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

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  • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 12 confirmed cases due to novel animal coronavirus - 6 fatalities, at least 2 cases still in hospital - September 20, 2012 +

    Saudi Arabia has reported an additional fatal case, the 13th case and 7th death worldwide:

    Comment


    • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

      Saudi Arabia reports new coronavirus case; UK wonders about 4th case in cluster
      By: Helen Branswell, The Canadian Press

      TORONTO - Saudi Arabia has discovered another infection with the novel coronavirus, the World Health Organization announced Thursday.
      The infected person was hospitalized in late January and died on Feb. 10, but confirmation of the infection was only made Feb. 18, the WHO said in a statement. Further investigation of the new case is underway.

      The Geneva-based agency urged countries to consider testing for the new virus when patients present for care with unexplained pneumonias or when patients with severe, progressive or complicated respiratory illnesses don't respond to treatment ? especially if those patients have recently travelled to or come from parts of the world where infections have occurred.
      To date, cases have been linked to three countries in the Middle East ? Saudi Arabia, Qatar and Jordan.

      The new case is the 13th confirmed infection and seventh death caused by the new coronavirus, which the WHO is calling NCoV.
      In addition, there are nearly a dozen cases the WHO considers "probable" infections ? people who were exposed to cases and who later became sick but who were not tested or weren't tested in time. If an infected person had recovered from the illness, current tests ? which look for virus DNA in mucus ? would not find evidence of infection.
      Some laboratories are working to develop a blood test that will detect antibodies to the virus. Once blood tests are available it should be possible to figure out whether some of the probable cases were actually infected.
      One instance where such a tool would be useful involves the current cluster of NCoV cases in Britain.

      A man who had recently travelled to Pakistan and Saudi Arabia became severely ill after his return. He tested positive for the virus, as did two other members of his family who had not travelled abroad. But a fourth infection may have also occurred in that family....http://www.winnipegfreepress.com/wor...192256741.html
      CSI:WORLD http://swineflumagazine.blogspot.com/

      treyfish2004@yahoo.com

      Comment


      • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

        This is a report of the Qatari man hospitalized in Germany (case #5). The entire article is worth reading.

        Note the following text. This might be indicative of a large number of missed milder cases. It brings to my mind the initial report at the start of the H1N1 pandemic from the Diario Desperatar de Oaxaca mentioning mild respiratory symptoms in 16 HCW contacts of a fatal confirmed case. This seems like a LOT of people to coincidentally have respiratory symptoms.

        On 24 October 2012, a patient with acute respiratory distress syndrome of unknown origin and symptom onset on 5 October was transferred from Qatar to a specialist lung clinic in Germany. Late diagnosis on 20 November of an infection with the novel Coronavirus (NCoV) resulted in potential exposure of a considerable number of healthcare workers. Using a questionnaire we asked 123 identified contacts (120 hospital and three out-of-hospital contacts) about exposure to the patient. Eighty-five contacts provided blood for a serological test using a two-stage approach with an initial immunofluorescence assay as screening test, followed by recombinant immunofluorescence assays and a NCoV-specific serum neutralisation test. Of 123 identified contacts nine had performed aerosol-generating procedures within the third or fourth week of illness, using personal protective equipment rarely or never, and two of these developed acute respiratory illness. Serology was negative for all nine. Further 76 hospital contacts also tested negative, including two sera initially reactive in the screening test. The contact investigation ruled out transmission to contacts after illness day 20. Our two-stage approach for serological testing may be used as a template for similar situations.


        [snip]

        Contact investigation
        We identified 120 hospital and three out-of-hospital contacts, including the interpreter of the patient. Protective measures were largely limited to HCW wearing gloves and gowns when providing intimate care and use of surgical face masks during suctioning. From 31 October until 4 November (illness weeks five and six), the patient was isolated using barrier nursing due to a concurrent Pseudomonas aeruginosa infection. This included use of surgical masks only. Among the 120 hospital contacts the largest group were nurses (n=59; 49&#37, followed by physicians (n=26; 22%) and laboratory technicians (n=15; 13%) (Table 1). Median time from first contact to venipuncture was 39 days (range: 13–50 days).

