infection have included fever, cough, and shortness of breath. CDC is working with WHO and other partners to understand the public health risks from this virus.

How Can Travelers Protect Themselves?

Taking these everyday actions can help prevent the spread of germs and protect against colds, flu, and other illnesses:

• Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.
• Avoid touching your eyes, nose, and mouth. Germs spread this way.
• Avoid close contact with sick people.
• Be sure you are up-to-date with all of your shots, and if possible, see your healthcare provider at least 4–6 weeks before travel to get any additional shots. Visit CDC’s Travelers' Health website for more information on healthy travel.
• If you are sick
  • Cover your mouth with a tissue when you cough or sneeze, and throw the tissue in the trash.
  • Avoid contact with other people to keep from infecting them.

When Should Someone See a Health Care Provider?

You should see a healthcare provider if you develop a fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 10 days after traveling from countries in or near the Arabian Peninsula*. You should tell the healthcare provider about your recent travel.

Clinician Information:

Health care providers should be alert to patients who develop severe acute lower respiratory illness (e.g., requiring hospitalization) within 10 days after traveling from countries in the Arabian Peninsula* or neighboring countries, excluding those who transited at airports.

• Consider other more common causes of respiratory illness, such as influenza.
• Evaluate patients using the CDC’s case definitions and guidance
• Immediately report patients with unexplained respiratory illness and who meet CDC’s criteria for “patient under investigation” to CDC through the state or local health department.
• Consider evaluating patients for novel coronavirus infection who:
  • develop severe acute lower respiratory illness of known etiology within 10 days after traveling from the Arabian Peninsula,* but who do not respond to appropriate therapy
  • 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.*
• See additional recommendations and guidance on CDC’snovel coronavirus website.
• Contact your state or local health department if you have any questions.

Additional Information:

• CDC Novel Coronavirus
• WHO Novel Coronavirus Infection—Update
• Novel Coronavirus 2012, Health Protection Agency
• ECDC: Novel Coronavirus update to Rapid Risk Assessment
• Update: Severe Respiratory Illness Associated with a Novel Coronavirus—Worldwide, 2012–2013 MMWR March 7, 2013/62 (Early Release); 1–2
• Severe Respiratory Illness Associated with a Novel Coronavirus — Saudi Arabia and Qatar, 2012 MMWR October 12, 2012/61; 820–820.

*Countries in and near the Arabian Peninsula: Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Palestinian territories, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE), and Yemen.

NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN (16): SAUDI ARABIA, REQUEST FOR INFORMATION

 2013-05-02 15:29:28
Subject: PRO/AH/EDR> Novel coronavirus - Eastern Mediterranean (16): Saudi Arabia, RFI 
Archive Number: 20130502.1686948

NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN (16): SAUDI ARABIA, 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: Thu 2 May 2013
Source: Al Jazeera [edited]
http://www.aljazeera.com/news/middleeast/2013/05/201352795849599.html


Saudi Arabia's health ministry has said that 5 Saudis have died from a new SARS-like virus and it is taking "precautionary measures" with 2 more people being treated in an intensive care unit.

In a statement cited by the Saudi Press Agency [SPA] late on Wednesday [1 May 2013], the ministry said that all the deaths occurred in the Ahsaa province in the oil-rich eastern region of the kingdom, according to the AFP [Agence France-Presse] news agency.

Known as novel coronavirus or hCoV-EMC, the virus was first detected in mid-2012 and is a cousin of severe acute respiratory syndrome (SARS), which triggered a scare 10 years ago when it erupted in east Asia, leaping to humans from animal hosts.

The health ministry said it was taking "all precautionary measures for persons who have been in contact with the infected people ... and has taken samples from them to examine if they are infected."

However, the ministry gave no figures for how many people have been examined to see if they have the lethal disease.

So far 16 people have died from 23 cases detected in Saudi Arabia, Jordan, Germany, and Britain. Riyadh has accounted for most of the deaths, with 11 people, including the 5 new fatalities.

Coronaviruses cause most common colds and pneumonia, but are also to blame for unusual conditions such as SARS, which killed more than 800 people when it swept out of China in 2003.

The new virus is different from SARS, in that it causes rapid kidney failure. The strain is shrouded in mystery, and the World Health Organization does not yet know how it is transmitted or how widespread it is.

A 73 year old Saudi man died in Germany in March [2013, see prior ProMED-mail posts Novel coronavirus - Eastern Mediterranean (14): Germany ex UAE, WHO, fatal 20130326.1604564 and Novel coronavirus - Eastern Mediterranean (13): Germany ex UAE 20130326.1603038] from the lethal new virus. He had been travelling in Pakistan and Saudi Arabia before falling ill, and was transferred to Munich from Abu Dhabi on [19 Mar 2013].

--
communicated by:
ProMED-mail


[In the newswire above there are reports of 7 newly diagnosed cases of severe illness including 5 deaths attributable to infection with the novel coronavirus (nCoV).

