Worldwide: 24 confirmed cases due to novel animal nCoV coronavirus - 16 fatalities - September 20, 2012 - May 2, 2013

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/RespiratoryViruses/NovelCoronavirus/respPartialgeneticsequenceofnovelcoronavirus/

Partial genetic sequence information for scientists about the Novel Coronavirus 2012
Development of diagnostics for novel coronavirus - added 26 September 2012
•HPA has received a number of requests about molecular diagnostics and whether broadly reactive primers will pick up this virus. The pan-coronavirus primers described by Emery et al 2004 and Vijgen et al 2008 should both work.
•The World Health Organisation has convened relevant European laboratories to work collaboratively to produce clinically validated assays for real-time detection of the novel coronavirus.
•The patient clinical material that HPA has does not react with the specific detection assays which we have for OC23 [OC43? - alert], 229E, NL63 or SARS.
•The whole genome of the material that is described in ProMed post#501 is expected to be published by Professor Ron Fouchier, Rotterdam, in the next 24-48 hours. This sequence will be based on cultured virus which has been in Rotterdam since early July.
•The sequence data that HPA has from the London case is based on direct detection in clinical material obtained at the weekend. The HPA does not yet have a virus isolate, although obviously clinical material is already in tissue culture in an attempt to make isolates from the London case.
•HPA welcomes offers of reagents or information from scientists working in this area which may be useful in this situation.
References:
Emery et al. Real-time reverse transcription-polymerase chain reaction assay for SARS-associated coronavirus. Emerg Infect Dis. 2004 Feb;10(2):311-6.

Vijgen et al. A pancoronavirus RT-PCR assay for detection of all known coronaviruses. Methods Mol Biol. 2008;454:3-12.

[Giuseppe]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]


RAPID RISK ASSESSMENT

Severe respiratory disease associated with a novel coronavirus

24 September 2012



Main conclusions and recommendations

• Since June 2012, two patients who presented with symptoms of acute respiratory distress and pulmonary inflammation have tested positive for a novel coronavirus. Onset of disease was three months apart but both cases had a history of travel to Saudi Arabia in the immediate period before developing symptoms. Preliminary genetic tests show that the two viruses are very closely related.
• The first case developed symptoms in Saudi Arabia and died there on 24 June. The second case developed symptoms on 3 September in Qatar and was transferred to the UK by air ambulance on 11 September where he remains in intensive care.
• The novel coronavirus is not genetically similar to the SARS coronavirus (SARS-CoV), and to date the infection has not followed the same epidemiological pattern as the 2003 SARS outbreak.
• To date, there is no evidence of person-to-person transmission of this novel corona virus. A causal relationship between the viruses and severe disease is likely but has not yet been proven.
• As yet, the source and disease reservoir, transmission route, incubation period, and capacity for asymptomatic infection are unknown. Zoonotic infection cannot be ruled out.
• A sensitive case definition for finding cases has been collaboratively developed by international infectious disease control agencies and the concerned national authorities, and all cases meeting the definition should be reported through the Early Warning and Response System.
• Laboratory capacity to diagnose the virus is available in the EU, and more specific diagnostic tests are being developed.
• The Kingdom of Saudi Arabia is not recommending travel restrictions at this point, or any change in the travel advice for the Hajj.
• Even assuming that the novel coronavirus caused disease in both cases, the fact that only two cases have been identified in three months suggests that the virus is poorly transmissible among humans.
• Until more information becomes available, all cases should be managed strictly according to national infection control guidelines for respiratory viruses. ECDC recommends the HPA infection control advice for suspected or confirmed novel coronavirus case or the WHO interim guidelines on infection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care (WHO/CDS/EPR/2007.6) in the absence of appropriate national guidelines.

Public health issue

What is the public health risk associated with the detection of a novel coronavirus in two patients with a common travel history to Saudi Arabia?



Source and date of request

European Commission, 23 September 2012.



Internal response team

Katrin Leitmeyer, Pete Kinross, Herve Zeller, Niklas Danielsson, Rene Snacken, Anna-Pelagia Magiorakos, Amanda Ozin, Romit Jain, Eve Robinson, Angus Nicoll, Josep Jansa, Denis Coulombier.



Disease background information

Coronaviruses infect birds and mammals, and human coronaviruses cause up to one-third of upper respiratory tract infections in adults. They are enveloped, positive-sense, non-segmented, single-stranded RNA viruses, and members of the Coronaviridae family in the Nidovirales order. They are classified into three genera containing viruses pathogenic to mammals: alpha- and beta-coronaviruses (SARS coronavirus belongs to the latter), and gammacoronaviruses which are mainly pathogenic for birds. Human coronaviruses are transmitted through direct contact with secretions and via aerosol droplets. They have also been detected in faeces and urine and under certain circumstances, airborne transmission can occur from aerosolised respiratory secretions and faecal material.

Human coronavirus infections commonly manifest as upper respiratory infections, and/or gastrointestinal symptoms. More severe clinical disease by coronaviruses has also been reported, and has been associated with severe disease in infants, the elderly and the immunocompromised.

Coronaviruses have been shown to be the cause of lower respiratory disease and community-acquired pneumonia in neonates, infants, children and the elderly, including influenza-like illness and acute exacerbations of chronic bronchitis.

