Tag Archive: Severe Acute Respiratory Syndrome


Earth Watch Report  –  Biological Hazards

The Middle East respiratory syndrome (MERS) coronavirus is seen in an undated transmission electron micrograph from the National Institute for Allergy and Infectious Diseases (NIAID). (Reuters/National Institute for Allergy and Infectious Diseases)
The Middle East respiratory syndrome (MERS) coronavirus is seen in an undated transmission electron micrograph from the National Institute for Allergy and Infectious Diseases (NIAID). (Reuters/National Institute for Allergy and Infectious Diseases)

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March 14 2014 01:26 PM Biological Hazard Saudi Arabia Provinces of Riyadh, Tabuk and Makkah, [Riyadh, Tabuk and Riyadh] Damage level Details

 

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Biological Hazard in Saudi Arabia on Friday, 14 March, 2014 at 13:26 (01:26 PM) UTC.

Description
Saudi Arabia says a man has died from a new respiratory virus related to SARS, bringing to 63 the number of deaths in the kingdom at the center of the outbreak. The health ministry said on Friday that the latest victim, a 19-year-old, died in the city of al-Kharj, southeast of Riyadh, according to a report from the Associated Press news agency. Two of his sisters are in hospital on suspicion they have been infected with the virus. The new virus is related to SARS, or severe acute respiratory syndrome, which killed some 800 people in a global outbreak in 2003. It belongs to a family of viruses that most often causes the common cold.
Biohazard name: MERS-COv
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

 

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 FILE - Undated electron microscope image of novel coronavirus particles, also known as the MERS virus, colorized in yellow.

FILE – Undated electron microscope image of novel coronavirus particles, also known as the MERS virus, colorized in yellow.

Lisa Schlein

— The World Health Organization (WHO) says it believes the recent spike in cases of  Middle East Respiratory Syndrome, or MERS Corona virus is probably due to a seasonal increase of the disease rather than to any changes in the behavior of the virus.

WHO says similar upsurges have occurred around the same time in the past two years.

WHO spokesman Gregory Hartl says the increase in cases is most likely due to the warmer weather in the Arabian Peninsula and to outbreaks of the disease in two or three hospitals in Saudi Arabia and the United Arab Emirates.

He says health officials do not know how the virus is transmitted from person to person.  But it is clear, he says, the disease does not spread with the same ease that Severe Acute Respiratory Syndrome, or SARS, did.

Countries reporting new MERS cases, 2014.

Countries reporting new MERS cases, 2014.

“We do not think it does transmit very efficiently,” said Hartl. “It certainly is not anything like SARS or like diseases like influenza…There is no way we can predict the future.  But, for us, at the moment, certainly this virus MERS does not have the ability to infect in the same way that SARS did.  So, that is a good sign.”

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SARS: French scientists lose 2,300 samples of potentially deadly virus

Institut Pasteur realised tubes were missing during a routine inventory check. Pictured posed.
Institut Pasteur realized tubes were missing during a routine inventory check. Pictured posed.

 

The renowned Institut Pasteur in France has admitted that it has misplaced 2,349 vials containing samples of the potentially deadly SARS virus and, despite enlisting help from France’s drug and health safety agency, have been unable to find them.

 

The investigation by the ANSM at the unnamed laboratory failed to locate the samples, which have been missing since January. It has now filed a case to the prosecutor of Paris to investigate the disappearance.

The Institut Pasteur has been quick to reassure the public that the vials do not pose any risk, according to The Local.

“The tubes concerned have no infectious potential,” a statement said. “Independent experts referred by health authorities have qualified the risk as ‘nil’ in regards to available evidence and literature on the survival of the SAS virus.”

 

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Paris laboratory loses deadly SARS virus samples

©

Text by FRANCE 24

Latest update : 2014-04-16

The Pasteur Institute in Paris has asked the authorities to investigate the disappearance of more than 2,000 vials containing fragments of the SARS virus, while insisting that missing samples represent no danger to the public.

The institute said it discovered the loss of 29 boxes containing 2,349 tiny vials during a routine inventory check.

