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Wednesday, February 20, 2013

Eastern Syria, a new focus for the typhoid outbreak


 
Thousands in the province of Deir al-Zour get typhoid from drinking contaminated water, and the United Nations Forum organizes humanitarian Damascus.
 

Contaminated water ... Deadly diarrhea
Damascus - the World Health Organization said Tuesday that disease typhoid outbreak in the area controlled by the Syrian opposition because of consumption of contaminated drinking water from the Euphrates River.
The organization said the UN said an estimated 2,500 typhoid disease people in the northern province of Deir al-Zour in eastern Syria were contagious disease that causes diarrhea and can become fatal.
The representative of the World Health Organization in Syria Elizabeth Hoff telephone "there is not enough fuel or electricity to run pumps so people drink water from the Euphrates River, which has become polluted by sewage probably."
Not confirm the World Health Organization (WHO) reports of deaths so far due to injury typhoid.
And typhoid fever, an infection of the intestines and bloodstream caused by salmonella bacteria. And people get sick after eating special foods or drinks with an infected person or drinking contaminated water.
The spread of hepatitis C virus (a) is another disease transmitted by contaminated water and could become an epidemic in areas like Aleppo and Idlib and in crowded areas hosting the displaced in Damascus.
Hoff said, "This happens when you see the water and sanitation collapsed completely. Share of between 50 and 70 people in the toilets in many places of refuge in Damascus."
Hoff added that because of Deir al-Zour in the hands of the opposition, it can not Syrian government health authorities access to the region, but the World Health Organization adopted a local aid organizations to bring medical supplies.
"The people responsible (opposition) need to start taking action in areas they control."
Leishmania is spread - one of the causes of tropical diseases and is transmitted by sandflies and causes skin lesions resembling leprosy - in Syria and there are now 14 thousand cases in Hasaka province in the northeast of the country, according to the World Health Organization.
Huff said, "It very large number and spread with the movement of people. Locally displaced and brought from Aleppo to Tartus."
And hosts the United Nations Forum on humanitarian Syria in Geneva Tuesday attended by senior aid officials from UN agencies, the European Union and other humanitarian organizations.
He said UN spokesman Jens Erque at a news briefing on Tuesday that the Syrian government agreed to publish three other international organizations for assistance. And allowed eight international non-governmental organizations to work so far.
And attend Syria's ambassador to the United Nations in Geneva talks but opposition representatives usually not be invited.
And told Erque that Valerie Amos UN coordinator for humanitarian affairs, hosting the Forum met with Suheir Atassi, vice president of the National Coalition Syrian opposition Monday in the Swiss city.
"We meet with them like any other partner involved in humanitarian work in Syria. They discuss various issues related to humanitarian work in Syria."

Risk of new coronavirus infection unchanged: WHO

2013-02-21 00:31:40

GENEVA, Feb. 20 (Xinhua) -- A World Health Organization (WHO) spokesman said Wednesday that the risk of the novel coronavirus infection is unchanged but urged health authorities to remain vigilant as it is impossible to predict the future.
"We have not seen sustained human to human (h2h) transmission and three instances of limited h2h transmission do not necessarily mean that there will eventually be sustained h2h transmission," WHO spokesman Gregory Hartl said in a written interview with Xinhua.
Hartl said that it is impossible to predict the future so "we must remain vigilant."
"WHO has issued a case definition and clinical investigation guidance and these should be used by public health authorities to help them in their work," he said.
WHO updated its revised interim case definition of the new virus Tuesday and requested confirmed and probable cases to be reported to the organization within 24 hours.
The source of the infection is still unknown, said Hartl. He suggested that individuals should do what they would do in any case in coming across a person who is suffering from a cold or flu: practice social distancing.
Britain reported a confirmed case of the new coronavirus infection to WHO on Feb. 11, who had recently traveled to the Middle East and Pakistan. Two of his family members, who didn't travel to other countries recently, were later confirmed for infection.
WHO said the infections offered indications of person-to-person transmission, but "no sustained person-to-person transmission has been identified."
British Queen Elizabeth hospital in Birmingham confirmed on Tuesday that the second case in the family has died, bringing the death toll of the new virus to six. http://news.xinhuanet.com/english/world/2013-02/21/c_132181527.htm

The novel coronavirus Shenzhen rapid screening

The novel coronavirus Shenzhen rapid screening

Southern News reporters Wenting Wang Mu widely in the United Kingdom and the Middle East, a novel coronavirus similar to the SARS (SA RS) virus has killed six people. Shenzhen CDC yesterday revealed that the present, Shenzhen has the ability to preliminary detection of this virus, as well as hospital in unusual patients received, can the first time through the strengthening of unexplained pneumonia and influenza detection, specimens sent to the CDC for rapid detection.   This new type of coronavirus may cause serious respiratory problems, fever, cough and breathing difficulties, associated with renal failure symptoms in some patients. http://www.kaixian.tv/R1/n867046c7.shtml

THE CORONAVIRUS COULD BE THE 'NEXT BIG ONE'

..or maybe not! This is from a paper that sometimes has ebola stories. It has a buncha crazy stuff on it..

