Illinois Man is Third U.S. MERS Case, CDC Says

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JIM YOUNG / Reuters 22 minutes
First published May 17th 2014, 3:16 pm

By JoNel Aleccia

A business associate of the man who brought the first case of a mysterious Middle East virus to the U.S. has also tested positive for the disease, though he showed no signs of illness, federal health officials said Saturday.

The new case, the third reported in the U.S., is in an Illinois man who met twice with a health care worker who was hospitalized in Indiana after traveling from Saudi Arabia and was diagnosed May 2 with MERS, or Middle East respiratory syndrome.

The Illinois man had not traveled outside of the U.S. recently and he did not seek or require medical care, officials with the Centers for Disease Control and Prevention said in announcing the new case Saturday. Instead, laboratory tests showed that the man had evidence of the infection in his blood. He continues to feel well, CDC officials said.

“This latest development does not change CDC’s current recommendations to prevent the spread of MERS,” said Dr. David Swerdlow, who is leading the agency’s response to the infection that has sickened more than 570 people and killed 172, mostly in Saudi Arabia. It is formally known as the MERS coronavirus, or MERS-CoV.

“It’s possible that as the investigation continues others may also test positive for the MERS-CoV infection but not get sick,” Swerdlow added in a statement.

The new case was detected as part of efforts by CDC and state health departments to contact everyone connected with the Indiana man and a Florida man who was the second in the U.S. diagnosed with MERS May 11.

In both cases, the men were health care workers who came from Saudi Arabia and traveled on planes and other forms of public transportation to get home. The Indiana case is a health care worker in his 60s who was hospitalized April 28 and then diagnosed with MERS. In the Florida case, the 44-year-old man went to an Orlando emergency room, where he may have exposed others to the virus. None of the MERS cases has been identified.

MERS is spread through close contact, health officials say, and there’s no evidence of sustained transmission in public settings.

That could include contact such as handshakes typical of business gatherings. The Illinois businessman met twice with the Indiana patient just before he was diagnosed with MERS. Local health officials reached out to him and tested him for active infection on May 5, with negative results. But blood samples in a test returned May 16 showed evidence of MERS antibodies, indicating recent infection.

CDC officials are continuing to reach out to, test and monitor people who have come into contact the three U.S. cases. Officials say they have not changed their travel guidelines for U.S. residents heading to the Middle East and urge people to take sensible infection control precausions. The agency recommends that travelers closely monitor their health during and after the trip and report any signs of illness.

Health officials have been evaluating travelers from the Middle East for months and should continue to do so, with extra vigilance about any signs of respiratory illness.

 http://www.nbcnews.com/storyline/mers-mystery/illinois-man-third-u-s-mers-case-cdc-says-n108066

Questions about CDA difference about numbers

THE HAGUE - The CDA in parliament sees a difference between the information from the National Institute for Public Health and the Environment (RIVM) and the World Health Organization on the outbreak of the disease numbers.

Photo: Jan van Eijndhoven

The Dutch RIVM reports that the dangerous virus can be transmitted from animals to man almost exclusively while the UN agency WHO says that the majority of human infections have gone to human.
The CDA Minister Edith Schippers (Health) Saturday asked for clarification. According to CDA MP Hanke Bruins Slot, this difference may be of great significance for how to deal with infections.
This week it was announced that the disease in the Netherlands for two people is established. The disease resurfaced in 2012 in Saudi Arabia. Dromedaries are the source of the virus.
The MP also wanted to know whether there are steps to follow for people who make a pilgrimage to Mecca in Saudi Arabia.
Both Dutch patients, family members of each, are infected with the potentially deadly virus during the same trip to Saudi Arabia. They visited a dromedarissenboerderij. http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fwww.telegraaf.nl%2Fbinnenland%2F22636508%2F___Opheldering_over_mers-virus___.html

Confirmed three cases of chikungunya fever in Florida

Orlando - Florida health officials invoked the public to take precautions to prevent the spread of chikungunya fever, after being detected in this state the first three cases of this disease which is transmitted by mosquitoes and the still there is no vaccine .
According unveiled Friday the Florida Department of Health , the three cases of this fever are registered to women living in the south and center of the state and who recently traveled to the Caribbean.

A case is a resident of Miami- Dade , 30 , the second a 29 year old woman , a resident of Broward County , and the third infected is a 44- year-old living in Hillsborough County , on the central Florida.
 Health authorities estimate that the travelers might have acquired the virus in the Caribbean and then bringing him to the state, where they could have infected local mosquitoes, which propagate the virus.
"With the large number of people in Florida who travels to and from the Caribbean are monitoring for possible imported cases ," said Carina Blackmore, assistant director of epidemiology of Florida , who called on the population to remain alert and avoid mosquito bites especially now that the rainy and hurricane season approaches .
The first reports of chikungunya occurred in countries in Africa , Asia and the Indian Ocean islands , after which cases in Dominican Republic and other Caribbean countries were recorded.
As reported by the Pan American Health Organization (PAHO , in English ) , so far about 300 people have been reported infected with this disease.
" Early detection of symptoms and prevention of mosquito bites help that the disease does not spread ," Blackmore said.
These cases have been detected in the middle of the alert to be issued this week because of the latter Respiratory Syndrome Coronavirus Middle East ( MERS -CoV ) , detected in a tourist who came to Orlando from Saudi Arabia , and is the second case in the country , according to the authorities of the Centers for Disease Control and Prevention (CDC) . http://www.elnuevoherald.com/2014/05/16/1750063/confirman-tres-casos-de-fiebre.html

The deaths of 22 heads of camels Hail

Hail: Freeh Ramalli
Tunnel herd of camels exceeded numbering 22 upside yesterday, in Hail, north of the kingdom, while the owner of the camel reported that the cause of the injury may be a virus Corona. And embarked on several government agencies, including a branch of the Ministry of Agriculture in the region to determine the causes of mortality. The Hail did not register yet any injuries Corona disease among humans. For his part, said the owner of the herd rather leisurely Rashidi's "home": he was surprised Bnfogaha this way fast, where he found dead inside his barn and next, making it a province police Salimi in agriculture and allied branch. Rashidi added that it is likely the cause of death for the beauty of being infected with Corona, pointing out that the camel was not hit by any disease, and it takes care of the daily did not notice any change in them, and stressed that he was drinking milk on a daily basis.  http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fwww.alwatan.com.sa%2FDefault.aspx%3Fissueno%3D4978

Home Umrah, MERS-CoV Suspect Treated in Hospital Sanglah Bali

Saturday, May 17, 2014 3:15 pm

Illustration (Photo: Okezone) Denpasar - NA (46) citizens of Tuban regency of Badung, Bali treated at Sanglah General Hospital, for allegedly suspect Mers-Cov virus after returning from Umrah worship.

