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Jordan - Cluster of approximately 13 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

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  • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied

    Hat-tip Treyfish again:

    أجمع خبراء وأطباء في علوم الامراض الداخلية أن ما حصل من حالات مرضية في مستشفى الزرقاء الحكومي هي وباء محدود وفي مكان محدود تم السيطرة عليها وتطويقه بشكل كامل ولا يشكل خطرا.   وأكدوا خلال ندوة نظمتها لجنة الاطباء الشباب في نقابة الاطباء بعنوان ( مستشفى الزرقاء بين الحقيقة والغموض) أن اجمالي عدد الحالات التي اصيبت بهذا الوباء المحدود (التهاب الرئه) بلغت 11 حالة كانت منها 10 حالات متوسطه وحالة شديدة توفت نتيجة لذلك.   وبينوا أنه تم السيطرة على المرض وتطويقه بشكل كامل إلا أنهم اعتبروا أن جرى في الزرقاء يجب ان يكون حافزاً للالتزام بإجراء ضبط العدوى.   واكد مقرر لجنة الاطباء الشباب في نقابة الاطباء الدكتور مظفر جلامدة ان الهدف من اقامة هذه الندوة هو اظهار الحقيقة العلمية لهذا الموضوع الذي اصبح الشغل الشاغل للاعلام وحديث الشارع هذه الايام   وبين أنه بات ارضا خصبة لكثير من الاشاعات والتكهنات والمخاوف والتجاذبات التي اصبحت تسير بامواج الاعلام بحثا عن شاطىء آمن يروي عطشها لسماع منطق علمي طبي يفسر ما حدث ويحدث.   وبدوره قال مدير الأمراض السارية في وزارة الصحة الدكتور محمد العبداللات أن الاصابات التي حدثت في مستشفى الزرقاء الحكومي والتي نتج عنها اصابة عدد من الكوادر الطبية في مستشفى الزرقاء الحكومي بالتهاب الرئة تم التعامل معها بمهنية عالية وتم اتخاذ الاجراءات الاستباقية للسيطرة على المرض ومع انتشاره.   وبين أنه تم اجراء مسح الحالات المشتبهة بين الكوادر ومخالطيهم بالاضافة لتدريب عملي يومي للكوادر على غسل الأيدي وارتداء وسائل الوقاية الشخصية إشراف مباشر من قسم ضبط العدوى و خبراء على تطبيق إجراءات ضبط العدوى وتنظيف وتطهير الاسطح والارضيات في ICU , CCU التركيز على غسل الأيدي وأخذ مسحات من الأسطح والأرضيات والأدوات الموجودة في بيئة المرضى.   وأشار إلى أنه تم مشاركة خبراء في الأمراض المعدية والصدرية للمتابعة والأشراف على علاج الحالات المصابة بالمرض في مستشفى الزرقاء.    وقدم العبداللات شرحا مفصلا عن المنحنى الوبائي للمرض وانه عبارة عن وباء محدود في منطقة محددودة ومقتصر فقط على الكوادر الطبية في احد اقسام مستشفى الزرقاء وانه لم يتم تسجيل اية حالة مشابهة في اي مكان اخر من محافظات المملكة.   وأكد ان وزارة الصحة من خلال اقسامها المختصة قامت باجراء كامل الفحوصات المخبرية والشعاعية وزراعة الانسجة وكانت كل النتائج سلبية مضيفا ان الوزارة تعاونت مع فرق من الخدمات الطبية ومركز الحسين للسرطان ومستشف المللك المؤسس ومركز الاميرة هيا وبعص المستشفيات من القطاع الخاص.   وعن عدد الاصابات اشار الى ان عدد الحالات المثبتة بلغ ( 11 ) حالة منها تم شفاء 10 حالات وحالة وفاة واحدة نافيا كثيرا من الاشاعات التي تم تداولها عن حالات وفاة اخرى.   بدوره أشار استشاري الامراض الصدرية ورئيس قسم الامراض الباطنية في مستشفى الجامعة الاردنية الدكتور نذير عبيدات الى أن ما حدث في مستشفى الزرقاء هو زيادة في عدد حالات الالتهاب الرئوي ( ذات الرئه ) لفترة معينه وكانت عدد الحالات هو 11 حاله التي ينطبق عليها التعريف الوبائي.   وأضاف أن معظمها كانت من الحالات معظمها متوسطة الشده باستثناء حاله واحده كانت عبارة عن التهاب رئوي شديد ادّى الى هبوط حاد بالتنفس ومن ثم وفاتها وكانت هي حالة الوفاة الوحيدة.    وابدى عبيدات اعتقتاده ان هنالك حالات مشابهه تم تشخيصها كحالة التهاب رئوي أدخلت الى مستشفيات أخرى ولم تعتبر ذات أهمية وبائية بسبب ان عدد هذه الحالات لم يكن بعيداً عن معدل حالات الالتهابات الرئوية المعروفة .   ويرى عبيدات بأن عدد الحالات التي اصيبت قد انحسرت غير ان ذلك لا يعني عدم الالتزام بإجراءات ضبط العدوى بل ان ما جرى في الزرقاء يجب ان يكون حافزاً للالتزام بإجراء ضبط العدوى.    من جانبه استعرض الدكتور منتصر البلبيسي، اخصائي الالتهابات الميكروبية و رئيس قسم الامراض الباطنية في مستشفى الاردن التهابات الرئة في المستشفيات وكيفية حدوثها و تشخيصها و مسبباتها و طرق علاجها والوقاية منها.    و ذكر ان كثرة استخدام المضادات الحيوية دون رقابة هو احد اسباب مقاومة بعض البكتريا لهذه العلاجات وقد يؤدي ال فشلها. كما اكد على ضرورة تعزيز الالتزام الكامل من قبل الكادر الطبي والزوار لوسائل منع العدوى وتوفير الخبرات والاخصائيين و ادوات منع العدوى من الكمامات الواقية و غرف العزل في المستشفيات ومحاسبة المخالفين .


