Victims of SARS-like virus didn’t travel

RIYADH – Five Saudis who died after contracting a new SARS-like virus last week had not traveled abroad, a health ministry official said on Saturday.

“After questioning relatives, it turned out that none of these people had been abroad before being infected,” Dr. Ziad Mimish, Undersecretary of Ministry of Health for Public Health, told AFP.

The outbreak occurred in Al-Ahsaa, which is near Bahrain and Qatar.

The original seven cases in this group all reportedly had “multiple comorbidities.” A comorbidity is medical-speak for a disease or condition. The ages of the initial seven cases ranged from 24 to 94, though most were in their 50s.

The ministry was working closely with the World Health Organization (WHO) over cases registered in Saudi Arabia but did not need help from foreign medical teams, Mimish said.

A system was put in place across the Kingdom to detect suspected cases and to monitor the condition of medics in contact with the patients, he added.

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.

The WHO reported on Friday that three new cases of the virus were detected in Saudi Arabia, bringing to 27 the global total of confirmed cases, including 16 deaths.

The mysterious virus has been deadliest in Saudi Arabia, and the other cases were reported in Jordan, Germany and Britain.

In Geneva, a spokesman for the World Health Organization would not comment on why so many of the cases have occurred in the 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.

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. – Agencies   http://www.saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20130505164375

Qatar Top Health: No new HIV infections Coruna

Supreme Council affirmed that health is not registered any new cases of HIV infection Coronaemerging in Qatar until Saturday, and that he is watching the epidemiological situation of the emerging pattern of the Corona virus intensively and continuously monitoring and follow up the developments of the disease.

This came after the World Health Organization (WHO) announced that it had been recording the number of 10 laboratory-confirmed cases of infection in the city of Al-Ahsa in the Eastern Province of Saudi Arabia, including 5 deaths and 5 cases in critical condition. And notified the World Health Organization so far, including a total of 27 confirmed cases worldwide of human infection with the virus coronary including 16 deaths, WHO recommends not applying any special tests when customs ports or impose any restrictions on the activities of international travel or trade even today.

And the Department of Public Health at the Supreme Council of Health for the alarm to all hospitals and health facilities in the public and private State Report any suspected case of acute respiratory infection, especially 

travelers who may be exposed to socialize with people infected with the disease in the recent period

http://www.al-sharq.com/ArticleDetails.aspx?AID=264962&CatID=64&title=%D8%A7%D9%84%D8%A3%D8%B9%D9%84%D9%89%20%D9%84%D9%84%D8%B5%D8%AD%D8%A9%20:%D9%84%D8%A7%20%D8%A5%D8%B5%D8%A7%D8%A8%D8%A7%D8%AA%20%D8%AC%D8%AF%D9%8A%D8%AF%D8%A9%20%D8%A8%D9%81%D9%8A%D8%B1%D9%88%D8%B3%20%D9%83%D9%88%D8%B1%D9%88%D9%86%D8%A7

Novel coronavirus infection - update

03/05/2013 The Ministry of Health in Saudi Arabia has informed WHO of an additional three laboratory confirmed cases of infection with the novel coronavirus (nCoV). The three patients are from the same location as reported in the Disease Outbreak News published on 2 May 2013. They are currently in critical condition. The government is conducting ongoing investigation into this outbreak. According to preliminary information, at least two confirmed cases are from the same family. From September 2012 to date, WHO has been informed of a global total of 27 laboratory confirmed cases of human infection with nCoV, including 16 deaths. Based on the current situation and available information, WHO encourages all Member States (MS) to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. WHO is currently working with international experts and countries where cases have been reported to assess the situation and review recommendations for surveillance and monitoring. All MS are reminded to promptly assess and notify WHO of any new case of infection with nCoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied. WHO continues to closely monitor the situation.

Eastern Prince directed to harness all the possibilities to control the virus "Corona"

05/04/2013 - 16:10:00

Presided over by His Royal Highness Prince Saud bin Nayef bin Abdulaziz, Governor of the Eastern Province at his office in the emirate meeting to the concerned authorities about the Corona virus,

The meeting included Dr. Saleh Al-Salihi, Director General of Health Affairs in the Eastern Province and secretary of the province of Al-Ahsa Adel Al-Melhem and Dr. Abdul Mohsen Al-Melhem, Director of Health Affairs in Al-Ahsa Governorate, which recorded several injuries in the province of Al-   Ahsa.

The Director General of Health Affairs in the Eastern Province for his report on the virus "Corona" and how to prevent it and assured everyone that the disease is controlled and there is no presence in large gatherings such as schools and public places.