While alarming Big Issues like stray meteors unsuccessfully raining death on remote Russian villages and trigger-happy North Korean dictators might seem like the crises nudging us to the brink of catastrophe, there's always something less spectacular and arguably more dangerous rearing its head in the world of diseases and viruses. The most recent of those is a new strain of coronavirus, a deadly virus that gets its name from the crown-like spikes on its surface rather than an ill-advised sponsorship deal from a Mexican beer company.
This week, in the Queen Elizabeth Hospital in Birmingham, the "novel coronavirus" claimed its sixth victim worldwide. What’s more, over the past month, two more members of the victim’s family contracted the virus, leading scientists to suspect that this new infection can be transferred from human to human, which isn't the kind of news you want to hear about a deadly virus that could potentially kill everyone you know.
While medical authorities haven’t slammed down the panic button just yet, these developments could certainly raise the threat level, explained David Quammen, author of Spillover: Animal Infections and the Next Human Pandemic. “That rang alarm bells for obvious reasons,” he said, “because human-to-human transfer is one of the steps that a virus has to take if it’s going to turn into some sort of human pandemic.”
The novel coronavirus was first discovered last September, when a Qatari man travelled to London to receive medical attention for a mysterious illness. According to Quammen, it raised a red flag among experts from the outset. “There are certain families of viruses and groups of viruses that are on the watch list of special concern, because they have the potential to cause the next big outbreak, which might become an epidemic, which might even become a pandemic. The coronaviruses are on that list.”

David Quammen.
So far, only 12 confirmed cases of the novel coronavirus have been reported worldwide – a third of which were found in Britain. Similar to the SARS virus that plagued Asia a decade ago, the coronavirus is a respiratory disease that causes kidney problems, breathing difficulties and fever. So far, half of all reported cases have been fatal. More good news: a new study revealed the virus breeds in the human body faster than SARSand can evade the immune system as easily as the common cold. 
While medical authorities have made assurances that the virus currently poses a low risk to the general population, the truth is that – at this early stage – it’s impossible to determine exactly how dangerous it might be.
A spokesperson for the UK-based Health Protection Agency (HPA) explained: “With any of these sorts of new viruses, you don’t really know, because when you have such a small amount of cases, you think that it’s behaving in a certain way. But, of course, that could change. Viruses change quite frequently and sometimes suddenly a new one can emerge. But equally, one can slowly emerge over a long period of time with very small morphing. So it’s really very hard to say.”
But, whether this coronavirus ends with a whimper or a bang, scientists believe that it’s only a matter of time until a new potentially catastrophic global pandemic emerges. David Quammen explained, “What the experts say is that, first of all, yes, it is very likely that new diseases will continue to emerge. I talk about the 'Next Big One' – the NBO. It’s almost tautological that there will be a Next Big One. The question is: what will it be and how big will it be?”
New disease outbreaks are more common than you might assume. In the past few months alone, a strain ofcompletely drug-resistant TB has begun working its way through sub-Saharan Africa and the number ofincurable gonorrhea infections has risen significantly in the US. But more so than any of these other cases, the coronavirus has the potential to become a global problem.

Another pretty picture of the virus that can slowly kill you as your respiratory system shuts down.
“Experts say, ‘So, which groups of viruses fit [the NBO] category?’" said Quammen, "and one of the things they point to is the coronaviruses. So that’s why they’re very concerned, or at least very attentive to this novel coronavirus – because it fits right into the target zone of what the experts have been warning the next dangerous one would look like.”
While the anxious among us can take solace in the fact that improved medical technology and more efficient monitoring systems will undoubtedly help to stem the spread of the next big outbreak, modern advances can actually help, as well as hinder, the spread of a new virus. In fact, the very nature of our increasingly interconnected world means that conditions are perfect for a new virus to spread, like cold sores at the Oceana underage night.
“There are seven billion of us humans now, and we are very, very interconnected. We fly around the world, we ship products worldwide, everything is being transferred around the world very quickly,” Quammen explained. “So, if a new disease gets into us, it too will get transferred around the world very quickly. We’re like a forest of very dry trees and undergrowth, waiting to be hit by lightning.” 
Of course, with only a handful of cases so far, it would be highly premature to begin panicking over the latest outbreak of coronavirus. But that isn't to say that the Next Big One isn’t already on the horizon. And if it does strike, its impact could be dramatic.
“I think it’s reasonable to say that it could kill millions of people," Quammen told me. "Remember that the AIDS pandemic was something that we didn’t even imagine until the early 1980s, but it had been building over previous decades and, at this point, it has killed 33 million people and another 30 million are infected. So is it possible that something else would spill over into humans and either very quickly, or over a longer period of time, kill 33 million people? Yes, absolutely. Why not?”  http://www.vice.com/en_uk/read/the-coronavirus-could-be-the-next-big-one?

Although Well-Adapted To Humans, Novel Coronavirus Susceptible To Immunotherapy


The new coronavirus that has emerged in the Middle East is well-adapted to infecting humans but could potentially be treated with immunotherapy, according to a study published on February 19 in mBio®, the online open-access journal of the American Society for Microbiology. The study indicates that the virus HCoV-EMC can penetrate the lining of the passageways in the lung and evade the innate immune system as easily as a cold virus can, signs that HCoV-EMC is well-equipped for infecting human cells. The study also reveals that the virus is susceptible to treatment with interferons, comp...

