Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 10, 3-9 March 2013
(?)
Novel Coronavirus - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 8 March 2013
Epidemiological summary
The first case confirmed with the novel coronavirus was reported in a 60-year-old male resident of Saudi Arabia who died from severe pneumonia complicated by renal failure in Jeddah on 24 June 2012. The genome of the new coronavirus was isolated from this case, sequenced and the genetic code put in the public domain.
In September 2012, a second case, a 49-year-old male living in Qatar, presented with similar symptoms and was transferred for care in Europe. A virus was isolated from this case, which was almost identical to the virus from the case in Saudi Arabia.
In November 2012, additional cases with similar symptomatology were diagnosed in Qatar and Saudi Arabia, including a family cluster of three confirmed cases and one probable case.
Subsequently, two fatal cases were confirmed retrospectively in Jordan from within a cluster of 11 people with severe lower respiratory infections that were associated with a hospital in April 2012.
On 11 February 2013, the UK Health Protection Agency (HPA) published details of a male UK resident with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on 24 January 2013 and had arrived unwell in the UK on 28 January 2013. His condition deteriorated and he was admitted to hospital where he is in intensive care.
On 6 February 2013, a male household member who had contact with the patient from his arrival in the UK until hospital admission fell unwell. This patient had an existing medical condition that may have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital, where he subsequently died.
The third confirmed case is a younger female family member, who only had exposure to the original index case while he was in hospital. She became ill on 5 February 2013 with a typical flu-like illness, which did not require hospital admission and from which she has now fully recovered. Unlike the source case, neither of these two contacts have travelled abroad recently.
HPA is actively investigating the possible route of infection. Infection control measures around the three cases are following national UK guidance and case-finding is ongoing for those who may have been exposed.
Active follow-up of contacts of the three confirmed cases had not detected any additional confirmed secondary cases by 18 February 2013.
On 21 February 2013, the Ministry of Health in Saudi Arabia confirmed another case of infection with the novel coronavirus. The patient who was hospitalised on 29 January 2013 died on 10 February 2013. The case was laboratory-confirmed on 18 February 2013.
On 6 March 2013, the Ministry of Health in Saudi Arabia informed the World Health Organization (WHO) of a new confirmed case of novel coronavirus (NCoV) infection. It concerns a 69-year-old male. The patient was admitted to hospital on 10 February 2013 and died on 19 February 2013. This case has been notified through the International Health Regulation (IHR). Preliminary investigations indicated that the patient had no contact with previously reported cases of NCoV infection and did not have a recent history of travel.
This brings the number of confirmed cases of NCoV infections to 14 globally, including eight deaths.
(?)
ECDC assessment
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 routes of transmission to humans have not yet been determined. This is a common problem with emerging zoonoses where there is often simultaneous possibilities including environmental, animal and human exposures.
The recent three cases detected in the UK have changed the assessment of the situation regarding this novel coronavirus. The fact that an infection has come to Europe on a commercial flight and then resulted in two probable human-to-human transmission episodes has increased the threat, although the cluster has been restricted to one family.
There are now two instances of documented human-to-human transmission within the recent UK cluster. However, it is important to quantify infectivity and there is also evidence suggesting low infectivity at a population level. In Germany and the UK, follow-up of nearly 200 personal contacts and healthcare workers exposed to the first two imported confirmed cases has been completed and did not find evidence of human-to-human transmission.
The appearance of a milder secondary case might indicate that that milder cases could be present and potentially spread the infection but be missed in case-finding. This highlights the need for further work to document the spectrum of illness.
The new confirmed case of novel coronavirus (NCoV) infection reported by Saudi Arabia on 6 March 2013 does not change the updated risk assessment published by ECDC on 7 December 2012.
Actions
In light of the human-to-human transmission of the NCoV within the family cluster in the UK, ECDC has updated its rapid risk assessment, previously published on 7 December 2012. The results of a survey to determine the laboratory capacity for testing for the novel coronavirus in Europe, conducted by ECDC in coordination with WHO Regional Office for Europe, was published recently in EuroSurveillance.
On 7 March 2013, the US Centers for Disease Control and Prevention (CDC) updated its guidance on detecting novel coronavirus (NCoV) infections.
HPA has identified 100 people who had close contact with the cases in the family cluster and they were followed up.
To date all tests have been negative.
HPA has informed all countries whose residents may have been contacts of the index case during the flight from Jeddah to Heathrow (within 2 rows).
ECDC is closely monitoring the situation in collaboration with WHO and the European Member States.
If new sporadic cases of confirmed NCoV infection are reported, ECDC will communicate them through the weekly Communicable Disease Threat Report (CDTR).
(?)
