Coronavirus Infects Third U.K. Family Member - Confirmed by WHO

[Treyfish]

Coronavirus Infects Third U.K. Family Member, Health Agency Says
British health authorities identified an additional case of a new respiratory virus in a relative of a person diagnosed this week, bringing the global tally of cases to 12.
The patient, who doesn’t have any recent travel history, is recovering from a mild respiratory illness, the Health Protection Authority said in a statement today, without specifying the patient’s gender or age. Officials on Feb. 11 said a British resident who traveled to the Middle East and Pakistan was diagnosed with the novel coronavirus, and on Feb. 13 they said a family member had been infected.

more...

http://www.bloomberg.com/news/2013-0...ency-says.html

[Gert van der Hoek]

15 February 2013

Third family member has 'Sars-like virus'

By James Gallagher

Health and science reporter, BBC News

A third member of a family in the UK has been infected with a new respiratory illness similar to the deadly Sars virus, officials say.

It strengthens evidence that the virus can spread between people, however experts say the risk to the general population remains small.

Of the 12 people confirmed to have the virus, five have died.

This case appears to be a milder form of the infection and the patient is not being treated in hospital.

The infection is thought to come from contact with animals. However, if the virus can spread between people it poses a much more serious threat.

This is the fourth case identified in the UK. The first was a patient flown in from Qatar for treatment. The second was linked to travel to the Middle East and Pakistan.

BBC News

[Treyfish]

Third case of novel coronavirus infection identified in family cluster
15 February 2013
The Health Protection Agency (HPA) can confirm a third case of novel coronavirus infection in a family cluster, following the confirmed diagnosis of two cases announced earlier this week. The patient, who is a UK resident and does not have any recent travel history, is recovering from a mild respiratory illness and is currently well. This latest case brings the total number of confirmed cases globally to 12, of which four have been diagnosed in the UK.

Professor John Watson, head of the respiratory diseases department at the HPA, said: "Although this patient had a mild form of respiratory illness, as a precaution the HPA is advising that the patient self-isolate and limit contact with non-household members. Follow up of other household members and contacts of this case is currently underway.
“Although this case appears to be due to person-to-person transmission, the risk of infection in contacts in most circumstances is still considered to be low. If novel coronavirus were more infectious, we would have expected to have seen a larger number of cases than we have seen since the first case was reported three months ago. However, this new development does justify the measures that were immediately put into place to prevent any further spread of infection and to identify and follow up contacts of known cases.
“We would like to emphasise that the risk associated with novel coronavirus to the general UK population remains very low. The HPA will continue to work closely with national and international health authorities and will share any further advice with health professionals and the public if and when more information becomes available."
ENDS

Notes to editors:

1. Laboratory confirmed cases to date: 12
Saudi Arabia: 5 (3 deaths)
Jordan: 2 (2 deaths)
UK: 4 (1 patient from Qatar – receiving treatment, 3 patients from UK, 2 receiving treatment, 1 recovered)
Germany: 1 (patient from Qatar – discharged)
2. Coronaviruses are causes of the common cold but can also include more severe illness, such as SARS (Severe Acute Respiratory Syndrome). This new coronavirus was first identified in September 2012 in a patient who died from a severe respiratory infection in June 2012. The virus has so far only been identified in a small number of cases of acute, serious respiratory illness who presented with fever, cough, shortness of breath, and breathing difficulties.
3. For further information, see the HPA’s coronavirus webpages which includes a Q&A on this topic.

4. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013 the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk or follow us on Twitter @HPAuk.
5. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk. Out of hours the duty press officer can be contacted on 0208 200 4400.


http://www.hpa.org.uk/NewsCentre/Nat...ofcoronavirus/

[Treyfish]

"The patient ... is recovering from a mild respiratory illness and is currently well," it said in a statement.

John Watson, the HPA's head of respiratory diseases said that despite this, the HPA was advising the patient to self-isolate and limit contact with other people. Health officials are currently following up other household members.

snip

When a second case in this cluster was found on Wednesday, Tom Wilkinson, a senior lecturer in respiratory medicine at Britain's University of Southampton, said that if NCoV turned out to be like the previous SARS outbreak, it may prove quite slow to spread from one human to another.