Professor Christian Bréchot, the head of the Pasteur Institute, said “human error” was the most likely explanation, but that they “did not want to rule anything out.”
“From the start, we’ve known that the samples are harmless,’’ he said.
Severe acute respiratory syndrome (SARS) is an airborne virus.  In a 2003 outbreak, it  spread to 30 countries infecting  8,273 people and causing a reported 775 deaths, the majority in Hong Kong, for a mortality rate of almost 10 per cent.
An outbreak of a SARS-like illness in 2013 caused a reported  40 cases worldwide, two of them in France, where a 65-year old man died from the illness.

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The Daily Star

Saudi Arabia reports one more death from new virus

March 14, 2014 12:28 PM Associated PressMen wearing surgical masks as a precautionary measure against the novel coronavirus, speak at a hospital in Khobar city in Dammam May 23, 2013. REUTERS/Stringer

Men wearing surgical masks as a precautionary measure against the novel coronavirus, speak at a hospital in Khobar city in Dammam May 23, 2013. REUTERS/Stringer

 

RIYADH: Saudi Arabia says a man has died from a new respiratory virus related to SARS, bringing to 63 the deaths in the kingdom at the center of the outbreak.

The Health Ministry said Friday the latest victim, a 19-year-old, died in the city of al-Kharj, southeast of Riyadh. Two of his sisters are in hospital on suspicion they have been infected with the virus. If they prove to be positive, it would further raise the number of people infected.

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The New Zealand Herald

 

Saudi Arabia reports 1 more death from new virus

…..So far, 150 people have been infected in the kingdom since September 2012.

The new virus is related to SARS, or severe acute respiratory syndrome, which killed some 800 people in a global outbreak in 2003. It belongs to a family of viruses that most often causes the common cold.

 

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RSOE EDIS

Biological Hazard in Saudi Arabia on Monday, 24 February, 2014 at 04:05 (04:05 AM) UTC.

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Updated: Wednesday, 12 March, 2014 at 04:14 UTC
Description
The United Nations World Health Organization (WHO) revealed Tuesday it has been informed of two additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia. The case pertains to a 58-year-old man from Al-Ahsa province, who took ill on February 2 and was hospitalized on February 4. He recovered from the infection and was discharged from hospital on February 24. The patient suffered from multiple chronic diseases, and was reported to have had contact with animals. The second case is an 81 year-old woman from the Riyadh region. She had multiple underlying medical conditions, and was hospitalized on February 2. She developed symptoms of MERS on February 5 and died three days later. WHO said she had no reported contact with animals prior to falling ill. From September 2012 to date, WHO has been informed of a total of 186 laboratory-confirmed cases of infection with MERS-CoV globally, including 81 deaths. Based on the current situation and available information, WHO urged all Member-States to continue their surveillance for Severe Acute Respiratory Infections (SARI) and carefully review any unusual patterns. WHO stressed that recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. “WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions,” the press release read.

 

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EPIDEMICS


by Staff Writers
Hong Kong (AFP) Dec 26, 2013

A Hong Kong man infected with the H7N9 strain of bird flu died on Thursday, the first such death in the city since the virus emerged there this month.

The 80-year-old man was the second reported case of H7N9 infection in Hong Kong after one reported on December 2.

A government spokesman confirmed the death of the man, who had been suffering from other underlying medical conditions.

He had been taken to hospital after returning to Hong Kong from the neighbouring city of Shenzhen in mainland China, where he lives.

Hong Kong officials have stepped up border checks and traced hundreds who had been in contact with the two people infected.

Read More Here

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Man dies from H7N9 in Hong Kong

H7N9

H7N9

A Hong Kong man infected with the H7N9 strain of bird flu died on Thursday, the first such death in the city since the virus emerged there this month. The 80-year-old man was the second reported case of H7N9 infection in Hong Kong after one reported on December 2.

A government spokesman confirmed the death of the man, who had been suffering from other underlying medical conditions.

He had been taken to hospital after returning to Hong Kong from the neighbouring city of Shenzhen in mainland China, where he lives.

Hong Kong officials have stepped up border checks and traced hundreds who had been in contact with the two people infected.

The first case involved a 36-year-old Indonesian domestic helper who also had a history of travelling to Shenzhen.

Health officials had expected human cases of avian influenza in low winter temperatures, given the number of cases in mainland China.

In all, 138 human cases of H7N9 have been reported in mainland China since February with 45 deaths, according to the World Health Organisation.