"Patients who were hospitalized Sanglah, seen cider medical symptoms, patients should be assumed that isolated, because it has a history of returning from pilgrimage some time ago," said Head of the Bali Provincial Health Office Ketut Suarjaya in Denpasar, on Friday (05/16/2014) .

The patient's medical symptoms characterized high fever, coughing and shortness of breath. In addition, patients have abnormalities in the heart that needs to be isolated. Patients should be given the appropriate handling procedures anticipate the dangerous virus attacks.

The patient went into Sanglah General Hospital Thursday night May 15, at approximately 22:10 pm after experiencing a fever and cough. Currently, NA treated at room Nusa Indah Sanglah and in monitoring medical team.

Officers have checked the entire neighborhood and family and people who had direct contact with NA

Officers also perform blood sampling for laboratory testing results. Suarjaya Admittedly, during the entire examination of suspects who were treated at Mers virus Sanglah negative result. (Ydh) http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fnews.okezone.com%2Fread%2F2014%2F05%2F17%2F340%2F986143%2Fpulang-umroh-suspect-mers-cov-dirawat-di-rsu-sanglah-bali%3Futm_source%3Ddlvr.it%26utm_medium%3Dtwitter

newly-erected signs warning travelers about MERS

This image, provided by Denver International Airport, shows newly-erected signs warning travelers about the danger of the MERS virus http://www.arabnews.com/news/571651

UAE-Preventive measures for camel handlers announced

Sajila Saseendran / 16 May 2014

Prepared in a question and answer format, the poster explains the relationship between camels and the coronavirus that causes Mers.


The UAE on Thursday announced preventive measures against Mers-CoV recommended for camel breeders and others dealing with camels through tweets sent out by the Ministry of Environment and Water (MoEW).
The tweets from the ministry’s twitter handle @MoEWUAE gave out details printed a bilingual poster, apparently prepared to be distributed among camel handlers and others.
Prepared in a question and answer format, the poster explains the relationship between camels and the coronavirus that causes the Middle East Respiratory Syndrome and lists out preventive measures.
“Recent studies have found that coronavirus strains in some of the camel samples genetically match the strain that causes the disease in humans. However, until now, there’s no evidence that coronavirus can be transmitted from camels to humans. More research is required to identify how humans are infected and identify sources of infection,” the ministry said.
Tweeting the image of the poster, the ministry also detailed the preventive measures recommended for camel breeders and those in contact with them.
Preventive measures recommended for camel breeders included the following:
* Buying animals from reliable sources and avoiding adding sick animals to the herd; isolating animals that appear to be sick from healthy ones and calling the vet immediately to take necessary measures.
* Eating well-cooked meats, washing hands thoroughly after touching animals, avoiding drinking unpasteurised or unboiled milk, wearing protective clothing and gloves when dealing with camels or suspected animals and slaughtering animals at the abattoir under supervision, are also among the recommendations.
* Additional preventive measures recommended when dealing with camels included avoiding contact with camels if you have a weak immune system or suffer from chronic diseases and avoiding the habit of kissing camels especially camels that are less than one year old.
* Wearing protective clothes, gloves and masks when directly contacting camels that show respiratory signs or nasal discharges was also highlighted.
“Animal products that are well prepared through cooking or pasteurisation are safe to consume,” the ministry reaffirmed in another tweet.
This is the first official announcement from the MoEW on precautionary measures for camel handlers and others coming in contact with the animal. Though the ministry last week announced strict Mers screening for camel shipment from the GCC, there was nothing specifically addressing the handlers of an estimated over 2,50,000 camels in the country.
On May 1, a Khaleej Times report had highlighted that no awareness drive had been launched to educate camel handlers in the UAE. The next day, the newspaper also reported about the need for spreading awareness among tourists who go for camel riding as many of them touch and kiss the camels.  http://www.khaleejtimes.com/nation/inside.asp?xfile=/data/nationhealth/2014/May/nationhealth_May27.xml&section=nationhealth

Interim Infection Prevention and Control Recommendations for Hospitalized Patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

• Standard, Contact, and Airborne Precautions Recommended
• Preparedness
• Home Care and Isolation Guidance

Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection, based on CDC's case definition for patient under investigation. Note that additional infection prevention precautions or considerations may be needed if a MERS-CoV patient has other conditions or illnesses that warrant specific measures (e.g., tuberculosis, Clostridium difficile, multi-drug resistant organisms).
Though these recommendations focus on the hospital setting, the recommendations for personal protective equipment (PPE), source control (i.e., placing a facemask on potentially infected patients when outside of an airborne infection isolation room), and environmental infection control measures are applicable to any healthcare setting.
In this guidance healthcare personnel (HCP) refers all persons, paid and unpaid, working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. HCP include, but are not limited to, physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual personnel, home healthcare personnel, and persons not directly involved in patient care (e.g., clerical, dietary, house-keeping, laundry, security, maintenance, billing, chaplains, and volunteers) but potentially exposed to infectious agents that can be transmitted to and from HCP and patients. This guidance is not intended to apply to persons outside of healthcare settings.
As information becomes available, these recommendations will be re-evaluated and updated as needed. These recommendations are based upon available information (as of May 14, 2014) and the following considerations:

• Suspected high rate of morbidity and mortality among infected patients
• Evidence of limited human-to-human transmission
• Poorly characterized clinical signs and symptoms
• Unknown modes of transmission of MERS-CoV
• Lack of a vaccine and chemoprophylaxis
•  
•  http://www.cdc.gov/coronavirus/mers/infection-prevention-control.html

Hajj has become a center for the spread of "Corona"

Report reveals: Hajj has become a center for the spread of "Corona" There is no clear plan to deal with it

Date Published: 16/05/2014

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Ramallah - minimum home
In the first investigation to news agency "Associated Press" virus "Corona" and the possibility of spread of the disease through the Hajj, and appeared in the international media, criticized the agency twice the health authorities and the lack of clear plans to deal with the virus in the pilgrimage season, citing the absence of posters warning about the virus at airports, especially Jeddah International Airport, in the Grand Mosque in Mecca, and criticized the lack of any information guidelines or programs warn of disease in public places in Mecca and in the courtyards of the Haram, and was amazed at the lack of any guidance or signals about the disease in my Ministry of Hajj, the Saudi Ministry of Health, and are concerned to serve the pilgrims.