Coronaviruses are globally distributed. In temperate climates, coronavirus respiratory infections occur primarily in the winter. Smaller peaks are seen in the autumn or spring.

SARS coronavirus (SARS-CoV) which caused the 2003 international severe acute respiratory syndrome (SARS) outbreak, is one of the best known coronaviruses infecting humans. The outbreak resulted in 8 422 cases with 916 deaths (case-fatality ratio: 10.9 %). Similar to coronaviruses causing common colds, the SARS coronavirus spread from person to person by droplets and transmission to healthcare workers was a common feature of the epidemic.



Event background information

A first case (Case 1) was reported on Thursday 20 September through ProMED. The case was a 60 year-old patient in Jeddah, Kingdom of Saudi Arabia, from whom a novel coronavirus was isolated. He was admitted to hospital on 13 June with severe pneumonia after having developed the first symptoms seven days earlier. His condition was complicated by acute renal failure and he died on 24 June 2012.

Post mortem tests on lung tissue were negative for influenza virus A, influenza virus B, parainfluenza virus, enterovirus and adenovirus. Testing with a pancoronavirus RT-PCR was positive for a coronavirus. The virus genome was later sequenced in Erasmus Medical Centre, Rotterdam and identified as a putative novel betacorononavirus, closely related to bat coronaviruses. Further analysis is being carried out in the Netherlands.

A second case (Case 2) was reported on Saturday 22 September, by the Health Protection Agency (HPA), UK. The case is a 49 year-old Qatari national with no underlying health conditions and a history of travel to Saudi Arabia. He developed respiratory symptoms on 3 September and was admitted to an intensive care unit (ICU) in Doha, Qatar on 7 September, where he subsequently developed renal failure. He was transferred by air ambulance to an ICU in the UK on 11 September. Upper and lower respiratory samples tested between 17 and 20 September were negative for respiratory viruses including influenza A (H1/H3/H1N1pdm09), influenza B, hMPV, RSV, and specific tests for the human coronaviruses NL63, 229E, OC43 and SARS-CoV. On 21 September, tests on samples for Case 2 using a pancoronavirus RT-PCR test were positive from two lower respiratory tract samples only.

A nucleotide BLAST search in the UK revealed 80% homology to bat coronaviruses. A 250bp PCR fragment was compared by the Erasmus Medical Centre to Case 1?s isolate, and a 99.5% sequence homology was identified (1 nucleotide difference).

These are currently the only two known cases where these homologous coronaviruses have been identified.

As of 24 September, the HPA reports that the UK is actively finding and following up all contacts of Case 2 and the possible case, including healthcare workers in the UK. No illness has been reported amongst contacts of the laboratory-confirmed case, and there is no evidence of these healthcare workers developing relevant symptoms.

The UK has also contacted the medical evacuation company that transferred the patient from Qatar.



Threat assessment for the EU

Although the identification of RNA from a novel coronavirus in the absence of other positive laboratory findings is a strong indication that the novel virus caused the acute severe disease in these two patients, further evidence is needed to establish causality. It is not clear which laboratory tests are most applicable for detection of the novel coronavirus and there is therefore an urgent need to validate the existing tests and to develop more specific ones.

In light of the seriousness of the illness in these two patients and the unknown nature of the novel coronavirus, the patient in the UK is being managed in respiratory isolation and all staff caring for him are required to wear full personal protective equipment. FFP3 respirators should be used by staff carrying out clinical procedures and by all staff in the room during aerosol producing procedures. Anyone who was in close contact with the patient while the patient was ill is being followed up - this includes healthcare workers who provided direct clinical or personal care or examination of the case while they were symptomatic.

There is no evidence of person-to-person transmission and none of the monitored contacts and exposed health care workers have so far developed disease of similar severity.



Conclusions and recommendations

Novel coronaviruses have been identified in two cases of acute severe respiratory illness and renal failure who presented three months apart.

Comparison of a gene sequence from each of the viruses showed that they are 99.5% homologous and it is highly likely that both patients were infected with the same novel virus. The fatal case was resident in Saudi Arabia and developed the disease there. The other case had visited Saudi Arabia but had returned to Qatar more than 10 days before onset of symptoms. There is currently no evidence of person-to-person transmission to close contacts, including healthcare workers and relatives, nor is there any evidence of ongoing transmission in the community. As of 25 September, ECDC is not aware of any increase in the number of patients with acute respiratory infections of unknown cause in intensive care units in Saudi Arabia or Qatar.

There is no indication that this novel coronavirus is closely related to the SARS-CoV which caused the 2003 outbreak of SARS. In addition, to date, the epidemiological behaviour of the infections is very different from that seen in 2003. However, when it comes to managing the case, as a precautionary measure, the UK is taking stringent infection control measures.

There is capability in the EU to diagnose infections with the novel virus. A number of questions remain to be answered. Although the two viruses are 99.5% homologous the match is so far only for a 250 nucleotide long region of the virus?s polymerase gene and a more extensive comparison of the two identified viruses is a priority. Given that the two cases are temporally separated by three months and that there is no link between them, apart from having been in Saudi Arabia, means that independent non-human-to-human transmission must be considered. Zoonotic infection cannot be excluded. There is no information on the possible mode of transmission, route of transmission (e.g. droplet), or possible contact with animals.