Hong Kong is especially alert to the spread of viruses after an outbreak of Severe Acute Respiratory Syndrome swept through the city in 2003, killing 299 people and infecting around 1,800.

Voice of Russia, AFP

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Earth Watch Report  –  Biological Hazards

File:Camel in Giza.jpg

 

Image Source  :  Wikimedia.org

Author kallerna

 

File:Camel and it's rider in Giza.jpg

Image Source  :  Wikimedia.org

Author kallerna

Lisa Schnirring | Staff Writer | CIDRAP News

Aug 08, 2013

A WHO spokesman said the findings in camels provide clues, but the issue of how humans are being infected is still unresolved.

Researchers who conducted blood tests on animals from different regions found evidence that camels have been exposed to the Middle East respiratory syndrome coronavirus (MERS-CoV) or a very close relative, the outbreak’s first strong clue about a possible animal reservoir.

Until now, the only animal clue has been from genetic sequencing studies, which suggested the virus came from bats. Though there are no reports that any of the patients had contact with bats, a man from the United Arab Emirates who was treated for his fatal infection in Germany had been exposed to a sick racing camel.

The investigators, mostly from the Netherlands and Germany, reported their findings today in The Lancet Infectious Diseases.

The first MERS-CoV illness was reported a year ago, and so far 94 cases and 46 deaths have been confirmed by the World Health Organization (WHO), all of them from or linked to Middle Eastern countries.

Human-to-human infections have been rare, and health officials suspect that an animal reservoir could be playing a yet unknown key role in the spread of the new virus.

The research team obtained 349 blood serum samples from livestock animals including dromedary camels, cows, sheep, goats, and other animals closely related to dromedaries. The animals were from different areas, including Oman, the Netherlands, Spain, and Chile.

They analyzed the blood samples for antibodies to MERS-CoV, other antibodies that react to SARS (severe acute respiratory syndrome) coronavirus, and HCoV-OC43, another strain of coronavirus that can infect humans and is related to a bovine form of the virus.

No cross-reactivity was seen between MERS-CoV antibodies and those for SARS or HCoV-OC43, and the team confirmed those findings with highly specific virus neutralization tests. Presence of MERS-CoV antibodies probably shows previous infection with MERS-CoV, or a closely related virus, the group reported.

No MERS-CoV antibodies were found in the blood of 160 animals from the Netherlands and Spain, but evidence of earlier exposure to the virus was found in all 50 samples taken from dromedary camels in Oman. Sampling in Oman involved camels from different parts of the country, suggesting that MERS-CoV or a close relative is circulating widely in the region’s dromedary camels, the authors reported.

No antibodies were found in animals from the Netherlands and Chile that are closely related to dromedaries, such as Bactrian camels, alpacas, and llamas.

Lower levels of MERS-CoV antibodies were found in 14% (15) of samples taken from two herds of dromedaries from the Canary Islands, a Spanish island group located off the coast of mainland Africa that has not reported any human MERS-CoV cases.

The authors said in a journal press release that the dromedaries from Oman were positive more often and had much higher antibody MERS-CoV antibody levels than the ones from Spain. “The best way to explain this is that there is a MERS-CoV-like virus circulating in dromedary camels, but that the behavior of this virus in the Middle East is somehow different to that in Spain,” they noted.

The findings suggest dromedary camels may be one reservoir for MERS-CoV and that their popularity in the Middle East, where they are used for racing, meat, and milk, presents a variety of contacts with humans that could lead to virus transmission, the investigators said in the press release.

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Earth Watch Report  –  Epidemic Hazards

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12.07.2013 Biological Hazard United Arab Emirates Capital City, Abu Dhabi Damage level Details

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Biological Hazard in United Arab Emirates on Friday, 12 July, 2013 at 19:14 (07:14 PM) UTC.

Description
Health officials in Abu Dhabi have confirmed that an 82-year-old Emirati has been diagnosed with the SARS-type coronovirus. The elderly man was diagnosed while being treated in one of the hospitals in the UAE capital. It represents the first diagnosed case of the disease within UAE, news agency WAM reported. The patient is male with multiple myeloma and currently admitted in the ICU, the Health Authority in Abu Dhabi (HAAD) confirmed. It added that it is coordinating with the Ministry of Health and other authorities in the country and has taken the necessary measures as per the international standards and recommendations of the World Health Organisation (WHO).
Biohazard name: MERS-CoV (novel coronavirus)
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

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First SARS-type virus case confirmed in the UAE

Health officials in Abu Dhabi have confirmed that an 82-year-old Emirati has been diagnosed with the SARS-type coronovirus.

