WHO reports UAE MERS case, confirms 5 Saudi cases

From Robert Roos at CIDRAP, excerpt :

" The wife of a United Arab Emirates (UAE) man who contracted Middle East respiratory syndrome coronavirus (MERS-CoV) is now infected but has no symptoms, the World Health Organization (WHO) said today as it confirmed the latest five cases reported in Saudi Arabia.

The six cases raise the WHO's MERS-CoV tally to 176 cases, including 74 deaths.

The new UAE case is in a 59-year-old woman from Sharjah who is married to a 68-year-old man whose case was reported earlier, the WHO noted. Despite having no symptoms, the woman is in isolation in a hospital.

She is reported to have no history of contact with animals or recent travel, the agency said. It also said other contacts of the couple have tested negative for the virus.

The woman's husband, who had been treated in an intensive care unit (ICU), has died, the WHO said. His illness was reported by the media on Dec 20 and noted by the WHO on Dec 22. He had diabetes and chronic kidney failure.

In confirming the five latest cases reported by Saudi Arabian authorities, the WHO added a little additional information. The Saudi Ministry of Health (MOH) said all five people are from Riyadh."

Hong Kong, China offer more details on H7N9 cases

From Lisa Schnirring at CIDRAP :

" Hong Kong health officials investigating two imported H7N9 influenza from mainland China have found poultry exposures for both patients, as new details emerged about a family connection between China's two newest cases, a father and son from Zhejiang province.

Updates on Hong Kong's cases were provided today during a pandemic preparedness steering committee meeting called by Ko Wing-man, MBBS, Hong Kong's secretary for food and health, according to a government press release.

Hospital officials told the group that the first patient, a 36-year-old woman, is still hospitalized, and her condition has been upgraded from critical to serious. Her fever has subsided and she no longer needs extracorporeal membrane oxygenation (ECMO) treatment. The second patient, an 80-year-old man, is still hospitalized in an isolation unit in stable condition and has a slight fever.

MERS-CoV: UAE reports cases, Qatar finds infected c

From Robert Roos at CIDRAP, excerpt :

" The United Arab Emirates (UAE) yesterday reported three Middle East respiratory syndrome coronavirus (MERS-CoV) cases in one young family, including a pregnant woman. That report came 4 days after Qatari officials revealed that the virus was found in three camels with links to two human case-patients.

The World Health Organization (WHO) said today that the UAE cases involved a 38-year-old man, a 32-year-old woman, and their 8-year-old son. Media reports said the three were from Jordan, but the WHO statement did not list their nationality. A report today in the UAE newspaper The National said the mother has died of her illness.

The report from Qatar marks the second time the virus has been found in camels, the previous instance having been reported by Saudi Arabia about 3 weeks ago. But scientists have not yet found conclusive evidence that camels are a source of human infections."

Saudi Arabia : Camel with MERS-CoV had signs of illness

From Robert Roos at CIDRAP :

" A camel that might have passed the Middle East respiratory syndrome coronavirus (MERS-CoV) to its Saudi Arabian owner had signs of illness, a Saudi health official said today in revealing a little more information about the situation.

Saudi officials reported yesterday that a camel had tested positive for MERS-CoV, a few days after its owner, a 43-year-old man from Jeddah, was confirmed to have the virus. The case marks the first time of the virus has been found in an animal.

In a ProMED-mail post today, Ziad A. Memish, MD, the Saudi deputy minister for public health, wrote, "Camels owned by the patient which were symptomatic with fever and rhinorrhea were tested for MERS-CoV and tested positive." ProMED-mail is the online reporting service of the International Society for Infectious Diseases.

Memish added, "This is the first time that a camel related to a case tests positive for MERS-CoV by PCR. Further testing is ongoing to sequence the patient [virus] and the camel virus and compare genetic similarity level to conclude causality."

He also said the 43-year-old patient, who has no underlying chronic diseases, is still in an intensive care unit.

His comments left it unclear whether more than one camel tested positive for the virus. Today the Saudi Ministry of Health (MOH) posted an English-language version of yesterday's Arabic statement about the findings, which said, "The initial laboratory test conducted on one of those animals was positive."

MERS update: 3 more Saudi cases, 1 in Qatar

From Robert Roos at CIDRAP :

" Three more Middle East respiratory syndrome coronavirus (MERS-CoV) cases, apparently including a fatal one, were reported in Saudi Arabia over the weekend, while Qatar reported an asymptomatic case in a foreigner in the country, according to government statements and news reports.