In prior reports the total number of reported/confirmed cases had been 17, with 11 deaths. If the accounts in the newswire above are correct, there are now 24 confirmed cases with 16 deaths.

As of today, 2 May 2013, the breakdown of cases (and deaths) by country of report is:
- Saudi Arabia: 16 (11 deaths)
- Jordan: 2 (2 deaths)
- UK: 4 (one patient from Qatar -- under treatment, 3 patients from UK -- one with history of travel to Saudi Arabia and Pakistan prior to illness; one recovered, 2 deaths)
- Germany: 2 (one patient from Qatar -- discharged, one patient from the UAE -- one death).

This nCoV is genetically closely related to a bat coronavirus. The actual route of transmission to humans has not yet been definitively defined. Contact with farm animals has been noted in a number of the cases (see prior ProMED-mail posts).

Information on the dates of onset of illness, age, and gender of cases, possible exposures (animal and human) and other information from epidemiologic investigations would be greatly appreciated.

Saudi Arabia was watching 'Corona' double precautionary measures

5 deaths and referral of two intensive care because of the virus 'mysterious'

Ministry of Health sent a medical committee to examine the Relatives of Victims of Al-Ahsa and still according to officials unaware of the type of statements and the reasons for the transmission of the virus to Saudi Arabia

Riyadh: Bader Al-Qahtani 
awaiting the Saudi Ministry of Health the results of a report prepared by a medical commission headed to the province of Al-Ahsa (eastern Saudi Arabia) after the announcement of the death of five people and referred two others to intensive care after contracting HIV «Corona», bringing the number of all cases that wiped out as a result of HIV infection 17 cases at the level of the whole world.

He says Dr. Ziad ميمش, Undersecretary of the Ministry of Public Health Health «will be the team checks on persons in contact with the seven cases. The «The disease is still a mystery for us, we did not discover no vaccine or cure for the virus.

Agent confirms the Saudi Ministry of Health among other precautionary measures taken by the ministry, said that the most prominent circular to all the country's hospitals to send samples to the laboratory in Jeddah to examine regional samples and raise their ministry to any developments about it.

 He says «difficult to predict the possibility of the spread of the virus or not, is still insufficient information about the virus. The World Health Organization says that «Corona» is one of the viruses that infect the respiratory tract, and represents 15 per cent of influenza viruses that affect humans.

The ministry revealed the disease through regional laboratory in Jeddah, which is the only lab in Saudi Arabia who can analysis and detection of the virus.

Says Dr Saeed Al Amoudi is the director of the laboratory of regional Jeddah The analysis of the virus is not over samples informant usual, «but analysis is performed Jenny molecular, by examining the DNA of the patient, in the case of injury, the additional vehicles occur on the composition of the DNA of the infected».

Dr. vertical adds that «the laboratory being molecular assays for installation of the virus, which will help in the discovery of appropriate treatment, or choose the best treatments if it appears more than one option.

And whether the infected cases have a close relationship, said Dr. vertical The laboratory deals with numbers and symbols, so you can not say for sure this information. But the ministry announced in advance in the injury of two brothers, says Dr. ميمش «We can not say for sure until the moment attachment of injury to persons, it is better to wait for the report of the Committee.

After the announcement of the Ministry of Health because the virus «vague» in the medical world to the fore again, and the World Health Organization says on its front page on the Internet that the virus is not known is from the same virus family «SARS», who conquered the world in advance quickly when you start to spread in 2002, in more than 30 countries and led to the loss of 800 people.

Dr. ميمش says that the onset of the disease were not from Saudi Arabia, but Saudi Arabia سابقت advertising, as published in September last first case of the disease, pointing to the Jordan recording the first actual case, but the announced delay.

The preferred health authorities Jordanian wait before the announcement, «and sent the samples to the global laboratory due to the desire of the Ministry of Health to make sure full of injury cases ended symptoms of the disease بوفاتهما», according to Dr. Abdul Latif Wreikat, Minister of Health of Jordan said in remarks following the announcement, which was released in early December (January I) the past, the virus caused the death of a Jordanian nurse on 19 April 2012, as well as a college student died twenty-fourth day of April 2012.

 The new virus belongs to the family of coronal virus - which also include cold viruses, according to the World Health Organization, which said it takes an incubation period of about 7 days, «should therefore monitor any respiratory problems anybody have seven days after the start of his dealings with the injured. Said Dr. Mohsen al-Hazmi, chairman of the Committee on Health Affairs, the Council of the Saudi Shura «The virus Corona is a pattern متحورا of another virus, is still unknown to install, but you should know exactly the reasons and answer questions of the type: Why in Al-Ahsa specifically, are there any areas other potentially infected patients has not yet discovered.

The «very necessary to know the mode of transmission of the virus, because it is the only way to be able to prevent it, pointing to the medical instructions always calling to wash your hands thoroughly and check the hospital when a sharp cough or pneumonia and other necessary actions. 