The elderly man was diagnosed while being treated in one of the hospitals in the UAE capital. It represents the first diagnosed case of the disease within UAE, news agency WAM reported.

The patient is male with multiple myeloma and currently admitted in the ICU, the Health Authority in Abu Dhabi (HAAD) confirmed.

It added that it is coordinating with the Ministry of Health and other authorities in the country and has taken the necessary measures as per the international standards and recommendations of the World Health Organisation (WHO).

The Ministry of Health said that WHO first issued an international alert in September 2012 and a total of 80 cases of MERS-CoV have been confirmed worldwide.

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Earth Watch Report  –  Epidemic Hazards

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05.07.2013 Epidemic Hazard United Kingdom Capital City, London [St Thomas Hospital] Damage level Details

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Epidemic Hazard in United Kingdom on Thursday, 04 July, 2013 at 12:36 (12:36 PM) UTC.

Description
A man infected with a Sars-like respiratory illness has died in London, officials say. The Qatari man, who was being treated in an intensive care unit at St Thomas’s hospital in central London, had contracted the Middle East respiratory syndrome coronavirus – or Mers-CoV. Hospital officials said the man, who was 49 when he was admitted, died after his condition deteriorated. The patient, who was suffering from acute respiratory syndrome and renal failure, was admitted to an intensive care unit in Doha, Qatar, on 7 September last year. The man, who has not been named by officials, was transferred to the UK by air ambulance on 11 September. Before he became ill he had travelled to Saudi Arabia, officials said. Despite doctors’ efforts to keep him alive, including connecting him to an artificial lung, he died on Friday last week. A hospital spokeswoman said: “Guy’s and St Thomas’s can confirm that the patient with severe respiratory illness due to novel coronavirus … sadly died on Friday 28 June, after his condition deteriorated despite every effort and full supportive treatment.”
Biohazard name: Mers-CoV (SARS-like virus)
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

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Epidemic Hazard in United Kingdom on Thursday, 04 July, 2013 at 12:36 (12:36 PM) UTC.

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Updated: Friday, 05 July, 2013 at 03:17 UTC
Description
A Qatari man has died in a British hospital from the Middle East Respiratory Syndrome virus which has been causing increasing alarm among world health experts, officials said. The death brings to 43 the number of people to date who have died from the SARS-like infection, which has an extremely high mortality rate. The unnamed 49-year-old man had been in a London hospital since September 2012 receiving treatment for acute symptoms from the virus, having earlier been airlifted from the Qatari capital Doha. The man had previously traveled to Saudi Arabia where the majority of cases have been concentrated. He died last week after his condition sharply deteriorated, a spokeswoman for Guy’s and St Thomas’ hospital said. MERS is a member of the coronavirus family, which includes the pathogen that causes Severe Acute Respiratory Syndrome (SARS). The World Health Organization (WHO) said on June 26 that 77 laboratory-confirmed cases had surfaced worldwide with 40 deaths. Saudi Arabia announced two further deaths on Wednesday.

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The Telegraph

Middle East virus claims third life as fears of pandemic spread

A man being treated in a London hospital for a lethal ‘Sars-like’ Middle Eastern virus has died.

Coronavirus cases may be 'tip of the iceberg'
The patient had severe respiratory illness due to novel coronavirus (MERS-nCV) Photo: Health Protection Agency/AP

The man, a Qatari national, had been admitted to a private clinic in London in September, before being transferred to the specialist centre at Guy’s and St Thomas’ Hospital.

He was diagnosed as suffering from the Mers virus – Middle East Respiratory Syndrome – which has affected 77 people worldwide, with 43 deaths.

“Guy’s and St Thomas’ can confirm that the patient with severe respiratory illness due to novel coronavirus (MERS-nCV) sadly died on Friday 28 June, after his condition deteriorated, despite every effort and full supportive treatment,” said Robin Wilkinson, a spokesman for the hospital.

The death of the Qatari man brings to three the number of victims who have died in the UK.

