Announcement

**sharon sanders** · May 17, 2014, 01:57 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

From: "Media@cdc.gov (CDC)" <sohco@CDC.GOV> [Add to Address Book]
To: MMWR-MEDIA@LISTSERV.CDC.GOV
Subject: CDC Press Release: Illinois resident who had contact with Indiana MERS patient tests positive for MERS coronavirus *Embargoed until 3:30 p.m. ET
Date: May 17, 2014 2:32 PM
Press Release

Embargoed until 3:30 p.m. ET
Saturday, May 17, 2014

Contact: Barbara Reynolds (404) 918-1586
CDC Media Relations: (404) 639-3286

Illinois resident who had contact with Indiana MERS patient tests positive for MERS coronavirus
Ongoing investigation of the first imported case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in the United States has identified evidence of apparent past MERS-CoV infection in an Illinois man who had close contact with the Indiana MERS patient. The Illinois resident did not seek or require medical care. However, local health officials have monitored his health daily since May 3 as part of the investigation. At this time, the Illinois resident is reported to be feeling well.
The previously reported Indiana MERS patient is a U.S. resident who had traveled from Saudi Arabia and was admitted to an Indiana hospital on April 28; the patient was confirmed to have MERS on May 2, and has since been released from the hospital.
For the Illinois resident, laboratory test results showing apparent past MERS-CoV infection were reported late night on May 16. CDC officials explained that these laboratory test results are preliminary and suggest that the Illinois resident probably got the virus from the Indiana patient and the person?s body developed antibodies to fight the virus. There are two main ways to determine if a person is or has been infected with MERS-CoV. We can collect a respiratory sample and use a test called PCR to determine if a person has active infection with the virus. Or we can do a blood test that looks for antibodies to MERS-CoV that would indicate a person had previously been infected with MERS-CoV.
?This latest development does not change CDC?s current recommendations to prevent the spread of MERS,? said David Swerdlow, M.D., who is leading CDC?s MERS-CoV response. ?It?s possible that as the investigation continues others may also test positive for MERS-CoV infection but not get sick. Along with state and local health experts, CDC will investigate those initial cases and if new information is learned that requires us to change our prevention recommendations, we can do so.?
The Illinois resident has no recent history of travel outside the United States. He met with the Indiana patient on two occasions shortly before the patient was identified as having MERS-CoV infection. As part of the MERS follow-up investigation, the local health department in Illinois contacted the Illinois resident on May 3. The health department first tested this person for active MERS-CoV infection on May 5. Those test results were negative. Public health officials are collecting blood samples from people who were identified as close contacts of the Indiana patient. On May 16, the test result was positive for the Illinois resident, showing that he has antibodies to MERS-CoV.
Reports of the first two confirmed imported cases of MERS in the United States ? the first in Indiana on May 2, and the second in Florida on May 11 ? have resulted in large-scale multistate investigations and responses aimed at minimizing the risk of spread of the virus. As part of this effort, public health officials are reaching out to healthcare professionals, family members, and others who had close contact with the patients to provide guidance about monitoring their health and recommendations about when to see a healthcare provider for an evaluation. Public health officials also are working with airlines to identify and notify U.S. travelers who may have been exposed to the patient on any of the flights. Efforts are now under way to identify, notify, test, and monitor close contacts of the Illinois resident.
All reported cases of MERS have been linked to countries in and near the Arabian Peninsula. In some instances, the virus has spread from person to person through close contact. However, there is currently no evidence of sustained spread of MERS-CoV in community settings.
At this time, CDC?s recommendations to the public, travelers, and healthcare providers have not changed on the basis of this new information.
For the general public: While experts do not yet know exactly how this virus is spread, CDC routinely advises that people help protect themselves from respiratory illnesses by taking everyday preventive actions like washing their hands often; avoiding touching their face with unwashed hands; avoiding contact with people who appear sick; and disinfecting frequently touched surfaces.
For travelers: CDC currently does not recommend that anyone change their travel plans. If you are traveling to countries in or near the Arabian Peninsula, CDC recommends that you pay attention to your health during and after your trip. The CDC travel notice for MERS-CoV was upgraded to a level 2 alert. The travel notice advises people traveling to the Arabian Peninsula for health care work to follow CDC?s recommendations for infection control, and other travelers to the Arabian Peninsula to take general steps to protect their health.
Healthcare professionals should evaluate patients for MERS-CoV infection who have
(A) fever and pneumonia or acute respiratory distress syndrome, and either
a history of travel from countries in or near the Arabian Peninsula within 14 days before symptom onset, or
have had close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula, or
are part of a cluster of patients with severe acute respiratory illness of unknown etiology in which MERS-CoV is being evaluated;
(B) or anyone who has had close contact with a confirmed or probable case of MERS while the person was ill, in consultation with state and local health departments.
Background
Middle East Respiratory Syndrome Coronavirus is a virus that is new to humans and was first reported in Saudi Arabia in 2012. As of May 16, there have been 572 laboratory-confirmed cases of MERS in 15 countries. Most of these people developed severe acute respiratory illness, with fever, cough, and shortness of breath; 173 people died. Officials do not know where the virus came from or exactly how it spreads. There is no available vaccine or specific treatment recommended for the virus.
For more information about MERS-CoV, please visit:
Middle East Respiratory Syndrome: http://www.cdc.gov/coronavirus/mers/index.html
Frequently Asked MERS Questions and Answers: http://www.cdc.gov/coronavirus/mers/faq.html
Indiana State Department of Health: http://www.state.in.us/isdh/
Illinois Department of Public Health: http://www.idph.state.il.us/

