Efficient Replication of the Novel Human Betacoronavirus EMC on Primary Human Epithelium Highlights Its Zoonotic Potential

1. Eveline Kindler^a, 
2. Hulda R. Jónsdóttir^a, 
3. Doreen Muth^b, 
4. Ole J. Hamming^c,
5. Rune Hartmann^c, 
6. Regulo Rodriguez^d, 
7. Robert Geffers^e,
8. Ron A. M. Fouchier^f, 
9. Christian Drosten^b, 
10. Marcel A. Müller^b,
11. Ronald Dijkman^a, 
12. Volker Thiel^a,g

+Author Affiliations

1. Institute of Immunobiology, Kantonal Hospital, St. Gallen, Switzerland^a;
2. Institute of Virology, University of Bonn Medical Center, Bonn, Germany^b;
3. Department of Molecular Biology and Genetics, Centre for Structural Biology, University of Aarhus, Aarhus, Denmark^c;
4. Institute of Pathology, Kantonal Hospital, St. Gallen, Switzerland^d;
5. Genome Analytics Group, Helmholtz Center for Infection Research, Braunschweig, Germany^e;
6. Viroscience Lab, Erasmus Medical Center, Rotterdam, The Netherlands^f;
7. Vetsuisse Faculty, University of Zürich, Zürich, Switzerland^g

1. Address correspondence to Ronald Dijkman, Ronald.Dijkman@kssg.ch, or Volker Thiel, Volker.Thiel@kssg.ch.

1. Editor Michael Buchmeier, University of California, Irvine

ABSTRACT

The recent emergence of a novel human coronavirus (HCoV-EMC) in the Middle East raised considerable concerns, as it is associated with severe acute pneumonia, renal failure, and fatal outcome and thus resembles the clinical presentation of severe acute respiratory syndrome (SARS) observed in 2002 and 2003. Like SARS-CoV, HCoV-EMC is of zoonotic origin and closely related to bat coronaviruses. The human airway epithelium (HAE) represents the entry point and primary target tissue for respiratory viruses and is highly relevant for assessing the zoonotic potential of emerging respiratory viruses, such as HCoV-EMC. Here, we show that pseudostratified HAE cultures derived from different donors are highly permissive to HCoV-EMC infection, and by using reverse transcription (RT)-PCR and RNAseq data, we experimentally determined the identity of seven HCoV-EMC subgenomic mRNAs. Although the HAE cells were readily responsive to type I and type III interferon (IFN), we observed neither a pronounced inflammatory cytokine nor any detectable IFN responses following HCoV-EMC, SARS-CoV, or HCoV-229E infection, suggesting that innate immune evasion mechanisms and putative IFN antagonists of HCoV-EMC are operational in the new host. Importantly, however, we demonstrate that both type I and type III IFN can efficiently reduce HCoV-EMC replication in HAE cultures, providing a possible treatment option in cases of suspected HCoV-EMC infection.

IMPORTANCE A novel human coronavirus, HCoV-EMC, has recently been described to be associated with severe respiratory tract infection and fatalities, similar to severe acute respiratory syndrome (SARS) observed during the 2002-2003 epidemic. Closely related coronaviruses replicate in bats, suggesting that, like SARS-CoV, HCoV-EMC is of zoonotic origin. Since the animal reservoir and circumstances of zoonotic transmission are yet elusive, it is critically important to assess potential species barriers of HCoV-EMC infection. An important first barrier against invading respiratory pathogens is the epithelium, representing the entry point and primary target tissue of respiratory viruses. We show that human bronchial epithelia are highly susceptible to HCoV-EMC infection. Furthermore, HCoV-EMC, like other coronaviruses, evades innate immune recognition, reflected by the lack of interferon and minimal inflammatory cytokine expression following infection. Importantly, type I and type III interferon treatment can efficiently reduce HCoV-EMC replication in the human airway epithelium, providing a possible avenue for treatment of emerging virus infections.

This Article

1. doi: 10.1128/​mBio.00611-1219 February 2013 mBio vol. 4no. 1 e00611-12

1. All Free via Open Access: OA
3. » Abstract
4. OA Importance
5. OA Figures
6. OA Full Text
7. OA PDF
8. http://mbio.asm.org/content/4/1/e00611-12

New deaths Department of Health to closely monitor overseas novel coronavirus caused severe respiratory disease

February 22, 2013

Department of Health (DH) today (February 22) is closely monitoring the health department reported to the World Health Organization (WHO) by the Kingdom of Saudi Arabia (Saudi) to add a new coronavirus infection deaths.

