Re: Saudi Arabia - Woman, 69, died + MOH statement - May 12, 2013 nCoV coronavirus
Published Date: 2013-05-12 22:28:00
Subject: PRO/AH/EDR> Novel coronavirus - Eastern Mediterranean (25): KSA deaths, WHO
Archive Number: 20130512.1708475
NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN (25): SAUDI ARABIA DEATHS, WHO
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[1] Additional deaths Saudi Arabia
[2],[3] WHO communication
[4] Family members involved in cluster
[5] International team joins investigation
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[1]
Date: 12 May 2013
Source: Reuters [edited]
http://www.chicagotribune.com/healt...94b05e-20130512,0,1937226.story#ixzz2T7IX5I7R
Two more people die of novel coronavirus in Saudi Arabia
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Two more people have died from novel coronavirus, a new strain of the virus similar to the one that caused SARS, in an outbreak in al-Ahsa region of Saudi Arabia, the deputy health minister for public health said on Sunday.
Ziad Memish said that in the latest cluster of infections, 15 cases had been confirmed, and nine of those patients had died.
[Byline Angus McDowall; Editing Kevin Liffey]
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ProMED-mail
<promed@promedmail.org
[A similar story was submitted by ProMED Rapporteur Kunihiko Iizuka. - Mod.LM]
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[2]
Date: 12 May 2013
Source: Reuters via Euronews [edited]
http://www.euronews.com/newswires/1...-probably-can-be-passed-person-to-person-who/
New virus can probably pass person to person - WHO
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World Health Organisation (WHO) officials said on Sunday it seemed likely a new coronavirus that has killed at least 18 people in the Middle East and Europe could be passed between humans, but only after prolonged contact.
A virus from the same family triggered the outbreak of Severe Acute Respiratory Syndrome (SARS) that swept the world after emerging in Asia and killed 775 people in 2003.
On Sunday French authorities announced that a second man had been diagnosed with the disease after sharing a hospital room with France's only other sufferer.
WHO Assistant Director-General Keiji Fukuda told reporters in Saudi Arabia, the site of the largest cluster of infections, there was no evidence so far the virus was able to sustain "generalised transmission in communities" - a scenario that would raise the spectre of a pandemic.
But he added: "Of most concern ... is the fact that the different clusters seen in multiple countries ... increasingly support the hypothesis that when there is close contact, this novel coronavirus can transmit from person to person.
"There is a need for countries to ... increase levels of awareness," he said.
A public health expert who declined to be identified, said "close contact" meant being in the same small, enclosed space with an infected person for a prolonged period.
The virus first emerged in the Gulf last year, but cases have also been recorded in Britain and France among people who had recently been in the Middle East. A total of 34 cases worldwide have been confirmed by blood tests so far.
NEW DEATHS
Saudi Deputy Health Minister for Public Health Ziad Memish told reporters that, of 15 confirmed cases in the most recent outbreak, in al-Ahsa district of Eastern Province, nine had died, two more than previously reported.
Saudi Arabia's Health Ministry said in a statement the country had had 24 confirmed cases since last summer, of whom 15 had died. Fukuda said he was not sure if the two newly reported Saudi deaths were included in the numbers confirmed by the WHO.
Memish added that three suspected cases in Saudi Arabia were still under investigation, including previous negative results that were being re-examined.
The first French patient was confirmed as suffering from the disease on Wednesday after travelling in the Gulf. The second patient was transferred to intensive care on Sunday after the two men shared a room in a hospital in Lille.
Professor Benoit Guery, head of the Lille hospital's infectious diseases unit, said the first patient had not been immediately isolated because he presented "quite atypical" symptoms.
He added in comments broadcast by BFMTV channel the case suggested that airborne transmission of the virus was possible, though still unusual, and that the public "should not be concerned" as there had been only 34 cases globally in a year.
Fukuda, part of a WHO team visiting Saudi Arabia to investigate the spread of the disease, said although no specific vaccine or medication was yet available for novel coronavirus, patients were responding to treatment.
"The care that is taken in the hospitals, in terms of using respirators well, in terms of treating pneumonia, in terms of treating complications, in terms of providing support, these steps can get patients through this very severe illness," he said.
