Hong Kong : Fatal case of invasive pneumococcal infection investigated

Press release from Hong Kong's CHP :

" In response to media enquiries, a spokesperson for the Centre for Health Protection (CHP) of the Department of Health said today (November 19) that the CHP is investigating a fatal case of invasive pneumococcal infection involving a 3-year-old boy. This kind of infection is caused by the bacterium Streptococcus pneumoniae.

The boy, with good past health, presented with fever and cough on November 12. He sought medical consultation from two private hospitals on November 12 and 14 respectively. He was admitted to another private hospital on November 15. As his condition deteriorated, he was transferred to Queen Mary Hospital (QMH) Paediatric Intensive Care Unit on November 17 and died on the same day.

The boy's pleural fluid specimens tested positive for serotype 3 Streptococcus pneumoniae upon laboratory testing by both the Public Health Laboratory Services Branch of the CHP and QMH.

Preliminary investigation revealed that the boy had been immunised with 7-valent Pneumococcal Conjugate Vaccine (PCV) and 10-valent PCV booster. He had no recent travel history and his family contacts are currently asymptomatic. No other similar cases have been reported by the kindergarten which he attended. Advice on prevention of respiratory infectious diseases has been given to the management of the kindergarten. The case will be referred to the Coroner's Court for investigation."

Singapore : Dengue still spreading in Orchard Road cluster, 93 people infected so far

Article via Straits Times :

" Dengue is still spreading along Orchard Road and the adjoining areas.

So far, 93 people have been infected in the Orchard Road cluster - making it the second-largest cluster in the country. More than half are workers at a construction site there.

Another 40 people have been infected in adjoining clusters in areas such as Oxley Road, Devonshire Road and Leonie Hill."

African swine fever kills over 1, 682 pigs in Zambian capital

Via Shanghai Daily :

"  An outbreak of African swine flu in Lusaka, the Zambian capital, has killed more than 1,682 pigs for the past month, prompting the government to put in place measures to contain the outbreak, a senior official said on Monday.

Minister of Agriculture and Livestock Robert Sichinga said preliminary estimates indicate that 11,000 pigs have so far been affected by the disease on 14 farms and another 14,000 animals from areas near the affected farms are at risk of contracting the disease. The minister however said the figures could be much higher because some farmers were not being cooperative while others may be under-reporting the mortalities.

"Immediate measures have been instituted to contain and eradicate African swine fever from Lusaka Province. To that effect, pork processing plants have been directed to stop processing pork. In addition, all pig movements and marketing in Lusaka Province has been banned with immediate effect," he told journalists at a press briefing at his office."

Australia : New dengue case sparks warning

Via ABC News :

" Port Douglas residents are being urged to take precautions against dengue fever after confirmation of a new case.

Queensland Health says it is the fifth case of the mosquito-borne virus in the far north this month.

The other cases were at Miallo in the Mossman area.

Dr Richard Gair from the Cairns Tropical Public Health Unit says people should use repellent and clear-up possible breeding sites around the home.

"We've already treated all the affected premises in Miallo, so we are now concentrating on anywhere that the new case in Port Douglas might have caught the disease from mosquitoes, so anywhere that the case had been in the incubation period we are checking and doing mosquito control," he said.

Dr Gair says a man was diagnosed with the virus on Friday."

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

Press release from WHO :

" 18 NOVEMBER 2013

WHO has been informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) from Kuwait.

The first patient is a 47 year-old man who became ill on 30 October 2013 and was hospitalised on 7 November 2013. He is in critical condition. The second patient is a 52-year-old man with underlying medical conditions. He became ill on 7 November and was hospitalised on 10 November 2013. He is in critical condition.

Globally, from September 2012 to date, WHO has been informed of a total of 157 laboratory-confirmed cases of infection with MERS-CoV, including 66 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations."

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

From WHO :

" 15 November

WHO has been informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV). These include one laboratory-confirmed case from the United Arab Emirates and one laboratory-confirmed case in Qatar.

The patient reported from the United Arab Emirates is a national of Oman. He is 75 years old, with underlying medical conditions. He became ill on 1 October 2013, was hospitalized on 12 October 2013 and died on 10 November 2013.

The patient from Qatar is a 61-year-old man with underlying medical conditions. He became ill on 4 November 2013, and was hospitalised on 7 November 2013. He is in critical condition. Preliminary epidemiological investigation indicates that the patient had exposure to farms where livestock are kept.