New SARS-Like Virus is Well-Equipped for Infecting Humans



By Lisa Raffensperger | February 20, 2013 12:32 pm
A virus related to SARS has claimed its sixth victim, officials announced yesterday. A British man has died of the coronavirus, called HCoV-EMC, which was first identified last year. There have been a total of 12 cases of the coronavirus in the UK, Saudi Arabia and Jordan.
Now in a new study researchers have actually quantified the infection rate of the new virus. Results show that at a cellular level EMC is as efficient at infecting human cells as the common cold. Scientists isolated cells from the lining of three healthy people’s airways and cultured them in the lab, then introduced EMC, SARS, and a common cold virus to different groups of cells.
They found that EMC did indeed replicate in the airway cells (this tissue is especially vulnerable, which explains why infected individuals suffer respiratory problems). No detectable inflammation was produced, meaning that cells’ inbuilt immune defenses didn’t even see the virus, signalling that EMC is very effective at evading immune system defenses. However, its efficiency at causing disease is yet to be determined. Many coronaviruses are similarly good at infecting human cells—ie, getting inside them and replicating—but they cause only mild disease symptoms.
The research, published in the online journal mBio yesterday, shows the new coronavirus “grows very efficiently” in human cells, lead author Volker Thiel said in a press release. That suggests it is well-equipped for infecting humans despite its origins in animals. The virus’s closest relatives are bat coronaviruses, researchers said.
Importantly, the study also found that a class of proteins made naturally in the body’s immune response, called interferons, can reduce cells’ susceptibility to EMC. Interferons are already regularly used in treatment for cancer and hepatitis, and may hold promise in preventing the new virus from taking hold or treating it in infected individuals. http://blogs.discovermagazine.com/80beats/?p=43047&utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+DiscoverHealthMedicine+%28Discover+Health+%26+Medicine%29#.USUrzqVwe5I

SARS drug eyed for new peril



Mary Ann Benitez and Beatrice Siu
Thursday, February 21, 2013

A virus that attacks the respiratory system and which has emerged in the Middle East could be treated with a drug that worked during the SARS crisis 10 years ago.Twelve people are known to have fallen sick and six have died from the novel coronavirus - now referred to as NCov - since September last year.
The latest death was a 39-year-old British citizen. He was infected by his 60-year-old father, who was ill after travels in Saudi Arabia and Pakistan and remains in hospital. A young female in the family was infected but did not need hospital treatment.
Swiss researchers said NCov can penetrate the lining of breathing systems and evade the immune system like common cold coronaviruses.
This shows it "grows very efficiently" in human cells and suggests it is well equipped for infecting humans, said Volker Thiel of the Institute of Immunobiology at Kantonal Hospital, who led the study.
Malik Peiris, chair of virology of the University of Hong Kong's School of Public Health, said that was useful.
The researchers "showed in an artificial human cell culture that the virus replicates very well, and they also showed interferon can stop the viral replication," he said.
But it did not necessarily mean that the novel coronavirus could transmit efficiently from human to human.
Peiris noted that interferon was used to treat some SARS patients in Canada in 2003 and had been tried with success on macaques in laboratory experiments.
The head of the Chinese University of Hong Kong's division of respiratory medicine, David Hui Shu-cheong, also said the Swiss study did not "reflect infectivity" and more data is needed.
The Guangdong doctor who went to a Hong Kong hotel infected 16 tourists after staying one night in February 2003, he recalled. But the elderly Briton has only infected two family members with NCov.  http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=131274&sid=39026049&con_type=1&d_str=20130221&fc=4

Bird flu hits one million birds in state

LOCAL • 
One million 20 thousand chickens were infected and be killed, the health emergency has spread to two other municipalities, it is Juventino Rosas and San Luis de la Paz

The SARS outbreak source of civet cats still secret Sold


 February 20, 2013 (Epoch Times reporter Zhu Wen roundup) flu cases recently succession occurred in countries, "Ming Pao Daily News" reporter found that civet cats underground trading situation in Guangzhou10 years ago, testing out the wildlife civet cats carry the virus, SARS coronavirus S gene sequence is highly homologous to close all the wildlife markets to block out the source of the virus. Around the world work together to isolate ill, slowly control the SARS epidemic raging human life.

Guan Yi, a professor of the University of Hong Kong School of Public Health, said, "Although we can not ensure that SARS does not come back, but as long as control of the game market, does not allow different wildlife off the virus shuffle, I believe 100% easily large outbreak.".http://www.epochtimes.com/gb/13/2/20/n3804587.htm