His Highness the face of Health Affairs and the Secretariat to harness all possibilities to ensure that awareness of citizens and residents alike and harness all the possibilities provided by the Government of the Custodian of the Two Holy Mosques in their respective fields.  http://www.alyaum.com/News/art/81061.html

3 person cluster in same family : Some child deaths suspected

Corona» snatched Sheikh Mohamed Al Bin ... And two of his sons in 'intensive care'

Al-Ahsa - Good البقشي and Ibrahim Alambrza,

Saturday, May 4, 2013

Enter Virus «Corona», Hesham Mohamed Al Bin Sheikh and his family, in the event of «sorrow», since lost their father, while lying two members of the family on the family white, in two hospitals for treatment after injuries Balvyrus, who scored 7 injuries in Al-Ahsa, 5 of whom died. The remaining (Hisham BROTHERS) being treated.

Said Hisham Al Bin Sheikh, told «life»: «wounded شقيقاي Abdullah Hussein, this virus. They are lying in intensive care since 8 days. And each one of them in the hospital. We ask God's healing for them, and go home at the earliest ', adding' I hope from the bottom of my heart, there is a cure for this virus, or the transfer of my brothers for treatment in specialized hospitals.

Hisham stopped talking, after remembering his father, who left the world a week ago, wounds sustained Pfyrus the 'Corona'. The «live our family psychological conditions extremely difficult, because of the injury 3 of our family with this virus. But we say thank God if at all.And asked everyone to pray for his brothers, 'until you get back a smile to the lips of our family. We ask God to have mercy on my father's mercy and eternal peace.

Furthermore, live-Ahsa hospitals, public and private, case of severe Sentry, since the announcement of the Ministry of Health, two days before the discovery of the seven cases, and the death of 5 of those infected. And subject to all the conditions that come to the emergency departments, to the tests «very accurate», while the observed «serious concern» among workers in these hospitals, which is monitored by the «life» during her round on Friday, in the emergency department in a hospital birth and children.

Al «life», the death of a baby 10 days ago, at the age of 11 years, having arrived at the emergency department, an 'excellent health'. It was only suffering from a high temperature. It was only after an hour of arrival to the emergency department, was transferred to the intensive care room. And died two hours later, amid distraught all members of the medical staff at the hospital. He also received the emergency department was a kid, at the age of 10 years. And died hours after his arrival. The ambulance upon arrival children 'in good health'. 

Medical sources did not reveal that the children were infected Pfyrus 'Corona'. As I tried «life», to obtain clarification from a spokesman for the Directorate of Health Affairs in Al-Ahsa province, Ibrahim al-Hajji, who could only say: «The entity authorized to respond with respect to this virus, the agency is the Ministry of Public Health.  http://translate.google.com/translate?sl=ar&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&eotf=1&u=http%3A%2F%2Falhayat.com%2F

Saudi victims of SARS-like virus didn't travel: doctor

 May 04, 2013 12:55 PM

RIYADH: Five Saudis who died after contracting a new SARS-like virus last week had not travelled abroad, a health ministry doctor said on Saturday.
"After questioning relatives, it turned out that none of these people had been abroad before being infected," Dr Ziad Mimish, who heads the ministry's disease prevention unit, told AFP.
The outbreak occurred in the oil-rich Red Sea region of Al-Ahsaa, which is near Bahrain and Qatar.
The ministry was working closely with the World Health Organisation over cases registered in Saudi Arabia but did not need help from foreign medical teams, Mimish said.
A system was put in place across the kingdom to detect suspected cases and to monitor the condition of medics in contact with the patients, he added.
The WHO reported on Friday that three new cases of the virus were detected in Saudi Arabia, bringing to 27 the global total of confirmed cases, including 16 deaths.
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 mysterious virus has been deadliest in Saudi Arabia, and the other cases were reported in Jordan, Germany and Britain.

 

Read more: http://www.dailystar.com.lb/News/Middle-East/2013/May-04/216011-saudi-victims-of-sars-like-virus-didnt-travel-doctor.ashx#ixzz2SJr7Mymw
(The Daily Star :: Lebanon News :: http://www.dailystar.com.lb) 

Can Tho control an outbreak of A/H5N1 flu

04/05/2013 | 11:29:30

An outbreak of avian influenza A/H5N1 found in O Mon district, Can Tho City (Mekong Delta), was controlled by the local Centre for Preventive Medicine. According to him, a farm located in the district of Truong Lake rounding O My reported April 22 the unusual death of many chickens that tested positive for the H5N1 virus. center shot all poultry on the farm, decontaminated the area and its surroundings, and ensures the health of the livestock owner and all members of his family. Can Tho is the third town in the Mekong Delta have discovered an outbreak of avian flu after Hau Giang and Kien Giang. VNA- 
http://fr.vietnamplus.vn/Home/Can-Tho-ma%eetrise-un-foyer-de-grippe-AH5N1/20135/30359.vnplus

feather removal machines??

...Influenza (of all types) becomes a real danger, however, when the virus mutates to a form easily transmitted between humans without any animal vector. Lately, there are signs this may be happening, and one vector facilitating human-to-human spread of the virus is as unexpected as it is common: poultry feather removal machines.