A machine-translated statement from the Saudi Ministry of Health (MOH), apparently issued on Oct 26, said the new cases all occurred in the Eastern province. The cases involve:

An 83-year-old citizen who had contact with a confirmed case-patient, had chronic illnesses, and was in an intensive care unit (ICU)

A 54-year-old resident healthcare worker with chronic illnesses who was in stable condition in an ICU

A 49-year-old citizen, also in stable condition in an ICU

In an English-language statement dated yesterday, the MOH announced that an 83-year-old in the Eastern region who had "many chronic diseases" died of MERS-CoV. The patient appears to be the same 83-year-old whose case was announced a day earlier."

Study: Gowns, gloves in ICU don't cut MRSA, VRE

From Lisa Schnirring at CIDRAP, excerpt :

" Wearing gowns and gloves in all patient rooms in intensive care units (ICUs) didn't lead to a significant drop in two key antibiotic-resistant threats, but the practice didn't seem to have any negative effects on patient care, according to a new study.

Though the trial, which covered ICUs in 20 US hospitals in 15 states, didn't reduce the rates of acquiring methicillin-resistant Staphylococcus aureus(MRSA) or vancomycin-resistant Enterococcus (VRE), researchers did see a slightly lower risk when they looked at MRSA by itself.

The study authors, led by researchers at the University of Maryland, published their findings in an Oct 4 early online edition of the Journal of the American Medical Association (JAMA). The group also reported its findings last week in San Francisco at IDWeek, the annual meeting of four major infectious disease associations."

Eight new Saudi cases push global MERS total to 130

From Lisa Schnirring at CIDRAP, excerpt :

" Saudi Arabia's health ministry today and yesterday announced eight new Middle East respiratory syndrome (MERS) cases, all of which involved contact with previously confirmed cases, including four possible healthcare exposures.

The patients are all younger or middle-aged adults from Riyadh and Medina, and most have mild infections or are asymptomatic, the Saudi Ministry of Health (MOH) said. The new detections lift the unofficial global total to 130 cases, of which 57 have been fatal.

Three of the four cases reported yesterday were asymptomatic: a 22-year-old man from Medina, a 24-year-old man who works in a health setting in Medina, and a 60-year-old man from Riyadh. The other patient is a 47-year-old man from Riyadh who is in stable condition, according to the MOH.

Of the four MERS cases reported today, all were reported from Riyadh, and three involve healthcare workers: a 47-year-old woman who had mild symptoms, a 39-year-old woman who had mild symptoms, and a 38-year-old man whose health status is stable, the MOH said. The fourth patient is a 51-year-old woman who is also in stable condition.

The newly announced cases follow closely on the heels of eight other cases that the health ministry announced on Sep 7 and Sep 8. Three of those infections were fatal.

The World Health Organization, which has not issued a MERS update since Sep 7, lists 114 global cases, 54 of which were fatal. That total does not include the 16 most recent Saudi cases."

Study reveals more signs of MERS-CoV in cam

From Robert Roos at CIDRAP :

" Scientists have found more evidence that many camels in the Middle East have been exposed to the Middle East respiratory syndrome coronavirus (MERS-CoV) or a close relative, increasing the suspicion that camels may have spread the virus to humans.

In serologic tests on 110 dromedary camels in Egypt, one test showed that 94% of them had antibodies to MERS-CoV, and a second test revealed antibodies in 98%, according to a report in today's issue of Eurosurveillance. Tests of humans, water buffaloes, cows, and other domestic animals in Egypt and Hong Kong showed no MERS-CoV antibodies.

"The antibody titres were very high" in both sets of tests, "suggesting that the virus infecting these camels was MERS-CoV virus itself or a very closely related virus," says the report by a team of Chinese, Egyptian, and American scientists.

The findings echo those published last month by a team from the Netherlands and Germany, who tested 50 dromedaries in Oman and found that all had antibodies to MERS-CoV or a close relative. They also found that 14% of a sample of camels in the Canary Islands had similar antibodies.

Which animals harbor the MERS virus and which ones passed, or are passing, it to humans remains a mystery. Although the antibody findings indicate that camels probably have been exposed to MERS-CoV or a very similar virus, scientists have not yet isolated the virus itself from camels or any other animals."

Global MERS count tops 100 with latest from Saudi Arabia

From Robert Roos at CIDRAP :

" In a brief statement, Saudi Arabia's Ministry of Health (MOH) has reported three more cases of Middle East respiratory syndrome coronavirus (MERS-CoV), apparently pushing the global case count over 100.