Fukuda said that as far as he knew all cases in the latest outbreak in al-Ahsa district were directly or indirectly linked to one hospital.
He added that Saudi Arabian authorities had taken novel coronavirus very seriously and had initiated necessary health measures such as increased surveillance systems.
[Byline Angus McDowall; Additional reporting Nicolas Delame in Paris; Editing William Maclean and Andrew Roche]
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[3]
Date: 12 May 2013
Source: WHO
http://www.who.int/mediacentre/news/statements/2013/Novel_Coronavirus_12052013/en/index.html
WHO Press Statement Related to the Novel Coronavirus Situation
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The emergence of this new coronavirus is globally recognized as an important and major challenge for all of the countries which have been affected as well as the rest of the world. The Ministry of Health of the Kingdom of Saudi Arabia has recognized this and invited the World Health Organization (WHO) to help them assess the situation and to provide guidance and recommendations. WHO is pleased to be here to work together with the Kingdom of Saudi Arabia.
At this time there are some things about this new disease we understand. However I would like to remind everyone that this is a new infection and there are also many gaps in our knowledge that will inevitably take time to fill in.
We know that the disease is caused by a virus from a group called coronaviruses. One member of the coronavirus family is the SARs virus. This new virus is NOT the SARS virus. They are distinct from each other. However, the fact that they are related has added to the world's concern. We know this virus has infected people since 2012, but we don't know where this virus lives. We know that when people get infected, many of them develop severe pneumonia. What we don't know is how often people might develop mild disease. We also know that most of the persons who have been infected so far have been older men, often with other medical conditions. We are not sure why we are seeing this pattern and if it will change over time.
There are many other things that we don't understand. For example, how are people getting infected? Is it from animals? Is it from contaminated surfaces? Is it from other people? Finally, we don't know how widespread is this virus, both in this region and in other countries.
The greatest global concern, however, is about the potential for this new virus to spread. This is partly because the virus has already caused severe disease in multiple countries, although in small numbers, and has persisted in the region since 2012. Of most concern, however, is the fact that the different clusters seen in multiple countries increasingly support the hypothesis that when there is close contact this novel coronavirus can transmit from person-to-person. This pattern of person-to- person transmission has remained limited to some small clusters and so far, there is no evidence that this virus has the capacity to sustain generalized transmission in communities.
At this point, several urgent actions are needed. The most important ones are the need for countries, both inside and outside of the region, to increase their levels of awareness among all people but especially among staff working in their health systems and to increase their levels of surveillance about this new infection. In Saudi Arabia, we have seen the importance of better surveillance. When new cases are found, as is likely, it is critical for countries to report these cases and related information urgently to WHO as required by the International Health Regulations because this is the basis for effective international alertness, preparedness and response. Countries also need to assess their level of preparedness and readiness if this virus should spread and to intensify strengthening the core capacities identified in the International Health Regulations if they are not adequate. WHO is ready to assist countries in this region and globaly in these
tasks.
There are also some questions that urgently need to be answered including how people are getting infected, and what are the main risk factors for either infection or development of severe disease. The answers to these questions hold the keys to preventing infection.
In closing, we want to note that the Government of Saudi Arabia has taken the novel coronavirus situation very seriously. The Ministry of Health has initiated crucial public health actions -- including intensifying surveillance, initiating investigations and important research and putting control measures in place.
One of the reasons why more cases have been identified in KSA may be because they have gone ahead to strengthen their surveillance system and lab capacities and network.
For more information contact
Gregory H?rtl
WHO Media Coordinator
Department of Communications
WHO, Geneva
Mobile: +41 79 203 6715
E-mail:
hartlg@who.int
--
Communicated by:
ProMED Rapporteur Kunihiko Iizuka
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[4]
Date: Sunday 12 May 2013
Reuters via Ahram [edited]
http://english.ahram.org.eg/NewsCon...rief-and-questions-Virus-ravages-a-Saudi.aspx
Rumours, grief and questions: Virus ravages a Saudi family
Coronavirus - a disease similar to the SARS virus - infects family in Saudi Arabia, marking first cases to appear in Middle East region
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On the third day after his father's death from a respiratory infection, [the man] began to feel feverish.
Shortly afterwards, says the 27-year-old Saudi, "I was almost dead".