It also shed light on the agency of health facilities in Mecca, and its inability to respond to the deadly virus in the pilgrimage season.

The agency said: "The officials in Saudi Arabia, raising alarm that Saudi Arabia is not doing enough to prevent Mecca from becoming a location and a way to export respiratory virus killer among millions of Muslims from around the world who gathered in the city to perform the pilgrimage."

The report added: Saudi Arabia is struggling to contain the escalation of injuries from pneumonia, the Middle East or "Merz," where the country has seen most of the injuries in all parts of the world so far, more than 500 injured since 2012, and during the past few weeks has accelerated numbers with many of the deaths reported it almost every day, and new infections are often in the double digits.

The report went on: yet Mecca, near the Red Sea coast, the west, has seen fewer cases than other areas in the Kingdom of Saudi Arabia, and since the discovery of the first case of the virus, "Corona" in 2012, there was a Mossman of the annual pilgrimage to the city, and there are no cases injury among the pilgrims, where some of the cases that have emerged out of Saudi Arabia, including two in the United States, foreigners returning home from work in the Kingdom of Saudi travelers or abroad. "

The rising number of cases in the UK, what is worrying is the lack of adequate precautions taken in Mecca, which is a hot spot and clear potential for the spread of the disease, according to the report.

Experts say: You need the Saudi Ministry of Health to be moving faster to create more public awareness, promote testing and analysis are more stringent in hospitals and take precautions best among the medical staff, who make up a large proportion of those infected because of unsanitary conditions in health facilities.

The report added: Makkah is witnessing a constant flow of pilgrims throughout the year from all over the world, and their numbers swell during the holy month of Ramadan, which begins in late June

The pilgrimage season - which Islam affirms that it is the duty of all Muslims who are able to perform once in their lives, it brings the crowds more than the magnitude of about two million pilgrims from all over the world, and gather in tight places; they visit to the Kaaba the holiest site in Islam, and other sites around Mecca, where the visit will last about five days and will begin the pilgrimage this year in early October

The report pointed out that most of the pilgrims international arrivals to Mecca come across the nearest international airport in the coastal city of Jeddah, which has seen the largest number of cases, however there are no posters in the airport or the Grand Mosque warns of virus or give visitors information about how to prevent its spread , and that was evident during the recent visit by a reporter, "The Associated Press" through the airport in Jeddah, in the Grand Mosque where roams the pilgrims.

The report added: website of the Ministry of Hajj, which is visited by many pilgrims international For information, does not mention the virus, or the urge to work special precautions, and the website of the Ministry of Health advised people over 65 years old, and children under the age of 12 who are suffering from the postponement of their pilgrimage.

He added the report: Since the beginning of April, saw the Mecca 21 new confirmed case, including the status of one of the pilgrims Turks, and four deaths during the same time period, where there were 114 new cases in Jeddah and 23 deaths, and saw Asia's first case of death due to virus Last month, when a man from Malaysia trip pilgrimage to Mecca and Jeddah from across where he returned in March, and found that he had wounded infected.

The report also pointed out that King Abdullah bin Abdul Aziz, has replaced the health minister, last month, in a sign of dissatisfaction with efforts to curb the spread of the virus, and visited the new minister Adel Faqih, health workers in Jeddah, and said to them: "The virus is spread among working in the medical field; because hospitals do not take measures in the fight against infection. "

According to Ismail Mohammed, a director of the hospital in Mecca: has been equipped medical facility and the only one in the city of Mecca, King Abdullah Medical to deal with cases infected with the virus.

He said Ismail Mohammed, told the agency: "The Mecca almost free from the virus, but warned that steps should be taken to ensure that it remains so, and the policy of the government to a large extent rely solely on the reaction, and there is a need to further educate the patient and there is no So far, no general trend in anti-virus policy toward the pilgrims. "

He explained Adnan bar, who served for years as director of public health in Mecca, it should be updated and the Ministry of Health to become less bureaucratic because the medical infrastructure in Mecca need to be a quick turnaround, and indeed we did not have enough facilities to provide primary health care to pilgrims.

"The bar:" The current health care system in Mecca does not cover half the necessary services, and fortunately the virus is not contagious too, has been observed to spread from person to person only in close contact, such as family members or workers in the field of health care, who are interested persons injured.

In the same context, according to the report, the WHO said on Wednesday that the virus does not constitute yet global health emergency, in all parts of the world and the World Health Organization has assurances from the 572 case at least, including 173 deaths, with the vast majority in the UK Saudi Arabia 0.160 deaths and 514 confirmed cases since 2012, according to government figures.

The virus often begins with flu-like symptoms but can lead to pneumonia and breathing problems and in severe cases, kidney failure and death, and scientists are not sure exactly how people can be infected with the disease but suspect link with the disease camels.

She sharihan Mufti, need Egyptian She is 61 years old wore a mask surgically blue They roam around the Grand Mosque, which houses the Kaaba, where the visit, her first to Mecca, and she wanted to be cautious, but says the opportunity to pray in the courtyard of the Kaaba dispel any fears about the virus , and she wondered: "Is there anything more beautiful after this? hope to come every year."