###

U.S. Department of Health and Human Services

CDC works 24/7 saving lives and protecting people from health threats to have a more secure nation. Whether these threats are chronic or acute, manmade or natural, human error or deliberate attack, global or domestic, CDC is the U.S. health protection agency.

**Giuseppe** · May 17, 2014, 02:04 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

I do not think there is a consensus serology test for MERS-CoV to date.

The patient may have developed a sub-clinical infection caused by MERS-CoV or another closely related beta-coronavirus.

It would be interesting to know what kind of contact he had with the index patient, at this point.

**Treyfish** · May 17, 2014, 03:20 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

.."We think that this patient was likely infected with MERS, but technically he doesn't count as an official case of MERS" because the World Health Organization doesn't list the antibody test the Centers for Disease Control and Prevention used to confirm it in the official description, said David Swerdlow, incident manager for MERS response activities at the CDC.

http://www.usatoday.com/story/news/h...ction/9217731/

**sharon sanders** · May 17, 2014, 03:30 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

FluTrackers Notes.

Please read from bottom up:

FluTrackers.com @FluTrackers · 14m
Media conference over. Transcript posted on CDC media site later. #coronavirus #MERS

FluTrackers.com @FluTrackers · 15m
Swerdlow: We need to be vigilant about monitoring for #coronavirus #MERS #coronavirus #MERS

FluTrackers.com @FluTrackers · 16m
Swerdlow: Face-to-face contact within 6 feet,w/hand shaking - total of an 1 hour in 2 meetings of Indiana & Illinois men #coronavirus #MERS

FluTrackers.com @FluTrackers · 18m
Swerdlow: Indiana & Illinois men - 2 meetings were, total combined, about an hour. They did shake hands. #coronavirus #MERS

FluTrackers.com @FluTrackers · 20m
Swerdlow: This is the 3rd known infection in the US. Testing and re-testing - numbers may change. #coronavirus #MERS

FluTrackers.com @FluTrackers · 22m
Swerdlow: Indiana man had contact within 6 feet distance with Illinois man at 2 meetings - #coronavirus #MERS does transmit

FluTrackers.com @FluTrackers · 23m
Swerdlow: Don't understand a lot about how virus is transmitted. Doing extensive investigation w/ any US cases 2 gain info #coronavirus #MERS

FluTrackers.com @FluTrackers · 25m
Swerdlow: Seen limited human to human transmission throughout #coronavirus #MERS saga - but not sustained or easy.