Poultry feather removal machines are commonly used to pluck freshly slaughtered chickens, ducks and geese at China's urban live poultry markets. To prepare birds for customers, market sellers spin them in machines into which hot water is added. The tubs then spin at high speeds, quickly and efficiently plucking the feathers. But the trouble is that droplets of steam and spray emanating from the machines could carry H7N9 bird flu viruses directly into the lungs of sellers, customers, and anyone else in the area. "If there is a virus, it can be easily inhaled this way," explained Feng Zijian, director of the emergency response center of the Chinese Center for Disease Control and Prevention, in a recent briefing with Chinese reporters.

"This is what we suspect to be a major environmental exposure that causes human infections." Once inhaled into the lungs of one human, a simple cough, sneeze or sigh could release the virus into society time and time again, far from the nearest infected chicken.

Large poultry feather removal machines are mainly employed by commercial poultry producers in Western countries, whereas in China, much smaller machines are a common feature at the live poultry markets where the majority of Chinese consumers buy their poultry. Should these machines be positively identified as an influenza transmission vector, the resulting disruption to China's food distribution system would be massive, to say the least.

For a photo of the machine, see:
http://inventorspot.com/files/images/04_8.img_assist_custom.jpg.

http://www.promedmail.org/direct.php?id=20130504.1690089

Dongguan pregnant women suffering from a flow of workers mistaken for avian influenza cited panic

　　Post time :2013-05-04 09:14

Yangcheng Evening News reporter Fu Cryomax, reported: Dongguan factory, a pregnant woman suffering from "a flow" coma in the hospital, the results lead to workers suspicions if it is infected with avian influenza. To this end, more than 800 workers in Dongguan sand town Futura plus appropriate connector 3 am collective out of business, require the manufacturer informed. Shatian Town multisectoral has intervened to mediate, require the manufacturer to fully assist the families to treat the patients, and take active steps to improve the company system, to resume production as soon as possible.

Pregnant women suffering from a stream caused a small panic

Recently, the Dongguan pregnant women suffering from the "avian flu" message factory in Dongguan sand town Futura and should, spread like wildfire. Yesterday morning, more than 800 workers gathered at the plant entrance, require the manufacturer to "explain" to inform pregnant women infected. Workers talking about a piece of paper medical records hanging in the heart so that the workers put down. According to Mr. families of patients with skin resume, pregnant women, Lee was diagnosed with severe influenza A (H1N1) infection.
"The doctor said the H1N1 flu, and now people are unconscious in an isolation room." Families of skin, said Mr. Lee in the Sha Tin FCIConnect connector (Dongguan) Co., Ltd. has more than 10 years. On March 20, the relatives of the symptoms of fever, the hospital, diagnosed as "a flow".

Although only a false alarm, but the workers still have concerns. Workers reflected the prevalence of avian influenza in poultry prices, the factory did not reduce the number of workers to eat poultry, but to attend a lecture to eat chicken. In addition to the anxiety of the avian flu, the workers also reflects the decrease in factory orders, reduced wages, reduced overtime...
http://news.ycwb.com/2013-05/04/content_4436681.htm

Pregnant women suffering from influenza A (H1N1) thousand workers worried about avian flu shutdown

2013 05 04
Incident Sha Tin City CDC says the flu can preventable and controllable, the public do not have to worry about

　　Dongguan time Reuters 8 o'clock yesterday morning, a factory in Sha Tin, a pregnant woman, surnamed Li in the hospital last week diagnosed with influenza A H1N1 influenza, panic, lay-off thousands of employees, require the manufacturer to improve management and to improve the food to avoid the occurrence of avian influenza. Yesterday, the Municipal Center for Disease Control said, H1N1 influenza is preventable and controllable, people do not have to worry about.

　　8 o'clock yesterday morning, the Sha Tin FCIConnect connector Limited, did not start as usual. The gate of the plant gathered nearly 1,000 workers, improve the management system, improve the cafeteria food, in order to avoid the risk of avian influenza.

　　According to one surnamed workers, the reason why the workers to cease, the one that most workers noon half-hour dinner time is too short, the fight card have to line up, just not enough. In addition, a pregnant woman surnamed Li factory last week by the hospital diagnosed as suffering from influenza A (H1N1), are still in hospital for treatment, it caused among the workers a lot of conjecture and worried.

　　Mr. Chen said, "Now we hear the flu scared, very worried about being infected, with our canteen food was not good, so I hope the manufacturer to improve."

　　The families of the pregnant woman, surnamed Li told reporters, "She has been treated in the hospital a week, although the common flu, but not much improvement, coupled with her contracting the disease in the factory, so everyone suspected cafeteria food is also normal. "

　　Yesterday, the company official Mr. Hou admitted that the plant does have imperfections in the management of the future will be gradually improved. The workers food standards and have been recorded in the factory make the appropriate countermeasures.

　　The reporter then see in Sha Tin aspects communications, the company's work stoppages, as well as the recent decrease in factory orders, lower wages, weekends do not give overtime pay and other reasons. Currently, Sha Tin multisectoral have been involved in mediation.