[The man], who had often visited his father's bedside in his last days, was admitted to intensive care in a hospital in Dhahran, in the Eastern Province oil heartland of Saudi Arabia.
Then his brother, and later his sister, fell ill, obtaining treatment in hospitals in the nearby oasis district of al-Ahsa.
Their father, it has since emerged, was probably a victim of what doctors believe was novel coronavirus, the new SARS-like disease that first emerged in the Gulf last year and has gone on to claim 18 lives, nine of them in the kingdom.
There is international concern, because it was a virus from the same family of pathogens that triggered the outbreak of Severe Acute Respiratory Syndrome (SARS) that swept the world after starting in Asia in 2003 and killed 775 people.
Some of the cases of the new virus were in Britain and France, among them people who had recently travelled from the Middle East. A total of 34 cases worldwide have been confirmed by blood tests so far.
"My temperature was really high, my blood oxygen levels were very low. I was so tired I couldn't walk for days and any kind of activity made me cough," said [the man], a PhD student who studies in Canada. To avoid spreading infection, he wore a green face mask.
SLEEPY OASIS
World Health Organisation (WHO) experts this week visited Ahsa, a sleepy oasis of around a million people, to work with Saudi authorities in investigating the latest outbreak.
Much of the attention has focused on the private al-Moosa General Hospital in Hofuf, Ahsa's main town, where many of those infected, including Mohammed al-Sheikh, were treated in the intensive care unit.
A senior WHO official said on Sunday it appeared likely that the virus could be passed between people in close contact.
WHO Assistant Director-General Keiji Fukuda said, however, that there was no evidence so far that the virus was able to sustain "generalised transmission in communities", a scenario that would raise the spectre of a pandemic.
A public health expert, who declined to be identified due to the sensitivity of the matter, said "close contact" in this context meant being in the same small, enclosed space with an infected person for a prolonged period of time.
[Another man], who suffered from diabetes and had been admitted to hospital with a high fever and low blood sugar never knew what had infected him. He lost consciousness two days before he died.
"The doctors said they didn't know what was wrong," said [the first man]. "During his first two days in intensive care he could talk and eat by himself and go to the washroom. But then it got worse. He was on the highest level of oxygen and they had to drug him. He left without saying goodbye," he said, referring to his death.
In the wake of rumours about the extent of the virus in Ahsa last week, some families of people who were hospitalised said they had been asked by authorities not to speak to media.
Separated from the big cities of Riyadh and Dammam by large stretches of desert, Ahsa is a pretty area famous for its date farms. Drive through its dusty villages and goats appear grazing beneath the palm fronds. Between the trees jut pale rocky outcrops carved by the elements into outlandish shapes.
CALAMITY OF A FATHER'S DEATH
There was little sign in the al-Moosa General Hospital's reception area late on Saturday that it was at the centre of a global health concern.
Visitors, doctors and nurses hurried down the corridors. Two women in black hijab waited with their babies outside a door marked "vaccination room".
[The man] said he believed his father contracted novel coronavirus in the hospital's intensive care unit and that he then caught it there himself during the hours he spent visiting his father in the days before he died on April 15.
But Malek al-Moosa, the hospital's general manager, denied this suggestion and said he believed the patients were in fact exposed to a common source of the virus outside Moosa General Hospital.
Fukukda of the WHO said it was not yet clear how the virus was transmitted.
Of the four members of the family who fell sick, only one, [the man], 33, has so far been tested positive for novel coronavirus.
Samples from [the other three] are still being tested but Moosa said it was likely that they also had the virus.
A poster-sized portrait of Mohammed al-Sheikh, a 56-year-old former employee of the national oil company Saudi Aramco, is displayed in the family's reception room, where three of his 10 children sat to describe what they call the "calamity" that has hit their family.
"Our father's dream was that we should all live in one house with a big garden. He had started building it and finished almost 50 percent. This is just killing us," said Hussein.
--
Communicated by:
ProMED Rapporteur Kunihiko Iizuka
******
[5]
Date: 13 May 2013
Source: Arab News
http://www.arabnews.com/news/451453
WHO endorses Saudi steps to check coronavirus
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Saudi Arabia has taken steps to protect its people from the coronavirus. The experience and knowledge that the country has gained fighting coronavirus can benefit the rest of the world, said a visiting WHO official.