Additionally, a previously laboratory-confirmed case from Oman has died."

India : Two-year-old dies in Chennai after contracting H1N1

Article via Times of India :

" A two-year-old girl died in Chennai after being infected by H1N1 virus on Sunday. 

Tamil Nadu health department confirmed that she tested positive for the virus, but denied it was the cause of death. 

The city recorded its first death due to H1N1 this year on October 12 when Kathirvel (65) died of respiratory infection. The latest case takes the number of reported H1N1 cases in the state to 24 this year. 

Dharshini Senthil Kumaran from Kalpakkam was diagnosed with steroid-resistant nephrotic syndrome, a form of kidney disease in August for which she was being treated in Dr Mehta Hospitals in Chennai. Dharshini was admitted on October 21 and discharged on October 29. 

"She was re-admitted to the hospital on November 6 after she developed swelling on the legs," said director of public health K Kulandaisamy. She also had cough and fever for one day which developed into a respiratory problem. When the child began developing breathing difficulties, she was shifted to the intensive care unit on November 9. "

There are already 129 the dead by the dengue epidemic in Colombia

Machine translated article via El Economista :

" The number of people who have died from dengue fever epidemic has broken out in Colombia has risen to 129, as reported by the director of the National Institute of Health (NIH), Fernando de la Hoz.

Also been estimated at 110,000 the number of people affected, indicating that focus on children under 15 years of age. "This population has the greatest risk of death from dengue present," he said.

Geographically, explained that there are 825 municipalities affected, of which 76 are in "outbreak situation" and 99 on "alert status", as reported by the Colombian radio station RCN."

India : As chill sets in, H1N1 fears rise in Bangalore

Via The New Indian Express :

" After dengue, the State and the city in particular are being advised to prepare for yet another arrival of an unwelcome visitor this winter-H1N1 (Swine) flu. With 18 deaths and 115 cases reported since January, cases could shoot up during the cold season.

Speaking to Express, Dr Geetha Nyamgouder said the figures were not alarming compared to the last few years. However, the State government recently issued a standing instruction to all district health officers to increase awareness, education and communication programmes to the public through its 35,000 link workers. “Neglecting common cold, fever, headache and nasal secretions may cost people their lives as they may be one of the symptoms of the virus,” Dr Nyamgouder said. She noted that children and the elderly were more vulnerable as their immunity levels were low.

Worryingly for Bangaloreans, areas under BBMP limits registered more cases than the average incidence in the State. In BBMP limits, 64 cases were detected in 2012, out of which three turned out to be fatal.

Dr Manoranjan Hegde, BBMP nodal officer, said, “We have deployed three health officers, six deputy health officers, 27 medical health officers and all auxiliary nursing midwives to reach out to people with information on precautions to avoid the complications of this disease.”

Dr Shashidhar Buggi, medical director, Rajiv Gandhi Institute of Chest Diseases, confirmed the hospital recorded a significant number of cases of H1N1 flu in 2012, many of which were fatal. “Swine flu claimed 48 lives in 2012, but things have improved this year. However, the virus has a higher chance of spreading through droplets during winter,” Buggi said."

Malaysia : 67 Per Cent Increase In Dengue Fever Cases Nationwide To Date

Via Bernama :

" The total number of dengue fever cases rose by 67 per cent from January to Nov 9 this year compared to the same period last year.

Deputy health director-general (Public Health) Datuk Dr Lokman Hakim Sulaiman said there were 31,170 dengue fever cases reported for the period, 67 per cent higher than 18,679 cases last year.

Dengue fatalities also increased to 63 this year compared to 32 deaths for the same period last year, he said in a statement here.

Lokman said there were 412 localities with dengue fever infection at the moment with 79 hotspots found only in Selangor.

"The dengue hotspots are in four districts in the state namely 38 localities in Petaling district, 30 localities in Hulu Langat district, nine localities in Gombak district and two localities in Sepang district," he said.

He said between Nov 3 to 9 last week, there were 1,416 dengue cases reported nationwide with seven states showing more cases compared to the previous week."

Dengue cases on the rise in Nicaragua

Another article from Xinhua :

" Dengue cases are still on the rise in Nicaragua despite the end of the rain season, with a total of 7,294 people have been infected by the mosquito-borne disease this year, the government said Wednesday.