The patient was admitted to hospital on January 29, subsequently died on February 10. The case on February 18, after laboratory tests confirmed. Saudi health authorities are further investigating the cases.

The number of new cases around the world has confirmed infection novel coronavirus caused severe respiratory disease cases increased to thirteen (including seven deaths), six of which came from Saudi Arabia (including four deaths).

Department of Health spokesman said: "The response to the latest development, the Centre for Health Protection of the Department of Health will be more information to follow up cases to WHO and the health sector. Addition, the CHP will remain vigilant, continue to work with the WHO and overseas health departments work closely monitor the latest development of this new type of infectious disease. "

In addition, Hong Kong has been implemented to strengthen the monitoring of the measures of the new type of coronavirus, from today to further strengthen the monitoring of the laboratory tests of a new type of coronavirus.Required to undergo intensive treatment for unexplained pneumonia cases, cases of pneumonia, pneumonia group cases or cases of health care workers infected with pneumonia, regardless of their travel records, authorities the novel coronavirus constancy laboratory.

The spokesman said: "The CHP will continue with various public and private hospitals, medical practitioners and the airport set up monitoring mechanism to monitor any novel coronavirus caused severe respiratory disease suspected cases."

The spokesman stressed: "Hong Kong has found no cases of human infection with the virus."

The spokesman advised travelers to Hong Kong, such as from the countries affected by the new coronavirus and respiratory symptoms should wear a mask and seek medical attention to the doctors to report their travel history.  http://www.dh.gov.hk/tc_chi/press/2013/130222-2.html

Goats: potential carriers of the new coronavirus?

02/22/2013

A Saudi man sits next to his sheep at an animal market in Riyadh in December 2008. (Fahad Shadeed/Reuters)

Scientists still have no idea how people are getting infected by the novel coronavirus, or which animal might be spreading it to humans.

But yesterday, Eurosurveillance published a paper detailing the investigation of a Qatari patient who was treated in Germany in October and November. And it had this interesting tidbit:

"The patient owned a camel and goat farm and reported a large number of casual contacts (approx. 50 persons per day) on a regular basis. He remembered that before his disease onset some goats were ill and had fever. He did not have direct contact with the goats or any other animals especially falcons or bats, but said he had eaten goat meat. He also reported to have had contact with one of his animal caretakers who was ill with severe cough and was hospitalised."

Since April 2012, the virus has infected 13 people and killed seven — cases so far have been linked with Qatar, Jordan and Saudi Arabia.

Evidence strongly suggests the new coronavirus originated in bats — and since people don't tend to hang around bats too much, scientists are also considering the possibility that the virus is passing to an intermediary animal which, in turn, is infecting humans.

In a previous Eurosurveillance paper, we learned that one of the first known coronavirus patients spent time on a ranch where there were camels and sheep — although he apparently didn't contact them directly. 

But in this latest report, one detail leaps out: the sick goats. When it comes to zoonotic diseases, unusual animal illnesses or deaths can act as warning signs for human outbreaks. Case in point, avian flu: when there is a human infection, chances are there will also be a lot of dead chickens nearby.

Dr. Anthony Mounts, the WHO's technical lead on the novel coronavirus, said goats — and camels — are definitely among the animals investigators are poking and prodding in their search for the virus.

"We don't really know where this virus is lurking, what kind of animal it might be circulating in," he said. "But certainly, if you had a sick animal that someone had been exposed to, that would really raise a red flag."

But he points out that there are multiple routes a virus could take to get into people. Nipah virus, for example, is a bat virus that can infect pigs, which have caused human outbreaks in Malaysia and Singapore; but in Bangladesh, studies have suggested that people there are getting infected by drinking raw palm date juice collected in clay pots -- which fruit bats like to slurp from at night.

Aside from this latest Eurosurveillance report, Mounts said he is not aware of any other reports of unusual animal illnesses or deaths that might be linked to the novel coronavirus.