　　Expert

　　Influenza A (H1N1) controlled anti-

　　Suspended workers for fear of avian influenza has also caused the health sector is highly concerned about. Yesterday, the Municipal Center for Disease Control relevant responsible person said, H1N1 has been included within the scope of the monitoring and management of the common flu, is entirely preventable and controllable, workers worry about it is totally unnecessary. http://news.timedg.com/2013-05/04/content_13781450.htm

Three more Saudi coronavirus cases raise worries

Robert Roos  News Editor

May 3, 2013 (CIDRAP News) – Saudi Arabian officials and the World Health Organization (WHO) reported three more novel coronavirus (nCoV) cases today in the same area of Saudi Arabia as seven cases reported yesterday, raising worries about possible person-to-person transmission.

Saudi Arabia also revealed today that all 10 case-patients have or had underlying health conditions. That, along with yesterday's report that the seven patients were in the same hospital, suggested the possibility of a hospital cluster. Today's reports did not specify whether the three new case-patients are all in one hospital or in the same one as the earlier patients.

Ziad A. Memish, MD, Saudi Arabia's deputy minister for public health, reported that one of the three new patients is a 53-year-old woman who got sick Apr 27 and is in stable but critical condition.

The other two patients are a 50-year-old man and a 33-year-old man, both hospitalized but doing well, Memish reported via ProMED-mail, the online reporting service of the International Society for Infectious Diseases.

 The respective illness-onset dates for those two patients were Apr 30 and Apr 28.

Five of the seven case-patients reported yesterday died, and the other two are in critical condition.

The WHO said in a statement today that all three of the latest patients were in critical condition, contradicting Memish's report. The agency also said preliminary information was that at least two patients are from the same family, a detail not provided by Memish.

"The three patients are from the same location as reported" in yesterday's WHO statement on the seven earlier patients, the WHO said. The area is Al-Ahsa province in eastern Saudi Arabia.

Memish said no illnesses have been found in any healthcare workers exposed to the latest patients. Investigations of family contacts for three of the cases are to be completed May 4, and the rest will be done when authorities gain access, he added.

The new cases raise the global count of nCoV illnesses to 27, including 16 deaths, the WHO reported.

Memish's report reveals that 6 of the 10 latest case-patients are in their 50s. All seven patients reported yesterday have or had "multiple comorbidities," while the three newest patients are listed as having "comorbidity" or "comorbidities," he wrote. None of those conditions are specified.

Memish's report today described the seven cases reported yesterday as follows:

• A 50-year-old man, Apr 14 illness onset, died Apr 19
• A 24-year-old man, Apr 17 onset, in critical but stable condition
• An 87-year-old man, Apr 17 onset, died Apr 28
• A 58-year-old man, Apr 22 onset, in stable but critical condition
• A 94-year-old man, Apr 22 onset, died Apr 26
• A 56-year-old man, Apr 22 onset, died Apr 30
• A 56-year-old man, Apr 22 onset, died Apr 29

The age and gender profile of the latest 10 cases bears a strange resemblance to the mysterious pattern seen in H7N9 influenza cases in China: mostly older and male.

Neither Memish nor the WHO statement mentioned whether the patients had any exposure to animals. The source of nCoV remains a mystery, though some of the previous patients had visited farms before they got sick.

The ability of the virus to spread form person to person also remains unclear, though such transmission occurred in at least one previous family cluster, in the United Kingdom earlier this year.

Marion Koopmans, DVM, PhD, of the National Institute of Public Health and the Environment in the Netherlands told CIDRAP News via e-mail today, "All patients had multiple comorbidities, so were already in poor health. An earlier message stated that all patients were in the same hospital. Therefore, this may be a hospital cluster, as we have seen for SARS [severe acute respiratory syndrome], which then immediately would imply person to person transmission, unless some common exposure occurred (food? some medication?).

"However without more details, this is all speculative. What we need to know is dates of hospitalization versus onset of illness," she added. She is chief of virology in the institute's Laboratory for Infectious Diseases and Screening.

Michael T. Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, which publishes CIDRAP News, agreed that the available information suggests the possibility of a hospital cluster.

He said the comorbidities might be a general risk factor for getting infected and sick with the virus, or they could suggest a common exposure for all the patients. "Healthcare is surely one of the areas where people are there because of comorbidities," suggesting the possibility of common exposure to the virus in a healthcare setting, he said. "We look forward to getting more information from the Saudis.

"If it's healthcare-related, that obviously poses some real challenges, because healthcare played a very important role in accelerating the SARS situation in 2003," he said. "But we don't know that yet."

Osterholm also observed that the median age of the latest group of patients is 56, which is older than the median for the country. He said it's not clear whether that means older age is a risk factor for getting infected in the first place or for getting severely ill once infected.

"Based on what we see with comorbidities and age and all one hospital, it suggests there's some common exposure that's really important," he said. "If animals are not involved, the only likely sources are human. I think what this really is begging for is more transparency on the part of the Saudis."