Of the 7,294 confirmed cases, 39 are in serious conditions, according to government spokeswoman Rosario Murillo. In addition, some 1,522 people are suspected of having dengue."

Taiwan : First Case of New Bird Flu Identified in Human Patient

From Time, excerpt :

" The latest version is called H6N1, and represents the first time that this strain of bird flu has jumped from birds to people.

Flu researchers are especially wary of birds, from wild avian species like migrating geese to run-of-the-mill chickens at local poultry markets. They harbor a series of influenza strains that generally don’t make the birds sick, but could cause serious disease in people if if they jumped to human hosts.

In recent years, more bird flu viruses that had never infected people before have been finding new human hosts. Last spring, for example, scientists in China reported the first human cases of H7N9 infections. These viruses previously circulated among birds, but mutations helped  them to survive and sicken people as well.

Now, researchers in Taiwan say another avian flu strain, H6N1, may have made the jump as well. Reporting in the journal Lancet, scientists describe what they found when they analyzed a throat swab from a 20-year old woman who came to the hospital with shortness of breath and flu symptoms. When they sequenced the virus in her sample, they found it was very similar to H6N1 strains that have been found in chickens in the country since the 1970s, with one exception: this H6N1 had a mutation that gave it the ability to stick to human cells and gain entry, causing infection. Specifically, the mutation helped the virus to bind to cells in the human upper airway – a good place for viruses to attach after they are inhaled through the nasal passages."

H1N1 death toll in Honduras rises to four

Via Xinhua : 

" The death toll from the H1N1 Influenza A virus in Honduras has risen to four, with the latest death in the northern city of San Pedro Sula, a Health Ministry official said Wednesday.

Bredy Lara, Director of the health monitoring department of the ministry, confirmed the death of the fourth victim only a week after announcing the death of the third.

The latest fatality involves a woman with a history of respiratory disease, Lara said, adding, "we conclude that besides her history, flu contributed to her death."

The previous victims included a woman from Haiti, a woman from the central town of Valle de Angeles, and a man from the southern city of Choluteca.

This year has seen 127 confirmed cases of H1N1, including 71 women and 56 men, Lara said."

Kuwait reports 2nd MERS-CoV. infection case

From KUNA :

" A 52-year old citizen tested positive for the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection, the Ministry of Health announced on Wednesday.

The man has recently arrived from an overseas trip; his condition is stable so far, Dr. Mosaab Al-Saleh, head of the Ministry's anti-epidemic unit, told KUNA tonight. "The man was admitted to the Infectious Diseases Hospital and the necessary preventive measures were put in place pursuant to the guidelines of the World Health Organization (WHO)," he added.

Dr. Al-Saleh noted that the second infection case has no relation to the first one announced earlier today.

All those in contact with the first case - a 47-year old citizen, are in good health, he said, promising that the Ministry will update the public on the developments of the matter in a transparent way."

WHO : Cholera in Mexico – update

Press release from WHO : 

" The Ministry of Health in Mexico has reported an additional four cases of infection with Vibrio cholerae O1 Ogawa. Of these, two are from the state of Hidalgo and two from the state of Veracruz.

Since the beginning of this outbreak in September 2013 to date, a total of 180 confirmed cases, including one death, of cholera due to Vibrio cholerae O1 Ogawa has been reported in the country. Of these, two are from the Federal District, 159 cases from the state of Hidalgo, nine from the state of Mexico, two from the state of San Luis Potosi and eight from the state of Veracruz. Ninety-two of the total confirmed cases are women and 88 are men, with the age ranging from three-months to 88 years old.

The health authorities of Mexico continue to strengthen outbreak investigation and surveillance at the national level and continue to ensure the availability and quality of care in medical units. Health professionals at different levels of the health care system are being trained in prevention and treatment of the disease. Measures are being implemented to ensure access to drinking water and basic sanitation at the community level. Awareness campaigns, particularly around safe water and food consumption are being carried out in Spanish and indigenous languages.

An antimicrobial susceptibility test for Vibrio cholerae O1 Ogawa was conducted by the Institute of Epidemiological Diagnostics and Reference (InDRE) which demonstrated that the bacterium was susceptible to doxycycline and chloramphenicol, with reduced susceptibility to ciprofloxacin and resistance to trimethoprim/sulfamethoxazole.