Said Dr. Khaled Marghalani spokesman «Saudi Health»

«We can not rename the virus Palmqlq, but if he moves quickly, and did not prove to have it passed from person to person», pointing to the inclusion of the vaccine prevention of HIV «Corona» within the dose «vaccination» influenza during next year, and so by the World Health Organization, as the annual renewal of viruses speaks every year, and different vaccine year with the following year, and added «will take the medical world the necessary measures to find a medicine, and the inclusion of the vaccine next year», said that the discovery of treatment is not difficult , because of respiratory diseases.

 The Saudi Ministry of Health announced on the third of November () symmetry someone to healing and stabilize his condition, but Dr. Ziad ميمش, says he did not receive immediate treatment, as was a therapeutic way through the supportive drugs for the respiratory system.

http://aawsat.com/details.asp?section=43&article=727047&issueno=12575#.UYLxR7Vwe8A

Normal vigilance at UAE borders with Saudi Arabia to check novel coronavirus

Checks to ensure novel coronavirus infection is detected early

Abu Dhabi: To ensure that any suspected cases of infection by the novel coronavirus are detected at the earliest, the UAE Ministry of Health (MoH) and other UAE health authorities in the UAE are closely monitoring border entry points with Saudi Arabia, a senior officials at the MoH said on Thursday.

According to a statement by the Saudi Press Agency on Wednesday, the novel coronavirus, or nCoV, has resulted in the death of five more people in Saudi Arabia’s eastern Ahsaa province over the last few days. Two other infected patients are also currently being treated at intensive care units in the country.

The new cases in Saudi Arabia add to the 11 other deaths worldwide among 17 confirmed cases of nCoV infection, as recorded in the latest disease update by the World Health Organisation, dated March 26.

However, because the number of cases has so far been small and easy to monitor, no trade or travel restrictions have yet been implemented in the UAE, Mahmoud Fikri, assistant undersecretary for health policies at the MoH, told Gulf News.

• 
  
“In the meantime, we have notified hospitals and clinics across the country to immediately report any suspicious cases. The situation is not at the level of an emergency, so there is no need to panic. All the procedures being implemented are just to ensure normal vigilance,” Fikri said.
He added that the MoH is in constant contact with the Saudi Ministry of Health and the WHO.
“We will notify the WHO in case there is any change in disease status in the UAE,” Fikri said.
Trade and travel restrictions have also not been put in place by the WHO, but the watchbody has recommended close monitoring.
The nCoV has worrying international health authorities because it resembles the SARS (Severe Acute Respiratory Syndrome) virus, which killed about a tenth of the 8,000 people it infected worldwide in late 2002 and early 2003. It was first noted when the WHO issued an international alert in September 2012, saying a virus previously unknown in humans had infected a Qatari man who had recently been in Saudi Arabia.
Still, not much is yet known about the virus, including its source or how widespread it is. The WHO has found some evidence of human-to-human transmission in some cases, and is also investigating animal sources.
Up until now, the majority of nCoV deaths have occurred in Saudi Arabia. The SPA statement added that the Saudi ministry of health is taking “all precautionary measures for persons who have been in contact with the infected people... and has taken samples from them to examine if they are infected.” However, no figures were released on the number of people who have been examined for the NCoV infection.
A 66-year-old Emirati also succumbed to the virus in March. He passed away in a German hospital, where he had been receiving treatment for cancer. Following this, the Health Authority Abu Dhabi (HAAD)reassured residents that although no cases of nCoV infection had been detected in Abu Dhabi emirate so far, the test for the virus is available at the Shaikh Khalifa Medical City.
Dr Jamal Al Kaabi, director of customer services and corporate communication at the HAAD, also told Gulf News that all Abu Dhabi hospitals had been notified in September 2012 to look out for suspicious cases.
“Additional checks are also being conducted at the Ghweifat border on people and products coming in from Saudi Arabia, However, as the number of cases is under control, no additional emergency measures have yet been implemented,” he added. http://gulfnews.com/news/gulf/uae/health/normal-vigilance-at-uae-borders-with-saudi-arabia-to-check-novel-coronavirus-1.1178563

Preventive measures in place for coronavirus, claims MoH

RIYADH — The Ministry of Health has taken precautionary measures against the spread of coronavirus after five people infected with the SARS-like virus died in Al-Ahsa region during the last few days.The ministry said all the deaths as well as the infections occurred in the Al-Ahsa region in the eastern part of the Kingdom.

Known as novel coronavirus or hCoV-EMC, the virus was first detected in mid-2012 and is a cousin of Severe Acute Respiratory Syndrome (SARS) virus, which triggered a scare 10 years ago when it erupted in East Asia, leaping to humans from animal hosts.
hCoV-EMC stands for human coronavirus-Erasmus Medical Center, after the Dutch health institution that identified it.
The health ministry said it is taking “all precautionary measures for persons who have been in contact with the infected people... and has taken samples from them to examine if they are infected.”
The ministry has started conducting surveillance search of all persons who mingled with the patients, whether family members or acquaintances, and testing their samples, to determine if any of them has any sign of contracting the virus.
The ministry said that its announcement comes as part of its transparency policy toward public regarding all the health matters that might affect them. 
 