The goats — they "could just be a red herring," Mounts said. "It could be that there are different sources, different routes of transmission."   http://thestar.blogs.com/worlddaily/2013/02/goats-and-camels.html

Epidemiological update: additional case of severe lower respiratory tract disease associated with a novel coronavirus in Saudi Arabia

Epidemiological update: additional case of severe lower respiratory tract disease associated with a novel coronavirus in Saudi Arabia

22 Feb 2013

ECDC On 19 February 2013, the Ministry of Health in Saudi Arabia has informed the World Health Organization (WHO) about an additional confirmed case of novel coronavirus (NCoV) infection. The patient was admitted to hospital on 29 January 2013 and died on 10 February. An investigation by the Ministry of Health in Saudi Arabia is on-going. This case has been notified through the International Health Regulation (IHR) on 20 February 2013. Since April 2012, thirteen cases of NCoV have been confirmed, including seven deaths. In the United Kingdom, the Health Protection Agency (HPA) is actively investigating the recent family cluster of cases to identify the possible route of infection and detect any additional secondary cases. Active follow-up of contacts of the three confirmed cases of the family cluster have not detected additional confirmed secondary cases by 22 February 2013. On 19 February, in light of the NCoV family cluster in the United Kingdom, the European Centre for Disease Prevention and Control (ECDC) has updated its risk assessment. This 13th case reported from Saudi Arabia does not change the ECDC assessment of the situation. ECDC is closely monitoring the situation in collaboration with WHO and the European Member States. http://ecdc.europa.eu/en/press/news/Lists/News/ECDC_DispForm.aspx?List=32e43ee8-e230-4424-a783-85742124029a&ID=851&RootFolder=/en/press/news/Lists/News

Guizhou another bird flu death

Guizhou another bird flu death the Government to strengthen the prevention and control of infectious diseases

Feb 22, 2013 8:47 PM

 Guiyang, February 22 (Reporter Wang Chao Yang Qian) 22 afternoon, Guizhou Province, another human cases of avian influenza were due to disease progression, the Second People's Hospital of Guiyang rescue died. Guizhou Province did not report new human bird flu prevention and control work into the norm.

　　February 10, Guizhou Provincial Health Department Bulletin, Guiyang confirmed two cases of human infection of highly pathogenic avian influenza cases. Patients Shuai Peng months, female, 21 years old, February 2, transferred to Guizhou Provincial People's Hospital intensive care unit treatment. Patients Cai as a mountain, male, 31 years old, the February 3 disease drugs, self-serving healed, from 8 am to Guiyang City People's Hospital for treatment and later transferred to the hospital intensive care ward for treatment. February 10, after a review of detection of two respiratory specimens confirmed positive for human avian influenza virus H5N1 nucleic acid.According to the survey, case history of close contact with poultry.

　　Two of the patients, respectively, at 13 and 22 days after she died.On the 17th, in close contact with the two patients 110 close contacts all the lifting of medical observation, none of fever and other abnormal clinical manifestations. Far, Guizhou not received a report of a new outbreak of avian flu.

　　22, the Guizhou provinci.. http://www.chinanews.com/jk/2013/02-22/4589092.shtml

Guizhou, a male human bird flu patients died from

February 22, 2013 20:53:33
Source: Xinhua


　　Guiyang, Xinhua, February 22 (LI Jing Asia) Guizhou recently confirmed two human cases of avian flu patients, female patients died on the 13th, another male patient died on the 22nd death.

　　Reporter learned from the Guizhou Provincial Health Department, 31-year-old male patient Cai, before his death in Guiyang City, a KTV waitress, February 3rd onset to Guiyang Jinyang hospital on the 8th, the 10th, the expert group confirmed human infected with the highly pathogenic avian influenza. At 16:40 on the 22nd, due to multiple organ failure, died in the hospital of Jinyang death.

　　It is understood that the two patients were alive with birds history of close contact, and are at ..
http://big5.xinhuanet.com/gate/big5/..._114772091.htm

WHO: Risk of new coronavirus infection remains unchanged

Posted on February 22, 2013, Friday

Read more: http://www.theborneopost.com/2013/02/22/who-risk-of-new-coronavirus-infection-remains-unchanged/#ixzz2LaHxkZmeA World Health Organisation (WHO) spokesman said the risk of the novel coronavirus infection remains unchanged but urged health authorities to remain vigilant, Xinhua news agency reported.

“We have not seen sustained human to human (h2h) transmission and three instances of limited h2h transmission do not necessarily mean there will eventually be sustained h2h transmission,” said spokesman Gregory Hartl said.

Read more: http://www.theborneopost.com/2013/02/22/who-risk-of-new-coronavirus-infection-remains-unchanged/#ixzz2LaHmoRzu

Vietnam MOH has officially launched the warning about corona virus

Can be cured by a new virus like SARS

Friday, 22/02/2013 07:12

ANTD - Department of Health - Ministry of Health has officially launched the warning about severe acute respiratory disease caused by the corona virus. 