        Eighty-five (69%) of all respondents reported contact at a distance of less than or equal to 2 m, 14 (11%) of more than 2 m, and 24 (20%) of unknown distance to the patient. Frequency of ARI by week of first contact differed significantly among the groups (Table 1). However, there was no trend in the ARI proportion over time: eight of 33 contacts with first exposure during illness weeks three or four experienced ARI within 10 days of last contact; five of nine contacts with first exposure during the patient’s fifth week of illness; and none of 14 with first contact during week six of illness developed ARI.

        Among 81 contacts reporting exposure within 2 m, 21 had ARI compared to none of 14 with contact of more than 2 m (p value; 0.04) (Table 1). Among those with first exposure in week three or four of illness of the patient, the proportion of contacts with ARI was not significantly different between those considered to be at high risk and the remaining contacts (p value, 0.87) (Table 1). Thirteen HCW had contact to the patient in weeks three or four of illness, had contact within 2 m to the patient and had worn surgical face masks rarely or never. Among these, nine were high-risk contacts, including one nurse who assisted in a bronchoscopy on 25 October. All nine provided a blood sample. The median time after last contact with the patient for these nine HCW was 32 days (range: 13–46 days). No sample was reactive by IFA.

        [snip]

        During two interviews that the patient kindly agreed to, we explored a wide spectrum of factors that he might have been exposed to. Even though NCoV is genetically similar to bat coronaviruses [1,13,14], other animals may serve as (intermediate) host as well. While our patient denied contact to bats, he remembered ill goats among the animals on his farm. Albarrak et al. reported that the first Saudi case was exposed to farm animals, but the first Qatari patient and the second Saudi patient were not [15]. Although our patient reported no direct contact with his animals, one animal caretaker working for him was ill with cough and might have been an intermediate link in the chain of infection.

        Coronaviruses do infect ruminants such as goats [16] and thus goats could be considered as a possible source of origin for the novel virus, particularly in the geographical and cultural context of our patient. Recent experimental studies have found that NCoV can infect and replicate in cells of various species including humans, swine, monkeys and bats, suggesting a more promiscuous host specificity compared to other human coronaviruses such as SARS CoV [17]. Susceptibility of goat cells was not tested, but it cannot be excluded that NCoV might infect this species as well.

        [snip]

        Comment


        • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

          NONE among the HCWs entered in contact with German patient had demonstrated infection with NCoV through sequential serology.

          Despite the study limitations, this is an evidence that the patient was not infectious at the time HCWs provided care.

          Of concern, instead, the fact that so many HCWs entered in contact with a severely ill patient - presenting an acute respiratory infection - without complete PPE.

          A lot of pneumonia cases remains unexplained and treated as community associated pneumonia empirically every day in our countries hospitals.

          Are we sure that health care workers are protecting themselves and all other patients from infections?

          Comment


          • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

            MoH confirms death of woman from rare form of coronavirus


            Saturday 23 February 2013

            Last Update 22 February 2013 9:15 pm

            A Riyadh resident has died from a rare form of a coronavirus, according to the Saudi Ministry of Health (MoH).
            Undersecretary to the Ministry of Health for Public Health, Dr. Ziad Al-Memish, told Arab News yesterday that the victim was a 61-year-old Saudi woman. The cause of death was confirmed by a laboratory test.
            It is the third such fatality in the Kingdom and the constitutes the 13th confirmed case of a coronavirus infection. It is the seventh death blamed on the virus worldwide.
            The Saudi patient was hospitalized on Jan. 29 in a hospital in Riyadh and died there on Feb. 10.
            The woman had recently returned from abroad with symptoms of severe acute respiratory syndrome (SARS), the official said. She did not respond to treatment.
            In September last year, the ministry reported three cases of the virus, two of whom were Saudis while one was from Qatar. Two of the patients died in Saudi Arabia.http://arabnews.com/moh-confirms-dea...m-coronavirus?
            CSI:WORLD http://swineflumagazine.blogspot.com/

            treyfish2004@yahoo.com

            Comment


            • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

              Here's some more details about cases #10 and #11:



              Deadly Virus Could Cause Problems Worldwide
              Posted by David Arnold on Mar 2nd, 2013 // No Comments

              Khalid Hussain was the first person from Britain who died from the new SARS-type virus in late February. Hussain was just 38 and died at a hospital in Birmingham, England after his father infected him. His father had just returned from a trip to Mecca, when Hussain become sick.

