Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract, edited.]
COMMUNICABLE DISEASE THREATS REPORT / CDTR
Week 48, 25 November - 1 December 2012
Novel coronavirus - Multistate - Severe respiratory disease
Opening date: 30 November 2012
Epidemiological summary
A first case, reported on Thursday 20 September through ProMED, was a 60-year-old patient in Jeddah, Kingdom of Saudi Arabia. He was admitted to hospital on 13 June with severe pneumonia. He developed acute renal failure, and died on 24 June. Post mortem lung tissue tests 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 and the virus genome was later sequenced in Erasmus Medical Centre, Rotterdam, and identified as a putative novel beta-corononavirus, closely related to bat coronaviruses.
A second case was reported on Saturday 22 September, by the UK Health Protection Agency (HPA). The case is a 49 year old Qatari with no underlying health conditions and a history of travel to Mecca, Saudi Arabia. He developed respiratory symptoms on 3 September, and on 7 September was admitted to an intensive care unit (ICU) in Doha, Qatar, where he subsequently developed renal failure. On 11 September he was transferred by air ambulance to an ICU in the UK. On 21 September, tests on samples from the patient using a pancoronavirus RT-PCR test were positive. Comparison of a 250bp PCR fragment between this and the isolate of the first case performed by the Erasmus Medical Centre showed 99.5% sequence homology (1 nucleotide difference).
A third case of infection with the novel coronavirus was reported on 4 November by Saudi Arabia. The patient was admitted to hospital in Riyadh with pneumonia and was subsequently diagnosed with the novel coronavirus by RT-PCR. This patient also developed renal failure, however he did have a medical history of only one functional kidney. He is out of intensive care and is currently recovering. A case report on this case was published in the Saudi Medical Journal (http://www.ecdc.europa.eu/en/publications/Publications/communicable-disease-threats-report-8-dec-2012.pdf ) this week.
Germany reported a fourth case of the novel coronavirus on 23 November in a patient from Qatar with onset of symptoms in October. He was initially treated in Qatar but was later transferred to Germany for treatment for severe respiratory distress syndrome and acute renal failure. The diagnosis of the novel coronavirus was made at the Health Protection Agency using samples sent from Qatar. He has been discharged from hospital. The patient has no epidemiological link to the previous cases.
On 23 November WHO provided information on the above mentioned fourth case, and two further confirmed cases in Saudi Arabia, one of whom died. These two cases in Saudi Arabia were part of a cluster in a family household involving two additional cases: one of whom also died and was confirmed as positive on 28 November; the other recovered and is considered a probable case. This cluster may indicate the possibility of person-to-person transmission; however, it could also be explained by exposure to a common source.
On 30 November WHO confirmed that two samples taken during an investigation into an unexplained respiratory disease cluster in Jordan have retrospectively tested positive for novel coronavirus. Both of these two cases were fatal.
As of 30 November, a total of nine laboratory confirmed cases of the novel coronavirus have been reported to WHO ? five cases (including 3 fatalities) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.
Further details on the first six cases are available in the rapid risk assessment of 24 September and the updated rapid risk assessment of the 26 November.
Web sources: Interim case definition -WHO |HPA infection control advice |Partial genetic sequence information |ProMed link to third reported case |whole genome sequence | ProMed fourth reported case | relatedness to bat coronaviruses| WHO update
ECDC assessment
A novel coronavirus has been identified in nine patients with severe respiratory and, in five cases, renal disease. Two of the cases were treated in the United Kingdom and Germany after medical evacuation, but so far there are no indications of transmission of the virus within the EU.
Research on the complete genome sequence of HCoV-EMC/2012, has characterised the virus as a new genotype that is closely related to bat coronaviruses that are distinct from SARS-CoV. The source and possible routes of transmission of the virus remain unknown. At this stage, the detection of a household cluster does not provide conclusive evidence for or against limited person-to-person transmission.
It is possible that enhanced surveillance in the Arabian Peninsula, neighbouring countries and worldwide will detect additional sporadic cases or clusters.
Actions
ECDC updated the rapid risk assessment and this was published on the website on 26 November. ECDC are coordinating with relevant stakeholders regarding the detection, laboratory diagnosis, and management of cases should the threat evolve to affect the EU.
ECDC published an "Epi update" on 30 November and is in the process of updating the rapid risk assessment related to this event.