In February two members of the same family died from the virus. One, a 39-year-old man, died in Birmingham having picked up the virus from his father, who had recently travelled to Saudi Arabia. The father then died around a month later in Manchester’s Wythenshaw hospital. A female relative was also treated for mild Mers symptoms, raising fears of human-to-human contact.

The disease is spread by people coughing or sneezing and can cause breathing difficulties, lung damage and pneumonia.

Known cases of the illness have quadrupled since April, and it is deadlier than Sars, which killed 774 people in 2003. SARS killed one in ten affected people; Mers has proved fatal in 65 per cent of cases.

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Earth Watch Report  –  Epidemic  Hazards

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17.06.2013 Epidemic Hazard Saudi Arabia MultiProvinces, [Provinces of Eastern and Al-Qassim] Damage level Details

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Epidemic Hazard in Saudi Arabia on Thursday, 02 May, 2013 at 07:12 (07:12 AM) UTC.

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Updated: Monday, 17 June, 2013 at 10:17 UTC
Description
Saudi Arabia says four more people have died from a new respiratory virus related to SARS, bringing the total number of deaths to 32 in the kingdom at the center of the growing crisis. Overall, nearly 40 people have died from the virus since September, mostly in Europe and the Middle East. That’s according to local officials and the World Health Organization. The Saudi Health Ministry also said on Monday that it confirmed three more cases of the virus, including in a 2-year-old child. Officials are still seeking clues on how easily it is spread between humans. The new virus is related to SARS, which killed some 800 people in a global epidemic in 2003, and belongs to a family of viruses that most often causes the common cold.

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CIDRAP

Report: Saudi MERS hospital outbreak had some SARS-like traits

Jun 19, 2013 (CIDRAP News) – A study of the recent hospital outbreak of MERS-CoV (Middle East respiratory syndrome coronavirus) in Saudi Arabia reveals, among other things, that the virus spread in three hospitals and that some patients transmit it much more than others do.

The report, published today in the New England Journal of Medicine, shows that 21 of 23 cases involved person-to-person transmission in healthcare facilities, and that 9 cases were in hemodialysis patients.

Testing of more than 400 healthcare workers and household contacts of MERS patients turned up only 7 additional cases, the report says, which supports previous findings that the virus doesn’t spread very readily. Investigators found that some patients didn’t spread the virus to anyone else, but one of them infected seven others.

The report was prepared by a large international team with members from Saudi Arabia, Canada, the United Kingdom, and the United States.

All the hospitals involved are in Al-Hufuf (also spelled Al-Hofuf) in Al-Ahsa governorate of eastern Saudi Arabia. The report covers 23 confirmed cases that were identified between from Apr 1 to May 23; 11 probable cases also are considered part of the outbreak.

As of Jun 12, 15 of the 23 patients (65%) had died, 6 had recovered, and 2 remained hospitalized, the report says. Most of the patients were men, and the median age was 56. Disease manifestations included fever in 20 patients, cough in 20, shortness of breath in 11, and gastrointestinal symptoms in 8.

Most of the cases occurred at one general hospital, called hospital A, which has 150 beds, plus a dialysis unit. The event began on Apr 5 with admission of a patient with dizziness and sweating, followed by a fever 3 days later. He was not tested for MERS-CoV, but his son later had a confirmed case.

Another patient, who was on dialysis, was admitted Apr 6 and put in a room next to the first patient. By Apr 11 he had a fever, and he underwent dialysis in the hospital on Apr 11 and 13. Between Apr 14 and 30, MERS-Cov was confirmed in nine more patients who were receiving dialysis in hospital A. Eight of these cases developed before or within 1 day after infection control steps were taken in the dialysis unit.

One dialysis patient who had a confirmed MERS-CoV infection was admitted to a medical ward on Apr 21. In the following week, two other patients, located two and three rooms away from the dialysis patient, fell ill with the infection.

The virus spread to “hospital C” when a patient who was infected at hospital A underwent dialysis at hospital C while sick. Two other patients at the latter hospital subsequently were infected.

In addition, eight MERS-CoV patients were transferred to “hospital D,” a regional referral hospital. One of those patients passed the virus to two others at hospital D, and another passed it to a physician there, the authors concluded.