المزيد على دنيا الوطن ..  http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fwww.alwatanvoice.com%2Farabic%2Fnews%2F2014%2F05%2F16%2F538662.html

Silently among us: Scientists worry about milder cases of MERS

(Reuters) - Scientists leading the fight against Middle East Respiratory Syndrome say the next critical front will be understanding how the virus behaves in people with milder infections, who may be spreading the illness without being aware they have it.
Establishing that may be critical to stopping the spread of MERS, which emerged in the Middle East in 2012 and has so far infected more than 500 patients in Saudi Arabia alone. It kills about 30 percent of those who are infected.
It is becoming increasingly clear that people can be infected with MERS without developing severe respiratory disease, said Dr David Swerdlow, who heads the MERS response team at the U.S. Centers for Disease Control and Prevention.
"You don't have to be in the intensive care unit with pneumonia to have a case of MERS," Swerdlow told Reuters. "We assume they are less infectious (to others), but we don't know."
The CDC has a team in Saudi Arabia studying whether such mild cases are still capable of spreading the virus. Swerdlow is overseeing their work from Atlanta.
They plan to test the family members of people with mild MERS, even if these relatives don't have any symptoms, to help determine whether the virus can spread within a household.
Cases of the disease, which causes coughing, fever and sometimes fatal pneumonia, have nearly tripled in the past month and a half, and the virus is moving out of the Arabian peninsula as infected individuals travel from the region.
Since late April, the first two cases of MERS have been reported on U.S. soil. Dutch officials reported their first two cases this week. Infections have also turned up in Britain, Greece, France, Italy, Malaysia and elsewhere.
Since MERS is an entirely new virus, there are no drugs to treat it and no vaccines capable of preventing its spread. It is a close cousin of the virus that caused Severe Acute Respiratory Syndrome or SARS, which killed around 800 people worldwide after it first appeared in China in 2002.
Because MERS patients can have "mild and unusual symptoms," the World Health Organization advises healthcare workers to apply standard infection control precautions for all patients, regardless of their diagnosis, at all times.
"Asymptomatic carriers of diseases can represent a major route for a pathogen to spread," said Dr Amesh Adalja of the University of Pittsburgh Medical Center.
"Just think of Typhoid Mary," he said, referring to the asymptomatic cook who spread typhoid fever to dozens of people in the early 20th century.
NOT EVEN A COUGH
Milder symptoms played a role in the second U.S. case of MERS, a man who started having body aches on a journey from Jeddah on Saudi Arabia's Red Sea coast to the United States.
It took the patient more than a week before he sought help in an emergency department in Orlando, Florida. Once he arrived, he waited nearly 12 hours in the ER before staff recognized a MERS link and placed him in an isolation room. The patient did not have signs of a respiratory infection, not even a cough.[ID:nL1N0O002W]
Dr Kevin Sherin, director of the Florida Department of Health for Orange County, believes that made it less likely that he could spread the infection. Hospital workers have tested negative, but the health department and the CDC are still checking on hundreds of people who might have been in contact with the patient.
A CDC study published earlier this week looked at some of the first cases of MERS that occurred in Jordan in 2012.
Initially, only two people in that outbreak were thought to have MERS. When CDC disease detectives used more sensitive tests that looked for MERS antibodies among hospital workers, they found another seven people had contracted MERS and survived it.
That suggests there may be people with mild cases "that can serve as a way for the virus to spread to other individuals, which makes it a lot harder to control," Adalja said.
Scientists are especially concerned because a lot of recent cases of MERS are among people who did not have contact with animals such as camels or bats that are believed to be reservoirs for the virus.
"If they don't have animal contact, where do they pick it up? Potentially, asymptomatic cases," said Dr Michael Osterholm, an infectious disease expert from the University of Minnesota.  http://www.reuters.com/article/2014/05/16/us-health-mers-research-idUSKBN0DW1LT20140516

World Health Organization: MERS Isn't an Emergency

By Maria Cheng May 14, 2014 12:13PM After a meeting of the World Health Organization's expert group on the Middle East respiratory syndrome, or MERS, it was decided that the virus is not a global health emergency. Some scientists said while MERS technically meets the criteria for a global health emergency, declaring it as such could confuse the public...

..."Calling a global emergency in a world which has a lot of urgent issues going on is a major act," said Dr. Keiji Fukuda, an assistant director-general of WHO, told reporters Wednesday. "You have to have really solid information to say this is a global emergency." Fukuda said there wasn't yet proof of the virus' sustained transmission among people... ..Some scientists said while MERS technically meets the criteria for a global health emergency, declaring it as such could confuse the public. "People might think (WHO) is crying wolf because MERS is still primarily a problem in the Middle East," said Michael Osterholm, an infectious diseases expert at the University of Minnesota who has worked in the Middle East. "But if one of those infected people gets on a plane and lands in London, Toronto, New York or Hong Kong and transmits to another 30 people, everyone will have a different view." On Wednesday, the Netherlands' National Institute for Public Health and the Environment announced its first case of MERS, a man who became infected during a visit to Saudi Arabia. He is now in isolation at a hospital in The Hague...   http://www.sci-tech-today.com/story.xhtml?story_id=100002488JPO

Saudis question Makkah preparedness as Mers spreads

Makkah, Saudi Arabia: Officials in Saudi Arabia are raising alarm that the kingdom is not doing enough to prevent Makkah from becoming a route for exporting an often deadly respiratory virus as millions of Muslims from around the world converge on the city to perform pilgrimage at Islam’s holiest site.

The calls have taken on greater urgency as Saudi Arabia struggles to contain a surge in infections from the Middle East respiratory syndrome, or Mers.

The country has seen the most infections worldwide by far — more than 500 since 2012 — and in past weeks the numbers have accelerated with several deaths reported nearly every day and new infections often numbering in the double digits.

So far Makkah, near the western Red Sea coast, has seen fewer cases than other parts of Saudi Arabia....

Experts say the Saudi Health Ministry needs to move faster to create more public awareness, promote more aggressive testing in hospitals and take better precautions among medical staff — who have made up a significant proportion of those infected because of improper conditions.

Makkah sees a constant stream of pilgrims throughout the year from around the world, and their numbers swell during Ramadan, which begins in late June.

The Haj pilgrimage — which Islam says is a duty of all able-bodied Muslims to perform once in their lives — brings even more gigantic crowds: More than 2 million pilgrims from all over the world, packed into the close quarters as they visit the Kaaba, Islam’s holiest site, and other locations in and around Makkah for a period of around five days. This year, Haj starts in early October.

Also, most of the international pilgrims travel to Makkah through the closest international airport, in the coastal city of Jeddah, which has seen far more cases.