              The symptoms of the SARS-like coronavirus are shortness of breath, a strong cough and a fever. Those symptoms are similar to a common cold. Shortly afterwards, breathing becomes difficult and the lips on the person start to turn blue.

              [snip]

              Comment


              • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 13 confirmed cases due to novel animal coronavirus - 7 fatalities, at least 2 cases still in hospital - September 20, 2012 +

                Saudi Arabia has confirmed an additional fatal case, the 14th case worldwide and the 8th fatality:

                Comment


                • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 14 confirmed cases due to novel animal coronavirus - 8 fatalities, at least 2 cases still in hospital - September 20, 2012 +

                  Let us not also forget that 2 of the 6 non-fatal cases (#2 and #10) are still ill, so if one were to calculate the CFR based only on cases that have reached a final outcome, the apparently CFR would be 66.7%, 8 deaths in 12 cases.

                  Published Date: 2013-03-06 19:06:11
                  Subject: PRO/AH/EDR> Novel coronavirus - Eastern Mediterranean (07): Saudi Arabia, WHO
                  Archive Number: 20130306.1574423

                  NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN (07): SAUDI ARABIA, WHO
                  ************************************************** ***************
                  A ProMED-mail post
                  ProMED is the largest publicly-available surveillance system conducting global reporting of infectious diseases outbreaks. Subscribe today.

                  ProMED-mail is a program of the
                  International Society for Infectious Diseases
                  The International Society for Infectious Diseases (ISID) brings together a network of individuals from around the world.


                  Date: 6 Mar 2013
                  Source: WHO GAR (Global Alert and Response) [edited]



                  Novel coronavirus infection - update 6 Mar 2013
                  -------------------
                  The Ministry of Health in Saudi Arabia has informed WHO of a new confirmed case of infection with the novel coronavirus (NCoV).

                  The patient, a 69-year-old male, was hospitalized on [10 Feb 2013] and died on [19 Feb 2013]. Preliminary investigation indicated that the patient had no contact with previously reported cases of NCoV infection and did not have recent history of travel.

                  To date, WHO has been informed of a global total of 14 confirmed cases of human infection with NCoV, including 8 deaths. Of the total number, 7 cases, including 5 deaths, have been reported from Saudi Arabia.

                  Based on the current situation and available information, WHO encourages all Member States (MS) to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. WHO is currently working with international experts and countries where cases have been reported to assess the situation and review recommendations for surveillance and monitoring.

                  All MS are reminded to promptly assess and notify WHO of any new case of infection with NCoV along with information about potential exposures that may have resulted in infection and a description of the clinical course.

                  WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.

                  WHO continues to closely monitor the situation.

                  --
                  Communicated by:
                  ProMED-mail Rapporteur Marianne Hopp

                  [As stated above, the current total number of confirmed cases of illness associated with infection with the novel coronavirus (nCoV) is now 14, of which 8 had a fatal outcome, a case fatality rate (CFR) of 57 percent. As the total number of confirmed cases to date is small (14), the observed CFR of 57 may be a reflection of non-confirmation of milder illness associated with infection with this nCoV.

                  The breakdown of cases (and deaths) by country of report is:
                  - Saudi Arabia: 7 (5 deaths)
                  - Jordan: 2 (2 deaths)
                  - UK: 4 (1 patient from Qatar - under treatment, 3 patients from UK - one with history of travel to Saudi Arabia and Pakistan prior to illness; 1 under treatment, 1 recovered, 1 death)
                  - Germany: 1 (patient from Qatar - discharged).

                  More information on the epidemiologic investigation surrounding this case's potential exposures, such as animals, including bats, would be greatly appreciated.