FluTrackers.com @FluTrackers · 26m
Swerdlow: In Illinois event also monitoring contacts, testing, self isolation #coronavirus #MERS

FluTrackers.com @FluTrackers · 28m
Swerdlow: There is not a change in general risk to population as result of Illinois man + serology test #coronavirus #MERS

FluTrackers.com @FluTrackers · 30m
Swerdlow: Broad range of illness with this virus. #coronavirus #MERS

FluTrackers.com @FluTrackers · 30m
Swerdlow: Illinois man had some cold like symptoms - may or may not be related to #coronavirus #MERS

FluTrackers.com @FluTrackers · 31m
Swerdlow: Will be discussing serology testing with @WHO #coronavirus #MERS

FluTrackers.com @FluTrackers · 33m
Swerdlow: Illinois man is healthy. Netherlands is also doing serology testing #coronavirus #MERS

FluTrackers.com @FluTrackers · 34m
Swerdlow: Indiana man had fever and aches - not respiratory - when meeting w/Illinois man #coronavirus #MERS

FluTrackers.com @FluTrackers · 37m
Swerdlow: 53 HCW + 6 household members were tested in Indiana case - Illinois man was included b/c of 2 meetings #coronavirus #MERS

FluTrackers.com @FluTrackers · 39m
Swerdlow: Illinois man is not exactly an "official" case b/c pcr test was negative #coronavirus #MERS

FluTrackers.com @FluTrackers · 42m
Swerdlow: Recommends the usual hygiene practices. Travel notice is not changed but is at alert status. #coronavirus #MERS

FluTrackers.com @FluTrackers · 43m
Swerdlow: US health authorities are routinely testing for present and past possible #coronavirus #MERS infections in contacts

FluTrackers.com @FluTrackers · 44m
Swerdlow: Illinois man had mild symptoms but well and is in self isolation until further notice. #coronavirus #MERS

FluTrackers.com @FluTrackers · 45m
Swerdlow: Contact - Illinois man, tested negative via pcr test but antibody test positive for #coronavirus #MERS

FluTrackers.com @FluTrackers · 46m
Swerdlow: New case is a contact of Indiana man and contact was on April 25 & 26 #coronavirus #MERS

FluTrackers.com @FluTrackers · 49m
Media conference starting... Speakers - David Swerdlow, M.D. (CAPT, USPHS), incident manager for #coronavirus #MERS response activities

FluTrackers.com @FluTrackers · 53m
#USA - @CDCgov press release about new #coronavirus #MERS case http://www.flutrackers.com/forum/sho...d.php?t=223450 …

Lisa Schnirring @lisaschnirring · 56m
Illinois man met with 1st #MERS patient twice, PCR testing was negative. Didn't seek medical care, and is doing well 2/2

Lisa Schnirring @lisaschnirring · 56m
CDC is reporting secondary #MERS transmission in Illinois close contact of 1st US case, based on serology testing 1/2

FluTrackers.com @FluTrackers · 55m
#USA - Starting Now @CDCgov media conference on new #coronavirus #MERS case http://www.flutrackers.com/forum/sho...d.php?t=223450

**sharon sanders** · May 17, 2014, 03:32 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

There was a one hour embargo of this event. We initially started this thread in our moderator's room and then moved the thread onto the main site at 3:31 pm.

**sharon sanders** · May 17, 2014, 03:36 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

At FluTrackers we count all test positive cases. So for us, this is a case.

For instance, we have notated all Saudi cases that were test positive but asymptomatic.

**Treyfish** · May 17, 2014, 06:16 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

..It is becoming increasingly clear that people can be infected with Mers without developing severe respiratory disease, said Dr David Swerdlow, who heads the Mers response team at the US Centres for Disease Control and Prevention (CDC).
"You don't have to be in the intensive care unit with pneumonia to have a case of Mers," Swerdlow said. "We assume they are less infectious [to others], but we don't know."
The CDC has a team in Saudi Arabia studying whether such mild cases are still capable of spreading the virus..