TS. Tran Thanh Duong, Deputy Director, Department of Preventive Medicine, said up to this point in our country has not detected any cases of coronaviruses, a dangerous virus like SARS.However, the risk of epidemic spread and actively prevent the pandemic virus in Vietnam, the Ministry of Health has written proposal to strengthen the international medical quarantine at borders to detect and isolate suspected cases of coronavirus infection. PhD. Tran Thanh Duong said, as notified by the World Health Organization (WHO), from  22-9-2012 to 16-2, the world has recorded 12 cases positive for the corona virus, which has 5 deaths in Saudi Arabia, Jordan and the United Kingdom. 15-2, in the UK confirmed one case of new infections and to determine the corona virus is spread from person to person (family has had 2 previous coronavirus infections). 

According to Yang, the health sector in Vietnam was able to test samples to find out what kind of new virus. If corona virus-infected patients, the health of our country is completely curable.  

http://www.anninhthudo.vn/Khoe-dep/Co-the-chua-duoc-benh-do-virus-moi-giong-SARS/486939.antd

»

«

Bartan appeared to avian influenza in emerging Valley Governorate

22-02-2013 - 12:58 AM

Dr Mohammed Bashir, Director General of Veterinary Medicine in the New Valley that when the passage of commissions of inquiry for bird flu Educational household Baforeigp committees suspected that there are symptoms of avian influenza.

The Directorate took samples from infected birds and sent on the same day to the laboratory reference for controlling the production of poultry in Cairo and will be held on 19.02.2013 and emerged as a result lab positive disease and was immediately assigned committees of doctors Veterinary Department Baforeigp to get rid of birds remaining execute her to cleanse the place with disinfectant was notified Directorate of Health Affairs for the detection of contacts of these birds and take samples of nearby houses to be sent to labs for testing where Bartan appeared to bird flu in emerging Valley Governorate.

Today, the launch of the Department of Veterinary Medicine in New Valley Governorate to Agraeamlah cleansing and elimination of the disease to prevent its spread.

http://onaeg.com/?p=611791

Saudi Arabia reports to WHO another death of confirmed new coronavirus infection

GENEVA, Feb. 21 (Xinhua) -- The Ministry of Health in Saudi Arabia has informed the World Health Organization (WHO) of another death of confirmed infection with the novel coronavirus, WHO announced Thursday evening.

The patient was hospitalized on Jan. 29 and died on Feb. 10. Further investigation into this case is ongoing, WHO said in its latest disease outbreak update.

To date, WHO has been informed of a total of 13 confirmed cases of human infection with the new coronavirus, including seven deaths.

In Britain, where three family members had been confirmed with new coronavirus infection and one of them died, the Health Protection Agency continued to carry out investigations, WHO said.

In a newly-published article in American online journal mBio, researchers in the cantonal hospital in St. Gallen, Switzerland said that the novel coronavirus can reach its peak ability to replicate in two days, compared with as much as four days for the SARS virus.

WHO spokesman Gregory Hartl told Xinhua Thursday that the speed of replication of the virus is not related with its actual ability to spread.

He also reiterated that a comparison between the new virus and SARS virus is "not helpful".

He said that the novel coronavirus which we are seeing now is different genetically from SARS, it does not transmit as easily as SARS did, there are many fewer cases for the time-being of this novel coronavirus, and it causes a different spectrum of disease in some patients.

"So the two viruses are not the same," he said.

"We prefer to say that the two viruses are from the same family of coronaviruses, but that is where comparisons stop," he said.

Hartl said on 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.

WHO continues to closely monitor the situation, it said in the update.  http://news.xinhuanet.com/english/world/2013-02/22/c_132183971.htm

Canada-Statement from Dr. Arlene King, Chief Medical Officer of Health

Novel Coronavirus

Statement from Dr. Arlene King, Chief Medical Officer of Health

February 21, 2013 6:00 pm

Ministry of Health and Long-Term Care

The Ministry of Health and Long-Term Care, in collaboration with Public Health Ontario (PHO) and the Public Health Agency of Canada (PHAC), is closely monitoring the small number of cases of novel (or new) coronavirus reported globally.

To date, there have been no cases of novel coronavirus detected in Ontario or Canada and the risk to Ontarians of contracting this virus remains very low.

Although the majority of cases identified are in individuals who have travelled to or reside in Saudi Arabia, Jordan or Qatar, two recent cases in the United Kingdom appear to have acquired the virus through contact with a relative with recent travel history to Pakistan and Saudi Arabia.