The first known cases of nCoV occurred in a hospital cluster in Jordan in April 2012, though the illnesses were not identified as nCoV until much later in the year. The cluster included two confirmed cases and 11 probable ones, and 10 of the 13 people involved were healthcare workers, according to the WHO.

http://www.cidrap.umn.edu/cidrap/content/other/sars/news/may0313corona.html

Hanoi: Management of foreign visitors staying tight to prevent bird flu spread

05/04/2013 07:37:00,  To make good the prevention of influenza A (H1N1, H5N1, H7N9 ...) in humans, the Hanoi People's Committee has asked local authorities directing the veterinary facility, village health workers, community health volunteers coordinate closely monitoring the situation on avian diseases, plague cases in humans inspection requirements of accommodation establishments in the area to declare the full list of new entry of foreign guests, noted visitors from infected areas, made possible the exchange of information on the disease in poultry, humans, zoning, timely processing services. The city also requires "strict control of trade, movement of poultry; severely dealt with trade, movement of poultry of unknown origin" http://www.cand.com.vn/vi-VN/xahoi/2013/5/198017.cand

Announcing the H5N1 flu outbreak

05/04/2013 04:38

* Timely quell an outbreak

Creative 3.5, the Steering Committee on the prevention of disease and animal H.Binh Tan (Vinh Long) announced H5N1 avian influenza.

Earlier, on 28.4, 1,200 ducks flock of Nguyen Van Tam (The Hamlet live Ninh Thanh Loi commune, and district) was almost half dead patient. After receiving information, and relevant agencies to coordinate with local families destroyed whole flocks of ducks, and sent samples to be tested, the results were positive for H5N1 influenza.

* On 3.5, the information from the Center for Preventive Medicine Q.O Mon (Can Tho) said on 22.4, some chickens found dead, one household at KV School Hoa Lac P.Truong report with veterinary offices. The result of tests positive for influenza A (H5N1), veterinary force destroyed just the 869 chickens and disinfection in the outbreak, the area surrounding the enclosure organizing vaccination in outbreak the commune nearby. Center for Preventive Medicine in conjunction with district health centers to monitor the health of family members within 14 days with 21 days for adults and children under 15 years of age. So far, not locally generated new outbreak detection and patients not infected with influenza A (H5N1). http://www.thanhnien.com.vn/pages/20130504/cong-bo-o-dich-cum-h5n1.aspx

China declares war on "rumors electronic"

Friday, 03 - May -2013

Almatmrnt - China declares war on "rumors electronic"  announced by Chinese authorities of its intention to launch a war on what he described as "rumors electronic" that spread across the Internet, and that they were considered "ruined the credibility of the electronic media, and weakened the system of normal communication, and aroused hatred among the public. "  The Office of Internet Information, affiliated to the Chinese government, that "a minority of Internet users spread many rumors on the network, with some rumors distorting the reputation of others, images fabricated, and do some deliberately publish rumors, claiming that seek to help others, to dispel these rumors."  According to the Chinese news agency "Xinhua", in a report on Friday that the Government Office for Internet Information involved in the take "strict measures towards these distorted images, or spreading rumors online." and pointed out that the authorities security recently arrested at least 11 people, in a number of provinces, after accusing them of spreading "rumors electronic" about virus H7N9 virus that causes "bird flu", caused panic among Internet subscribers and locals.  As reported, "Xinhua that" the Information Office Internet has closed more than 20 account codes are small, used these people to spread rumors, Office has publicly quoted pledge to continue to take "strong approach", against rumors electronic, also announced rewards for mentors for "troublemakers" those rumors. CNN   http://www.almotamar.net/news/107654.htm

Beta2c Coronavirus Cluster In Al-Ahsa Grows To Ten

Recombinomics Commentary 18:00
May 3, 2013

 1:  59M symptoms [14 Apr 2013] died [19 Apr 2013].
 2:  24M symptoms [17 Apr 2013] ICU in critical but stable condition.
 3:  87M symptoms [17 Apr 2013] died [28 Apr 2013].
 4:  58M symptoms [22 Apr 2013] ICU in stable but critical condition.
 5:  94M symptoms [22 Apr 2013] died [26 Apr 2013].
 6:  56M symptoms [22 Apr 2013] died [30 Apr 2013].
 7:  56M symptoms [22 Apr 2013] died [29 Apr 2013].

 8:   53F  symptoms [27 Apr 2013] stable but critical condition
 9:   50M  symptoms [30 Apr 2013] with pneumonia inpatient ward.
10:  33M* symptoms [28 Apr 2013] Inpatient ward and doing well
 *Family contact of fatal case

The above summary of nCoV cases in Al Ahsa provided by Ziad A Memish to ProMED includes age, gender and disease onset dates which suggest multiple rounds of human to human transmission of the SARS-like  nCoV.