The team monitored 217 household contacts of patients with confirmed cases. They found only five cases—three confirmed and two probable—in adult relatives of three of the patients. One of them was treated at another hospital, “hospital B,” where the report lists no other cases.

Only two confirmed cases were detected among more than 200 healthcare workers who were monitored after exposure, according to the report.

In mapping transmission chains, the team found that one patient passed the infection to seven other people, one passed it to three others, and four transmitted it to two persons each. The authors say this variability in transmission is “reminiscent of SARS” (severe acute respiratory syndrome), which is caused by another coronavirus. Some patients in the SARS epidemic in 2003 were described as “super spreaders.”

The median incubation period in the outbreak was 5.2 days (95% confidence interval, 1.9 to 14.7 days). On the basis of recent MERS cases, the World Health Organization has said the incubation time may run as long as 10 to 14 days.

The investigators obtained full genome sequences from isolates from four patients. From a phylogenetic analysis of these sequences and from other data, they estimated that the date of the most recent common ancestor of MERS-CoV was Aug 18, 2011. This broadly agrees with the conclusion of a German team that, in a Lancet Infectious Diseases report this week, estimated the date of the most recent common ancestor as mid-2011.

The authors were unable to determine if the hospital outbreak involved just one, or more than one, transmission of the virus from the community.

Also, they couldn’t answer another key question about the virus: whether person-to-person transmission occurred through respiratory droplets or direct or indirect contact and whether aerosol transmission occurred over a distance of more than 1 meter.

The report says the pattern of the outbreak is consistent with the assumption that patients were infectious only when they had symptoms, but this doesn’t rule out transmission during the incubation period or during asymptomatic infection.

In other findings, the authors note that the survival rate was higher for patients who were identified through active surveillance than for those who were identified clinically. They say the likely reason was that active surveillance was better at picking up less-severe disease.

Assiri A, McGeer A, Perl RM, et al. Hospital outbreak of Middle East respiratory syndrome coronavirus. N Engl J Med 2013 (Early online publication). [Abstract]

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CDC expert reports some anomalies in Jordan MERS cases

Jun 19, 2013 (CIDRAP News) – Eight Jordanians who had MERS-CoV (Middle East respiratory syndrome coronavirus) infections in a hospital outbreak more than a year ago, as determined by recent blood tests, didn’t quite match the profile of more recent cases, according to a CDC expert.

Most of the eight people did not have preexisting diseases, and one of them had no symptoms, said Mark Pallansch, PhD, director of the CDC’s Division of Viral Diseases.

The majority of MERS-CoV cases reported in recent months involved patients who had preexisting health problems such as diabetes or heart disease. And the asymptomatic case appears to be the first one reported.

The eight cases were associated with a hospital outbreak in Zarqa, Jordan, in April 2012. The cause of the outbreak was a mystery at the time, because MERS-CoV was not discovered until June of last year, when a Saudi man died of his infection.

The Jordan outbreak involved 11 cases, 2 of them fatal. Samples from the patients were stored, and later analysis led to confirmation of the virus in the two fatal cases. The WHO said the other cases probably were MERS, but that couldn’t be confirmed.

Earlier this week a Canadian Press report revealed that serologic (antibody) tests of 124 people related to the Jordan cluster had turned up 8 more cases, raising the number of confirmed cases in the outbreak to 10. The testing was done by the CDC in collaboration with Jordanian health officials.

Pallansch provided more details on the study in an interview. He cautioned that the findings are preliminary, because the CDC has had few serum samples from MERS-CoV patients with which to validate the two new serologic tests that were used.

“There’s always a caveat that we could have subsequent testing change some of the results,” he said.

Six of the eight cases were in healthcare workers and were part of the hospital illness cluster, Pallansch said.

One of the other two, the asymptomatic case, was in a household contact of one of the confirmed cases, he reported. The other one involved a healthcare worker who worked at the same hospital as the others. That person “by recall did have an illness, but was not considered part of the cluster at the time,” he said.

Among the other six case-patients, “there was a range of illness, but all were hospitalized, so it was reasonably severe,” Pallansch said.

He said he is not aware of any other asymptomatic MERS-CoV cases. Such cases are considered important because they suggest that people who aren’t sick can unknowingly spread the virus. Asymptomatic cases are likely to be discovered only through serologic tests, which for MERS-CoV have become available only recently.