Sixteen people have now died from 23 cases detected in Saudi Arabia, Jordan, Germany and Britain. Saudi Arabia  has accounted for most of the deaths, with 11 people including the five new fatalities.
In Geneva, a spokesman for the World Health Organization would not comment on why so many of the cases have occurred in the Saudi kingdom.

“We have received a formal notification from the Saudis about these cases,” spokesman Glenn Thomas told AFP.
When asked if the WHO is planning to issue a travel warning for Saudi Arabia, he said this was “unlikely” since “there has been no change in the risk assessment.”
Coronaviruse causes most common colds and pneumonia, but are also to blame for unusual conditions such as SARS which killed more than 800 people when it swept out of China in 2003.
The new virus is different from SARS, in that it can cause rapid kidney failure.
The strain is shrouded in mystery, and the WHO does not yet know how it is transmitted or how widespread it is.
The WHO said a 73-year-old Saudi man died in Germany in March from the lethal new virus. He had been traveling in Pakistan and Saudi Arabia before falling ill, and was transferred to Munich from Abu Dhabi on March 19.
Six research monkeys infected with novel human coronavirus were found to quickly develop pneumonia, according to a letter by National Institutes of Health experts published in the New England Journal of Medicine.
After being exposed to samples of the virus, the rhesus macaques fell ill within 24 hours, with symptoms including elevated temperature, lack of appetite, coughing and fast breathing. http://www.saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20130503164057

CK kills five Saudis amid warnings of global epidemic

He died five infected with SARS-like new Corona, during the past few days in the province of Ahsa eastern Saudi Arabia, according to Wednesday and announced the Saudi Ministry of Health.

And published by the official news agency Arabia "SPA" the ministry said in a statement on Wednesday evening, "do all the precautionary measures for Mkhaltin the injured, according to the guidance of scientific local and global sampling of them, to see if there are cases among them," noting that it "recorded so far 17 cases certain of this disease in the world. "

The ministry pointed out that the "virus Corona is a virus that affects the respiratory tract, which represents 15% of the viruses that cause the flu, affecting humans, including this new style, does not yet exist at the level of the world accurate information about the origin and modes of transmission, as There are no preventive vaccination or antibiotic treatment for this virus. "

The World Health Organization (WHO) announced in March \ March last year for new infections with the virus coronary new Corona virus-like SARS (severe acute respiratory syndrome), in Saudi Arabia.

A statement of the World that the Saudi Ministry of Health informed that infected with the virus suffered illness is at risk, adding that "the patient has recovered and left the hospital," according to the organization, but pointed out that this patient met the people in the thirty-ninth had the symptoms of this virus in February 24 last , and died on the second of March / March.

And not the World Health Organization so far, information to reach conclusions about the transmission of this virus, which has been verified for the first time in mid-2012, and this case is the sixth of ten (including nine deaths), which are reported to WHO for wounding a person with HIV New.

And cases of HIV infection are nine in Saudi Arabia (six of them died), and Ovian in Jordan and four hits in Britain, one of whom died and one injury in Germany.

New virus belongs to a large family, including viruses responsible for diseases ranging from colds to normal SARS outbreak led to a global epidemic that killed 800 people in the world in 2003. The World Organization renewed call to be cautious about this virus that infects the respiratory tract.

- See more at: http://www.watanserb.com/201305022486/%D8%AD%D9%8A%D8%A7%D8%AA%D9%86%D8%A7/%D9%83%D9%88%D8%B1%D9%88%D9%86%D8%A7-%D9%8A%D9%88%D8%AF%D9%8A-%D8%A8%D8%AD%D9%8A%D8%A7%D8%A9-%D8%AE%D9%85%D8%B3%D8%A9-%D8%B3%D8%B9%D9%88%D8%AF%D9%8A%D9%8A%D9%86-%D9%88%D8%B3%D8%B7-%D8%AA%D8%AD%D8%B0%D9%8A%D8%B1%D8%A7%D8%AA-%D8%B9%D8%A7%D9%84%D9%85%D9%8A%D8%A9-%D9%85%D9%86-%D8%AA%D9%81%D8%B4%D9%8A-%D8%A7%D9%84%D9%88%D8%A8%D8%A7%D8%A1.html#sthash.kUlLeQ35.dpuf

Chinese Scientists Create Mutant Bird Flu

Single gene swap enables avian virus to change hosts

By Cassie Ryan, Epoch Times | May 2, 2013

A doctor working in the lab at the Beijing Center of Disease Control on April 16, 2013, during the H7N9 bird flu outbreak. Chinese researchers have published a paper about a mutant virus they created from the H5N1 bird flu and H1N1 swine flu viruses that can infect guinea pigs. (STR/AFP/Getty Images)

Chinese researchers have created a virus that can infect mammals via coughing and sneezing by hybridizing the H5N1 bird flu virus with the H1N1 swine flu strain that caused the 2009 pandemic.