Human-to-Human Spread of New Virus Lifts Threat to EU


By Simeon Bennett - Feb 20, 2013 6:09 AM ET

The appearance of a mild case of the disease caused by the virus also raises concern because it suggests more people may be infected than are known, have few or no symptoms, and are spreading the bug to others, the European Centre for Disease Prevention and Control said in a report late yesterday.
The new virus, which is related to the one that killed 774 people in the SARS outbreak of 2002 and 2003, is known to have infected 12 people in the past year, and half of them died. Ten of those infected either lived in or traveled to the Middle East, while two people diagnosed in the U.K. last week almost certainly contracted the bug from a family member who had traveled to Saudi Arabia and Pakistan, the ECDC said.
“The fact that an infection has come to Europe on a commercial flight and then resulted in two probable human-to- human transmission episodes has increased the threat,” the ECDC said in the report. “There is a lot more that we do not know than we know about this virus.”
The coronavirus can infect the lining of a person’s airways faster than the SARS bug, according to a study published yesterday, though researchers still don’t know how easy it is to transmit from person to person.
There’s no evidence so far of “SARS-like super-spreading events to date,” the ECDC said. Like H5N1 bird flu, the virus may have the potential to spread more widely, but not without acquiring multiple genetic changes, said Ian Jones, a professor of virology at the University of Reading in England.

Likely Outcome

“The most likely outcome for the current infections is a dead end, that is, the virus will become extinct locally,” Jones said in e-mailed comments distributed by the U.K.’s Science Media Centre.
Of the three recent cases in the the U.K., the first patient, a man, is still receiving treatment, while a male relative who had an underlying condition that may have made him susceptible to respiratory infections has died. A younger female relative, who was exposed to the original case while he was hospitalized, had mild flu-like symptoms and has recovered, the ECDC said. She is one of only two women infected so far, the agency said.
While the virus is related to the one responsible for SARS, it shouldn’t be described as SARS-like because the two pathogens are genetically distinct, the World Health Organization has said. Genetic evidence suggests the virus is most closely related to a coronavirus found in bats, the Geneva-based WHO said in November.
The earliest known cases are two hospital workers aged 25 and 45 in Jordan who died in April but weren’t found to have the coronavirus until samples were tested in November. A further nine less severe cases associated with the same hospital fit the WHO definition for the illness and haven’t yet been tested, the ECDC said in its report. http://www.bloomberg.com/news/2013-02-20/human-to-human-spread-of-new-virus-lifts-threat-to-eu.html

Tuesday, February 19, 2013

British man dies from novel coronavirus infection


British man dies from novel coronavirus infection

Feb 19, 2013 (CIDRAP News) – One patient in a British family cluster of novel coronavirus (NCoV) infections, a 38-year-old man with an underlying medical condition, has died, and fresh details about a recently reported mild case have sparked new questions about how the virus is spreading and how big a threat it poses.
The man died Feb 17 in the critical care unit at Queen Elizabeth Hospital Birmingham, where he had been undergoing treatment for a chronic health condition, the hospital said in a statement today. He was immunocompromised, and health officials believe he was exposed to NCoV by sustained close contact with a sick relative, a 60-year-old man who was hospitalized in Manchester shortly after traveling in Pakistan and Saudi Arabia.
He received extracorporeal membrane oxygenation (ECMO), a heart-lung-bypass procedure designed to allow disease-damaged lungs to heal. His death raises the number of fatalities from the new virus to 6 of the 12 cases reported so far.
Mild infection raises transmission questions
The UK Health Protection Agency (HPA) today released new information about the third patient in the family cluster, who has recovered from a milder version of the illnesses after more limited contact: visiting the older man in the hospital on three occasions. The third patient had no contact with the man who died and, according to a new risk assessment from the European Centre for Disease Control and Prevention (ECDC), is a 30-year-old woman.
Neither the woman nor the patient who died had a recent travel history, and HPA and ECDC officials have said both cases provide further evidence of person-to-person NCoV spread, but so far there is no sign of sustained transmission.
The woman's limited contact with the man who died raises the possibility of an intermediary case within the extended family, the HPA said. The ECDC also noted the limited time the woman spent with the older patient, which it said might point to an intermediary case or fomite spread. "However, the investigation and intensive case finding around the three cases remain ongoing and the results cannot be prejudged," the agency said.
Public health authorities are tracing the contacts of the family members, including people who sat within two rows of the older man on a flight from Saudi Arabia to London, during which he first felt ill. Follow-up is also underway on health workers, patients, family, and friends who were in contact with the patients in hospital settings.
Health officials reconsider threat assessments
John Watson, MB BS, MSC, the HPA's head of respiratory diseases, said in the statement that the routes of NCoV transmission haven't been fully determined, but the recent UK cases show strong evidence of human-to-human spread in some circumstances.
"The three recent cases in the UK represent an important opportunity to obtain more information about the characteristics of this infection in humans and risk factors for its acquisition, particularly in the light of the first ever recorded instance of apparently lower severity of illness in one of the cases," he said.
The risk of infection in contacts is still considered low, and the threat to the general UK population remains very low, the HPA said.
Meanwhile, the ECDC said recent developments with the three UK cases increase the threat to the European Union, because the infection came to Europe on a commercial flight and resulted in two more illnesses, though the cluster is isolated to one family.
Emergence of a mild secondary case, the first of its kind, is worrisome, because other mild illnesses that are missed during NCoV detection efforts could spread the infection, the ECDC said. More work is needed to flesh out the illness spectrum, such as whether it causes severe disease of uncommon zoonotic origin, as well as mild or even asymptomatic infections, it said in the risk assessment.
Also, the emergence of the mild illness and the possibility that surveillance will find more of them raises questions about whether new case-finding strategies are needed, the ECDC said, noting that it is reviewing the issue with its member countries and global health partners.
Though it's reassuring that health officials have found no expanding case clusters, "the fact remains that there is a lot more that we do not know than we know about this virus," the ECDC said, adding that discussions are underway to provide guidance on research priorities.
Study finds NCoV easily infects lung lining
In a related development today, a European research group reported that the NCoV easily penetrates human airway passages and evades the immune system like other coronaviruses, such as one responsible for the common cold. The findings were published today in mBio, the online journal of the American Society for Microbiology (ASM).
The team used cultured bronchial cells that were engineered to mimic the epithelial lining to explore how well the new virus could infect and multiply. Their findings suggest that the airway cells are highly susceptible to NCoV infection, and the virus multiplied faster than the SARS virus, another member of the coronavirus family.
Volker Thiel, a study coauthor with the Institute of Immunobiology at Kantonal Hospital in St. Gallen, Switzerland, said today in an ASM press release that though data suggest the virus may have jumped from animals to humans very recently, it is just as well-adapted to infecting the human respiratory tract as other more familiar coronaviruses, which was surprising.
The investigators suspected that the NCoV uses the same strategy as other common coronaviruses to evade the immune system, and they tested the notion by pretreating epithelial cells with lambda-type interferon to boost their immune response.
They reported that the treatment significantly reduced the number of infected cells, which is encouraging, given that interferons are promising for treating SARS and hepatitis C.
In another lab-related development, the World Health Organization (WHO) today issued updated interim recommendations for managing NCoV lab risks. The document includes epidemiological developments that have occurred since the last update on Oct 31.
The guidance urges labs conducting routine tests to follow biosafety level 2 (BSL 2) practices, that labs working with viral isolates from clinical samples use additional containment practices, including those recommended for BSL 3, and that work with animals infected with NCoV take place in an animal BSL 3 facility. http://www.cidrap.umn.edu/cidrap/content/other/news/feb1913coronabr.html