Notably, no posters warning of the virus or giving visitors information on how to prevent its spread are visible through Jeddah airport or at the Grand Mosque in Makkah, where pilgrims circumambulate the Kaaba.

The Haj Ministry’s website, which many international pilgrims refer to for information, makes no mention of Mers or special precautions.

The Health Ministry’s website, however, advises people over 65, children under 12 and those who are ill to delay their pilgrimage.

“Makkah is a location for people from all over the world with all kinds of problems that could be spread all over,” said Adnan Al Bar, a member of Saudi Arabia’s top consultative body, the Shura Council, at a recent summit in Jeddah on development in the holy city.

Since the beginning of April, Makkah has seen 21 new confirmed cases — including one Turkish pilgrim — and four deaths.

Over the same time period, there have been 114 new infections in Jeddah and 23 deaths. Asia saw its first Mers death last month, when a Malaysian man who went on pilgrimage to Makkah and passed through Jeddah in March returned home and was found to have been infected.

King Abdullah Bin Abdul Aziz last month replaced the health minister in a sign of displeasure over efforts to control the virus’ spread.

The new minister, Adel Faqih, visited health workers in Jiddah on Wednesday and told them the coronavirus was spreading in part because hospitals are not taking anti-infection measures.

Only one medical facility in Makkah — the King Abdullah Medical City — is equipped to handle Mers cases, according to Esmail Mohammad, the director-general of another hospital in the city, Umm Al Qura.

“Makkah is almost considered to be free” of the virus, he said. But he warned steps have to be taken to ensure it remains so.

Government policies have largely “only been reactive” greater patient education is needed” and there is still no “overall orientation [of anti-Mers policy] toward the pilgrims.”

Preparations, he said, are only on “an ad hoc basis.”

Al Bar, who served for years as Makkah’s general health director, said the Health Ministry should be overhauled to become less bureaucratic and that Makkah’s medical infrastructure needs a rapid transformation. Already, it does not have enough facilities to provide primary care for pilgrims.

“The current health care system in the Makkah does not cover half of the needed services,” he said.

Fortunately, Mers is not highly contagious — person-to-person spread has been seen only in close contacts, like family members or health care workers who care for an infected person.

The World Health Organisation said Wednesday the virus does not yet constitute a global health emergency. Worldwide, WHO has confirmations of at least 572 cases, including 173 deaths. The vast majority has been in Saudi Arabia — 160 dead and 514 confirmed cases since 2012, according to government figures.

Mers often starts with flu-like symptoms but can lead to pneumonia, breathing problems and in severe cases, kidney failure and death. Scientists are unsure exactly how people are catching Mers but suspect the disease is linked to camels.

Pilgrims are largely undaunted.

Sharihan Abdul Mufti, a 61 year-old Egyptian pilgrim, wore a blue surgical mask around the Grand Mosque that houses the Kaaba.

It is her first time to visit Makkah and she wanted to be careful, but she says the chance to pray at the base of the Kaaba supersedes any concerns about the virus.

“Is there anything more beautiful after this?” she said. “I hope to come every year.”  http://gulfnews.com/news/gulf/saudi-arabia/saudis-question-makkah-preparedness-as-mers-spreads-1.1333605

CDC in KSA

Riyadh, Rajab 12, 1435, May 11, 2014, SPA -- Eng. Adel bin Mohammed Faqih, acting minister of health, received here yesterday a delegation a US federal Agency "Centers for Disease Control and Prevention" within the framework of global efforts to limit spread of virus Corona.
In a statement to Saudi Press Agency (SPA), Eng. Faqih said that the Health Ministry deals with a number of international organizations and agencies for efforts' coordination in combating spread of the virus in the Kingdom and the world.
For his part, the spokesperson of the US center said that the US team will work with the Kingdom's specialists for conducting more scientific researches.

--SPA
18:46 LOCAL TIME 15:46 GMT  http://www.spa.gov.sa/English/details.php?id=1231173

Will there be a WHO travel warning on Tuesday?

 World health meeting over Mers
 May 11, 2014
GENEVA // Government authorities and international health experts are to meet tomorrow to decide whether the deadly Mers coronavirus is a “public health emergency of international concern”.

The World Health Organisation has organised the meeting in Geneva for its experts and representatives of affected countries.
Middle East Respiratory Syndrome has infected at least 536 people and killed 145 since its first known case was discovered in 2012. The WHO’s emergency committee will advise its director general on whether Mers constitutes a public health emergency of international concern, and whether to issue temporary recommendations to prevent the disease from spreading.
International health regulations define such an emergency as an extraordinary event that constitutes a public health risk to other WHO member states through international spread of the disease, and which could require a coordinated international response.
These regulations went into force in 2007. The emergency committee has only been used so far for Mers and H1N1, the 2009 pandemic strain of influenza.
H1N1 is the only disease that the WHO has named a public health risk of international concern. It left more than 18,000 dead from infections in more than 214 countries and territories.
The number of Mers cases has almost doubled in recent months, with by far the most being in Saudi Arabia.
The kingdom has counted 480 laboratory-confirmed cases, with 139 deaths, as of Sunday.
The UAE has had 37 lab-confirmed Mers cases since late March, all in Abu Dhabi emirate, with more than two thirds being healthcare workers. Most of those recently infected had mild or no symptoms.
Despite the recent rise in cases, Mers seems to be contagious only to a limited extent, not passing easily from person to person unless through close contact, the WHO says.
The organisation’s mission to Jeddah found the outbreak there was caused by an increase in the number of primary cases, possibly seasonal, coupled with inadequate infection prevention and control measures.
One explanation for a seasonal increase could be related to the weaning of young camels from their mothers in the spring, the WHO said in its May 9 risk assessment report.
Recent studies have suggested that camels are a proba..

Read more: http://www.thenational.ae/uae/health/world-health-meeting-over-mers#ixzz31QVebJif

The big meeting on Tuesday, will tell the the world what is most important to you. Doing your job.. or allowing some countries to keep the rest of the world in the dark about MERS. Even casual observers can now see this outbreak is getting way out of hand. The toll is growing by the day, by the hour. Some tracking teams cannot even keep up with the daily case count, as you knowingly try to only count confirmed cases, as whole families come down with similar symptoms but are not tested.