The agency said two of the cases involve a 31-year-old male citizen who has several chronic diseases and is in stable condition in intensive care, and a 55-year-old male citizen who has no symptoms. The older man had contact with a confirmed case-patient. Both cases are in the Asir province in the country's southwest.

In addition, the ministry said a 51-year-old man in Riyadh who had chronic illnesses has died of a coronavirus infection, but it didn't specify whether or not his case was reported previously. The statement apparently was issued late yesterday.

The MOH's English-language media page for MERS-CoV today listed a total of 82 cases with 41 deaths in the country. That amounts to three more cases and one more death than the page showed yesterday, suggesting that all three cases are new."

US : Quadrivalent flu vaccines coming; companies cite good demand

From Robert Roos at CIDRAP :

" Quadrivalent (four-strain) influenza vaccines will make their US market debut during the upcoming vaccination season, and vaccine makers are reporting good demand for them, spurred in part by a large order from the US Centers for Disease Control and Prevention (CDC).

On the market this year are quadrivalent vaccines made by MedImmune, GlaxoSmithKline (GSK), and Sanofi Pasteur, all of which won approval from the US Food and Drug Administration (FDA) within the past 18 months.

For decades, seasonal flu vaccines have targeted three flu strains—two type A (H1N1 and H3N2) and one type B. In contrast, quadrivalent vaccines include two different B strains, in an effort to ensure that vaccinees will have reasonable protection regardless of which type B lineage turns out to be most common. In recent years it has been difficult to predict which B lineage would predominate in any given winter."

New bat virus called closest known relative of MERS-CoV

From Robert Roos at CIDRAP, excerpt :

" The view that MERS-CoV (Middle East respiratory syndrome coronavirus) originated in bats gathered steam today with the report that a new coronavirus (CoV) found in the feces of a South African bat is more closely related to MERS-CoV than any other known virus.

The study, published as a letter in Emerging Infectious Diseases, doesn't solve the mystery of what animal is passing MERS-CoV to humans. But the authors, from the University of Bonn, Germany, and several South African institutions, say the findings suggest that ancestors of the human virus evolved in African bats.

The scientists previously discovered that MERS-CoV is closely related to CoVs found in European Pipistrellus bats. They say their newly discovered virus is genetically much closer to MERS-CoV than the Pipistrellus viruses are."

CDC says norovirus sickens up to 21 million a year

From Lisa Schnirring at CIDRAP, excerpt :

" Getting a handle on the nation's norovirus burden is difficult, because reporting isn't required and there's not a widely used test for the disease, but experts from the US Centers for Disease Control and Prevention (CDC) who analyzed the latest data reported new estimates yesterday—up to 21 million infections each year, as many as 800 fatal.

The new estimates provide some detailed and surprising numbers. For example, the CDC experts predict that the disease strikes five times during a typical American's lifespan.

Before yesterday's new numbers, reported in Emerging Infectious Diseases, the most often cited norovirus burden numbers were from a 1999 report that covered a broad array of foodborne illnesses. While the new annual illness estimate is slightly lower than the earlier one, the CDC researchers reported overall upticks in hospitalization and death numbers."

WHO sees changing pattern in recent MERS cases

From Robert Roos at CIDRAP, excerpt :

" Recent MERS-CoV cases have featured less severe symptoms and patients who were younger and more likely to be female, but precisely what the changing pattern means is not clear, the World Health Organization (WHO) said in a new summary today.

The report came on the heels of a Saudi Arabian Ministry of Health (MOH) report of another new case, this one in a 66-year-old man in the southwestern province of Asir, who was said to be in stable condition. His illness raises Saudi Arabia's MERS-CoV (Middle East respiratory syndrome coronavirus) count to 66 cases with 38 deaths.

The MOH also announced the recovery of another patient, a female healthcare worker in Hafr Al-Batin in the northeastern part of the country. She apparently is the same patient whose case was noted by the WHO 2 days ago. The WHO listed her age as 56.

In still another development, the WHO's new emergency committee on MERS-CoV held its first teleconference today and scheduled a second session for Jul 17, the WHO said. Today's inaugural session focused on background briefings."

H7N9 prompts fresh look at H7 pandemic potential

From Lisa Schnirring at CIDRAP : 

" Some of the US government's top influenza experts today weighed in on the threat from the new H7N9 virus, airing some unusual properties of H7 viruses that challenge the notion that they aren't likely to adapt to humans or cause pandemics.