This is the first local transmission of cholera recorded since the 1991-2001 cholera epidemic in Mexico. The genetic profile of the bacterium obtained from patients in Mexico presents high similarity (95%) with the strain that is currently circulating in three Caribbean countries (Haiti, Dominican Republic and Cuba), and is different from the strain that had been circulating in Mexico during 1991-2001 epidemic."

Resistance to Malaria Drugs Has Spread in SE Asia

Article from ABC News, excerpt :

" International experts raised the alarm Tuesday over the spread of drug-resistant malaria in several Southeast Asian countries, saying it endangers major global gains in fighting the mosquito-borne disease that kills more than 600,000 people annually.

While the disease wreaks its heaviest toll in Africa, it's in nations along the Mekong River where the most serious threat to treating it has emerged.

The availability of therapies using the drug artemisinin has helped cut global malaria deaths by a quarter in the past decade. But over the same period, resistance to the drug emerged on Thailand's borders with Myanmar and Cambodia and has spread. It has been detected in southern Vietnam and likely exists in southern Laos, said Prof. Nick White of the Thailand-based Mahidol Oxford Tropical Medicine Research Unit.

White, a leading authority on the subject, said that while there's no confirmed evidence of resistance in Africa, there's plenty of risk of transmission by air travelers from affected countries, such as construction laborers, aid workers or soldiers serving on peacekeeping missions."

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."

Indonesia : Youth Suspect Bird Flu Origin Purwakarta Working in Poultry

Machine translated article from Detik News :

" The boy from Purwakarta initials RH (18), who was diagnosed with bird flu suspect, breathed his last while undergoing treatment at Hasan Sadikin Hospital (RSHS) Bandung. 

He had a history of contact with poultry. "He's been working. Incidentally worked as a technician at a chicken farm. suspected Thus (suspect bird flu) have been in contact with poultry," said Head of Public Relations and Protocol RSHS Tengku Djumala Bandung Sari reporters when met at RSHS, Pasteur Road, City of London, on Tuesday (11/12/2013).

Teenage it had received treatment at the Flamboyant RSHS for three days or since last Saturday, November 9. But the patient's medical condition Bayu Asih Purwakarta referral hospitals was already deteriorating when they arrive at RSHS."

Malaysia, Malacca : Hospital purportedly turns away patients with suspected dengue

Via The Star, excerpt :

" Several patients seeking treatments for suspected dengue complications claimed that medical officers at Malacca Hospital had asked them to leave earlier or return daily for treatments purportedly due to lack of hospital beds.

Some, who turn up with high fever were told that their treatment had to be postponed because the hospital was filled to the brim with patients and it could not safely take them in.

Patients believed that the bed crunch could be a result of several factors, including the increase of dengue cases, recently.

Scores of patients’ relatives told Star Metro that the hospital was forced to turn away patients due to the purported overcrowding.

One of them who requested anonymity claimed that his sister-in-law was weak and dehydrated when she was referred to the hospital by a panel clinic with suspected dengue but was not admitted despite her anaemic condition."

China : 2 human H7N9 cases reported in October

Via Xinhua :

" Two new human H7N9 avian flu cases were reported on the Chinese mainland in October, according to an update released Monday by China's health authority.

Two men, a 35-year-old from Shaoxing and a 67-year-old from Jiaxing, both cities in east China's Zhejiang Province, were confirmed as having the disease last month, the National Health and Family Planning Commission said in the report.

China had reported 136 total cases by the end of October, with 45 fatalities.

Of the total, 87 H7N9 patients have been discharged from hospitals after receiving treatment, according to the commission.

The H7N9 infections cover 42 cities in 12 provincial regions, the commission said."

India, Bangalore : Haj returnee diagnosed with MERS

Via Deccan Herald :

" A passenger who returned to the City after Haj has been diagnosed with Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which, though rare in India, has killed 63 people globally.

Bangalore International Airport health officials directed the person to the Rajiv Gandhi University of Chest Diseases in the city after finding her ill.

Speaking to Deccan Herald, department of health and family welfare director Geetha Nyama Goudar said the patient was suspected of being affected and was coughing severely.

"Though she was permitted to go home, we have informed the authorities to keep a check,” she added.

Rajiv Gandhi University of Chest Diseases and SDS Tuberculosis Research Centre Director Dr Shashidhar Buggi said the patient was brought to hospital on Sunday afternoon and preliminary tests conducted.