Their paper was published in the journal Science on May 2, the same day a man from Henan Province died from the H7N9 bird flu virus–reportedly the first death outside of eastern China and the 27th death among over 120 cases to date.

The H7N9 virus is believed to be a reassortment of several avian flu viruses, but is relatively benign in birds, according to recent research by another Chinese team published in the New England Journal of Medicine.

H5N1 bird flu is highly pathenogenic, but does not easily infect people, whereas H1N1 swine flu infected many millions in 2009. As yet, there is no evidence that the two viruses have mixed in nature, but they do overlap geographically and share some host species.

In the controversial new research the Chinese scientists deliberately manipulated the two viruses to make them more dangerous, for what they said was for the purpose of improving their understanding of pandemic risks. Some of the resultant mutants easily spread through the air between guinea pigs in the lab.

“If these mammalian-transmissible H5N1 viruses are generated in nature, a pandemic will be highly likely,” said research leader Hualan Chen at the Harbin Veterinary Research Institute of the Chinese Academy of Sciences.

“High attention should be paid during routine influenza surveillance to monitor such high-risk H5N1 hybrid viruses in nature.”

While Chen believes her work could benefit disease control and prevention, other scientists are critical of these so-called gain-of-function mutation studies, as manipulating viruses requires excellent lab security standards to prevent the viruses spreading or being accessed by terrorists. 

Microbiologist Richard Ebright at Rutgers University, New Jersey, said two other studies had already looked at how H5N1 mutations spread through the air between mammalian hosts–in that case ferrets. That flu research triggered a debate about biosecurity, and led to a one-year moratorium on any similar projects.

“This argument—even if one accepts it, which I do not—does not provide a rationale for the third, fourth, fifth, and nth research projects confirming the same point,” Ebright told Science Magazinevia email.

Baron May of Oxford, a former U.K. government chief scientist, told The Independent that the work by Chen’s team is “appallingly irresponsible.”

“They claim they are doing this to help develop vaccines and such like. In fact the real reason is that they are driven by blind ambition with no common sense whatsoever,” he added.

Further research by Hualan’s team has apparently been delayed by investigations into the new H7N9 virus.

http://www.theepochtimes.com/n3/36679-chinese-scientists-create-mutant-bird-flu/

Zhong Nanshan: within 5 days of onset Tamiflu can significantly reduce H7N9 severe

2013-05-03 06:05 
According to Xinhua News Agency, Guangdong Province, the prevention and control of H7N9 avian influenza team leader Zhong Nanshan, human infection of H7N9 avian influenza within 5 days of onset Tamiflu can significantly reduce severe.

　　Guangdong Province, the province's emergency meeting of the 2nd of human infection of H7N9 avian influenza prevention and control of the Group of Experts on the second working meeting, Zhong Nanshan, pointed out that the current clinical studies have shown that the incidence within 5 days of Tamiflu and other neuraminidase inhibitors will significantly reduce into the probability of severe, early diagnosis, early treatment, early use of antiviral drugs is to reduce the severe cases and the key to reducing mortality. In the present circumstances, especially in patients with influenza patients with a history of poultry exposure early use of Tamiflu and other neuraminidase inhibitors, the use of corticosteroids is not recommended. Shortness of breath patients into severe symptoms, clinicians should be vigilant, timely identification and found that in severe cases, severe cases should be immediately transferred to conditionally designated hospital to treat the.

　　Vice Governor of Guangdong Province, Lin Shaochun stressed the need to do the prevention and control security work, not only to Tamiflu and other neuraminidase inhibitors included in the medical institutions, drug procurement catalog, but also included in the Medicare drug directory and list of essential medicines in Guangdong Province ; must focus on the management of live poultry market, to the current emergency response and long-term standardized management organically linked. http://www.cnr.cn/gundong/201305/t20130503_512497522.shtml

Now 128 cases

Date: Wed 1 May 2013
Source: CIDRAP News [edited]


The new H7N9 avian flu virus has been detected in one more patient in China, a finding that brings the number of cases in the outbreak to 128, which includes 24 deaths. [Now 26 deaths according to WHO; see part [2] below]. The patient is a 69 year old man from Hunan province, located in south-central China, according to a statement today [1 May 2013] from Hong Kong's Centre for Health Protection (CHP). The man -- Hunan province's 2nd H7N9 case-patient -- is hospitalized in critical condition.

The World Health Organization (WHO) yesterday [30 Apr 2013] updated its "frequently asked questions" background information on the H7N9 virus, which said that although evidence points to live poultry as the source of infections, investigations haven't confirmed that the birds are the primary or only source. Addressing the role of live-bird markets in the transmission of the virus, WHO said the markets should be periodically closed and emptied of all birds for regular cleaning. New birds brought into the market should be regularly sampled and tested to detect diseases early. WHO said regular maintenance of market environments can help minimize economic disruptions and the impact on a key source of protein for people. It also noted that the markets help ensure that the bird trade isn't diverted to channels of uncontrolled sales.