While the recent cases identified in the United Kingdom suggest evidence of person-to-person transmission, no sustained transmission has been identified.

No special travel restrictions have been implemented and Ontarians are advised to follow normal precautions to protect themselves and others from the spread of germs and influenza like illness, including: frequent hand washing, proper cough and sneeze etiquette and up-to-date immunizations.

Coronaviruses are common and are typically associated with mild upper respiratory illness, such as the common cold. Although rare, some strains of coronaviruses produce more severe illnesses, and could cause death.

The Ministry of Health and Long-Term Care will continue to work with our health partners to monitor this issue and will continue to share any further advice or updates with health professionals and the public.

To keep informed on any new developments, please visit Information for Health Workers regularly for updates.  

http://news.ontario.ca/mohltc/en/2013/02/novel-coronavirus.html

Shenzhen Ports to strengthen monitoring of novel coronavirus

Ports to strengthen monitoring of novel coronavirus Luo Jielin

[Shenzhen Economic Daily News】 (the reporter Luo Jielin) World Health Organization urged members on 16 February, a novel coronavirus dissemination wary of a similar "SARS SARS virus. Yesterday, the reporter from the Shenzhen Inspection and Quarantine Bureau was informed that the council has to strengthen port quarantine to prevent the input risk. Strengthen the focus on inbound travelers and quarantine monitoring. Various ports focus on strengthening the body temperature monitoring and medical inspections of travelers from the relevant countries and regions, found at the scene and take the initiative to declare fever, headache, cough and other symptoms of travelers, targeted to carry out medical investigation and, once found suspicious outbreaks of infectious diseases, to take timely corresponding quarantine measures. Strengthen the response to the outbreak of the technical reserves. Do a good job of the crossings body temperature testing equipment operation, protective equipment and health treatment 药械 reserves of the check, to ensure that the the ports all quarantine equipment, facilities worked well, full of personal protective equipment, emergency supplies, disinfection 药械 reserve. At the same time, the laboratory do virus detection preparations. According to statistics, this year January 1-February 16, 2011, the Shenzhen Port quarantine immigration officers 14 million people and found 157 cases of infectious diseases, and have not yet found similar cases. Shenzhen Inspection and Quarantine Bureau to remind travelers that will travel to the countries and regions in the near future to do personal protection, Once symptoms should seek medical care immediately. Travelers from countries and regions, if they run a fever, headache and other symptoms, and entry to the inspection and quarantine authorities should take the initiative oral declaration after entering the above symptoms should seek medical care immediately to the doctor to explain the recent history of travel, in order to receive timely diagnosis and treatment .  http://szsb.sznews.com/html/2013-02/22/content_2382970.htm

Infectious Disease Chief at NIH Tackles New, Deadly Virus

5:23 PM, Feb 21, 2013

BETHESDA, Md. (WUSA9)-- "When you look at it under a sharp microscope, it looks like it has these very sharp spokes around it, like the spikes of a crown. So it IS called a coronavirus." 

Dr. Anthony Fauci, director of the National Institute for Allergy and Infectious Diseases is talking about a newly identified virus in the coronavirus family, which also encompasses the deadly SARS virus and some strains that cause the common cold.  So far, 13 cases of the new virus have been confirmed in Saudi Arabia, Qatar, and the UK.

Dr. Fauci says this brand new coronavirus seems to have come from bats, and the first human case emerged in the Middle East last summer.

Dr. Fauci says, "They developed a severe pneumonia and died. Nobody made anything of it because they didn't know what it was."

But subsequent testing of lung tissues revealed a brand new virus in the same family as SARS, the frightening respiratory infection that killed hundreds back in 2003, especially in Asia.  But Dr. Fauci says this new coronavirus is very different from SARS, in that it doesn't seem to spread easily from person to person.  During the SARS pandemic of 2002-2003,  there were 8,273 cases and 775 deaths worldwide.

Dr. Fauci says one cluster of cases involving the new coronavirus were family members of a person from the UK who traveled to Saudi Arabia and Pakistan and apparently brought the virus back.

So while he does not consider the new infection a threat in the U-S right now, Dr. Fauci says doctors in international cities like Washington, D.C. need to be on the lookout. 