A causal relationship between infection with the novel virus in these two cases and disease is likely but has not yet been proven. Assuming a causal relationship, its infectiousness is unknown, although it is thought to be low because no secondary cases have been identified. The potential for asymptomatic infection is unknown.

The Kingdom of Saudi Arabia is not recommending travel restrictions at this point, or any change in the travel advice for the Hajj. The UK is not recommending any travel restrictions at this point.



Information to healthcare professionals, including precautions

Healthcare professionals should be alerted to the possibility that patients who present with acute severe respiratory symptoms and have a history of staying in Saudi Arabia or Qatar in the last 10 days may be infected with the novel coronavirus.

Patients presenting with this case history should be managed according to infection control guidelines for respiratory infections, and the case should be reported to national authorities. A case definition for case finding was agreed by ECDC and WHO on 25 September following a consultation of experts and is available on the WHO website http://www.who.int/influenza/case_definition_NovelCoronavirus_20120925/en/index.html .
There is no evidence of person-to-person transmission at this point but as this cannot be excluded on the available information, it is prudent to exercise strict infection control in the management of possible cases. The Health Protection Agency in the UK has published specific infection control advice which should be used in the absence of appropriate national guidelines. Healthcare workers and close contacts of suspected and confirmed cases must be monitored for symptoms. This includes healthcare workers who provided direct clinical or personal care or examination of the case while they were symptomatic.

Bronchoalveolar lavage (BAL) samples should be taken from suspected cases and tested with the pancoronavirus reverse transcriptase polymerase chain reaction (RT-PCR) test and/or sent to a specialised reference laboratory for coronaviruses.

Additional testing of faecal or urine samples should be considered. A list of reference laboratories is found European Network for imported viral diseas http://www.enivd.de/index.htm and also WHO SARS collaborative laboratories http://www.who.int/csr/sars/networkshome/en/index.html.

Diagnostic screening tests are being developed and information about these tests will be disseminated to appropriate health authorities in EU Member States as it becomes available.



References

1. WHO final summary SARS, 15 August 2003:Summary table of SARS cases by country, 1 November 2002?7 August 2003
2. Links to European Network for Imported Viral Diseases http://www.who.int/csr/sars/country/country2003_08_15.pdf - http://www.enivd.de/index.html
3. WHO SARS collaborative laboratories http://www.who.int/csr/sars/networkshome/en/index.htm
4. ECDC Public Health Microbiology Programme web page for relevant documentation for EU laboratory biosafety issues, guidelines and regulation http://www.ecdc.europa.eu/en/activities/microbiology/Pages/Activities_MicrobiologyCooperation.aspx
5. WHO biosafety guidelines for handling of SARS specimens: http://www.who.int/csr/sars/biosafety2003_04_25/en/
6. WHO Guidance on infection control December 2003 http://www.smp-council.org.hk/mlt/english/mlt_message_infection_e.pdf
7. HPA, infection control advice suspected or confirmed novel coronavirus cases, 24 September 2012. http://www.hpa.org.uk/webc/HPAwebFile/HPAweb_C/1317136232722

-
-------

[Giuseppe]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK). Edited.]

Novel coronavirus: rapid risk assessement

26 Sep 2012



Following the identification of a novel coronavirus in two patients, both having been in Saudi Arabia albeit three months apart, ECDC has prepared a rapid risk assessment to consider the risk to the public in the EU. A version of this risk assessment was shared with EU and EEA national public health competent bodies and WHO on 24 September.

No additional cases have been confirmed at this point and there is no evidence of person-to-person transmission of this novel coronavirus to date. An infection transmitted by contact with animals cannot be ruled out at this stage.

ECDC is working with the UK Health Protection Agency (HPA) and the World Health Organisation (WHO) to develop an appropriate definition to be used by national public health authorities for investigating patients and identifying possible and confirmed cases. An interim case definition has been agreed and is under ongoing review.

Preliminary molecular tests show that the viruses identified in the two confirmed cases are very closely related. Further investigations are needed to better understand the epidemiology of this novel coronavirus and refine ECDC?s assessment of the public health implications. This requires coordinated international surveillance and laboratory testing.

The value of laboratories has been demonstrated by the excellent work done by the HPA laboratories in the UK and the Erasmus University Medical Centre in Rotterdam, the Netherlands.

Until more information becomes available, all cases should be managed strictly according to national infection control guidelines for respiratory viruses. ECDC recommends the HPA infection control advice for suspected or confirmed novel coronavirus case or the WHO interim guidelines on infection prevention and control of acute respiratory diseases in health care (WHO/CDS/EPR/2007.6) in the absence of appropriate national guidelines.

Based on the available information, ECDC assesses the current risk as low. Information for visitors to The Kingdom of Saudi Arabia for the pilgrimage to Mecca (Hajj) can be found through WHO website and The Kingdom of Saudi Arabia website.



Event background

The first case associated with this novel coronavirus is a 60 year old patient in Jeddah, Saudi Arabia. He was admitted to hospital on 13 June with severe pneumonia seven days after having developed symptoms. He later developed acute renal failure and died on 24 June 2012.

The second case was reported on Saturday 22 September, by the Health Protection Agency (HPA), UK. The patient is a 49 year old from Qatar with no underlying health conditions who had travelled to Saudi Arabia prior to onset of disease. He developed respiratory symptoms on 3 September, and was admitted to an intensive care unit in Doha, Qatar, on 7 September, where he subsequently developed renal failure. He was transferred by air ambulance to a hospital in the UK on 11 September.