Until more information is known about the infections, it's difficult to determine whether the H7N9 virus poses a significant risk of person-to-person spread in the community, WHO said. "This possibility is the subject of epidemiological investigations that are now taking place." It's not known yet whether H7N9 is a pandemic threat, the agency said. Animal viruses that infect people theoretically carry a pandemic risk, but some animal influenza viruses known to infect people haven't sparked pandemics.

Regarding potential risks to health care workers, WHO said standard and extra precautions should be taken when caring for patients with suspected or confirmed H7N9 infections. In China and Taiwan, monitoring of close contacts of H7N9 patients turned up some instances of respiratory symptoms in health workers who cared for H7N9 patients, but so far, tests have not confirmed H7N9 flu in any worker.

In other developments, a rush to publish scientific papers based on H7N9 genetic sequences that the Chinese National Influenza Center uploaded to the GISAID database early in the outbreak has sparked worries that China might not receive credit for its efforts to isolate and sequence the virus, according to a news report in Nature today [1 May 2013]. One of the points of conflict involves a genetic analysis and case study that Chinese scientists submitted to the New England of Journal of Medicine on 5 Apr 2013. At about that time, the researchers learned that other groups were preparing papers or had already published studies on the sequences that Chinese researchers had uploaded to GISAID. At that time, the Chinese researchers also learned that pharmaceutical company Novartis and the J Craig Venter Institute had used the uploaded sequences to develop US-funded H7N9 vaccine without collaboration with the Chinese team, according to Nature. The Chinese researchers believed that the usage wasn't handled in the spirit of the GISAID database, which requires scientists who use the sequences to credit and propose collaboration with those who deposited the data. A spokeswoman from Novartis said the company explored research collaboration with China and is committed to sharing meaningful insights from the vaccine work with Chinese officials, Nature reported.

Kristine Sheedy, PhD, associate director of communication science at the National Center for Immunization and Respiratory Diseases, with the US Centers for Disease Control and Prevention (CDC), told Nature that the CDC's use of the sequences isn't part of the misunderstanding. She added that the agency has had strong ongoing collaborations with China since the start of the outbreak.

[byline: Lisa Schnirring]

Fowls die‚ bird flu suspected in Rautahat

RAUTAHAT: Scores of fowls are reported to have died in Rautahat in the past few days, raising fear that the deaths could be due to outbreak of bird flu in the district, after Chitwan and Rupandehi.

Local poultry farmers are worried after receiving reports about fowls dying in Chandranigahapur, Judibela and Dumariya.

“Over 50 fowls died in different farms on Tuesday,” said Ramkrishna Banjara, a poultry farmer of Chandranigahapur. 

Rautahat Fowls Producers Association Chairperson Binod Pande, however, ruled out a bird flu outbreak and attributed the deaths to rising temperature. “The fowls might have died due to extreme heat,” he said. District Livestock Office, Rautahat, Chief Dinanath Yadav said specimens of the dead fowls have been collected and sent to the veterinary laboratory in Janakpur for test.

Meanwhile, police has detained Yugal Kishor Sah, a meat shop owner in Chandranigahapur, for selling meat of dead fowls. Police have initiated necessary action against him, but poultry farmers have sought Sah’s unconditional release. http://thehimalayantimes.com/fullNews.php?headline=Fowls+die%26sbquo%3B+bird+flu+suspected+in+Rautahat&NewsID=375000

Bird flu likely to appear in Europe, other places, expert says

Published May 02, 2013

Human cases of a deadly new strain of bird flu that has killed 27 people in China are likely to crop up in Europe and around the world but that should not cause undue alarm, Europe's leading flu expert said on Thursday.

In his first media interview since returning from an international scientific mission to China last week, Professor Angus Nicoll said the H7N9 flu outbreak in humans was one that should be taken extremely seriously and watched closely.

"We are at the start of a very long haul with H7N9," Nicoll told Reuters in a telephone interview from the Stockholm-based European Centre for Disease Prevention and Control (ECDC), where he is head of the influenza and respiratory viruses program.

He said there were many scientific questions to be answered about the new flu strain, which was first detected in patients in China in March having been previously unknown in humans.

The flu has so far infected at least 127 people in China and killed 27 of them, according to latest data from Chinese health authorities and the World Health Organization.

Scientific studies of the virus have established it is being transmitted from birds - probably mostly chickens - to people, making it a so-called zoonotic disease that humans catch from animals rather than from other humans.

Nicoll, who visited Beijing and Shanghai last week with a team of international scientific experts, confirmed what the WHO has repeatedly said - that there is no evidence yet of the virus efficiently passing from person to person - a factor that would make H7N9 a serious pandemic flu threat if it were to evolve.

Nicoll said the "most pressing public health question" for now was to identify the source of the circulating virus - the so-called "reservoir" - that is leading to chickens contracting it and sporadically passing it on to humans. This is likely to take time, with any results unlikely for several months.