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COMMUNICABLE DISEASE THREATS REPORT
Week 10, 3-9 March 2013
(?)
Novel Coronavirus - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 8 March 2013
Epidemiological summary
The first case confirmed with the novel coronavirus was reported in a 60-year-old male resident of Saudi Arabia who died from severe pneumonia complicated by renal failure in Jeddah on 24 June 2012. The genome of the new coronavirus was isolated from this case, sequenced and the genetic code put in the public domain.
In September 2012, a second case, a 49-year-old male living in Qatar, presented with similar symptoms and was transferred for care in Europe. A virus was isolated from this case, which was almost identical to the virus from the case in Saudi Arabia.
In November 2012, additional cases with similar symptomatology were diagnosed in Qatar and Saudi Arabia, including a family cluster of three confirmed cases and one probable case.
Subsequently, two fatal cases were confirmed retrospectively in Jordan from within a cluster of 11 people with severe lower respiratory infections that were associated with a hospital in April 2012.
On 11 February 2013, the UK Health Protection Agency (HPA) published details of a male UK resident with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on 24 January 2013 and had arrived unwell in the UK on 28 January 2013. His condition deteriorated and he was admitted to hospital where he is in intensive care.
On 6 February 2013, a male household member who had contact with the patient from his arrival in the UK until hospital admission fell unwell. This patient had an existing medical condition that may have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital, where he subsequently died.
The third confirmed case is a younger female family member, who only had exposure to the original index case while he was in hospital. She became ill on 5 February 2013 with a typical flu-like illness, which did not require hospital admission and from which she has now fully recovered. Unlike the source case, neither of these two contacts have travelled abroad recently.
HPA is actively investigating the possible route of infection. Infection control measures around the three cases are following national UK guidance and case-finding is ongoing for those who may have been exposed.
Active follow-up of contacts of the three confirmed cases had not detected any additional confirmed secondary cases by 18 February 2013.
On 21 February 2013, the Ministry of Health in Saudi Arabia confirmed another case of infection with the novel coronavirus. The patient who was hospitalised on 29 January 2013 died on 10 February 2013. The case was laboratory-confirmed on 18 February 2013.
On 6 March 2013, the Ministry of Health in Saudi Arabia informed the World Health Organization (WHO) of a new confirmed case of novel coronavirus (NCoV) infection. It concerns a 69-year-old male. The patient was admitted to hospital on 10 February 2013 and died on 19 February 2013. This case has been notified through the International Health Regulation (IHR). Preliminary investigations indicated that the patient had no contact with previously reported cases of NCoV infection and did not have a recent history of travel.
This brings the number of confirmed cases of NCoV infections to 14 globally, including eight deaths.
(?)
ECDC assessment
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 routes of transmission to humans have not yet been determined. This is a common problem with emerging zoonoses where there is often simultaneous possibilities including environmental, animal and human exposures.
The recent three cases detected in the UK have changed the assessment of the situation regarding this novel coronavirus. The fact that an infection has come to Europe on a commercial flight and then resulted in two probable human-to-human transmission episodes has increased the threat, although the cluster has been restricted to one family.
There are now two instances of documented human-to-human transmission within the recent UK cluster. However, it is important to quantify infectivity and there is also evidence suggesting low infectivity at a population level. In Germany and the UK, follow-up of nearly 200 personal contacts and healthcare workers exposed to the first two imported confirmed cases has been completed and did not find evidence of human-to-human transmission.
The appearance of a milder secondary case might indicate that that milder cases could be present and potentially spread the infection but be missed in case-finding. This highlights the need for further work to document the spectrum of illness.
The new confirmed case of novel coronavirus (NCoV) infection reported by Saudi Arabia on 6 March 2013 does not change the updated risk assessment published by ECDC on 7 December 2012.
Actions
In light of the human-to-human transmission of the NCoV within the family cluster in the UK, ECDC has updated its rapid risk assessment, previously published on 7 December 2012. The results of a survey to determine the laboratory capacity for testing for the novel coronavirus in Europe, conducted by ECDC in coordination with WHO Regional Office for Europe, was published recently in EuroSurveillance.
On 7 March 2013, the US Centers for Disease Control and Prevention (CDC) updated its guidance on detecting novel coronavirus (NCoV) infections.
HPA has identified 100 people who had close contact with the cases in the family cluster and they were followed up.
To date all tests have been negative.
HPA has informed all countries whose residents may have been contacts of the index case during the flight from Jeddah to Heathrow (within 2 rows).
ECDC is closely monitoring the situation in collaboration with WHO and the European Member States.
If new sporadic cases of confirmed NCoV infection are reported, ECDC will communicate them through the weekly Communicable Disease Threat Report (CDTR).
(?)
-
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