NCoV victim had cancer


Saudi bug kills

Mecca trip dad infected son with SARS

A MAN killed by a new SARS-like virus got it from his dad — who was infected while visiting Mecca to pray for his son’s cancer recovery.

Khalid Hussain, 38, died in intensive care on Sunday, the first UK victim of rare respiratory bug coronavirus.
He had been initially treated for cancer at Birmingham’s Queen Elizabeth Hospital.
It is believed his father flew to the Muslim holy city of Mecca to pray for his recovery. But while in Saudi Arabia he picked up the virus, passing it on to his son when he returned.
The dad was being treated for the virus in a Manchester hospital. A third man, also believed to be a family member, was in a London hospital with the bug. A family source said: “It’s a tragedy. They’re devastated.”
Khalid, of Rotherham, South Yorks, leaves a widow Azima, 38. In 2003 an outbreak of the flu-like SARS killed 775 worldwide.

Read more: http://www.thesun.co.uk/sol/homepage/news/4803501/First-British-victim-of-new-SARS-like-virus-dies-in-hopsital.html#ixzz2LOrRAvw0

No answer to SARS-like virus, doctors warn

No answer to SARS-like virus, doctors warn

Mary Ann Benitez
Wednesday, February 20, 2013

Using steroids to treat SARS was not only less effective, it made it worse and should not be used against the novel coronavirus, Chinese University of Hong Kong doctors said yesterday.
Ten years ago tomorrow, a Guangzhou doctor arrived in Hong Kong and inadvertently passed on the severe acute respiratory syndrome virus to fellow hotel guests, sparking the global spread of the disease.
But it was not until 23 doctors and medical students at Prince of Wales Hospital became ill that the danger was recognized.
The World Health Organization sent out a global alert on March 12, 2003, for the first time in more than a decade.
But with yet another SARS- like coronavirus infecting 12 people overseas, six of whom have died, the same Chinese University doctors who battled SARS said there is still no potential treatment or vaccine in sight.
"We are still a little bit behind on the treatment of coronaviruses," admitted Nelson Lee Lai-shun, head of CUHK's division of infectious diseases.
"What we do know is probably we should avoid using high- dose steroids very early on in the viral replication phase."
SARS hero CUHK vice chancellor and professor of medicine Joseph Sung Jao-yin said it is "unethical" to test the potential drugs in randomized clinical trials.
"Without trials, a lot of treatment is based on our experience," he said.
"So based on our experience, the important thing to remember is if steroids are to be used at all, they should be used at a later stage of the disease. They should [also] be used at a lower dose so that you will not stimulate the virus to proliferate more."
Lee added there is still no useful vaccine because of technical problems.
"The immune response has been difficult to handle," he said.
David Hui Shu-cheong, head of CUHK's division of respiratory medicine, said not much is known about the virus, including its exact source and route of infection.
The three described the SARS outbreak 10 years ago as a battlefield.
"To me it was a shock at the beginning that we were dealing with such a dangerous infection that we were totally unprepared [for]," Sung said.
The Chinese University will mark the 10th year anniversary of SARS on March 12 with a day- long conference where some of the major players during the outbreak - then deputy director of the Hospital Authority now Secretary for Food and Health Ko Wing-man, then secretary for health, food and welfare Yeoh Eng-kiong and former controller of the Centre for Health Protection Thomas Tsang Ho-fai - will provide insights into the disease that almost broke Hong Kong's health system.  http://www.thestandard.com.hk/news_detail.asp?we_cat=4&art_id=131210&sid=39012631&con_type=1&d_str=20130220&fc=4