..No travel bans to KSA have been enforced by any country, and travelers from the Kingdom have not faced any problems entering other countries around the world. The World Health Organisation has not recommended any travel restrictions to or from KSA..According to the World Health Organization, there is no epidemic... http://www.arabnews.com/news/569146
  
Recent cases in Lebenon, Indonesia, U.S., Egypt,..
an update of MERS cases in KSA tally is 483, with 142 deaths... These number are low at best, while Jordan is back on the bandwagon with new cases. Your time is running short to take some concrete steps to stop this growing threat.. if it is not already too late...

Cianjur hospitals treating patients suspected of contracting MERSMay 11 , 2014Kesehatan
Cianjur (Reuters ) - Suspected virus MERS (Middle East Respiratory Syndrome ) , a male patient Gekbrong District residents , Cianjur , West Java , received special treatment in Cianjur District Hospital on Sunday .

Cece on behalf of the pat... http://bebekgorengslamet.com/kesehatan/rsud-cianjur-merawat-pasien-diduga-terjangkit-mers.html

Menkokesra ask the public aware of MERS-CoV

Sunday, May 11, 2014 22:10 pm
 Jakarta (ANTARA News) - Coordinating Minister for People's Welfare Agung (Menkokesra) Laksono asking the public to raise awareness of the case Respiratory Syndrome Middle East or Middle East Respiratory Syndrome Corona Virus (MERS-CoV).
"Be cautious, especially after the WHO declared that MERS-CoV potentially a public health emergency that is troubling the world," said Laksono here on Sunday. ..http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fwww.antaranews.com%2Fberita%2F433762%2Fmenkokesra-minta-masyarakat-waspadai-mers-cov%3Futm_source%3Dtwitterfeed%26utm_medium%3Dtwitter

 

Video .. Luxor security chief for "winners pilgrimage": "Do not be afraid Corona virus"

Sunday 11 / May / 2014 - 17:00

Hajar al-Hakim

Maj. Gen. Mustafa Bakir, the director of security Luxor in his speech this afternoon in a ceremony announcement the winners in the draw for the pilgrimage, which was held in the conference room in Luxor: The hajj is the largest and most important conference in the world and bestowed by calling him God away from the states, and non-governmental organizations, a confirmation for Islamic unity... http://translate.google.com/translate?hl=en&sl=auto&tl=en&u=http%3A%2F%2Fwww.vetogate.com%2F1004801

Second Indonesian found with #MERS in Saudi Arabia http://crofsblogs.typepad.com/h5n1/2014/05/second-indonesian-foun...

First H7N9 case detected in Malaysia involving Chinese tourist

by lee yen mun

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PUTRAJAYA: The Health Ministry has confirmed the first Influenza A (H7N9) case in the country, involving a female tourist from China.
The import case involves a 67-year-old Chinese woman, who had travelled from Guangdong, China, to Kuala Lumpur on Feb 4.
The woman went to Sandakan, Sabah the next day before going on to Kota Kinabalu on Feb 6.
"The woman was referred to a private hospital in Kota Kinabalu on Feb 7, and (after two screenings) on Feb 11, the sample tested positive for the Influenza A (H7N9) virus.
"She is currently receiving treatment in the ICU, put on ventilator and is in a stable condition," Health Minister Datuk Seri Dr S Subramaniam said in a press conference, here, Wednesday.
Dr Subramaniam stressed that there was no cause for panic over the matter as the risk for human transmission of H7N9 is "very low".http://www.thestar.com.my/News/Nation/2014/02/12/H7N9-first-case-msia-china-tourist/

WHO · FAO 'not reported avian influenza in North Korea'

Kim, Hyun - Jin

11/02/2014

North Korean state media over recent bird flu prevention measures can promote a large scale. Because of this, the incidence of bird flu in North Korea'm interest to the United Nations from the North Korean government said it had no reports of bird flu outbreaks. Delivered reporter Kim, Hyun - Jin.

United Nations World Health Organization (WHO) is the 10th bird flu outbreaks are reported from the North Korean government said it received.

[Interview: Gregory Hartland spokesman] "No .... not that I know of ...."

World Health Organization spokesman Gregory Hartland `VOA 'with the phone call, he reported having knowledge there was no bird flu in North Korea said.

FAO Food and Agriculture Organization of the international day kisan Dr. gunjal `VOA 'e-mail sent to the" bird flu from North Korea reported having received no requests or support, "he said.
Meanwhile, the North Korean government has recently devoting to focus bird flu. South Korea and China have incurred damage due to bird flu, the action.

The official North Korean newspaper 'labor' in the last 4-8 days five times over the bird flu after another, and the risks and prevention measures reported.

Yet the Ministry of Health is "a turning pandemic flu and measles, as well as bird flu preventive measures to prevent the spread of infectious diseases and the laying out stubbornly enforcement," he stressed.

`Korean Central TV 'is for the last 5 days trying to prevent bird flu introduced.
[Interview: Chosun Central TV] "The number of migratory birds in the quarantine sector moving path ... to establish a monitoring and notification system for poultry inspection to proceed."

But if a bird flu outbreak there was no mention of. http://www.voakorea.com/content/article/1848869.html