http://www.scmp.com/news/world/artic...ness-mild-mers

**Treyfish** · May 17, 2014, 06:35 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

...Transmission risk considerations

Most MERS infections have occurred in the Middle East or have been directly linked to a case in that region. Though sporadic imported cases have been occurring since early in the outbreak, secondary infections have been more rare but did occur after primary cases were detected in the United Kingdom, France, and Tunisia.
Global and national health officials have said the risk of secondary infections is low and limited mainly to people who had unprotected, close contact with MERS patients, such as family members or healthcare workers. Today's CDC announcement raises questions about the level of contact that puts people at risk, with a business meeting presumably reflecting a lower level of contact than a care-giving scenario involving a sick family member or hospital patient.
Swerdlow told reporters that the virus still doesn't appear to spread among humans easily in a sustained way, but he added that aggressive testing will not only help flesh out transmission patterns but also reveal more about what appears to be a broader range of severity for the disease, from no symptoms to severe and sometimes fatal pneumonia. "We don't understand a lot about how the virus is transmitting, so we're casting a wide net, hoping to learn more," he said. "Our most important point is that doctors should be vigilant."
"We don't think this changes the risk to the general public or public health practices," Swerdlow said.
The Illinois man's illness, though considered the third US infection, won't be reflected in the global MERS count, because positive serology results aren't included in the World Health Organization (WHO) case definition for MERS, Swerdlow said.
Michael T. Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, said one case doesn't change the picture and the event is consistent with other examples of MERS spread.
Though the risk of transmission still appears to be low, he said there's a lot that is still not known about the disease?for example, whether some patients are "super shedders" who are more likely to transmit the disease to others.
"All of us should be more careful to describe the risk to the public," Osterholm said, adding that the message should be balanced and not "oversell" a lack of risk....

http://www.cidrap.umn.edu/news-persp...s-illinois-man

**Pathfinder** · May 17, 2014, 11:04 PM

Re: USA - CDC Media Conference today 3:30pm - Contact of Indiana case tests positive for coronavirus MERS

Originally posted by Treyfish View Post

.."We think that this patient was likely infected with MERS, but technically he doesn't count as an official case of MERS" because the World Health Organization doesn't list the antibody test the Centers for Disease Control and Prevention used to confirm it in the official description, said David Swerdlow, incident manager for MERS response activities at the CDC.

http://www.usatoday.com/story/news/h...ction/9217731/

More from this article...

"The Illinois man had two business meetings with the Indiana patient shortly before the Indiana patient was identified as having MERS, CDC officials said.

The longest of those meetings was for 40 minutes, said Swerdlow. It involved "face-to-face, close contact, within 6 feet, for over 30 to 40 minutes," said Swerdlow. The two men shook hands, he said.

The Illinois man is a U.S. citizen and has never traveled to the Arabian Peninsula. He might have reported a slight runny nose, but it wasn't clear whether that was related to the MERS infection, CDC said. He is reported to be feeling well now.
...
Initial tests of the man, whom health officials are not naming, were negative.

But blood tests that came back late Friday night showed that the Illinois man had had a MERS infection, the CDC reported Saturday afternoon."

**Pathfinder** · May 17, 2014, 11:23 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

Illinois man tests positive for MERS virus without falling ill

By Nick Carey
CHICAGO Sat May 17, 2014 7:12pm EDT
...
The Illinois resident did not seek or require medical care and is reported to be feeling well, but officials involved in investigating the first casehave been monitoring his health since May 3. A blood test on Friday showed he had developed antibodies to MERS.
...
On April 25, the Illinois man had a 40-minute face-to-face meeting with the Indiana patient, a business associate, Swerdlow said. The two men shook hands but the Indiana patient did not have a cough at the time.
...
The first case of MERS was confirmed in Indiana in early May and the second, in Florida, on May 11. Swerdlow said 50 people who came into contact with the Indiana patient have tested negative for MERS but are undergoing more tests. Health officials are now trying to identify and monitor close contacts of the Illinois resident.
...

reuters.com

http://www.reuters.com/article/2014/05/17/us-mers-illinois-idUSBREA4G08G20140517

**Pathfinder** · May 19, 2014, 11:36 AM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

Press Release
FOR IMMEDIATE RELEASE
May 19, 2014
CONTACT:
Melandy Arnold (217) 558-0500
Shelia Porter (312) 814-3524

www.idph.state.il.us

Illinois Department of Public Health Reports Negative Results for MERS-CoV

CHICAGO – Illinois Department of Public Health (IDPH) Director Dr. LaMar Hasbrouck today announced the Illinois resident who previously tested positive for Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) antibodies in his blood, has again tested negative for the ability to spread the virus.