"But it's early days to make any definite statements because viruses can change and mutate very rapidly, so what is right today may be wrong tomorrow," he said.
more..


http://uk.reuters.com/article/2013/0...medium=twitter

[Treyfish]

Third family member has 'Sars-like virus'
By James Gallagher

A third member of a family in the UK has been infected with a new respiratory illness similar to the deadly Sars virus, officials say.

It strengthens evidence that the virus can spread between people, however experts say the risk to the general population remains small.

Of the 12 people confirmed to have the virus, five have died.

This case appears to be a milder form of the infection and the patient is not being treated in hospital.

more..


http://www.bbc.co.uk/news/health-21478320

[sharon sanders]

Please do not copy/paste entire news articles in English onto the English forums on FT. I have said this several times.

We want snips and/or facts only with a link back.

[Treyfish]

SORRY

The HPA has announced that another member of the same family has caught the disease and was being treated in isolation. The patient was said to be recovering.

Four out of the 12 confirmed global coronavirus cases have been diagnosed in Britain.
Prof John Watson, head of the respiratory diseases department of the HPA, said: "Although this patient had a mild form of respiratory illness, as a precaution the HPA is advising that the patient self-isolate and limit contact with non-household members.

"Follow-up of other household members and contacts of this case is under way.

"Although this case appears to be due to person-to-person transmission, the risk of infection in contacts in most circumstances is still considered to be low. http://www.ibtimes.co.uk/articles/43...firmed-hpa.htm

[curiosity]

It continues to surprise me that they will quote in an article that "if this affected a dr. or nurse, it would be more serious."

They omit ENTIRELY the Jordan outbreak!

[sharon sanders]

Most main stream media have closed their health reporting departments. I can count 5ish working journalists that focus on health. It is a shame. Most journalists are not familiar with health issues.

Jordan - Cluster of approximately 12 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

Originally Posted by curiosity

It continues to surprise me that they will quote in an article that "if this affected a dr. or nurse, it would be more serious."

They omit ENTIRELY the Jordan outbreak!

[curiosity]

Re-reviewing the Jordan thread, there are some interesting similarities to the Argentina event.

• Illness presenting in HCW
  Index case from another country/recent visit to another country
  Initial suspicion for influenza type virus, quickly discounted
  Administration very quickly assures public that disease is contained
  Searching for another type of influenza - bird flu
  Searching for bacterial causes
  Scattered reports of bacterial causes - atypical types of bacteria, in Jordan's case Klebsiella, in Argentina's case - still looking (Strep, Staph, and Legionella would have been detected long ago)
  Closing the ICU for disinfection procedures

So, either investigations are all led this way, and the index case will always be presumed to have been from another country, or -

What these facilities have seen, the symptoms, the onset, the people affected, the event unfolding - are red flag events that warrant intense investigation, intensive cleaning, and a lot of persuasive discussion with the public to believe that everything is under control and there is not a thing to worry about.

[solitaire]

Does a pandemic alert level only apply to influenza? It seems to me HCoV EMC/2012 fulfills the criteria for a phase 3 alert, though I fully understand why they might not want to do so as the media and general public has difficulty understanding that it's a geographic definition only.

[sharon sanders]

I think the pandemic scale can be used for a "public health emergency of international concern".

The problem here is that, apparently, some countries are not accurately reporting the new novel coronavirus cases - or the cases are so mild that they are mostly unnoticed. I search Arabic sources almost every day and I particularly look for respiratory disease. There are very few reports. Remember, the initial disclosure of new coronavirus was made by a researcher in a letter to ProMED, not the Saudi Arabia government.

Are they in violation of IHR (2005)?

"Mandatory notification of four diseases and assessment of events involving diseases with the ability to cause serious public health impact and to spread internationally.