The same experts addressed the H7N9 virus linked to China's recent outbreak more specifically in the Jun 20 issue of the New England Journal of Medicine (NEJM), but their report today looks at the pandemic potential through the lens of what's known about other H7 viruses.

The group's review appears in the latest issue of mBio, the online journal of the American Society for Microbiology. The experts are all from the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH). They are NIAID Director Anthony Fauci, MD, Dave Morens, MD, senior advisor to Fauci, and Jeffery Taubenberger, MD, PhD, section chief of NIAID's Laboratory of Infectious Diseases."

Saudi Arabia says 2 more MERS patients have died

From Robert Roos at CIDRAP :

" Two more Saudi Arabians have died of MERS-CoV (Middle East respiratory syndrome coronavirus) infections, the Saudi Ministry of Health (MOH) reported today. Both cases had been announced previously.

The patients were a 75-year-old "citizen" in Al-Ahsa governorate and a 63-year-old woman in Riyadh. The MOH simultaneously also announced the recovery of three other MERS patients: a 61-year-old citizen in Al-Ahsa, a 41-year-old woman in the Riyadh region, and a 50-year-old woman in the Eastern region.

The two deaths raise the Saudi death toll, unofficially, to 36, out of 64 cases. At this writing, the MOH's coronavirus overview page has not been updated since Jun 24 and still lists the death toll at 34."

Poultry contact, chronic illness cited as H7N9 risk factors

From Lisa Schnirring at CIDRAP :

" A study designed to sift out some of the risk factors for H7N9 influenza in China found that exposure to live poultry and their environments were the main drivers, as well as having some types of chronic illness, researchers reported yesterday.

The group, from the Chinese Center for Disease Control and Prevention and provincial centers, focused their study on H7N9 patients from Jiangsu province, and they surveyed controls to identify features that did and didn't associate with infection risk. They published their findings in Eurosurveillance.

Jiangsu province had 27 cases as of May 27, but researchers excluded 2 of them, because one involved human-to-human transmission and data were missing for the other. Eight of the cases were fatal. The study included 93 controls that were matched by age, sex, and location.

Researchers conducted the survey between Apr 25 and May 12. It included questions about health status, daily habits, and activity and environmental exposures within 2 weeks of case illness onsets. Questions about poultry exposure asked about direct contact at markets, home, or work.

Patient ages ranged from 21 to 85, with 12 of them older than 60. Nineteen of the patients were men."

China : H7N9 cases found by routine surveillance trended younger, milder

From Lisa Schnirring at CIDRAP :

" A report on five Chinese H7N9 cases that were detected during routine flu surveillance reveals that the patients had milder infections and were younger than most, shedding new lighton the spectrum of illness and the challenges officials could face in controlling the disease.

China is thought to have a good influenza surveillance system, and the report yesterday in the British Medical Journal (BMJ) provides a useful look behind the curtain on how they monitor flu, especially during an outbreak of an emerging infections.

The five surveillance detections were included in the 130 H7N9 infections reported by China as of May27. The country reported 131 cases overall, and Taiwan has reported one infection, putting the total outbreak number at 132. So far 39 patients have died from their illnesses.

China's national sentinel surveillance system includes 554 hospitals across the mainland's 31 provinces. Influenza-like illnesses are reported weekly to the China Centers for Disease Control and Prevention (China CDC). At each site, 10 to 15 nasopharyngeal swabs are collected weekly in convenience sampling of patients who have had flu-like illness with fever for no longer than 3 days and have not had antiviral drugs.

Outpatient clinics and emergency departments are the first step for sick patients, because of China's national health insurance coverage and the lack of stand-alone clinics, according to the report.

Three of the five H7N9 patients were young children, and the ages ranged from 2 yearsbto 26 years. Four were male, and all lived in urban areasin three provinces. Their symptom onsets ranged from Mar 17 to Apr 26. Four had been exposed to live animals, including chickens.

All of the patients had fever and upper respiratory tract infections, and all had mild-to-moderate H7N9 infections and quickly recovered. Two patients were hospitalized, one of whom had pneumonia that didn't require intensive care. Close-contact monitoring turned up no additional cases."

Saudis, WHO report 8 asymptomatic MERS cases

From Robert Roos at CIDRAP :

" Saudi Arabia reported nine new MERS-CoV (Middle East respiratory syndrome coronavirus) cases in the past 3 days, including six cases that were asymptomatic.