Sars victim’s eight-day fight for life



Picture exclusive: Inside the critical care unit


Every medic who came into contact with the man wore protective masks, gowns and gloves – as did the patient’s three visitors
Picture exclusive: Inside the critical care unit
Edward Moss
This is the emergency unit where doctors battled in vain for eight days to save the Sars-like virus victim’s life.
The man, 39, had admitted himself to the Queen Elizabeth Hospital in Birmingham on February 9.
Within 24 hours he had fallen seriously ill and was transferred to the 100-bed critical care unit, which is the biggest in Europe.
Every medic who came into contact with the man wore protective masks, gowns and gloves – as did the patient’s three visitors.
The victim had already been an outpatient of the £545million hospital.
He was having treatment for a health problem unconnected to the illness that killed him.
The victim is thought to have caught the respiratory illness from his dad who is believed to have brought it back to the UK after picking it up during recent travels to Saudi Arabia and Pakistan.
The dad is still being treated in a Manchester hospital.
A third family member has also been struck down with novel coronavirus but has recovered well enough to be cared for at home in the West Midlands.
Bosses at the Queen Elizabeth Hospital in Birmingham said that the victim – who has not been named by officials – died on Sunday morning.
Pakistani schoolgirl Malala Yousafzai, 15, who was shot in the head by the Taliban, was discharged from the unit just 48 hours before the virus victim was admitted. http://www.mirror.co.uk/news/uk-news/sars-photo-critical-care-unit-1719235?

New coronavirus as adept at infecting human lung cells as common cold: study



Published on February 19, 2013 by    ·  

By Helen Branswell
THE CANADIAN PRESS
TORONTO — British authorities announced Tuesday that another person has died from infection with the new coronavirus as European scientists revealed the new virus easily infects the cells of the airways of the human lung.
In fact, the new coronavirus is as adept at infecting the cells of the upper airways as two cousin viruses — the one that caused SARS and one that causes common colds, the new study reported. All three are members of the coronavirus family.
Also on Tuesday, the World Health Organization tweaked its case definition for the new coronavirus, in what appears to be an attempt to ensure health officials don’t miss mild cases. That comes in the wake of the discovery of a mild infection in a British resident related to the person who just died.
The man who died — the sixth confirmed fatal infection with this virus — was part of a cluster of three cases in the U.K. Only one, the first diagnosed, had recently travelled abroad. He is believed to have been infected during his trip, which took him to Pakistan and Saudi Arabia.
The other two family members were infected in the U.K., the first time infections with this virus have been seen to have taken place outside the Middle East. They are the man who died and his female relative, who suffered only a mild illness and has since recovered.
Authorities believe the second and third cases in this family were infected via person-to-person transmission, but it appears there are still unanswered questions about the pattern of spread within this group.
“The second and third cases were infected through human-to-human transmission although the exact route of transmission is still under investigation by the U.K. authorities,” the European Centre for Disease Control said Tuesday in a risk assessment on the virus updated to account for the British cluster.
The ECDC statement noted, however, that follow up with approximately 200 health-care workers, family members and other contacts of cases in Europe and the Middle East have not found other instances of secondary spread.
“The (U.K.) Health Protection Agency … is undertaking intensive follow-up of close contacts of these three recent cases to determine if there have been any further mildly symptomatic or asymptomatic infections,” the ECDC statement said.
“Depending upon these findings, case-finding strategies may need to be reviewed, which ECDC is currently considering.”
The WHO seemed to be thinking the same thing, releasing late in the day an updated case definition that suggested probable cases could include people who have an acute respiratory illness but who don’t necessarily have a fever.
That may be an attempt to ensure that health officials don’t overlook mild cases in the search for infections that resemble the high profile ones that have killed half of the 12 confirmed cases and left at least two people in intensive care for weeks or months.
The new WHO case definition also drops a reference to the fact that probable cases should be people whose illness cannot be explained by another infection.
That change may have been prompted by the fact that the first man in this British cluster tested positive for both the new coronavirus and a seasonal flu virus. In some centres if the man’s flu test had come back positive before the coronavirus test was ordered, he might not have been spotted as a coronavirus case.
As health authorities scrambled to try to assess the risk of the new virus the new research findings suggest it is already well-adapted to being a human pathogen. The virus is called EMC — for Erasmus Medical Centre, the Dutch research facility which first identified it — by some people and NCoV, short for novel coronavirus, by others.
In the new study, Volker Thiel and colleagues tested the new virus in human bronchial cells, comparing the EMC virus with the SARS virus and a human coronavirus called 229E that causes colds. The paper was published in the journal mBio.
The cells were as susceptible to the EMC virus as to the other two and in fact, the new virus multiplied at a faster rate than the SARS virus did in the human cells.
Thiel is with the Institute of Immunobiology is at the Kantonal Hospital in St. Gallen, Switzerland. He also teaches at the University of Zurich. Other scientists on this project are with the University of Bonn Medical Centre, the Helmholtz Center for Infection Research in Braunschweig, Germany and Erasmus Medical Centre in Rotterdam, the Netherlands.
Thiel said the team was not surprised that the new virus could infect the airway cells — called epithelial cells. But the degree of susceptibility of the cells to the new virus was unexpected.
“We were a bit surprised that it can so easily infect those cells,” he said in a telephone interview.
“Usually you think that there is a so-called species barrier when an animal virus gets into a human population. But at least on the epithelium layer, we don’t see that.”
The new virus was first spotted last June, when a Saudi Arabian man died from an initially unidentified respiratory infection. Since then, cases have emerged sporadically — some singly, others in small groups. As well, testing on stored samples revealed two people who died in a mysterious respiratory outbreak in Jordan last April were infected with the EMC virus.
All of the infections appear to have a link to the Middle East, with Saudi Arabia, Jordan and Qatar being the three countries from which most cases have arisen.
The source of the new virus is still unknown. As such, there are many unanswered — and currently unanswerable — questions about how much of a risk the virus poses to people. No one can say at this point whether it will fade away, continue to trigger the occasional infection, or start to spread easily from person to person.
But the question of whether the virus would need to evolve more to gain the power to infect human lungs does seem to have been answered.
Still, Thiel cautioned that just because the virus can easily infect human lung cells doesn’t mean it has all the tools it would need to take off and spread widely among people.
“We have shown that the airway cells can easily be infected. But this does not mean that the virus can easily be transmitted,” he said. “I think this distinction is important.”
The research may have provided a clue in how to treat infections with the new virus. When the scientists treated the cells with interferons — signalling proteins that cells release to warn surrounding cells of the presence of an attacker — the number of infected cells was significantly reduced. Interferons are currently used in the treatment of several viral diseases.