However, the relationship of the first nine cases to each other is unclear.  The 10th case is a relative of one of the fatal cases.  The first seven cases were in the WHO update, while the last three were listed in ProMed.  These three cases have a gap of at least five days with the prior cases, raising concerns that they represent a new and larger round of infections in cases not yet confirmed.
This cluster already includes five fatal cases and is likely to grow into the largest cluster of confirmed nCoV cases reported to date. 
More information on the relationships between the first 9 cases would be useful. 

Like the prior cases the above cases are predominantly adult males.

Media Link

Canada Travel Health Notice

2013-05-03
Since April 2012, cases of the novel (new) coronavirus have been identified in five countries: the United Kingdom, Jordan, Qatar, Saudi Arabia and the United Arab Emirates. Some of the infections have occurred in clusters – in a family in the United Kingdom, in a family in Saudi Arabia and among health workers in a hospital in Jordan. This suggests that the virus can spread between humans, however, there has been no sustained person-to-person transmission and the risk of contracting this infection is still considered to be very low.

For the latest updates on coronavirus including the total number of cases and deaths please visit the World Health Organization’s Global Alert and Response website.

Coronaviruses are the cause of the common cold but can also be the cause of more severe illnesses including Severe Acute Respiratory Syndrome (SARS). At this time, there is still more to learn about this novel coronavirus. All cases have experienced influenza-like illness including signs and symptoms of pneumonia which may include coughing, mucous, shortness of breath, malaise, chest pain and/or fever.

The World Health Organization continues to work with relevant ministries of health and other international partners to support investigations to gain a better understanding of the disease and its risks. There continues to be no travel restrictions as the risk to travellers remains very low.

http://www.phac-aspc.gc.ca/tmp-pmv/notices-avis/notices-avis-eng.php?id=108

Public Health Notice: H7N9 avian flu in China

3 May 2013
Information is reviewed on a regular basis and updated as required.

Why you should take note

The World Health Organization (WHO) confirmed a new type of avian influenza virus in humans identified as A(H7N9) in the People’s Republic of China. Not all cases develop severe pneumonia and breathing difficulties but most do, some resulting in death. Additional cases are expected. Official numbers are available here.

On April 24, the WHO confirmed the first case of the virus outside mainland China. The Taiwanese individual had worked in mainland China, which is where he was most likely infected. Risk to Canadians remains low.

Risk to Canadians

The avian influenza (H7N9) virus causing illness in people in China has not been identified in people or birds in Canada.

While emerging information suggests the possibility of some limited human-to-human transmission of this virus in China, there has been no evidence of ongoing human-to-human transmission. The risk to Canadians remains low.

While there is no risk of catching the flu virus by eating well-cooked affected poultry, Canada, in fact, does not import raw poultry or raw poultry products from China.

Canadians can help protect themselves and their fellow citizens from influenza in general by:

• Washing hands frequently;
• Covering coughs and sneezes;
• Keeping common surfaces clean; and
• Staying home when sick.

Travel information

While the Agency is not advising any travel restrictions related to this event at this time, aTravel Health Notice has been posted to provide advice to Canadian travellers. We will continue to monitor this situation very closely and advise Canadians as appropriate.

What the Public Health Agency of Canada is doing

The Public Health Agency is working closely with its national and international partners, including the World Health Organ.. 

http://www.phac-aspc.gc.ca/phn-asp/2013/h7n9-0403-eng.php

Novel coronavirus - Eastern Mediterranean (17): Saudi Arabia

 2013-05-03 11:27:27
Subject: PRO/AH/EDR> Novel coronavirus - Eastern Mediterranean (17): Saudi Arabia 
Archive Number: 20130503.1688355

NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN (17): SAUDI ARABIA
************************************************************
A ProMED-mail post
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In this report:
[1] Saudi Arabia - MOH report, 3 new cases, details
[2] Saudi Arabia - details on 7 cases reported 2 May 2013
[3] WHO update 2 May 2013

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[1] Saudi Arabia - MOH report, 3 new cases, details
Date: May 3, 2013, 7:16:49 AM EDT
From: Ziad Memish


Subject: Urgent update nCOV cluster KSA
------------- 
This is a preliminary update on the status as of a few minutes ago. Three further cases have been discovered from the investigation which is still ongoing:

Case 8: 53 y.o. female with comorbidities. Date of symptoms [27 Apr 2013] she is in stable but critical condition

Case 9: 50 y.o. male with comorbidity. Date of symptoms [30 Apr 2013] with pneumonia and he is well on the inpatient ward.

Case 10: 33 y.o. male with comorbidity. Family contact of a deceased patient. Date of symptoms [28 Apr 2013]. Inpatient in the medical ward and doing well.

As stated earlier our investigation of contacts and active screening of inpatients who fit case definition is ongoing.
--
Ziad A Memish,MD,FRCP(Can),FRCP(Edin),FRCP(Lond),FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia


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[2] Saudi Arabia - details on 7 cases reported 2 May 2013
Date: May 3, 2013, 5:15:28 AM EDT
From: Ziad Memish


Subject: Urgent update on nCOV from KSA
---------------- 
The following is the summary of the 7 reported cases confirmed microbiologically as of yesterday [2 May 2013]. Prior information was based on preliminary testing both to WHO and the press; we now confirm the following results. 