Pallansch said he couldn’t give any information about how the first case-patient in the Jordanian cluster might have caught the virus or about the patients’ possible animal exposures. Officials are still working on their report, he explained.

“This is a report that will go back to the Jordanian Ministry of Health, and they’ll make decisions about how it will be disseminated or published,” he said.

See also:

Related Jun 17 CIDRAP News story

Nov 30, 2012, CIDRAP News story

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Bloomberg Business Week

AP News

New MERS virus spreads easily, deadlier than SARS

By By Maria Cheng
June 19, 2013

LONDON (AP) — A mysterious new respiratory virus that originated in the Middle East spreads easily between people and appears more deadly than SARS, doctors reported Wednesday after investigating the biggest outbreak in Saudi Arabia.

More than 60 cases of what is now called MERS, including 38 deaths, have been recorded by the World Health Organization in the past year, mostly in Saudi Arabia. So far, illnesses haven’t spread as quickly as SARS did in 2003, ultimately triggering a global outbreak that killed about 800 people.

An international team of doctors who investigated nearly two dozen cases in eastern Saudi Arabia found the new coronavirus has some striking similarities to SARS. Unlike SARS, though, scientists remain baffled as to the source of MERS.

In a worrying finding, the team said MERS (Middle East respiratory syndrome) not only spreads easily between people, but within hospitals. That was also the case with SARS, a distant relative of the new virus.

“To me, this felt a lot like SARS did,” said Dr. Trish Perl, a senior hospital epidemiologist at Johns Hopkins Medicine, who was part of the team. Their report was published online Wednesday in the New England Journal of Medicine.

Perl said they couldn’t nail down how it was spread in every case — through droplets from sneezing or coughing, or a more indirect route. Some of the hospital patients weren’t close to the infected person, but somehow picked up the virus.

“In the right circumstances, the spread could be explosive,” said Perl, while emphasizing that the team only had a snapshot of one MERS cluster in Saudi Arabia.

Cases have continued to trickle in, and there appears to be an ongoing outbreak in Saudi Arabia. MERS cases have also been reported in Jordan, Qatar, the United Arab Emirates, Britain, France, Germany, Italy and Tunisia. Most have had a direct connection to the Middle East region.

In the Saudi cluster that was investigated, certain patients infected many more people than would be expected, Perl said. One patient who was receiving dialysis treatment spread MERS to seven others, including fellow dialysis patients at the same hospital. During SARS, such patients were known as “superspreaders” and effectively seeded outbreaks in numerous countries.

Perl and colleagues also concluded that symptoms of both diseases are similar, with an initial fever and cough that may last for a few days before pneumonia develops.

But MERS appears far more lethal. Compared to SARS’ 8 percent death rate, the fatality rate for MERS in the Saudi outbreak was about 65 percent, though the experts could be missing mild cases that might skew the figures.

While SARS was traced to bats before jumping to humans via civet cats, the source of the MERS virus remains a mystery. It is most closely related to a bat virus though some experts suspect people may be getting sick from animals like camels or goats. Another hypothesis is that infected bats may be contaminating foods like dates, commonly harvested and eaten in Saudi Arabia.

 

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Earth Watch Report  –  Epidemic Hazards

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06.06.2013 Epidemic Hazard Italy Tuscany , [The area was not defined.] Damage level Details

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Epidemic Hazard in Italy on Saturday, 01 June, 2013 at 02:56 (02:56 AM) UTC.

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Updated: Thursday, 06 June, 2013 at 02:06 UTC
Description
A new respiratory virus related to the severe acute respiratory syndrome (SARS) found in patients in Italy was “under control,” Health Minister Beatrice Lorenzin said on Wednesday. Lorenzin said 60 people who had been in contact with patients whose infection has been confirmed were being observed. “All reported negative tests and enjoy good health,” she said. “For this reason, I feel like assuring parliament and citizens that the situation is under control,” the health minister added. Three people were being treated in Tuscany region, in central Italy, for the SARS-related virus, including a middle-aged man who recently returned from Jordan, his little niece and a colleague, according to local media. The three cases were reportedly mild. Some 51 new cases of the flu-like disease have been confirmed since September last year, several across Europe, according to the U.N. health agency.

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