Risk assessment: Severe respiratory disease associated with a novel coronavirus



Read more

Epidemiological update: two cases of a novel coronavirus laboratory confirmed - 25 September

Coronavirus: collaboration and surveillance the key to early detection and understanding the risk - 25 September

Information for professionals - novel coronavirus September 2012 - Health Protection Agency, UK

Infection control advice - Health Protection Agency, UK

Novel coronavirus infection update ? WHO

Interim case definition as of 25 September ? WHO

-
-------

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

I cant tell what is supposed to have happened on September 10 here; that date is not yet significant in this outbreak. I don't think this is referring to a previously unreported case.

http://www.alarabiya.net/articles/2012/09/26/240368.html

Last Updated: Wednesday, November 10, 1433 - Sep 26 2012 KSA 22:11 - GMT 19:11 message from a doctor reveals the beginning of "the mysterious virus Arabia" sent to the World Health Organization details Hospital first infected in Jdhaleravae 10 November 1433 - 26 September 2012 m

Dubai - Mohammed Aliusa
Revealed an exchange of letters between a doctors in the Saudi city of Jeddah and the World Association for Infectious Diseases details mysterious virus of type "crowns" which was announced a few days ago.

While the Ministry of Health issued Arabia assurances that the disease is not serious, but the World Health Organization (WHO) today urged all workers in the medical field to report any patient with severe infection in the respiratory tract.

In one of the messages sent by the doctor from Saudi Arabia to the World Organization revealed the story of the virus details of which began in the city of Jeddah, after the arrival of one of the cases that showed the effects of the flu to a private hospital in the history of 10 of September / current.

And began a medical condition of the patient, who was in the sixty years of age, and was diagnosed as suffering from severe flu and kidney failure.

7 days between the discovery of the situation and disclosure Anhaautam virus isolation for analysis by one of the doctors who specialize in microbiology, to be the first result that this virus is a type of "crowns", and return the doctor to make sure these details by analyzing the virus laboratory specialist in the Netherlands.

Dutch laboratory confirmed that the virus is not influenza types A or B, it is a mysterious virus of the family of "crowns", which belongs to the virus that causes SARS, which killed 800 people nearly 10 years ago.

After approximately seven days announced the Saudi Ministry of Health for the discovery of this virus and caused two deaths and injuring a third person, the World Health Organization (WHO) issued on the same day a global alert about this mysterious virus.

The monitors "health" Saudi Arabia is currently the situation closely, especially with the approach of the pilgrimage season, in addition to the World Health Organization urged all workers in the medical field around the world to report any patient infected with severe respiratory may have traveled to Saudi Arabia or Qatar.

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

http://www.cidrap.umn.edu/cidrap/content/other/sars/news/sep2612corona.html

Some details emerge on coronavirus cases, but many gaps remain
Sep 26, 2012 (CIDRAP News) ? A European report has filled in some details about the two severe illnesses linked to a novel coronavirus, but most of the major questions, such as where it came from and how it spreads, remained unanswered today.

A 49-year-old Qatari man remained in a London hospital's intensive care unit with a severe respiratory illness accompanied by renal failure. A 60-year-old Saudi Arabian man who had a similar illness and was infected with a virtually identical coronavirus died in June in his home country. No new confirmed or suspected cases were reported today.

A risk assessment released by the European Centre for Disease Prevention and Control (ECDC) offered some new details on the cases, including that the Qatari patient had returned from a trip to Saudi Arabia more than 10 days before he fell ill on Sep 3, which seems to suggest that he wasn't infected while in that country.

A case definition released by the World Health Organization (WHO) yesterday lists a history of travel to Saudi Arabia within 7 days before illness onset, or close contact with a probable or confirmed case-patient in that same time frame, as a possible clue to the virus in a person who is hospitalized with an acute respiratory infection accompanied by fever and cough.

A Sep 25 letter from the head of the United Kingdom Department of Health to UK health workers said the incubation period for the new virus is assumed to be 7 days, given what is known about other human coronavirus infections. The letter to UK National Health Service workers was written by Dame Sally C. Davies, chief medical officer.

A then-novel coronavirus sparked the SARS (severe acute respiratory syndrome) outbreak in 2003, which involved more than 8,422 cases globally and killed 916 people, according to the ECDC risk assessment. Aside from the outbreak, human coronaviruses are mainly known for causing colds. Health officials have stressed that the new coronavirus is clearly different from the SARS virus.

Both the Davies letter and the ECDC risk assessment said no suspected cases have been found among contacts of the Qatari patient or elsewhere. "Many of these contacts are already likely to be beyond the incubation period . . . when symptoms would have developed had they been infected," Davies wrote.

The ECDC said that as of yesterday it was not aware of "any increase in the number of patients with acute respiratory infections of unknown cause in intensive care units in Saudi Arabia or Qatar."

The ECDC statement filled in some new details on the 60-year-old Saudi Arabian who died. It said he fell ill on Jun 6, was hospitalized with severe pneumonia on Jun 13, and died on Jun 24.