"IMPORTED CASES"

In the meantime, Nicoll said the ECDC, which monitors disease in the European Union, and health authorities around the world should expect that "imported cases" of H7N9 flu may well begin to crop up elsewhere.

Just as Taiwan reported its first case on April 24, other countries should expect that business travelers and tourists may occasionally return from China having picked up the infection, he said.

"I'm not sure when that will happen. But the case in Taiwan shows that it can. If that person had got on a different flight and ended up in Paris, then we would have had a scenario that we would expect people to be alarmed at," he said.

"But again we should stress that this thing doesn't seem to be transmissible from human to human, so if we get some sporadic cases appearing in Europe, that doesn't change anything."

Nicoll noted that genetic analysis studies of H7N9 samples taken from patients in China showed the virus had already acquired two genetic mutations that made it more likely to be able to become transmissible between people.

Flu experts speaking at a briefing in London on Wednesday said those mutations, together with evidence that H7N9 is still mutating rapidly and probably spreading almost invisibly among birds because it does not make them obviously sick, meant this new flu was a "serious threat" to world health.

"You can never predict anything about flu, but it is concerning to see those mutations there, Nicoll said. "That's why it's important Europe should take this very seriously."

Nicoll added that he thought the Chinese were doing an "impressive job" handling, reporting, investigating and seeking to contain the outbreak.

Read more: http://www.foxnews.com/health/2013/05/02/bird-flu-likely-to-appear-in-europe-other-places-expert-says/?#ixzz2SB0svk9p

'Appalling irresponsibility': Senior scientists attack Chinese researchers for creating new strains of influenza virus in veterinary laboratory

Doctors and nurses attend a training course for treatment of H7N9 virus at a hospital in China, where a H7N9 patient is being treated.

02 MAY 2013

SENIOR scientists have criticised the “appalling irresponsibility” of researchers in China who have deliberately created new strains of influenza virus in a veterinary laboratory.They warned there is a danger that the new viral strains created by mixing bird-flu virus with human influenza could escape from the laboratory to cause a global pandemic killing millions of people.

Lord May of Oxford, a former government chief scientist and past president of the Royal Society, denounced the study published today in the journal Science as doing nothing to further the understanding and prevention of flu pandemics.

“They claim they are doing this to help develop vaccines and such like. In fact the real reason is that they are driven by blind ambition with no common sense whatsoever,” Lord May told The Independent. 

“The record of containment in labs like this is not reassuring. They are taking it upon themselves to create human-to-human transmission of very dangerous viruses. It’s appallingly irresponsible,” he said. 

The controversial study into viral mixing was carried out by a team led by Professor Hualan Chen, director of China’s National Avian Influenza Reference Laboratory at Harbin Veterinary Research Institute. 

Professor Chen and her colleagues deliberately mixed the H5N1 bird-flu virus, which is highly lethal but not easily transmitted between people, with a 2009 strain of H1N1 flu virus, which is very infectious to humans. 

When flu viruses come together by infecting the same cell they can swap genetic material and produce “hybrids” through the re-assortment of genes. The researchers were trying to emulate what happens in nature when animals such as pigs are co-infected with two different strains of virus, Professor Chen said. 

“The studies demonstrated that H5N1 viruses have the potential to acquire mammalian transmissibility by re-assortment with the human influenza viruses,” Professor Chen said in an email.

“This tells us that high attention should be paid to monitor the emergence of such mammalian-transmissible virus in nature to prevent a possible pandemic caused by H5N1 virus,” she said.

 “It is difficult to say how easy this will happen, but since the H5N1 and 2009/H1N1 viruses are widely existing in nature, they may have a chance to re-assort,” she added.

 The study, which was carried out in a laboratory with the second highest security level to prevent accidental escape, resulted in 127 different viral hybrids between H5N1 and H1N1, five of which were able to pass by airborne transmission between laboratory guinea pigs.

Professor Simon Wain-Hobson, an eminent virologist at the Pasteur Institute in Paris, said it is very likely that some or all of these hybrids could pass easily between humans and possess some or all of the highly lethal characteristics of H5N1 bird-flu.

 “Nobody can extrapolate to humans except to conclude that the five viruses would probably transmit reasonable well between humans,” Professor Wain-Hobson said.

“We don’t know the pathogenicity [lethality] in man and hopefully we will never know. But if the case fatality rate was between 0.1 and 20 per cent, and a pandemic affected 500 million people, you could estimate anything between 500,000 and 100 million deaths,” he said.

 “It’s a fabulous piece of virology by the Chinese group and it’s very impressive, but they haven’t been thinking clearly about what they are doing. It’s very worrying,” Professor Wain-Hobson said.

 “The virological basis of this work is not strong. It is of no use for vaccine development and the benefit in terms of surveillance for new flu viruses is oversold,” he added.