18 North Carolina hospital patients potentially exposed to rare brain disease

Published February 11, 2014

FoxNews.com

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Nearly 20 patients at a North Carolina hospital may have been exposed to a rare and fatal neurological disease while undergoing surgery with surgical equipment that had not been properly sterilized, officials at Novant Health Forsyth Medical Center said Monday.
Jeff Lindsay, president of the Winston-Salem hospital, told a news conference that 18 patients may have been exposed to Creutzfeldt-Jakob Disease, an incurable and invariably fatal brain disorder that kills 90 percent of patients within one year.
"While the CDC categorizes such risks as 'very low,' any risk of transmission is simply unacceptable,” Lindsay told reporters. "On behalf of the entire team, I apologize to the patients and their families for this anxiety. We are committed to providing support to patients and their families." 
A neurosurgical procedure was done on Jan. 18 on a patient who was later confirmed to have the disease. The other 18 patients, all neurosurgical patients, were exposed to surgical equipment that had been cleaned using a typical sterilization procedures, but not the enhanced sterilization procedures used for Creutzfeldt-Jakob.
Novant vice president for clinical development Dr. Jim Lederer said the operation was performed on a patient that was suspected and later confirmed to have sporadic CJD. While CJD has been associated with mad cow disease, Lederer emphasized this particular strain isn't mad cow.
There's no known cure for CJD, which can lead to death in some cases. It could take years if not decades for other symptoms to show up. The disease causes dementia, impaired vision, involuntary movement and coma, according to the National Institute of Neurological Disorders and Stroke.
"We recognize that the risk to the patients is very small," Lindsay said. "However, we take any potential exposure seriously."
Amanda Morin, who had back surgery at Forsyth Medical Center last month, told Fox8.com she was contacted by a hospital staff member who informed her she is one of 18 patients who may have been exposed to the disease.
“I have a two year old to live for and mommy might not be here,” Morin told the station. “I am angry; very, very angry something so little could cost me my life. I want grandkids. I want to be there for them.”
The state Department of Health and Human Services said it was monitoring the possible exposure in a statement released Monday, Fox8.com reported.
“DHHS officials are aware of the incident at Novant Health Forsyth Medical Center and have been in contact with the facility. Our primary concern is the health, safety and welfare of patients, and we will continue to closely monitor the situation” said Kevin Howell, DHHS spokesperson.
About 200 cases of Creutzfeldt-Jakob disease are recorded annually in the United States, according to the National Institutes of Health. In fewer than 1 percent of cases, the disease is transmitted by exposure to brain or nervous system tissue, and there have been only four reported cases of transmission via surgical instruments.http://www.foxnews.com/health/2014/02/11/nc-hospital-apologizes-for-exposure-to-disease/

patient was now quarantined for follow-up treatment with the suspected H5N1 bird flu

2 H5N1 bird flu outbreaks in Vietnam

Updated: 2014-02-11 15:40

( Xinhua)

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HANOI - Central Vietnam's province of Thanh Hoa and central highlands province of Kon Tum have reported bird flu outbreaks in poultry, local media reported Tuesday.
Vietnam's state-run radio Voice of Vietnam (VOV) said on Tuesday that 186 chickens died on February 8 with positive test results of H5N1 bird flu from samples collected in a farm in Tinh Gia district, Vietnam's central Thanh Hoa province.
Department of Agriculture and Rural Development of Thanh Hoa province have asked the district to cull and safely dispose of all chickens in the infected farm and neighboring families to prevent the disease from spreading.
Vietnam's state-run news agency VNA reported Tuesday that another outbreak of H5N1 bird flu on chicken has been announced in the country's central highlands province of Kon Tum.
About 600 chickens in Kon Tum province showed symptoms of suspected avian flu and 470 died on February 8
Some 130 chickens left have been culled on Tuesday after the official conclusion was reached that they were positive with avian influenza or H5N1 virus.
According to VNA, a chief veterinary was reported to be hospitalized with symptoms of fever, fatigue and loss of appetite after contacting with the above-mentioned outbreak in Kon Tum province.
The patient was now quarantined for follow-up treatment with the suspected H5N1 bird flu on human, said VNA.
Earlier in January 28, another avian bird flu outbreak was reported with nearly 1,000 chickens sick and dead in Kon Tum province, according to VNA.
These outbreaks raise alarm over the spread of H5N1 virus in Vietnam among both local people and international communities.
In a related development, the United States Agency for International Development announced on Tuesday a project worth $800, 000 for preventing bird flu in Vietnam.
The project aims at helping reducing risks to community health caused by bird flu, epidemic and other emerging infectious diseases in Vietnam from now till September, 2015, VNA reported.
Bird flu, or avian influenza, is a contagious disease of animal origin caused by viruses that normally infect only birds and, less commonly, pigs. It can be fatal to humans.  http://www.chinadaily.com.cn/world/2014-02

 Symptoms of fever , breathing difficulties and a veterinarian after contact with these birds have been taken to hospital for treatment.
 http://www.chinanews.com/gj/2014/02-11/5824947.shtml



/11/content_17277289.htm

Bird flu patient says he ate bloody fried chicken leg before he fell ill

By Deng Kajia | February 11, 2014, Tuesday |

 

A H7N9 bird flu patient in Zhejiang Province remembered that he had eaten a fried chicken leg with fresh blood on the bone just before falling sick, the local Morning Express reported.
The man, identified as Liu Jintao, 39, was confirmed to have H7N9 bird flu on October 14, the first case reported in Zhejiang last fall. He became critically ill and was able to talk about eating the chicken leg only after he recovered.
Liu recalled he bought three fried chicken legs from a supermarket during the National Day holiday, finding blood on the bones as he ate the second one.
Though he stopped eating the chicken, he said he had diarrhea the next day. He went to the doctor after he did not get better on the fourth day. On October 11, he was transferred to the ICU of Shaoxing People’s Hospital since he was in critical condition.
There has been no confirmation from doctors that his H7N9 infection was connected with the bloody chicken leg.
He was discharged from hospital recently, the report said. Liu is expected to be able to resume work after resting for another one or two months, the report said...
. http://www.shanghaidaily.com/national/Bird-flu-patient-says-he-ate-bloody-fried-chicken-leg-before-he-fell-ill/shdaily.shtml

Xinhua Nanning, February 9 (Reporter Cheng group) Guangxi Zhuang Autonomous Region Health Department on February 9 briefing by experts in disease prevention and control efforts, the bird flu epidemic disinfection disposal has been completed. 80 close contacts of the patient have been timely epidemiological investigation to determine the measures to be taken under medical observation, there are currently û abnormal.
As of February 5, Hezhou Guangxi, Nanning two reports three cases of human infection of H7N9 avian influenza, Liuzhou report one case of human infection with H5N1 avian influenza. 3 cases of H7N9 cases, one case is imported cases, two cases for local residents cases.  http://translate.google.com/translate?sl=auto&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fnews.gxnews.com.cn%2Fstaticpages%2F20140210%2Fnewgx52f83670-9609117.shtml