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COMMUNICABLE DISEASE THREATS REPORT / CDTR
Week 48, 25 November - 1 December 2012
Novel coronavirus - Multistate - Severe respiratory disease
Opening date: 30 November 2012
Epidemiological summary
A first case, reported on Thursday 20 September through ProMED, was a 60-year-old patient in Jeddah, Kingdom of Saudi Arabia. He was admitted to hospital on 13 June with severe pneumonia. He developed acute renal failure, and died on 24 June. Post mortem lung tissue tests 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 and the virus genome was later sequenced in Erasmus Medical Centre, Rotterdam, and identified as a putative novel beta-corononavirus, closely related to bat coronaviruses.
A second case was reported on Saturday 22 September, by the UK Health Protection Agency (HPA). The case is a 49 year old Qatari with no underlying health conditions and a history of travel to Mecca, Saudi Arabia. He developed respiratory symptoms on 3 September, and on 7 September was admitted to an intensive care unit (ICU) in Doha, Qatar, where he subsequently developed renal failure. On 11 September he was transferred by air ambulance to an ICU in the UK. On 21 September, tests on samples from the patient using a pancoronavirus RT-PCR test were positive. Comparison of a 250bp PCR fragment between this and the isolate of the first case performed by the Erasmus Medical Centre showed 99.5% sequence homology (1 nucleotide difference).
A third case of infection with the novel coronavirus was reported on 4 November by Saudi Arabia. The patient was admitted to hospital in Riyadh with pneumonia and was subsequently diagnosed with the novel coronavirus by RT-PCR. This patient also developed renal failure, however he did have a medical history of only one functional kidney. He is out of intensive care and is currently recovering. A case report on this case was published in the Saudi Medical Journal (http://www.ecdc.europa.eu/en/publications/Publications/communicable-disease-threats-report-8-dec-2012.pdf ) this week.
Germany reported a fourth case of the novel coronavirus on 23 November in a patient from Qatar with onset of symptoms in October. He was initially treated in Qatar but was later transferred to Germany for treatment for severe respiratory distress syndrome and acute renal failure. The diagnosis of the novel coronavirus was made at the Health Protection Agency using samples sent from Qatar. He has been discharged from hospital. The patient has no epidemiological link to the previous cases.
On 23 November WHO provided information on the above mentioned fourth case, and two further confirmed cases in Saudi Arabia, one of whom died. These two cases in Saudi Arabia were part of a cluster in a family household involving two additional cases: one of whom also died and was confirmed as positive on 28 November; the other recovered and is considered a probable case. This cluster may indicate the possibility of person-to-person transmission; however, it could also be explained by exposure to a common source.
On 30 November WHO confirmed that two samples taken during an investigation into an unexplained respiratory disease cluster in Jordan have retrospectively tested positive for novel coronavirus. Both of these two cases were fatal.
As of 30 November, a total of nine laboratory confirmed cases of the novel coronavirus have been reported to WHO ? five cases (including 3 fatalities) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.
Further details on the first six cases are available in the rapid risk assessment of 24 September and the updated rapid risk assessment of the 26 November.
Web sources: Interim case definition -WHO |HPA infection control advice |Partial genetic sequence information |ProMed link to third reported case |whole genome sequence | ProMed fourth reported case | relatedness to bat coronaviruses| WHO update
ECDC assessment
A novel coronavirus has been identified in nine patients with severe respiratory and, in five cases, renal disease. Two of the cases were treated in the United Kingdom and Germany after medical evacuation, but so far there are no indications of transmission of the virus within the EU.
Research on the complete genome sequence of HCoV-EMC/2012, has characterised the virus as a new genotype that is closely related to bat coronaviruses that are distinct from SARS-CoV. The source and possible routes of transmission of the virus remain unknown. At this stage, the detection of a household cluster does not provide conclusive evidence for or against limited person-to-person transmission.
It is possible that enhanced surveillance in the Arabian Peninsula, neighbouring countries and worldwide will detect additional sporadic cases or clusters.
Actions
ECDC updated the rapid risk assessment and this was published on the website on 26 November. ECDC are coordinating with relevant stakeholders regarding the detection, laboratory diagnosis, and management of cases should the threat evolve to affect the EU.
ECDC published an "Epi update" on 30 November and is in the process of updating the rapid risk assessment related to this event.
(?)
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