                  Comment


                  • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 14 confirmed cases due to novel animal coronavirus - 8 fatalities, at least 2 cases still in hospital - September 20, 2012 +

                    Saudi Arabia has confirmed an additional fatal case:



                    bringing the worldwide total to 15 cases, 9 deaths.

                    Comment


                    • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 14 confirmed cases due to novel animal coronavirus - 8 fatalities, at least 2 cases still in hospital - September 20, 2012 +

                      Originally posted by alert View Post
                      And a contact of that case who had a mild illness has been confirmed to be case #16:

                      Comment


                      • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 16 confirmed cases due to novel animal coronavirus - 9 fatalities, at least 2 cases still in hospital - September 20, 2012 +

                        Hat-tip Treyfish. Case #10 has died:



                        Birmingham grandad is UK's second Coronavirus victim
                        23 Mar 2013 09:00
                        Abid Hussain, of Winson Green, lost battle against Sars-like bug in hospital on Tuesday

                        Birmingham grandad Abid Hussain has become the UK’s second victim to the new Sars-like bug Coronavirus.

                        The tragedy comes as Mr Hussain’s wife and daughter were in Pakistan after burying his son Khalid, 38, who had also fallen victim to the killer disease.

                        The dad-of-two, in his 60s, of Winson Green, was being treated at Wythenshawe Hospital, in Manchester, and seemed to be improving.

                        But he took a turn for the worse and lost his battle on Tuesday.

                        [snip]

                        ------------

                        [Now 2/3 of the confirmed cases that have reached a final outcome (10 of 15) have died, with case #2 possibly still hospitalized since September 2012. - alert]

                        Comment


                        • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 16 confirmed cases due to novel animal coronavirus - 10 fatalities, 1 case still in hospital - September 20, 2012 +

                          Patient released after coronavirus treatment


                          Last Update 24 March 2013 2:29 am

                          There was another case of coronavirus infection in the Kingdom, according to the World Health Organization (WHO).
                          Ziad Al-Memish, undersecretary to the Ministry of Health for Public Health, confirmed the new case. ?It was a mild infection in a person from Riyadh and the patient is already discharged from the hospital after complete recovery,? Al-Memish said.
                          The undersecretary said that there was no cause for alarm about the infection as the ministry had already taken all preventive measures to keep the disease under control.
                          The official also pointed out that people need not worry about the virus as it is believed that it cannot be transmitted from person to person. Still, he cautioned people to take measures to avoid the virus.
                          ?We are also monitoring the virus in all parts of the Kingdom through the regional directorates of the MoH,
                          ? he said.
                          Al-Memish, who is also the chairman of the National Scientific Committee for Infectious Diseases, said that only a few people had been found positive in the world.
                          Symptoms of the virus include runny nose, general feeling of illness, mild sore throat, cough, headache, low fever and chills. It can also cause respiratory, intestinal and neurological illness.
                          The official said most of those infected recover completely with no complications after receiving the required supportive therapy.
                          To date four countries have recorded infections: Saudi Arabia with nine cases and six deaths; Qatar with two cases; Britain with three cases and one death; and Jordan with two fatal cases. http://arabnews.com/news/445886?
                          CSI:WORLD http://swineflumagazine.blogspot.com/

                          treyfish2004@yahoo.com

                          Comment


                          • Re: Saudi Arabia, Qatar, Jordan, United Kingdom: 16 confirmed cases due to novel animal coronavirus - 10 fatalities, 1 case still in hospital - September 20, 2012 +

                            Germany has imported a case from the UAE, who has since died:



                            becoming the 17th case and 11th fatality.

                            In addition to updating the counts in this thread, I am changing the location listed to "Worldwide" (as ProMED did for SARS on March 15, 2003) rather than trying to expand the list of countries or to differentiate between countries that experienced local transmission and those that only reported imported cases. Besides, WHO guildlines currently do suggest that clusters of unexplained SARI should be tested for NCoV, no matter where in the world they occur.