An increasing number of scientists outside the influenza field have expressed concern over attempts to deliberately increase the human transmissibility of the H5N1 bird-flu virus. This is done by mutating the virus so that it can pass by airborne droplets between laboratory ferrets, the standard “animal model” of human influenza.

 Two previous studies, by Ron Fouchier of Erasmus Medical Centre inRotterdam and Yoshihiro Kawaoka of the University of Wisconsin, Madison, caused uproar in 2011 when it emerged that they had created airborne versions of H5N1 that could be passed between ferrets.

 The criticism led to researchers to impose a voluntary moratorium on their H5N1 research, banning transmission studies using ferrets. However they decided to lift the ban earlier this year, arguing that they have now consulted widely with health organisations and the public over safety concerns.

 However, other scientists have criticised the decision to lift the moratorium. http://www.independent.ie/world-news/asia-pacific/appalling-irresponsibility-senior-scientists-attack-chinese-researchers-for-creating-new-strains-of-influenza-virus-in-veterinary-laboratory-29238953.html

Shaanxi Yangxian 40, students fever hospital may temporarily exclude H7N9 avian influenza

　　Yang County, Shaanxi Province, Xi'an BEIJING, May 2 (Tian Jin edge peak) is called "the hometown of Crested Ibis" In recent days there have been 40 students admitted for treatment of fever, diarrhea and other symptoms start to appear. Yangxian official revealed to reporters BEIJING, temporarily exclude the infection of H7N9 avian influenza and other respiratory disease may initially diagnosed as acute intestinal infection. As at 5:00 p.m. on the 2nd, nine students were cured, there are 30 students in the county hospital for treatment. The etiology is still under investigation. 　　April 28, in Middle Vocational Education Center 8 students suffered from fever, diarrhea and other symptoms, have visited a local hospital. In recent days, the local hospital and gradually admitted students of similar symptoms. As at 5:00 p.m. on the 2nd, the county hospital has treated a total of fever, diarrhea 40 students. A 16-year-old male student fever of 40.0 ° C, transferred to Hanzhong Central Hospital for further treatment due to serious condition.　　In Yangxian propaganda office staff told BEIJING interview with reporters, said local hospital admissions immediately reported to the county health, disease control and other departments, the county set up an emergency the treatment leading group, with allied health professionals responsible for diagnosis and treatment. Local hospital patients detailed epidemiological investigation and necessary blood, chest X-ray or other examinations, according to the epidemiological investigations and laboratory examinations, Hanzhong City and Yang County medical experts examining consultation temporarily exclude infection H7N9 avian influenza and other respiratory disease may initially diagnosed as acute intestinal infection. 　　As at 5:00 p.m. on the 2nd, nine students have already been cured, there are 30 students in the local hospital for treatment, his condition is stable. The etiology is still under investigation. 　　Yang County is located in the southern part of Shaanxi Province, is Hanzhong City, North Qinling Mountains, south of Bashan, the world's rare birds "Oriental gem" the Crested Ibis wild habitat and captivity kinds of sources. http://news.sohu.com/20130502/n374641658.shtml

Scared because of false reports bird flu

05/03/2013 03:55

On 2.5, TS-BS Le Hoang Son, director of the Hospital (Hospital) Pediatric Tho, said the situation had happened BV reported rare disease that fake crew puzzled doctors and parents of the patients panicked.

Tho Children's Hospital is always very crowded patients to examination and treatment - Photo: Dinh Tuyen

28.4 dawn, when I put NKL (5 years old, live P.An Hoa, Ninh Kieu Dist, Can Tho) to check for a fever hospital, seeing patients in the emergency room is crowded, my parents L . said the nurse with her big L. infected with avian influenza by eating poultry disease ... Hearing this, dozens of parents are taking care of pediatric patients in the emergency department was holding the panic run out of room.

The hospital's doctors also reported that speed and leaders fully prepared clothing, protective mask, the number of medications to treat me special for L. BV had to put emergency patients to arrange follow-up specifically isolating patients suspected influenza. However, after the doctor wearing protective gear to the doctor and she suggested to L. the track isolation room, took specimens to be tested, the parents of the grandchildren L. I just said it was just normal fever, not eating sick poultry and close the drive does not have any AI. The family wants me to new medical examination before bird flu reported to be a priority. Soon after, the doctors asked my family L. Sign me written certification no contact with poultry disease patients and their families have reported false. By day 29.4, after doctors remove medical treatment, her family L. I have voluntarily taken the hospital.

TS-BS Le Hoang Son said: "This case is the first reported fake hospital patient encounter. Although the preparation to deal with the flu but is always ready to assume such patients have reported disruptive to the doctors and psychological impact of other patients. "

According to lawyer Tran Thanh Phong, Can Tho City Bar Association, fake illness behavior reported above may not amount to a criminal prosecution, but the need for sanctions have caused fear, anxiety for the and other public disorder.

http://www.thanhnien.com.vn/pages/20130502/phat-hoang-vi-tin-bao-cum-gia-cam-gia.aspx