While any urgent event can be assessed for notification, the decision instrument identifies two groups of diseases which raise particular concerns:

• Group 1: A single case of smallpox, poliomyelitis due to wild type poliovirus, human influenza caused by a new subtype and severe acute respiratory syndrome (SARS) must be immediately notified to WHO, irrespective of the context in which it occurs.

• Group 2: Events involving epidemic-prone diseases of special national or regional concern which "have demonstrated the ability to cause serious public health impact and to spread rapidly internationally" must always be assessed using the decision instrument but only notified when fulfilling the requirements of the algorithm."

What is SARS?

"Preliminary Clinical Description of Severe Acute Respiratory Syndrome

Severe Acute Respiratory Syndrome (SARS) is a disease of unknown etiology that has been described in patients in Asia, North America, and Europe. The information in this report provides a summary of the clinical characteristics of SARS patients treated in Hong Kong Special Administrative Region (China), Taiwan (China), Thailand, Singapore, the United Kingdom, Slovenia, Canada and the United States since mid-February 2003. This information is preliminary and subject to limitations because of the broad and non-specific case definition.

Most patients identified as of March 21, 2003 have been previously healthy adults aged 25-70 years. A few suspected cases of SARS have been reported among children (≤15 years).

The incubation period of SARS is usually 2-7 days but may be as long as 10 days. The illness generally begins with a prodrome of fever (>38°C), which is often high, sometimes associated with chills and rigors and sometimes accompanied by other symptoms including headache, malaise, and myalgias. At the onset of illness, some cases have mild respiratory symptoms. Typically, rash and neurologic or gastrointestinal findings are absent, although a few patients have reported diarrhoea during the febrile prodrome.

After 3-7 days, a lower respiratory phase begins with the onset of a dry, non-productive cough or dyspnea that may be accompanied by or progress to hypoxemia. In 10%-20% of cases, the respiratory illness is severe enough to require intubation and mechanical ventilation. The case fatality among persons with illness meeting the current WHO case definition for probable and suspected cases of SARS is around 3%...."


Can a country argue that an illness which can spread human-to-human in close contact and which has the symptoms of: respiratory distress, high temperature, and kidney failure is not an acute respiratory disease of "public health emergency of international concern"?

[Gert van der Hoek]

WHO

WHO - Novel coronavirus infection – update

16 FEBRUARY 2013 - The United Kingdom (UK) has informed WHO of another confirmed case of infection with the novel coronavirus (NCoV). This is the third case confirmed in the country this month and is in the same family cluster as the two recently confirmed cases.

The latest confirmed case does not have recent travel history outside the UK. The case is recovering from mild respiratory illness and is currently well.

The confirmation with NCoV in this case with no recent travel history indicates that infection was acquired in the UK. Although this new case offers further indications of person-to-person transmission, no sustained person-to-person transmission has been identified.

The Health Protection Agency (HPA) is following up on all close contacts who may have been exposed to the recently confirmed cases.

As of 16 February 2013, WHO is informed of a total of 12 confirmed cases of human infection with NCoV, including five 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. Testing for the new coronavirus should be considered in patients with unexplained pneumonias, or in patients with unexplained severe, progressive or complicated respiratory illness not responding to treatment.

Any clusters of SARI or SARI in healthcare workers should be thoroughly investigated, regardless of where in the world they occur.

New cases and clusters of the NCoV should be reported promptly both to national health authorities and to WHO.

WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.

WHO continues to closely monitor the situation.

WHO

[Giuseppe Michieli]

[Source: Department of Health, Hong Kong PRC SAR, full text: (LINK).]

DH closely monitors additional overseas case of Severe Respiratory Disease associated with Novel Coronavirus


The Department of Health (DH) is closely monitoring an additional case due to infection with the novel coronavirus confirmed by the Health Protection Agency (HPA) of the United Kingdom (UK). The latest case is the family member and of the 10th and the 11th cases announced by HPA earlier this week.

The patient, who is a UK resident, does not have any recent travel history, is recovering from a mild respiratory illness and is currently well. This latest case brings the total number of confirmed cases globally to 12, of which four have been diagnosed in the UK.