The fact that the two cases occurred 3 months apart and that time spent in Saudi Arabia is the only known link means that "independent non?human-to-human transmission must be considered" and that an animal source can't be excluded, the ECDC said.

In addition, it is likely that the novel virus caused both cases, but more evidence is needed to prove this, the agency said. It added, "It is not clear which laboratory tests are most applicable for detection of the novel coronavirus, and there is therefore an urgent need to validate the existing tests and to develop more specific ones."

Meanwhile, the UK Health Protection Agency (HPA) said today that the WHO "has convened relevant European laboratories to work collaboratively to produce clinically validated assays for real-time detection of the novel coronavirus." The HPA also said that Ron Fouchier, PhD, of Erasmus Medical Center in the Netherlands, is expected publish the full genome of the virus from the Saudi Arabian man within a day or two.

In other developments, the Hong Kong Centre for Health Protection (CHP) published some guidance related to the new coronavirus, including advice to schools and recommendations on personal protective equipment for helathcare personnel. Hong Kong served as the launching pad for the international spread of the SARS virus in 2003, after it emerged in mainland China in late 2002.

[hawkeye]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

===
The head of the country’s public health authority, Mohammed bin Hamad Al Thani, said the infected Qatari had “been treated in Qatar for two months before being transferred to London.”

http://m.gulfnews.com/news/gulf/saudi-arabia/saudi-downplays-impact-of-virus-on-haj-1.1081129

===
British Health protection officials are testing more than 30 health care workers who have come in contact with the Qatari patient.
“It’s still [in the] very early days,” said Gregory Hartl, a WHO spokesman. “At the moment, we have two sporadic cases and there are still a lot of holes to be filled in.”
He added it was unclear how the virus spreads. Coronaviruses are typically spread in the air but Hartl said scientists were considering the possibility that the patients were infected directly by animals.

http://gulfnews.com/news/world/other-world/five-more-with-sars-like-virus-1.1081384

===
“WHO is working closely with the Kingdom of Saudi Arabia, as in previous years, to support the country’s health measures for all visitors participating in the hajj pilgrimage to Makkah next month,” the World Health Organisation (WHO) said in a statement.

http://www.thenews.com.pk/Todays-News-1-134294-WHO-advising-Saudis-on-virus-ahead-of-Haj

===
"The Health Ministry has taken preventative measures to deal with the influx of over 2 million Haj pilgrims," Ziad Memish, the deputy minister for public health, told Reuters. "The measures include monitoring the entrances through land, sea and air to evaluate the people entering and obtain samples if any symptoms are apparent,"

http://www.reuters.com/article/2012/09/26/us-haj-infection-idUSBRE88P0VF20120926

===
ScienceInsider talked to Ron Fouchier, a virologist at Erasmus MC in Rotterdam, the Netherlands, who sequenced the virus's genome and concluded that the Saudi and Qatari patients most likely are infected with the same virus. Questions and answers have been edited for brevity and clarity.

http://news.sciencemag.org/scienceinsider/2012/09/ron-fouchier-on-the-new-coronavi.html

===

[Laidback Al]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

The head of the country's public health authority, Mohammed bin Hamad Al-Thani, said the infected Qatari had ?been treated in Qatar for two months before being transferred to London.?

This is not true - There are multiple media reports in this thread including a report from WHO (link) that this individual presented with symptoms on September 3, 2012. He was not treated in Qatar for two months before being transferred to the UK.
<object style="position:absolute;z-index:1000" type="application/x-dgnria" id="plugin0" height="0" width="0">

</object>

[sharon sanders]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

Tunisia Ministry of Health tells citizens not to worry about the new coronavirus. This news release refers to 4 total patients. I am not sure if this is true or not.

machine translation

The Ministry of Public Health confirms that the virus "crowns" does not represent a threat to the Tunisian pilgrims.

Thursday, September 27, 2012 - 01:02 PM
Reassured the Ministry of Public Health in a communiqu? issued her day pilgrims this year with attached monitor 4 cases infected with influenza "crowns" Saudi Asaudihmhirh that it is not to worry or concern given that these injuries are isolated cases have been diagnosed with three of them at the level clinical while signed sure one Mkhbayrh, so it has confirmed the Ministry of Public Health that the disease remained confined and were no cases of infection from human to human. and noted author himself that the World Health Organization declared the absence of contraindications to travel to holy sites and not the need for action The meeting further (such as vaccinations) and sufficiency precautions SSG transmitted diseases by breathing. This has confirmed the Ministry of Public Health that the health situation reassuring and invited pilgrims Tunisians to respect the rules of keeping physical health, for their own safety and health with the need to focus on personal hygiene and Wash hands frequently and the ministry has confirmed its commitment to pursue the epidemiological situation for providing the best health conditions for pilgrims in Miami until they return to the homeland health and wellness.

http://diyar.charlesayoub.com/index.php/article-details/150195

[sharon sanders]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

The Egyptian MOH will be giving a free N100 mask to each person who gets the vaccines required for the visa to the Hajj in Saudi Arabia.