"We have also taken the swabs and it will be sent to the National Institute for Mental Health and Neuro Sciences on Monday for examination” he said. He said the patient showed symptoms similar to those affected by the H1N1 virus.

"Though the patient was advised to get admitted, there was refusal from their side to do so,” Dr Buggi added. The resident of Ananthapur initially complained of sore throat and also had fever. The patient was normal and the condition did not appear to be serious, he said.

Dr Ravi, senior Pathologist at NIMHANS explained that MERS was a very rare condition and not more than ten cases in the country have been suspected of the virus so far. "It is more prevalent in the Middle East countries,” he said."

Vietnam : Poultry Infected With H5N1 In Mekong Delta Province

Via Bernama :

" Poultry flocks in Tan Phu Dong district in Mekong Delta province of Tien Giang have been found to be infected with H5N1 virus, Vietnam News Agency (VNA) reported.

Ducks from four households in Tan Phu and Tan Thoi communes had earlier tested positive for H5N1 with 315 out of 557 infected birds having died of the virus.

The remaining ducks have been culled.

The province's veterinary sector has conducted inoculation on more than 12,000 fowls in 54 households in the two communes and decontaminated the area."

Honduras confirms 3rd death from H1N1 flu

Via Xinhua :

" The Honduran Health Ministry on Wednesday confirmed the third death from the H1N1 Influenza A virus in the Central American country this year.

The victim was a female resident in Valle de Angeles, a tourist hamlet in eastern Tegucigalpa, capital of Honduras, said Bredy Lara, director of the health monitoring department of the ministry.

The two previous deaths involved a woman from Haiti and a man from the southern department of Choluteca.

A total of 91 H1N1 flu cases -- 51 women and 40 men -- have been confirmed so far in the country, Lara said.

Earlier this week, the Honduran Health Ministry launched a campaign to vaccinate more than 700,000 people against the virus. The campaign will last till Nov. 15."

India, Punjab : Two die of dengue, toll touches 4

Via The Indian Express :

" With two more dengue deaths, the toll in Ludhiana touched four on Tuesday while the number of patients in the district has touched 733 this season. As many as eight new patients were confirmed with dengue from different parts of the city on Tuesday.

The two dengue victims have been identified as 30-year-old Khanna and a 12-year-old girl from Giaspura. Both died in CMCH. The new patients who had been confirmed with dengue are from Dana Mandi, one each from Daad, Bharti Colony, Field Gunj, Kochar Market and Haibowal Kalan. District epidemiologist Dr Anil Verma said that the number of patients have reduced by one third due to the dip in temperature."

Hong Kong : Additional human case of avian influenza A(H7N9) in Zhejiang notified by NHFPC

Press release from Hong Kong's CHP :

" The Centre for Health Protection (CHP) of the Department of Health (DH) has been notified by the National Health and Family Planning Commission (NHFPC) of an additional human case of avian influenza A(H7N9) in Zhejiang affecting a woman aged 64.

The patient became ill on October 30 and is currently receiving treatment in hospital in critical condition. Her sample tested positive for the avian influenza A(H7N9) virus upon testing by the relevant health authority of Zhejiang and the case was subsequently confirmed.

To date, a total of 138 human cases of avian influenza A(H7N9) have been laboratory confirmed in the Mainland, including Zhejiang (49 cases), Shanghai (33 cases), Jiangsu (28 cases), Jiangxi (six cases), Fujian (five cases), Anhui (four cases), Henan (four cases), Shandong (two cases), Hunan (two cases), Beijing (two cases), Guangdong (two cases) and Hebei (one case).

A spokesman for the DH remarked that the CHP is closely monitoring the situation and maintaining close liaison with the Mainland health authorities for case details, as well as keeping a close eye on the latest advice from the World Health Organization (WHO)."

Cambodian toddler dies of bird flu, bringing cases to 23 so far this year

Via Xinhua :

" A two-year-old girl from northwestern Pursat province died late last month from the H5N1 virus, bringing the number of the cases to 23 so far this year, a joint statement by the World Health Organization and the Cambodian Health Ministry said Monday.

Only 11 cases out of this year's 23 cases survived, the statement said.

The little girl was confirmed positive for human H5N1 avian influenza after she was admitted to the Jayavarman VII Hospital in Siem Reap province on Oct. 25 with fever, running nose, lethargy, dyspnea, cough and breathing difficulties.