A DH spokesman said, "According to the World Health Organization (WHO), although this new case offers further indications of person-to-person transmission, no sustained person-to-person transmission has been identified.

"The Centre for Health Protection (CHP) of the DH will seek more information on these three recent cases from the WHO and HPA. The CHP will stay vigilant and continue to work closely with the WHO and other overseas health authorities to monitor the latest development of this novel infectious disease.

"Locally, the CHP will continue its surveillance mechanism with public and private hospitals, practising doctors and the airport for any suspected cases of Novel Coronavirus associated with Severe Respiratory Disease."

"No human infection with this virus has been identified so far in Hong Kong," the spokesman stressed.

The spokesman advised travellers returning from novel coronavirus affected countries with respiratory symptoms should wear a facial mask and seek medical attention and reveal the travel history to the doctor.

Ends/Saturday, February 16, 2013
Issued at HKT 19:26
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[Giuseppe Michieli]

Originally Posted by solitaire

Does a pandemic alert level only apply to influenza? It seems to me HCoV EMC/2012 fulfills the criteria for a phase 3 alert, though I fully understand why they might not want to do so as the media and general public has difficulty understanding that it's a geographic definition only.

Influenza has an unique nature of rapid, uncomptollable spread and - when pandemic potential virus emerges - the impossibility to contain it makes this pathogen of special concern for a public health perspective.

Other pathogens have pandemic potential or are ubiquitous in the world, such as HIV, cholera, plague, some other almost untreatable virus and bacteria (ebola/Marburg viruses, XDR-TB, NDM-1 carrier Enterobacteriaceae, etc.)

New Coronavirus (NCoV) is a newly discovered pathogen and its relatedness to the severe diseases described so far is not as sure as it was Severe Acute Respiratory Syndrome in 2003, caused by another coronavirus, the SARS-CoV.

No Koch postulate was proven for NCoV so far.

Koch's postulates are the following:
1.The microorganism must be found in abundance in all organisms suffering from the disease, but should not be found in healthy organisms.
2.The microorganism must be isolated from a diseased organism and grown in pure culture.
3.The cultured microorganism should cause disease when introduced into a healthy organism.
4.The microorganism must be reisolated from the inoculated, diseased experimental host and identified as being identical to the original specific causative agent.

(WikiPedia, http://en.wikipedia.org/wiki/Koch's_postulates )

The infectiousness, virulence and transmissibility of the NCoV remain to be established.

No clinical, laboratory or necroscopic findings were published through peer-review literature, so any conclusion on NCoV disease potential remain difficult.

Data sharing by authoritative source is lacking.

It is possible that this virus may exists in nature but only recently isolated because of highly sensitive diagnotics tools are available.

Finally, declaring a pandemic without a scientifically solid basis of proof for a new pathogen may resolve in a complete failure to control both the possible disease spread and panics, economic loss and social disruption.

Cold mind needed.

[Treyfish]

Indonesia Corona Virus Alert
Friday, February 15, 2013
The Indonesian government increased awareness of the spread of the virus Corona. It follows the reporting of the Middle East people are currently being treated at a hospital in London, who confirmed Corona virus. The report received the Director General of Disease Control and Environmental Health, Ministry of Health, Tjandra Yoga Aditana this morning.

'' Although the virus was detected in the Arabian Peninsula, but the Indonesian government also need to be vigilant,'' he said in Surabaya, on Friday (02/15/2013).

He said the precautions taken is to alert the 49 hospitals in all ports in Indonesia to detect the flow of passengers who indicated Corona virus.

'' All the laboratories of the Ministry of Health was also alerted to diagnose the symptoms of the virus,'' he said...http://regional.kompas.com/read/2013...a.Virus.Corona

[Treyfish]

Asked Umrah pilgrims Corona Virus Alert
The warning was delivered, Director General of Disease Control and Environmental Penyehatana (PP and PL) Ministry of Health, Prof. Dr. Tjandra Yoga Aditama told reporters on Friday (15/02/2013), after attending the handover position of the Chief of Engineering Center for Environmental Health and Disease Control (BBTKLPP ) Surabaya.http://www.tribunnews.com/2013/02/15...a-virus-corona

[kiwibird]

With regard to the third member of this family to contract this disease -
"This case had limited exposure to the index case on three occasions while the latter was in hospital and no contact with the second case."

http://www.hpa.org.uk/hpr/infections/respiratory.htm

I wonder if a low viral load has given this case more mild symptoms!??