Minister of Health spent 100 free mask each pilgrim for the prevention of the virus, "Corona"
Hossam Zayed
26-9-2012 | 18:35 230

Minister of Health
Issued Dr. Mohammad Mustafa Hamid, Minister of Health and Population, a decision regardless 100 mask for free each pilgrim went to the Office of Health to take the vaccinations required for Hajj, and that measure is important for the prevention of viruses, including influenza virus new "Corona." explained Dr. Maher Hashem sentences, Deputy Director in quarantine preventive medicine at the Ministry of Health, that the influenza virus, "Corona" does not appear in Egypt at all, and 3 cases only are popping up in Saudi Arabia since last July, and although the virus is lethal but that eating Vaccination against seasonal influenza before traveling to the Hajj Ten days and is available in all health offices of the ministry, can spare pilgrims infection, in addition to vaccinations other requested by Saudi Arabia for a visa Hajj and Umrah. it also must follow a number of Altalmyat important for the prevention of infection, including washing hands constantly with personal hygiene and change visor 3 times a day, and not to be subjected to crowded places and lack of direct exposure to sunlight.

http://gate.ahram.org.eg/NewsContent/13/54/255125/%D8%A3%D8%AE%D8%A8%D8%A7%D8%B1/%D9%85%D8%AD%D9%84%D9%8A%D8%A7%D8%AA/%D9%88%D8%B2%D9%8A%D8%B1-%D8%A7%D9%84%D8%B5%D8%AD%D8%A9-%D9%8A%D8%B5%D8%B1%D9%81-%D9%A1%D9%A0%D9%A0-%D9%82%D9%86%D8%A7%D8%B9-%D9%88%D8%A7%D9%82%D9%8D-%D9%85%D8%AC%D8%A7%D9%86%D9%8B%D8%A7-%D9%84%D9%83%D9%84-%D8%AD%D8%A7%D8%AC-%D9%84%D9%84%D9%88%D9%82%D8%A7.aspx

[sharon sanders]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

The Health Minister of Algeria accuses the pharmaceutical industry of confusing pilgrims about the new coronavirus to sell medicines and vaccines before the Hajj.


ealth Minister Abdelaziz Ziari accused
Foreign laboratories behind the launch of a virus'' Corona'' to sell the vaccine
Thursday, September 27, 2012 Algeria: Zoubir Fadel





Accused the Minister of Health and Hospital Reform, Abdelaziz Ziari, yesterday, laboratories foreign standing behind the launch of virus'' Corona'' to confuse the pilgrims and selling vaccine, adding that all medicines and masks available for 63 thousand pilgrims Algerian holy sites, starting from yesterday, with the arrival of the first Regiment of pilgrims.
reduced Ziari told Khabar, on the sidelines of the launch of the first flight of pilgrims from Houari Boumediene airport in Algiers, the risk of SARS virus'''', which is a new strain of virus'' Corona'' he said, adding that'' the World Health Organization did not inform us any information regarding this virus''. He'' is about Palmkhabr foreign seeking every autumn to launch viruses to be able to sell medicines, vaccines and make a profit'', suggesting that the current situation coincides with the Hajj season where will be present more than 3 million pilgrims in Saudi Arabia, allowing achievement of the goal of these laboratories.

more...

http://www.elkhabar.com/ar/watan/304020.html

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

Hat-tip Treyfish. An interview with the brother of the man in the ICU in London. This article suggests the man is showing some signs of improvement.

http://www.raya.com/news/pages/e931b338-d344-49a5-9977-de0a33923dfe

Health Council last to know the evolution of the case of a patient "Corona" the brother of the patient "Corona": Prince expenses Alalajthassan ensure that if citizen injured PAL "Corona"
Council did not know about the situation until after the announcement of the news from the World Health
Family transferred him to London Swiss plane
Hamad Hospital refused to move without endorsing his brother to take responsibility
? Statement of Health to transfer the patient from British Hamad Hospital is real
? Do not follow health "health" of the patient since his illness, otherwise why not Ieljoh before aggravation of his condition?
? talk about injuring my brother kidney failure is incorrect
? We turned to a private hospital after doctors failed Hamad to remedy the situation
? WHO urges doctors around the world to report any case
Books - Ibrahim Badawi:

Confirmed brother patient Qatari infected with "Corona" new, and lying now at a hospital in Britain, that if his brother is stable and gradually improving, contrary to what appeared in the news agencies, and after that began to move his eyes two days ago, also receded pneumonia testimony doctors, pointing that the state sponsored treatment expenses.

He told the flag: The lung brother was inflamed and Off 90% upon arrival at the hospital, "غيز Land St. Thomas" British past 15 days, they are beginning to recover after being placed on a respirator, pointing out that despite the situation remains critical but doctors They stabilize the heartbeat and oxygen in the blood and despite the presence of some kidney infections, but they seem to be in better condition than in the beginning of the [virus] infection.

He criticized what he described as the lack of transparency about the statement of the Supreme Council of Health announcing the transfer of the patient from Hamad Hospital, the British is the truth .. Stressing that the patient's family transferred him by helicopter Swiss at their own expense after Hamad Hospital's request for special equipment on board .. Stressing on the falsity of the statement on the follow-up of the Supreme Council of the patient for some time, but they treated him from the beginning by the worsening of the situation.