"The girl died on Oct. 26," the statement said.

"Investigations in her village found that two months before the girl's illness, poultry had suddenly died at her grandparent's house, and the child often stayed with her grandparent in this house," it said.

"Human and animal investigations are underway to determine if the girl had direct exposure or handled the dead chickens."

Malaysia hit hard by dengue virus

Via The Star :

" The country saw the highest number of dengue cases in a single week this year with 1,680 cases recorded from Oct 20 to 26, with Selangor bearing the brunt of the assault by the Aedes mosquito.

Selangor had the largest increase with 1,142 cases, up by 272 cases from the previous week.

From Jan 1 to Oct 26, a total of 28,707 cases has been recorded, which represents a 58% increase compared to the corresponding period last year, said the Health Ministry in a statement on Friday.

The Health Ministry is concerned as the weekly cases this year, at more than 900, is more than twice of last year’s weekly average of 400.

The analysis for Selangor (up to June) noted that it hosted 323 of the 408 dengue hotspots nationwide, with 26 high risk areas found in the Petaling district, 19 in Hulu Langat, eight in Gombak and one in Sepang.

The rest of the outbreak areas were located primarily in Johor (37) and Kuala Lumpur-Putrajaya (16), with the rest spread out over the other remaining states.

Johor saw 167 cases of dengue last week, while Perak had 64.

Kuala Lumpur and Putrajaya remained steady over the last two weeks with 60 cases."

Hong Kong : Patient with respiratory symptoms and travel history under CHP investigation

Press release from Hong Kong's CHP :

"   The Centre for Health Protection (CHP) of the Department of Health (DH) received notification from Tuen Mun Hospital (TMH) today (October 31) of a suspected case of Middle East Respiratory Syndrome affecting a 25-year-old man. 

The patient attended the Accident and Emergency Department of Pok Oi Hospital today for fever, runny nose, sore throat and cough with sputum. He was subsequently transferred to TMH for further management under isolation.

Initial investigations by the CHP revealed that the patient had travelled to the Kingdom of Saudi Arabia between October 4 and 28. He arrived in Hong Kong on October 29 after transit in Qatar.

His chest X-ray is clear. He is currently in stable condition.

He had no contact with animals nor patients during his visit. His travel collaterals and home contacts have remained asymptomatic.

The patient's respiratory specimens will be taken for preliminary laboratory tests by the Public Health Laboratory Services Branch of the CHP.

Locally, the CHP will continue its surveillance mechanism at public and private hospitals, with practising doctors and at the airport for any suspected case of Middle East Respiratory Syndrome."

Little girl becomes 22nd bird flu victim in Cambodia in 2013

Via Xinhua :

" A six-year-old girl from northwestern Battambang province has been confirmed of having contracted the H5N1 virus, which brings the number of the cases to 22 so far this year, a joint statement by the World Health Organization and the Cambodian Health Ministry said Friday.

The little girl was confirmed positive for human H5N1 avian influenza last week after she was admitted to the Jayavarman VII Hospital in Siem Reap province with fever, cough, abdominal pain, running nose, sore throat and dyspnea.

"The girl has been treated with Tamiflu and now, her condition is stable," the statement said.

"Investigations in her village found that chickens and ducks had recently died in the girl's neighbors' houses and also in nearby villages," it said. "Human and animal investigations are underway to determine if the girl had direct exposure or handled the sick and dead birds."

Only 11 out of the 22 cases this year survived."

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

From WHO :

"  WHO has been informed of an additional four laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV). These include the first laboratory-confirmed case from Oman and three additional laboratory-confirmed cases from Saudi Arabia.

The patient in Oman is a 68-year-old man from Al Dahkliya region who became ill on 26 October 2013 and was hospitalized on 28 October 2013. Preliminary epidemiological investigations revealed that he did not recently travel outside the country. However, investigations are currently ongoing to determine what exposures might be responsible for his infection

Of the three patients including one death reported from the Eastern Region in Saudi Arabia, one is a woman and two are men. The three patients, one of whom is a health care worker, had underlying medical conditions. Their ages range from 49 to 83 years old. All three patients reported having no contact with animals prior to their illness, while one patient was reported to have been in contact with a previously laboratory-confirmed case.

Globally, from September 2012 to date, WHO has been informed of a total of 149 laboratory-confirmed cases of infection with MERS-CoV, including 63 deaths."