"Particularly people who are travelling from those countries in the Middle East and come up with a respiratory infection that leads to pneumonia, you want to look for that particular virus. Because now we've identified that virus; we know what it is," says Dr. Fauci.  http://www.wusa9.com/news/article/244657/28/Infectious-Disease-Chief-at-NIH-Tackles-New-Deadly-Virus

Fresh fears as seventh death recorded in SARS-like virus

The World Health Organisation (WHO) said on Thursday the patient died on Feb. 10, two weeks after entering hospital. The cause of death was confirmed by a laboratory test three days ago...
http://www.independent.ie/world-news/middle-east/fresh-fears-as-seventh-death-recorded-in-sarslike-virus-29086861.html

Egypt-owners chickens infected with bird flu, demanding anti-virus in the New Valley

After the emergence of bird flu virus in بؤرتين in emerging New Valley Governorate, where انتابت state of panic and fear family members focus first area Alakeclaq Marine, a family of late Ahmed Marzouk Ahmed, a student citizen Marzouk Ahmed Marzouk owner infected chicken birds Balbarh first located area Alakeclaq Marine in emerging New Valley Governorate,

Asked officials to maintain fast intervention; to conduct business fortifications preventive to prevent an outbreak of bird flu in the province, where it came today vaccination teams veterinary, and have executed all birds at home and neighboring houses two more for us, and I ask the concerned authorities to maintain a work immunization and spraying preventive range of more than 500 meters , so to prevent any chance of the disease again in the city and beyond.
  stressed "Marzouk" It was executed more than 35 chickens infected Bashh located in the garden of the house, and tells "Marzouk" the beginning of the discovery of the disease two days ago has been the discovery of a dead chickens among birds, This past Tuesday, so we will immediately inform the Directorate of Veterinary Medicine in outflows, which came to the home garden, and took samples from the dead chickens and the neighborhood, to be sent to the central laboratory of Veterinary Medicine of the Ministry of Agriculture in Cairo, which reported this afternoon that there bird flu virus in the samples, and came this evening vaccination teams to the home area Alakeclaq sea, and have executed all birds Bashh own, has confused or fear and panic family members after their knowledge the existence of the disease in nests own garden house, where we live more than 3 families inside the house, this has not issued any statements or data from the Directorate of Veterinary Medicine, New Valley truth about the prevalence and spread of the bird flu virus in New Valley.

http://dostor.org/%D9%85%D8%AD%D8%A7%D9%81%D8%B8%D8%A7%D8%AA/149793-%D8%A3%D8%B5%D8%AD%D8%A7%D8%A8-%D8%A7%D9%84%D8%AF%D8%AC%D8%A7%D8%AC-%D8%A7%D9%84%D9%85%D8%B5%D8%A7%D8%A8-%D8%A8%D8%A7%D9%86%D9%81%D9%84%D9%88%D8%A7%D9%86%D8%B2%D8%A7-%D8%A7%D9%84%D8%B7%D9%8A%D9%88%D8%B1-%D9%8A%D8%B7%D8%A7%D9%84%D8%A8%D9%88%D9%86-%D8%A8%D9%85%D9%83%D8%A7%D9%81%D8%AD%D8%A9-%D8%A7%D9%84%D9%81%D9%8A%D8%B1%D9%88%D8%B3-%D8%A8%D8%A7%D9%84%D9%88%D8%A7%D8%AF%D9%8A-%D8%A7%D9%84%D8%AC%D8%AF%D9%8A%D8%AF

Saudi Arabia reports new coronavirus case; UK wonders about 4th case in cluster

By: Helen Branswell, The Canadian Press

TORONTO - Saudi Arabia has discovered another infection with the novel coronavirus, the World Health Organization announced Thursday.

The infected person was hospitalized in late January and died on Feb. 10, but confirmation of the infection was only made Feb. 18, the WHO said in a statement. Further investigation of the new case is underway.

The Geneva-based agency urged countries to consider testing for the new virus when patients present for care with unexplained pneumonias or when patients with severe, progressive or complicated respiratory illnesses don't respond to treatment — especially if those patients have recently travelled to or come from parts of the world where infections have occurred.

To date, cases have been linked to three countries in the Middle East — Saudi Arabia, Qatar and Jordan.

The new case is the 13th confirmed infection and seventh death caused by the new coronavirus, which the WHO is calling NCoV.

In addition, there are nearly a dozen cases the WHO considers "probable" infections — people who were exposed to cases and who later became sick but who were not tested or weren't tested in time. If an infected person had recovered from the illness, current tests — which look for virus DNA in mucus — would not find evidence of infection.

Some laboratories are working to develop a blood test that will detect antibodies to the virus. Once blood tests are available it should be possible to figure out whether some of the probable cases were actually infected.