“The second round of test results from oral and nasal swabs show the Illinois resident is not infectious,” said Dr. Hasbrouck. “What this means is, although the resident was infected at one time, if he sneezes or coughs, the virus is not in his nose or mouth and therefore cannot be spread to others. The risk of MERS-CoV to the general public remains very low. We will continue to follow-up with this individual.”

Health officials first tested this person using oral and nasal swabs for active MERS-CoV infection on May 5. Those test results were negative. On May 16, a blood test result was positive for the Illinois resident, showing that he had antibodies to MERS-CoV. Over the weekend, the resident was again tested using oral and nasal swabs and those have come back negative. Additional blood testing related to his positive MERS-CoV antibody test result is currently underway.

Health officials continue to follow-up with anyone who had close contact with the Illinois resident. Family members who had close contact with the Illinois resident have all tested negative, but will continue to be monitored.
The Illinois resident is considered to have had close contact with the first imported case in the United States, a Saudi Arabian resident who traveled to Indiana on April 24. All people considered to have had close contact with first case have been followed-up with and closely monitored.

“MERS-CoV is a relatively new virus and we still have much to learn about it, including how it is transmitted. The World Health Organization, U.S.

Centers for Disease Control and Prevention, state health departments and local health departments continue to investigate this virus as well as identify new cases around the world, conduct testing and implement infection control practices,” said Dr. Hasbrouck. “Additional cases are expected, but we are working diligently to eliminate the spread of this virus.”

As with other respiratory illnesses, IDPH recommends people take everyday preventive actions like washing their hands often; avoiding touching their face with unwashed hands; avoiding contact with people who appear sick; and disinfecting frequently touched surfaces.
IDPH has reactivated the expert medical staff at Illinois Poison Center to operate the MERS-CoV hotline. Illinois residents and medical professionals who have concerns or questions should call 1-844 565-0256.

For more information about the infected individual and the two confirmed MERS-CoV cases in the U.S., visit www.cdc.gov/coronavirus/mers/index.html. General information about MERS-CoV can be found on the IDPH website, including Frequently Asked Questions.

IDPH continues to implement its Five Year Strategy 2014-2018 to maximize IDPH’s effectiveness, influence and value for promoting wellness, health equity, safety and improved health outcomes. Strategic plan priorities include developing and expanding partnerships; improving data utilization; reducing health disparities; improving regulatory compliance; and branding, marketing and communicating IDPH’s value.

Illinois Department of Public Health Reports Negative Results for MERS-CoV

http://www.idph.state.il.us/public/press14/5.19.14_IDPH_Reports_Negative_Results_for_MERS-CoV.htm

**Emily** · May 19, 2014, 03:35 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

Additional blood testing related to his positive MERS-CoV antibody test result is currently underway.

Is there a chance that was a false-positive?

**sharon sanders** · May 19, 2014, 04:11 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

Anything is possible. He has never tested positive for active infection. I think we still have a lot to learn about this virus.

**Treyfish** · May 19, 2014, 05:49 PM

Re: USA - Illinois man, contact of Indiana case - seropositive test result for coronavirus MERS

?The second round of test results from oral and nasal swabs show the Illinois resident is not infectious,? said Dr. Hasbrouck. ?What this means is, although the resident was infected at one time, if he sneezes or coughs, the virus is not in his nose or mouth and therefore cannot be spread to others. The risk of MERS-CoV to the general public remains very low. We will continue to follow-up with this individual.?

...cannot spread to others...okkkaayyy...The guy just got it from a "handshake"..He might have reported a slight runny nose...On April 25, the Illinois man had a 40-minute face-to-face meeting ..follow up test shows he was infected.. I am feeling we are NOT getting timely information, moresoever, a whole bunch of WE DON'T KNOW.after 2 years!

Announcement

USA - Illinois man, contact of Indiana case - test negative for coronavirus MERS in follow-up tests after initial sero-positive results

USA - Illinois man, contact of Indiana case - test negative for coronavirus MERS in follow-up tests after initial sero-positive results

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