National guard Planning Commission: Recent H7N9 bird flu will distribute

2014-02-10 11:22 Source: Securities Times Online

[Recent H7N9 avian flu will distribute The State Planning Commission spokesman Wei Yao Hongwen, said at a news conference on the 10th, the current human infection with H7N9 avian flu epidemic characteristics did not change significantly, sporadic cases still based, monitoring is not Virus found occurrence of public health significance of variation, the spread of the virus from the birds to humans remains. Experts predict that the recent emergence of China's mainland will continue to sporadic cases.http://kuaixun.stcn.com/2014/0210/11152690.shtml

Jiangsu 40 days in patients diagnosed 12 cases of H7N9

Post reporter Gong Fei
Since January 8, 2014 in Jiangsu Province confirmed the first case of human infection with the H7N9 avian flu cases since, as of yesterday, the province has 12 patients were diagnosed, two patients died - Yesterday, the Post reporter learned from the Health Department of Jiangsu Province, 12 cases of confirmed cases in Nanjing 4 cases, Suzhou two cases, Wuxi two cases, Huai'an, Yancheng, Taizhou and Xuzhou in 1. 12 patients were over 50 years of age, 4 of which were over 70 years old.
Confirmed cases currently on the Health Department of the province, the deaths were from Nanjing and Wuxi. Wuxi Bao an afternoon on January 26 was diagnosed human cases of avian influenza H7N9 infection. It was then found that the condition is more critical, in Wuxi, a hospital, died early morning of February 1; Qianmou Nanjing was diagnosed at New Year's Eve (January 30) afternoon, after nine days of rescue, in The evening of February 7 deaths. Both patients died age higher Qianmou Nanjing 75 years old, female; Wuxi Martin a 76-year-old, is a male.
Jiangsu Provincial Health Department, according to data published on the website, as of February 8, 2014 the province a total of H7N9 bird flu confirmed 12 cases of human infection. Among them, the last four confirmed cases clearly shows that there is contact with chickens, while in other patients, the majority also have history of exposure to poultry. The evening of February 3, Wuxi infected human H7N9 avian influenza cases diagnosed Gumou 59-year-old, is a female, before the patient is sick went to the vegetable market to buy live chickens 2; February 6 am to be experts in Yancheng group confirmed cases diagnosed Qinmou, male, 66 years old, the sick, before the patient went to farms to buy two chickens, slaughtered by the market after home cleaning cooking; Another patient Xuzhou Xun also at a Feb. 6 Local expert group w  http://translate.googleusercontent.com/translate_c?depth=1&hl=en&ie=UTF8&prev=_t&rurl=translate.google.com&sl=auto&tl=en&u=http://news.ifeng.com/mainland/special/h7n9/content-3/detail_2014_02/10/33650624_0.shtml&usg=ALkJrhi4qvxgsDQdn78BIWfmIH-vQWE6hw#_from_ralated

Remember!!! This way bird flu

Monday, February 10, 2014, 6:38 pm

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Residents masked out of the victim's home unexpectedly terinfesi AI virus (avian influenza) or avian influenza in RW 6, Sunter Agung, Tanjung Priok, North Jakarta, Monday (9/1). (Reuters / Pradana Aditya Putra)

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REPUBLIKA.CO.ID, SRAGEN-Citizens in Sragen, East Java feared to be infected with the spread of bird flu that has made as many as 3,455 dead ducks or duck. This method is based on the handling of bird flu bird flu expert at the University of Airlangga (Airlangga University), Surabaya.
"The virus is behaving is not to kill but reproduce themselves. Virus AI want to preserve life but does not have the completeness of the body, so the ride AI virus in the bodies of animals such as ducks," said Chairman of Avian Influenza-Zoonosis Research Center (AIRC)-University of Airlangga (Airlangga University) Surabaya, East Java (East Java), Dr CA Nidom told Reuters on Sunday (9/2).
The first step is to evaluate the handling and control of the means of handling the AI ​​virus. To combat AI virus then takes control efforts by following the behavior or characteristics of the virus.

By knowing the characteristics of the AI ​​virus, he went on, farmers can directly determine the spread of AI virus and then reported to the local animal husbandry department. If the spread of the virus have been known since the beginning, the easier it is to handle.

The second step, burying animal carcasses ex... http://translate.google.com/translate?sl=auto&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.republika.co.id%2Fberita%2Fnasional%2Fumum%2F14%2F02%2F10%2Fn0r5ns-ingat-ini-cara-penanganan-flu-burung

Oops, Bird Flu Threatens Residents in Sragen

Monday, February 10, 2014, 6:31 pm

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REUTERS

Hong Kong Health workers pack dead chickens, Thursday (28/01/2014) and then destroyed in a move to overcome the spread of the deadly avian influenza virus H7N9.

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REPUBLIKA.CO.ID, SURABAYA-Chairman of Avian Influenza-Zoonosis Research Center (AIRC)-University of Airlangga (Airlangga University), Surabaya, East Java (East Java), Dr CA Nidom worrying cases of bird flu virus (Avian Influenza / AI) in Sragen, Java East. Because the bird flu makes as much 3,455 ducks or duck is dead and feared to be transmitted to the human body.

Nidom says duck death case due to the fact the AI ​​virus that surfaced today is an accumulation of duck deaths started late last January 2014. However, due to the lack of virus treatment, the mortality rate of up to thousands of ducks each tail.
"In fact, cases of bird flu occurred in 2009 and still not dead. Then appeared again a new virus that is now attacking the ducks," said Nidom told Reuters on Sunday (9/2).

The key, he added, the slower the AI ​​virus handling the more complex case. But she was not sure exactly what type of AI virus that attacks the ducks in Sragen, whether old or new virus virus. But he guessed, 3,455 ducks died suddenly in Sragen the result of marriage or a combination of old and new viruses virus AI.

If so, he mentions the handling of the virus is much more complicated because the virus is a combination virus. "I was worried if the AI ​​virus is left and uncontrolled handling can harm humans because it jumped into the human body," he said.

Moreover, the media increasingly widespread transmission of AI virus. If only the old type of AI virus spread through the air, while the new AI virus can be transmitted through air and water. To solve it, said Nidom, there are several steps.http://translate.google.com/translate?sl=auto&tl=en&js=n&prev=_t&hl=en&ie=UTF-8&u=http%3A%2F%2Fwww.republika.co.id%2Fberita%2Fnasional%2Fumum%2F14%2F02%2F10%2Fn0r5d1-waduh-flu-burung-ancam-warga-di-sragen