One instance where such a tool would be useful involves the current cluster of NCoV cases in Britain.

A man who had recently travelled to Pakistan and Saudi Arabia became severely ill after his return. He tested positive for the virus, as did two other members of his family who had not travelled abroad. But a fourth infection may have also occurred in that family.

Health officials investigating how the virus moved from one member of the family to the next suspect another relative may have contracted the virus and may even have spread it to the third confirmed case in the cluster.

This fourth family member had a respiratory illness but was not tested until after she recovered, at which point the test came back negative, said Dr. Anthony Mounts, the WHO's point person for the outbreak.

Mounts said the U.K. cluster adds slightly to the agency's concern over the virus. But he said in the main British cases confirm some things the organization has already strongly suspected — in some circumstances, person-to-person spread can occur. However so far, it appears those chains of infection has been short.

And while the first few cases were all severe, some infections produce only mild symptoms.

The third confirmed case in this cluster had mild symptoms and has since recovered. "The fact that she had such a mild illness really does raise our concerns about what we might be missing," Mounts admitted.

The WHO revised its new coronavirus case definition this week to remind doctors not to automatically rule out people with mild symptoms when they look for possible cases.

Mild infections are a mixed blessing. Obviously everyone would hope the virus didn't always cause severe disease. But people suffering only mild infections may be more likely to spread the virus — if the virus transmits easily.

That's because people sick enough to be in hospital ICUs mainly encounter health-care workers protected by masks, but people with mild respiratory infections generally go about their daily life. And mild infections are much harder to spot, especially when they occur during cold and flu season.

Others share the WHO's concern about the possibility of missed cases. In fact, several of the researchers who were key players in the response to the 2002-2003 SARS epidemic admit the patterns they are seeing bring back memories.

"It is certainly beginning to look concerning, given the obvious fact that there can be onward transmission," said Malik Peiris, chair of the department of microbiology at the University of Hong Kong.

"It is somewhat reminiscent of the emergence of SARS in 2002."

Ron Fouchier, a virologist at Erasmus Medical Centre in Rotterdam, the Netherlands, also sees those similarities.

Fouchier is concerned about how many infections may be going unnoticed, untested or unreported. He noted that several of the 13 confirmed cases were diagnosed in European hospitals.

In addition to the current cluster in Britain, one case from Qatar was diagnosed in Britain in September and a second from Qatar was diagnosed in Germany in October. Both men got sick in Qatar but left the country for treatment — a practice which is not uncommon for wealthy residents of Middle Eastern countries.

"The fact that we are finding these cases in Europe and not anywhere else, that has to raise suspicion," Fouchier says. "What we're seeing in Europe is just the tip of the iceberg and we really have no clue how big the iceberg is."

Saudi Arabia has now reported six cases. Qatar has had the two confirmed cases. And Jordan has reported two cases, but the confirmations came months after the two individuals died, after falling ill last April.

Mounts said the WHO is trying to get countries to look harder for the virus. "We're concerned and really watching it very closely and trying to push people to do more investigation."

He also said the organization is putting together networks of experts to help it with the coronavirus situation — an approach the WHO used with much success during the SARS outbreak.

A laboratory network and a network of expert epidemiologists — sometimes called disease detectives — are being set up. As well, a group of clinical experts who have advised the WHO over the past decade on possible treatments for H5N1 — bird flu — and during the 2009 H1N1 pandemic is being reactivated to help with this situation, Mounts said.  http://www.winnipegfreepress.com/world/there-may-have-been-a-fourth-case-in-uk-coronavirus-family-cluster-who--192256741.html

NEPAL-Country has witnessed 38 outbreaks in the last four years

 2013-02-21 10:12 PM
KATHMANDU: Bird flu outbreaks have killed 70,000 chickens worth Rs 29.4 million since 2008. The country has witnessed 38 outbreaks in the last four years. 

Bird flu has severely affected the country’s poultry farming, said spokesperson of the Directorate of Animal Health Dr Narayan Ghimire. “There have been over three dozen outbreaks in the last four years which have directly affected farmers,” he said, adding that chicken, eggs and feeds worth millions of rupees have been destroyed so far. 