New coronavirus has not yet appeared in Shenzhen


WHO has issued a warning, and asked members to guard against the spread of a novel coronavirus similar to the SARS SARS ". Reporter learned yesterday from the Municipal Center for Disease Control, Shenzhen monitoring system not yet discovered this new type of coronavirus.
This new virus may have interpersonal communication skills. The recent report in the UK from the same family, the third case of novel coronavirus infections, patients symptoms similar to mild respiratory disease, there is no danger. The first patients in this family had traveled to the Middle East and Pakistan tourism, with two other family members have no recent travel experiences, suggesting a novel coronavirus might have interpersonal communication skills.
It is understood that the beginning of last year, the world's first novel coronavirus infection cases of disease and death. New cases also make global novel coronavirus infections increased to 12 people, including five deaths, three deaths in Saudi Arabia, the other two cases in Jordan.
City Communicable Disease Prevention Branch main Renxie Xu introduced this virus and SARS (Severe Acute Respiratory Syndrome) virus belongs to the same family, is a new type of coronavirus. The usual symptoms of acute respiratory infection accompanied by acute renal failure. SARS is a contagious disease of the respiratory system caused by the infection of SARS coronavirus. Mainly through close air droplets, with fever, headache, muscle aches, fatigue, dry cough and sputum is the main clinical manifestations of severe respiratory distress may occur. Compared to the SARS, less understanding of the propagation characteristics of such a novel coronavirus.
The city is currently detected novel coronavirus by rapid nucleic acid detection methods.The city relying on hospitals and community health centers were established 30 influenza, unexplained pneumonia monitoring point, not yet monitored such novel coronavirus.
It is understood that such a novel coronavirus fatality rate has been close to 50%, and there is no vaccine and therapy. Experts suggest that can not be taken lightly, and should take precautions to guard against. Once input may be timely to start a similar response when SARS prevention strategy.
Municipal disease control experts have warned members of the public, have recently returned from the United Kingdom, Qatar and Saudi Arabia, there acute respiratory tract infection symptoms, you should go to the hospital, and doctors told recent experience abroad. http://szsb.sznews.com/html/2013-02/20/content_2380704.htm

After sixth patient dies, analysis of new coronavirus emerge


The new 'novel coronavirus,' NCoV, has claimed another life - bringing the death toll to six globally from a total known infection universe of 12 and setting in motion a greater analysis of the threat this SARS-like virus could pose.
The newly-emerged "novel coronavirus," known also as NCoV, has killed another victim and has driven the known number of total dead to six, loosely representing a known mortality rate of 50 percent - when looking at the 12 people known to be infected globally.
The latest death occurred in the United Kingdom, after a family of four was reported to have been infected after visiting the Middle East where the SARS-like NCoV virus is believed to have originated. The fatality represents the first NCoV-related death in the UK.
Given the historical severity and nature of SARS and the potential for this new coronavirus to pose a threat to human populations, the media have begun issuing more in-depth analysis of the NCoV virus.
On Tuesday, The Guardian issued a Q&A analysis of the NCoV threat, providing detail on what it is, how it operates, where it came from, and how dangerous it is currently.
Coronaviruses are particularly dangerous, as they utilize numerous proteins to help suppress early detection by the immune system, blocking the immune system's interferons from eliciting an early detection that would otherwise alert a healthy response from the body. This stealth mechanism allows the virus to replicate silently and to impact the lungs more deeply and dangerously than an influenza virus, which does not carry as many of these stealth proteins.
As the Toronto Star reported, NCoV is a very effective and disruptive virus, but it is challenged currently in spreading easily from person to person.
“The good news is this virus is not different to other coronaviruses in terms of its vulnerability to interferons,” Dr. Volker Thiel, of the Kantonal Hospital’s Institute of Immunology in Switzerland, said, according to the Toronto Star report. “Interferon treatment should work — to some extent, at least.”