In addition, the World Health Organization (WHO) reported on Jun 22 that two Saudi MERS cases that had been announced earlier were also asymptomatic. The Saudi and WHO reports offered the clearest evidence yet of such cases, which suggest the possibility that people can unknowingly carry and spread the virus.

Also over the weekend, the WHO's Eastern Mediterranean Regional Office (EMRO) appealed for fast, complete reporting of MERS-CoV cases, in the wake of a meeting in Cairo of public health experts from all countries that have had cases.

New Saudi cases

The Saudi Ministry of Health (MOH) announced the latest cases and deaths in statements on Jun 21 and 23.

The Jun 21 announcement reported the illness in a 41-year-old woman in Riyadh and a 32-year-old Saudi citizen in the country's Eastern region. The woman is a contact of a previous case-patient and was in stable condition, while the 32-year-old had cancer and was in an intensive care unit. The statement also noted the death of a previously reported patient but gave no details.

The MOH's Jun 23 statement announced the six asymptomatic cases and one symptomatic one. Four of the silent cases were in children between the ages of 7 and 15, all of whom had contact with other cases in Riyadh and the Eastern region.

The other two symptom-free cases involved female healthcare workers (HCWs in the Eastern region and Al-Ahsa. The MOH did not specify if the two HCWs were exposed to MERS patients, but it seemed likely, since Al-Ahsa was the site of recent hospital outbreaks." 

Saudis say 4 people beat MERS, but another 4 died

From Robert Roos at CIDRAP :

" Saudi Arabia announced today that four women have recovered from previously unreported cases of MERS-CoV (Middle East respiratory syndrome coronavirus), while another four people have died of MERS infections that were announced earlier.

With this news, the Saudi Ministry of Health's (MOH's) MERS-CoV count rose to 53 cases. However, the death toll listed on the MOH's MERS overview page remained at 32 at this writing.

If the new cases and deaths are added to the World Health Organization's (WHO's) global MERS tally, it will increase to 68 cases and 42 deaths. The current WHO count is 64 cases and 38 deaths.

The Saudi announcement closely followed the start of a 3-day meeting in Cairo at which health officials from the Eastern Mediterranean and Europe aim to develop a MERS-CoV response plan.

Also today, the WHO issued a summary of MERS-CoV developments over the past 3 weeks. The agency predicted, "It is likely that more sporadic cases with subsequent limited transmission will occur in the near future," a forecast that today's Saudi announcement seemed to fulfill.

The Saudi statement said the four new cases involved a 42-year-old Saudi woman in the Eastern region and three female healthcare workers, ages 45, 39, and 29, in Taif governorate, which is near Mecca in the western part of the country. 

The 42-year-old has been released from a hospital, and the other three have all recovered, the MOH reported. A total of 14 patients in Saudi Arabia now have recovered from MERS, the agency said." 

CIDRAP : WHO cites 7th coronavirus case, gives surveillance guidance

From Robert Roos at CIDRAP, please click the link for more information on patient details : 

A third case in a family cluster of novel coronavirus infections has been confirmed, raising the global case count to seven, and the fourth illness in the family is now listed as a probable case, the World Health Organization (WHO) has announced.

In a statement dated yesterday, the WHO also indicated that only one death has been attributed to the novel virus so far, contradicting a Nov 23 announcement that reported two deaths among the first six cases.

The WHO also offered new surveillance recommendations for the novel virus. The agency called for testing of patients in any cluster of severe, unexplained respiratory infections, regardless of location or travel history, and testing of healthcare workers who suffer unexplained pneumonia after caring for patients with severe respiratory infections.

And in a related development, the Saudi Medical Journal reported that the person who had the third known novel coronavirus case is a 45-year-old gym teacher who visited a farm 3 days before he got sick and who survived his severe illness despite having preexisting health problems and only one kidney.

Update on cases

In reporting on cases 3 through 6 on Nov 23, the WHO said two of the confirmed patients belonged to the same family and household in Saudi Arabia and that two more members of the same family were sick, but their cases had not been confirmed. The latest statement said three of the confirmed case-patients and the person with the probable case all belong to the same family.

The statement did not specify whether the family members are thought to have passed the virus to one another or caught it from another source. "The source of the virus is unknown, as is the mode of transmission," the statement says.

The cases occurred in the Jeddha and Riyadh areas of Saudi Arabia, which are bout 850 kilometers apart, and in Doha, Qatar, the WHO noted.

The new announcement notes only one death from the novel coronavirus so far, a change from last week's statement noting two deaths among the first six cases. The WHO did not respond to a query about this point this afternoon."