He stressed that the Supreme Council of Health did not know anything about the case of his brother only after the announcement of the news by the British Ministry of Health and the World Health Organization, and the Council was wrong in mentioning about the suffering of his brother from kidney failure two months ago .. Pointing out that the flight details sick to his brother began after returning from Umrah week where began to feel shortness of breath and cough, flu and was transferred him to a hospital Hamad Medical doctors giving him some antibiotics after measuring pressure, diabetes and heart and told him it was fine and that the problem lies in the slight increase in cholesterol .. Adding: not diagnostic well as continued suffering of my brother and we went by subsequently to a private hospital gave him an injection antibiotic severe called "Tstroyn" may have led to irritation virus strongly as resulted in a serious deterioration in his condition occurred narrow severe breathing we have quoted then to hospital Hamad again.

He continued: did not stay my brother Hospital Hamad only one night, the next day, we asked to move on our ambulance jumper for treatment in London and the hospital to communicate by helicopter from Dubai but they were not to have the necessary equipment to transport the patient was contacted by plane other Swiss by some friends and we are moving at our own expense and we have receipts to prove it.

He pointed out that immediately after the arrival of his brother to the hospital was put on a respirator to work on the rest lung, which suffered a lot during that period and two of his brothers to the hospital along with his sons accompany him now.

In a telephone conversation's flag with sister facilities to the patient in London, assured us that the state of his brother in a continuous improvement since 4 days, and pneumonia down the testimony of doctors who expressed optimism improved the situation, and they did not expect this development in light of the start of the patient to restore awareness The feeling of those around him.

He said: transfer my brother to London has the efforts of personal full, where Hamad Hospital refused to move claiming that it will not bear the travel only approved after it signed to approve moving on my own responsibility, has been ordered aircraft from Dubai, but they were not equipped and asked again through our personal relationship of Zurich, Switzerland, at our own expense.

On a reported injury brother acute kidney failure, he said that this is totally false and claims to prove securities official and vice versa, the case of his brother, significantly improved the testimony of doctors.

Dr. Mohammed Al-Hajri Director health protection and disease control transitional Supreme Council of Health said he was introduced patient dated September 8 intensive care in Hamad General Hospital before deteriorating condition were then sent the patient to London to undergo Vhsoat at the hands of the Committee of health protection (HBA) as supplied to him medical evacuation aircraft, while the World Health Organization declared the Qatari citizen diagnosed with a virus looks like severe acute respiratory syndrome "(SARS)," which he called "Corona" after returning from performing Umrah at the end of the last month of Ramadan.

In context, the World Health Organization urged yesterday in the medical field in various parts of the world to report any patient infected with severe respiratory and may have traveled to Saudi Arabia or Qatar and subjected to a new virus-like virus Severe Acute Respiratory Syndrome (SARS) .. The guidance Medical Health Organization for up to 194 member states that the medical personnel attention to anyone symptoms injury severe respiratory and possible rise in temperature accompanied by cough and require his treatment in the hospital and was in the area discovered the virus or been in contact with the case confirmed or suspected during the previous ten days.

The virus is defined as the coronary virus is linked to the roles the usual cold and belongs to the same family of virus Severe Acute Respiratory Syndrome (SARS), which appeared in China in 2002 and infected 8,000 people worldwide and caused the death of 800 before control.

The link between the virus and Saudi Arabia to raise concern, especially with the near Hajj season where millions flock to Saudi Arabia to perform the Hajj .. The World Health Organisation (WHO) said it had identified a group of laboratories that can provide experts in the coronal virus states that you need.

[Giuseppe]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

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

Update on overseas human cases with novel coronavirus infection


The Centre for Health Protection (CHP) of the Department of Health today (September 27) provided an update on developments and its work following the report by the World Health Organization (WHO) on human cases with novel coronavirus infection in two patients from the Kingdom of Saudi Arabia (KSA) and Qatar.

A spokesman for the CHP said that other than the two patients reported by the WHO, another five suspected cases of novel coronavirus infection had been admitted to a hospital in Denmark. According to the information released by the hospital, all the five patients were in fact suffering from influenza B infection.

"As such, the total number of laboratory confirmed cases of novel coronavirus worldwide so far remains at two," the spokesman said.

As regards the progress of the legislative preparations to include the novel coronavirus as a notifiable infectious disease under the law, the spokesman said that the work is now in full swing and the relevant legislative amendments will be gazetted tomorrow (September 28) with immediate effect.

The spokesman pointed out that under the amendments, "Severe Respiratory Disease associated with Novel Coronavirus" will be added to the list of infectious diseases specified in Schedule 1 as a statutorily notifiable disease, and the virus to the list of infectious agents in Schedule 2 under the Prevention and Control of Disease Ordinance, Cap. 599.

With the amendments, medical practitioners are required to notify the Director of Health if they have reason to suspect the existence of this disease, and persons in charge of a laboratory are required to notify any leakage of the virus in the laboratory that may pose a public health risk. In addition, the Director may exercise his power to institute relevant border control measures for travellers having regard to the development in the affected areas.

The amendments add to Hong Kong's protection against the disease by facilitating early disease detection, preventing laboratory-acquired infection and enabling the implementation of appropriate public health measures if they are called for, depending on public health risk assessment.

"The CHP will issue letters to doctors and the medical laboratory sector to inform them of the relevant legislative amendments," the spokesman said.

"We will continue to keep a close watch on the latest developments and liaise with international health partners on the progress of further epidemiological investigations and surveillance, and the corresponding advice from the WHO," he added.