Read more: http://www.digitaljournal.com/article/343897#ixzz2LOHkHLtQ

Revised interim case definition for reporting to WHO – novel coronavirus




Interim case definition as of 19 February 2013

Update



Based on additional information received since the original recommendations were published, WHO has updated its case definition for novel coronavirus. WHO will continue to review and revise guidance related to novel coronavirus as more information becomes available. 
Recommendations for surveillance are also being revised on the basis of additional information and will be posted as soon as possible.



Case definitions for reporting

Confirmed Case

A person with laboratory confirmation of infection with the novel coronavirus.



Probable Case
  • A person with an acute respiratory infection* with clinical, radiological, or histopathological evidence of pulmonary parenchymal disease (e.g. pneumonia or Acute Respiratory Distress Syndrome, (ARDS)); AND
  • no possibility of laboratory confirmation for novel coronavirus either because the patient or samples are not available for testing; AND
  • close contact** with a laboratory-confirmed case.


Reporting:

WHO requests that confirmed and probable cases be reported within 24 hours of being classified as such, through the regional Contact Point for International Health Regulations at the appropriate WHO Regional Office. 

______________

* This may include but is not limited to cases with a history of fever or measured fever.
 

** Close contact includes:

Canada-Novel coronavirus Travel Health Notice


Travel Health Notice

Updated: February 19, 2013
In fall 2012, a novel (new) coronavirus was identified in a small number of cases of persons who went to or came from Saudi Arabia, Qatar and Jordan.
A family cluster of three cases has recently been identified in the United Kingdom. The first case was confirmed in a resident of the United Kingdom with recent travel history to Pakistan and Saudi Arabia. Two additional cases from the same family have since been identified. They had no prior travel history. This suggests that these two new cases may have acquired the infection through human-to-human contact with the relative; however, the risk of contracting this infection is still considered to be very low. This brings the total number of confirmed coronavirus cases to 12, including five deaths.
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.

Recommendations

Consult a doctor, nurse or health care provider, or visit a travel health clinic at least six weeks before you travel...
  1.  http://www.phac-aspc.gc.ca/tmp-pmv/thn-csv/n-coronavirus-eng.php

Mild UK Beta Coronavirus Case Concerns



Recombinomics Commentary 22:30
February 19, 2013
On 5 February, an adult member of the same extended family of the two confirmed cases – who had not travelled abroad – developed an influenza-like illness. The illness remained mild, not requiring hospital admission, and there has been a full recovery. A sputum sample from this case was later confirmed to contain novel coronavirus. This case had limited exposure to the index case on three occasions while the latter was in hospital, and had no contact with the second case.

The limited contact that one of the cases had with the index case, however, leaves open the possibility of an intermediary case within the extended family.

The above comments are from a detailed description by the HPA of the four cases who were novel betacornavirus confirmed in the UK.  The other three cases had severe disease and were placed on life support (ECMO machines).  The first case (49M) developed symptoms whileperforming Umrah in Saudi Arabia in August.  Symptoms resolved after he returned to Qatar, but reappeared 2 weeks later and his condition deteriorate prior to transport to the UK by air ambulance.  He was placed on an ECMO machine and has been hospitalized for five months.  Contact health care workers developed mild symptoms and tested negative for the virus.

The second case (60M) also developed symptoms while performing Umrah in Saudi Arabia.  He returned to the UK via commercial airline and his condition deteriorated.  He was confirmed to be co-infected with the novel coronavirus as well as pandemic H1N1 (H1N1pdm09). He was also placed on an ECMO machine and remains hospitalized in critical condition.

The third case (38M) was the son of the index case and had contact at home and in the hospital.  He had no recent travel outside of the UK and developed symptoms.   He tested positive for the novel coronavirus, supporting import into the UK via his father's arrival via commercial airline, representing the first confirmed case due to import of the novel coronavirus.  He was also placed on life support (EMCO machine), but subsequently died.

The third family member (30F), described above, had limited contact with the index case and no contact with his son.  She also had no recent travel outside of the UK and represents the second example of a confirmed case infected by an imported virus.


She developed a mild case and was confirmed via testing of a sputum sample.  The testing of a sputum sample may explain why she is the first confirmed mild case.  The limited testing of mild cases has targeted nasal samples, which may have an undetectable level of viral RNA, leading to false negatives.

There have now been 12 confirmed cases.  Two were linked to symptomatic health care workers who tested negative.  However, eight of the remaining ten confirmed cases were linked to clusters with at least one additional confirmed case, raising concerns that the novel coronavirus is readily transmitted human to human, but confirmation remains depressed due to technical issues linked to lab confirmation.