Case 1: 59 y.o. male with multiple comorbidities. Date of onset of symptoms [14 Apr 2013] and passed away [19 Apr 2013].
Case2: 24 y.o. male with multiple comorbidities. Date of symptoms [17 Apr 2013] and still in ICU in critical but stable condition.
Case 3: 87 y.o. male with multiple comorbidities. Date of symptoms [17 Apr 2013] and passed away [28 Apr 2013].
Case 4: 58 y.o. male with multiple comorbidities. Date of symptoms [22 Apr 2013] still in ICU in stable but critical condition.
Case 5: 94 y.o. male with multiple comorbidities. Date of symptoms [22 Apr 2013] and passed away [26 Apr 2013].
Case 6: 56 y.o. male with multiple comorbidities. Date of Symptoms [22 Apr 2013] and passed away [30 Apr 2013].
Case 7: 56 y.o. male with multiple comorbidities. Date of symptoms [22 Apr 2013] and passed away [29 Apr 2013]. 

As the NFP for KSA you should know that the investigations are ongoing and include both testing and epidemiology investigations of family members and healthcare workers. So far we have not found symptomatic infection in any healthcare workers linked to these cases. Family investigations for 3 families are to be completed tomorrow [4 May 2013]; the others will be done as we gain access. Sensitivities around grieving are of course an issue.

--
Ziad A Memish,MD,FRCP(Can),FRCP(Edin),FRCP(Lond),FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia

The survey shows that: the H7N9 avian influenza may be derived from a vegetable market

Kyodo News April 30 a special working group by the Chinese and international medical experts say the H7N9 avian flu studies have shown that this virus may be derived from the vegetable market rather than poultry farms.

    Chinese and foreign experts to come to this joint research results of the Chinese health authorities on Tuesday reported that, Fujian Province, and new cases of H7N9 cases, so that the total number of confirmed cases to 128 cases.

    This Task Force is composed by the veterinary and medical experts from the World Health Organization and the Chinese Ministry of Agriculture. Shanghai and other infected poultry markets and poultry farms on-site survey at the end of April.

    The report said that the task force had contact with staff was not discovered the H7N9 virus in poultry farms, farms and farms.

    Reported that the risk of human infection from handling poultry, vegetable market.

    Reported that the group had been unable to confirm the mode of transmission of the virus in the East, and urged Chinese health authorities continue to closely monitor the food market and other possible channels of infection.

    The study conducted by the Chinese Center for Disease Control showed that H7N9 infection is closely related to the poultry market.

    In a research report published in a U.S. medical journal, the CDC said, the majority of H7N9 patients in the poultry market come into contact with live chickens and other poultry, they are either vegetable market staff, or go there to buy things .

    Shanghai and other local authorities shut down the live poultry market, in order to curb the spread of the disease, 24 patients had died since the end of March reports first H7N9 cases.http://news.xinhuanet.com/2013-05/03/c_124659078.htm

China approved to respond to the H7N9 new drugs for influenza in critically ill patients

2013 on May 03, 2011 - 13:36
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National Health and Family Planning Commission released the information of human infection with the H7N9 avian influenza outbreak. April 17 to April 17, the new report two cases of confirmed cases of H7N9 avian influenza infection. 2 new cases are from Shanghai, is active treatment, all close contacts found no abnormalities. As at 17:00 on the 6th, the country reported a total of 18 confirmed cases, including 6 deaths. The cases were distributed in Shanghai (8 cases, death four cases), Jiangsu (6 cases), Anhui (1), Zhejiang (3 cases, 2 deaths) in 4 Provinces. Found no epidemiological link between the confirmed cases, all close contacts of the cases have been measures to be taken under medical observation, no abnormality is found. The present situation in the dissemination of state, have not yet found the person to person. 6, Shanghai, Nanjing, Hangzhou total suspension of live poultry trade.

In response to the epidemic, the State Food and Drug Administration for regulatory approval of the anti-influenza drug peramivir sodium chloride injection. This is a new type of antiviral drugs for influenza, the existing clinical trial data to prove its influenza A and B. H7N9 is a subtype of the influenza A virus. China is the approval of the United States, Japan, South Korea and a few other peramivir one of the countries listed. Peramivir sodium chloride injection is the first intravenous administration of neuraminidase inhibitors for those patients with severe influenza can not be treated with inhaled or oral neuraminidase inhibitors in patients with other neurological neuraminidase inhibitors poor efficacy or provide a new treatment option for patients resistant. Currently, as a neuraminidase inhibitor class of drugs, China approved the listing of the Austrian Secretary phosphate oseltamivir the tablets and zanamivir inhalation.