Keiji Fukuda, assistant director-general of the WHO's Health Security and Environment, said the Kingdom has taken the coronavirus situation seriously and its Ministry of Health has initiated public health action, including intensifying surveillance, initiating investigations and research and putting preventive measures in place.
"One of the reasons why more cases have been identified in KSA may be because they have gone ahead to strengthen their surveillance system, lab capacity and network," he said.
Upon invitation from the Kingdom, a team of health experts arrived in the country on Friday to assess the status of the spread of the virus in the country. The visiting team includes two WHO officials, Fukuda and Dr. Jawad, quarantine director of communicable diseases of the WHO in Cairo. The other international scientists are Dr. Connie Savor Price, chief of the Division of Infectious Diseases at Denver Health Medical Center and assistant professor of medicine at the University of Colorado Denver; Trish Burrell, consultant, infectious diseases at Johns Hopkins University; Paul Tambaiah, consultant infectious diseases the University of Singapore; and Allison Mack Qier of Mount Toronto Hospital [probably Allison McGeer, of Mount Sinai Hospital, Toronto].
On Saturday, the team visited the health facilities in Hofuf and the hospital, where a number of infected cases were treated.
Fukuda was speaking at a meeting held yesterday under the chairmanship of Health Minister Dr. Abdullah Al-Rabeeah at the headquarters of the Ministry of Health here.
Welcoming the delegation, Al-Rabeeah said that since last September, the Kingdom diagnosed 45 virus infected patients [This is not consistent with other reports that indicate 24 cases have been detected - Mod.LM], of whom 15 died. He dismissed reports that the virus attack was confined to Al-Ahsa province, and said there were incidences in Jeddah, Dammam and Riyadh, too.
"We will continue to cooperate with the WHO and other international organizations in the fight against infectious diseases for the betterment of the nation," he stressed.
"We have not come to inspect the measures taken by the Kingdom," Fukuda said, adding that the team came here to see what was found in general about the disease.
"In the Kingdom, we have seen the importance of better surveillance. When new cases are found, as is likely, it is critical for countries to report these cases and related information urgently to the WHO as required by international health regulations because this is the basis for effective international alertness, preparedness and response," he said.
"Countries also need to assess their level of preparedness and readiness if this virus should spread and intensify the core capacities identified in the international health regulations if they are not adequate. The WHO is ready to assist countries in this region and globally in these tasks," he said.
--
Communicated by ProMED-mail
<promed@promedmail.org>
[This report should be interpreted with caution as it appears to contain some inconsistencies in facts and interpretation. - Mod.LM]
[Two deaths have occurred among the previously reported al-Ahsa cluster of novel coronavirus infection in Saudi Arabia, though it is impossible to know from the information given which of the previously described patients has died. Further details would be appreciated so that risk factors for death from novel coronavirus can be better understood. An international expert team is now assisting in the investigation. It appears that several members of the same family may have been involved in this cluster and the Reuters report adds a human dimension as well as additional details to the story.
WHO has issued a statement underscoring that person-to-person transmission of the virus has almost certainly occurred, now in several countries (including most likely the index outbreak in Jordan). So far, sustained transmission does not appear to have occurred, reducing the likelihood of a wider epidemic.
It is possible that, as was true with SARS, some individuals may act as "superspreaders", infecting larger numbers of contacts. I think of this as analogous to people with cavitary TB, who are far more infectious than others with pulmonary TB. So far it appears that close and prolonged contact has been required to transmit novel coronavirus, but much remains to be learned and the case count is still small.
It appears that a number of suspected cases remain under investigation both in France and Saudi Arabia. Presumably a serologic test, if it is sufficiently sensitive and specific, will be helpful in determining the extent of spread of the virus among contacts and to determine whether mild or asymptomatic cases may be occurring both in contacts and in the larger community. PCR, while sensitive and specific, is limited in that the assay can only be performed during the (unknown) period of active viral shedding and is also limited by sample quality and handling.
While a suspected animal source of the infection has been sought, none has yet been identified.
A map of Saudi Arabia can be seen at:
http://healthmap.org/r/1HAJ - Mod.LM]
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