I also wonder how limited his exposure was - there is no information given about protective clothing etc. - but what do they mean by "limited exposure"?

[sharon sanders]

I think the 3rd member had only casual contact with the index case.

[Giuseppe Michieli]

[Source: Centre for Health Protection, Hong Kong PRC SAR, full text: (LINK).]

No human infection with novel coronavirus identified so far in Hong Kong


In response to media enquiries on a rumour concerning human infection with novel coronavirus in Hong Kong, a spokesperson for the Centre for Health Protection (CHP) of the Department of Health today (February 20) clarified that no human infection with this virus has been identified so far in Hong Kong.

"According to the World Health Organization (WHO), of the total 12 confirmed cases of Novel Coronavirus globally, three recently confirmed cases have been diagnosed in the UK," the spokesperson said.

According to the latest information from the European Centre for Disease Prevention and Control (ECDC) and the Health Protection Agency (HPA) of the UK, a male UK resident (Case 10) with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on January 24 and then had arrived unwell in the UK on January 28. While staying with his family at home, his condition deteriorated and he was admitted to hospital under intensive care.

On February 6, a male household member (Case 11) who had contact with Case 10 from his arrival until hospital admission felt unwell. This patient had an existing medical condition that might have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital where he was under intensive care but subsequently died.

The latest confirmed case (Case 12) is a younger female family member, who only had exposure to Case 10 while he was in hospital. She became ill on February 5 with a typical influenza-like illness which did not require hospital admission. She has now fully recovered.

Cases 11 and 12 were likely infected through human-to-human transmission, although the exact route of transmission is still under investigation by the UK authority. The presence of an intermediary case or fomite spread are possible.

"According to the ECDC, close follow-up of approximately 200 health-care workers, family members and other contacts of cases in Europe and the Middle East has not yet found other demonstrated instances of human-to-human transmission. So far, no sustained transmissions or expanding clusters of infections have been identified in any country," the spokesperson remarked.

"Members of the public are advised to maintain good personal and environmental hygiene and avoid direct contact with animals, birds or poultry," said the spokesperson, adding that the virus may remain viable in the environment for some time and can be inactivated by 1:99 household bleach.

He also advised travellers returning from novel coronavirus-affected countries with respiratory symptoms to wear facial masks and seek medical attention and reveal their travel histories to doctors.

"The CHP will stay vigilant and continue to work closely with the WHO and other overseas health authorities to monitor the latest developments of this novel infectious disease," he said.

"Locally, the CHP will continue its surveillance mechanism with public and private hospitals, practising doctors and the airport for any suspected cases of Novel Coronavirus associated with Severe Respiratory Disease," he added.


Ends/Wednesday, February 20, 2013
Issued at HKT 19:26
NNNN

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[Giuseppe Michieli]

Originally Posted by sharon sanders

I think the 3rd member had only casual contact with the index case.

But, also:

Source: HK CHP, http://www.info.gov.hk/gia/general/2...1302200513.htm

(...)

"Members of the public are advised to maintain good personal and environmental hygiene and avoid direct contact with animals, birds or poultry," said the spokesperson, adding that the virus may remain viable in the environment for some time and can be inactivated by 1:99 household bleach.

(...)

-
------

[alert]

So case #12 is only the second female case confirmed, and is likely the youngest of the 12 confirmed infections.

I do believe that SARS was milder in children than in adults in 2003. If I remember correctly, the youngest SARS fatalities worldwide were in their 20s.

http://www.flutrackers.com/forum/sho...d.php?t=200610

The latest confirmed case (Case 12) is a younger female family member, who only had exposure to Case 10 while he was in hospital. She became ill on February 5 with a typical influenza-like illness which did not require hospital admission. She has now fully recovered.