Ends/Thursday, September 27, 2012
Issued at HKT 19:36
NNNN

- ------

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

http://www.google.com/hostednews/ukpress/article/ALeqM5gVylXoK7wowy2XfkyDpz2NRdUTBw?docId=N0434941348743771002A

'New virus' man in stable condition
(UKPA) ? 11 hours ago
A man who contracted a potentially fatal Sars-like virus is now in a stable condition.

The 49-year-old, from Qatar, is being treated in an intensive care unit at St Thomas' hospital in London after he became infected with a new type of coronavirus.

A spokesman for the hospital confirmed that the man, who is still in isolation and is connected to an artificial lung to keep him alive, has been in a stable condition for the last two days.

He is receiving extracorporeal membrane oxygenation (Ecmo) treatment, which delivers oxygen to the blood outside the body when the lungs are not able to. It also continuously pumps blood into and around the body.

The man, who was suffering from acute respiratory syndrome and renal failure, was admitted to an intensive care unit in Doha, Qatar, on September 7. He was transferred to the UK by air ambulance on September 11.

Before he became ill he had travelled to Saudi Arabia, the World Health Organisation said.

The Health Protection Agency (HPA) said the man has contracted a "new virus" which has only been identified in one other case. That patient, a 60-year-old from Saudi Arabia, died as a result of the virus.

A HPA spokeswoman said preliminary inquiries had found no contact between the two patients.

The organisation is also investigating a "small number" of cases which could be linked to the virus. One patient, who travelled to the Middle East in the last three months, was treated in the UK but has since died, the HPA said.

Coronaviruses cause most common colds but can also cause Sars (severe acute respiratory syndrome). In 2003, hundreds of people died after a Sars outbreak in Asia.

[alert]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

http://www.cidrap.umn.edu/cidrap/content/other/sars/news/sep2712corona.html

Full genome sequence of novel coronavirus expected shortly
Lisa Schnirring Staff Writer


Sep 27, 2012 (CIDRAP News) ? British health officials said today that a Rotterdam lab that first characterized the novel coronavirus linked recently to two severe illnesses hopes to publish the whole genome in the next 24 to 48 hours, and the UK's Health Protection Agency (HPA) launched guidance to help clinicians investigate and manage possible cases.

The HPA said in an update that the full genome sequence will be published by Ron Fouchier, PhD, based at Erasmus University in the Netherlands. The sequence will be based on cultured virus that has been at the lab since early July.

Yesterday the agency gave the same time frame for release of the full sequence and did not change the estimate in today's update.

The HPA had earlier released the partial sequence for the virus's polymerase gene, obtained from an infected patient undergoing treatment in London, which enabled scientists to compare it with others and determine that the new virus is related to bat coronaviruses. The HPA said it doesn't yet have a viral isolate, but clinical material from the patient is being cultured to make isolates.

Also, the HPA shared new details about molecular diagnostics for identifying the new virus. It said pan-coronavirus primers described by an international group of researchers in 2003 and in a 2008 report from Belgian researchers should both be useful. However, the clinical material the HPA has does not react with specific assays it has for OC23, 229E, NL64, or SARS. It said it welcomed offers of reagents and information from scientists who specialize in the area.

In other developments, the HPA published some clinical tools to help clinicians manage suspected and confirmed cases along with close contacts. The tools include an algorithm for investigating and managing possible cases; it describes the testing process, protective actions to take if an infection is confirmed, and the next steps to take for sample collection and data reporting.

Another algorithm walks clinicians through investigating close contacts of patients with confirmed novel coronavirus infections. For contacts who don't have clinical symptoms during the initial visit, the HPA recommends that baseline clotted blood samples be taken as soon as possible, ideally no later than 7 days after exposure. The algorithm recommends that follow-up samples be taken at least 14 days after baseline or 28 days after exposure if a sample couldn't be taken when the case-patient was asymptomatic. It says a contact form should be completed 10 days after the initial data is collected.

The HPA also issued a nine-page infection control resource for handling confirmed and suspected cases. It noted that coronaviruses are mainly transmitted by large respiratory droplets and direct or indirect contact with secretions. The agency also said the viruses can be detected in feces and urine and in some instances can be transmitted by aerosolized respiratory droplets and feces. It detailed steps to take in addition to standard precautions, such as what type of respirator and personal protective equipment (PPE) to use.

In developments elsewhere, Hong Kong's Centre for Health Protection (CHP) said today that the process to make novel coronavirus infection a notifiable disease is under way. It said a legislative amendment will be recorded tomorrow, taking effect immediately. Health practitioners will be required to notify the CHP's director of health if they suspect the disease, and labs will be required to report virus leaks that may pose a public health risk.

No new infections involving the novel coronavirus have been detected beyond the Qatari man hospitalized with a severe respiratory illness and renal failure in a London intensive care unit and a 60-year-old Saudi Arabian man who was infected with a virtually identical virus who died in June.

The identification of a new coronavirus has raised global health worries, because a then-novel one in 2003 caused the SARS epidemic that sickened 8,422 people, killing 916 of them. Health officials have said the new virus is clearly different than the one that caused SARS, and some have said that an animal source can't be excluded.

[Treyfish]

Re: Saudi Arabia: 3 cases, 2 deaths due to novel animal coronavirus

Human betacoronavirus 2c EMC/2012, complete genome http://www.ncbi.nlm.nih.gov/nuccore/JX869059