                            Comment


                            • Re: Worldwide: 17 confirmed cases due to novel animal coronavirus - 11 fatalities, 1 case still in hospital - September 20, 2012 +

                              From the comments on:



                              [snip]

                              [The above mentioned cases were reported in earlier ProMED-mail posts, including a media report announcing the death of the case in the UK (see Novel coronavirus - Eastern Mediterranean (13): Germany ex UAE 20130326.1603038 and Novel coronavirus - Eastern Mediterranean (12): KSA, UK fatality, RFI 20130323.1600113).

                              As of today, 26 Mar 2013, the breakdown of cases (and deaths) by country of report is:
                              - Saudi Arabia: 9 (6 deaths)
                              - Jordan: 2 (2 deaths)
                              - UK: 4 (one patient from Qatar -- under treatment, 3 patients from UK -- one with history of travel to Saudi Arabia and Pakistan prior to illness; one recovered, 2 deaths)
                              - Germany: 2 (one patient from Qatar -- discharged, one patient from the UAE - one death).

                              As mentioned in the above WHO release, the total number of confirmed nCoV cases is now 17 with 11 deaths, bringing the case fatality ratio to 64.7 percent. Caution in interpretation of this figure as the numbers of cases is still very low and the ability to detect prior mild infections with this specific coronavirus is presently absent. Given the histories of other respiratory illnesses in contacts of cases that were relatively mild and associated with full recovery, but tested negative for infection with the nCoV, the possibility that there are more infections associated with milder disease is there.

                              In the report of the Jordanian cluster, there were a total of 11 individuals reported to have had respiratory illnesses, with confirmation of nCoV infection in specimens from the 2 fatal cases only (see prior ProMED-mail reports: Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI 20121130.1432498 and Novel coronavirus - Saudi Arabia (04): RFI, Jordan, April 2012 20120925.1308001).

                              More information on the epidemiologic investigations of this newest case would be greatly appreciated.

                              Comment


                              • Re: Worldwide: 17 confirmed cases due to novel animal coronavirus - 11 fatalities, 1 case still in hospital - September 20, 2012 +

                                We only have 11 deaths in our count. Might this mean the hospitalized case from September 2012 has died?



                                Novel coronavirus summary and literature update ? as of 24 April 2013
                                As of 24 April 2013, 17 cases of human infection with novel coronavirus (nCoV) have been reported to WHO: two from Jordan, two from Qatar, 10 cases from Saudi Arabia, two from the United Kingdom (UK), and one from the United Arab Emirates. Most patients are male (81.3%; 13 of 16 cases with gender reported) and range in age from 25 to 73 years old (median 45 years old). The first cases had onset of illness in late March or early April 2012, the most recent case reported had onset on 8 March 2013. Most patients presented with severe acute respiratory disease requiring hospitalization, and at least 11 have required mechanical ventilation or other advanced respiratory support. Only 2 of the 17 presented with mild disease. Twelve patients have died. One was co-infected with influenza A virus.

                                Four clusters of cases have been identified. The first occurred in April 2012 in a health care setting in Jordan, with 2 confirmed cases, and 11 probable cases. Both of the confirmed cases died. Ten of the 13 persons in this cluster were health care workers. Two additional clusters occurred among family contacts of cases in Saudi Arabia and one among family members of a resident of the United Kingdom who had recently visited Saudi Arabia. Human-to-human transmission can be confirmed only in the latter as none of the family members who were infected had recently been outside of the United Kingdom and their only known exposure was to the first case (see UKHPA reference below). No sustained community transmission was observed in any of the clusters.

                                Although some of the cases may have become infected from animal exposures and zoonotic transmission, information on animal exposures is limited. An animal reservoir has not been identified. Investigations into animal sources are on-going.

                                Four viruses from the United Kingdom (n=2), Saudi Arabia (n=1) and Jordan (n=1) have been cultured and complete genome sequences have been posted to GenBank, a public database. All four of the viruses have a high degree of genetic similarity. Analyses show that the viruses are similar to a bat virus. It should be noted, however, that the similarity of the human virus to the bat virus does not necessarily imply that bats are the reservoir for the human virus. Given the living environment of most of the patients, direct exposure to bats appears unlikely.

                                Comment

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