According to Ghimire, bird flu has displaced farmers from the business. “Bird flu has been creating havoc among poultry farmers and hundreds have already quit the business,” he said. This trend has been creating chicken shortage in the market and its price has climbed to an all time high of Rs 280 a kg in the wholesale market and Rs 300 per kg in the retail market. The department’s report reveals that bird flu has affected all corners of the country. The first case was reported in Jhapa in 2008; followed by Pokhara, Banke, Kailali, Dang and Tanahu in 2009; and Kathmandu, Jhapa, Ilam, Panchthar, Bhaktapur, Lalitpur and Chitwan in 2010. Recent outbreaks have been reported since November, 2012, in Pokhara, Kathmandu, Bhaktapur and Nuwakot. Repeated bird flu outbreaks have been noticed in Jhapa, Kathmandu, Bhaktapur and Pokhara, said Ghimire. 

The department has suspected vaccines, feeds and other equipment used in poultry farms to be carriers of the bird flu virus — H5N1. Vaccines, feeds and equipment may be carriers of the virus, but we cannot inspect them, said a veterinary doctor. According to him, the Department of Drug Administration has the right under the Drug Act but its focus is only on public health, he said. 

Veterinarians have sought inspection rights to control bird flu. “If we are authorised to inspect drugs and other equipment used in chicken, it will help us control further outbreaks,” he said. http://www.thehimalayantimes.com/fullNews.php?headline=Bird+flu+kills+chickens+worth+Rs+29.4+million&NewsID=366841

U.S. Announces More New Rules for Potentially Risky Research

by David Malakoff on 21 February 2013, 3:00 PM

Researchers interested in conducting studies with 15 potentially dangerous agents and toxins—including the H5N1 avian influenza virus—face some new hurdles in getting funding from the U.S. government. Federal officials today released two policy documents that lay out stricter requirements for institutional and government oversight of studies that pose especially problematic safety concerns.

One policy, released by the U.S. Department of Health and Human Services (HHS), applies only to scientists seeking funds for experiments that might create new strains of the H5N1 virus that can move between mammals in respiratory droplets. (The virus normally infects birds.) Experts fear that such mammal-transmissible H5N1 viruses could spark a deadly human pandemic if they escape from a laboratory or are intentionally released by terrorists. U.S. officials outline the new policy today in a letter to Science.

The other document, released by the White.. http://news.sciencemag.org/scienceinsider/2013/02/us-announces-more-new-rules-for-.html?ref=hp

HKU eyes Middle East help in fight against new bug

Mary Ann Benitez and Beatrice Siu
Friday, February 22, 2013

Researchers at the University of Hong Kong are looking for collaboration in the Middle East to study the new SARS-like virus, which they believe may have originated from a Japanese bat species.
This comes as the Centre for Health Protection has stepped up monitoring for the new respiratory illness that is similar to the deadly SARS virus.
Twelve people have fallen sick from the novel coronavirus, or NCoV, since it first emerged in Saudi Arabia in September. Six of them died.
Yuen Kwok-yung, chair of infectious diseases at the university's department of microbiology said: "We are trying to find collaborators in the Middle East but cannot disclose any details at this stage."
Samples of the virus have been provided to HKU, and are being used to grow the virus and conduct research.
Yuen said that after the SARS outbreak in 2003, their team continued research on the SARS coronavirus and discovered the bat coronavirus, named HKU4 and HKU5, in 2006-2007.
The viruses, which were found in Japanese pipistrelle bats, can be found not only in Hong Kong but also in South China, Southeast Asia and the Middle East.
"So there is quite a possibility that the pipistrelle bats could transmit the virus into camels, goats, rodents in the Middle East, which somehow got into humans. That is something we can hypothesize," Yuen said.
Like the SARS virus, NCoV might have been transmitted from bats to other animals and to humans.
He said so far the transmission of the NCoV may not be very efficient and could be confined to household contact.
"At this stage, we have to be careful but there is no cause for panic," Yuen said.
The center's controller Leung Ting- hung said the mortality rate of NCoV is very high, and he cited the the case of a British family of three.
The son, 39, died after being infected by his 60-year-old father who fell sick after traveling to Saudi Arabia.
A younger female member had mild symptoms and did not require hospitalization.
The Hospital Authority's chief infection control officer Dominic Tsang Ngai- chon said suspected cases who have travelled to the Middle East and the UK, or where cases have occurred, and who came into contact with patients, will be isolated and tested.
The test results will be available in 24 hours.
The first 20 patients who test positive will be transferred to Princess Margaret Hospital. Also, 15 hospitals with A&E services could make available 1,000 beds for those kind of patients. http://www.thestandard.com.hk/news_detail.asp?pp_cat=11&art_id=131322&sid=39037980&con_type=1