6 am, convened by the National Health and Family Planning Organization of human infection with the H7N9 avian flu defense associate....http://news.0898.net/n/2013/0503/c231184-18587248.html

Continental Ministry launched the project of H7N9 response

• 2013-05-03
 
• In the Canton News / Canton News]

    The mainland arranged by the Ministry of Science and Technology thirty million yuan of funds, launched a technological emergency prevention and control "Research Project" of human infection of H7N9 avian influenza, to strengthen scientific and technological response as.

    This technology and solutions for the project can be divided into six key tasks, including the implementation of nucleic acid detection reagents and vaccines, epidemiology and research on the origin of the H7N9 avian influenza, H7N9 avian influenza clinical characteristics and clinical treatment technology research, the H7N9 avian influenza animal model studies and so on.

    Mainland China Ministry of Science and Technology also stressed the need to closely cooperate actively with health, food and drug, agriculture, forestry and other related departments to strengthen research and development, testing, registration and other aspects of convergence with the strain sharing, information sharing, as well as the integration and sharing of clinical cases messages.

H1N1 can combine with other viruses: experts

Last Updated: Thursday, May 02, 2013 02:30:00

Students at the Lao Cai Ethnic Boarding High School, where 37 students were detected having H1N1-like symptoms, wear face masks to prevent H1N1 virus transmission

Influenza A (H1N1) has spread widely in Vietnam and worried health experts warn of the possibility that it can combine with other type of dangerous flu viruses and become a greater threat.

Tran Nhu Duong, deputy director of the National Institute of Hygiene and Epidemiology, said H1N1 has accounted for approximately 50 percent of flu cases in Vietnam so far this year as against just 7 percent during the same period last year.
Former Deputy Minister of Health Trinh Quan Huan said it was very “worrying” that the virus is able to continuously change and pose risks of combining with other viruses including bird flu (H5N1) to become another dangerous, highly infectious virus.
Vietnam has recorded dozens of H1N1 infections so far this year. Recent cases were reported in Lao Cai Province in the north, with 37 students from the Lao Cai Ethnic Boarding High School showing H1N1-like symptoms.
According to the province’s Center for Preventive Medicine, three samples sent to the National Institute of Hygiene and Epidemiology have tested positive for H1N1.
Doctors said Tuesday morning said all the cases in the school have recovered.
Lao Cai on April 27 had reported its first five human H1N1 cases this year in two families in Lang Tong Hamlet, Bat Xat District, which borders China.Doctor Nguyen Ba Hue, director of the Lao Cai General Hospital said the five patients have recovered and could be discharged on May 2.
Nguyen Van Suu, director of the Lao Cai Center for Preventive Medicine, toldThanh Nien that the province has yet to identify the source of the epidemic. But he said local authorities have set up a team to study the problem and initiate steps to prevent infections in the locality.
Two men, aged 23 and 46, from the northern province of Yen Bai and one girl, 12, from the north-central province of Thanh Hoa died last month of the virus.
H1N1 has infected more than 11,200 people in Vietnam since it broke out in 2009. It had claimed 70 lives by the end of 2011 before easing last year.http://www.thanhniennews.com/index/pages/20130502-h1n1-can-combine-with-other-viruses-experts.aspx

Russians Should Not Visit China - Top Public Health Official

MOSCOW, May 3 (RIA Novosti) - Russia’s chief public health official Gennady Onishchenko has recommended the country’s nationals not to visit China where a new strain of bird flu is spreading.

“Now there’s not need to ban [visits to China] but please do not go there if there is such a chance,” Onishchenko said on Echo Moskvy radio.

He said over 130 people are infected with H7N9 avian influenza in China, and 26 of them have died.

Onishchenko said in April that his consumer rights watchdog Rospotrebnadzor was considering restrictions on poultry meat imports from China.

http://en.rian.ru/russia/20130503/180959874/Russians-Should-Not-Visit-China---Top-Public-Health-Official.html

Eleven arrested in China for "create panic" with rumors of H7N9 bird flu

The arrests are part of what the Chinese government called "war on internet rumors" began last year when false information about an alleged coup circulated in China in Beijing.All of them were in police custody for several days for "making news on the internet about H7N9 infections that caused panic among some Internet users and local residents" , said the office, which regulates the content of the network in China. 

The arrests are part of what the Chinese government called "war on internet rumors" began last year when false information about an alleged coup circulated in China in Beijing , despite being one of the countries that exert greater control and censure those contained in the network of networks. 

"A very small part of Internet spreads rumors online various, sometimes slandering others photomontages," said a statement released yesterday, Thursday, by the official institution. 

The new H7N9 strain of bird flu so far has been diagnosed in 128 people (one in Taiwan, the rest in China), of which 27 have died, according to data from Chinese and Taiwanese authorities. 

The World Health Organization, which sent experts to China to study the disease, has warned against H7N9, which is considered one of the most lethal influenza viruses, although so far not spread among humans, only in people who have had contact with birds.http://www.latercera.com/noticia/mundo/2013/05/678-521624-9-once-detenidos-en-china-por-sembrar-panico-con-rumores-sobre-la-gripe-aviar-h7n9.shtml