    Specialists: "blue disease" epidemic has limited control



    Blue State Hospital





    The consensus among physicians in the science of internal medicine that is what happened from the conditions in the government hospital is a blue and B in a limited place was limited to control and circumscribe the full and does not constitute a danger.



    They stressed at a seminar organized by the Physicians Committee for Youth in the Doctors' Union entitled (blue hospital between truth and uncertainty) that the total number of cases that were hit by the epidemic Limited (inflammation of the lung) was 11 cases had an average of 10 cases and a severe case died as a result.



    And indicated that it was to control the disease and circumscribe fully considered that they were in the blue should be an incentive to comply with infection control.



    He confirmed the decision of the Commission in young doctors, Dr. Muzaffar Medical Association Jalameda The goal of this seminar is to show the scientific truth of this subject, which became the main concern of the media and the talk of the street these days



    And it has become fertile ground for many of the rumors and speculation and fears and tensions that have become the media waves going in search of a safe beach tells the thirst to hear the logic of medical science explains what happened and is happening.



    For his part, director of communicable diseases at the Ministry of Health, Dr. Mohammed Al Abdallat that the injuries that have occurred in a hospital in the blue government, which resulted in the injury of a number of medical staff in hospital blue government pneumonia have been dealt with professionally and was taking measures proactive to control the disease and with its spread.



    And it has been to survey suspected cases among staff and their contacts in addition to practical training day for staff to wash hands and wear a means of personal protection the direct supervision of the department of infection control and experts on the application procedures for infection control and cleaning and disinfection of surfaces and floors in ICU, CCU focus on hand washing and took swabs from surfaces, flooring and tools in the environment of patients.



    He pointed out that it was the participation of experts in infectious diseases and follow-up bra and supervising the treatment of infected cases of the disease in hospital blue.



    The Abdallat a detailed description of the curve and the epidemiology of the disease that is epidemic in the region of Mahddodh limited and confined only to the medical staff in hospital departments blue one and it did not register any similar case in any other place of the governorates of the Kingdom.



    He emphasized that the Ministry of Health, through its divisions competent conducted the entire lab tests and x-ray and tissue culture were all negative results, adding that the ministry has collaborated with teams of medical services and King Hussein Cancer Center and the perceived Almellk founder and Center Princess Haya and Bas hospitals from the private sector.



    And the number of injuries indicated that the number of cases was installed (11) of these cases were cured 10 cases and deaths and one denying a lot of rumors that were circulating about the death of another.



    In turn, pointed Consultant Respiratory and Chairman Department of Medicine at Jordan University Hospital, Dr. Nazir slaves to what happened in a hospital in blue is an increase in the number of cases of pneumonia (pneumonia) for a certain period and the number of cases is 11 cases that fall under the definition of epidemiology.



    He added that most of the cases were mostly mild except for one case was a severe pneumonia, led to a sharp drop breathing and then her death and was the only death.



    He expressed his slaves Aatguetadeh that there are similar cases have been diagnosed as a case of pneumonia was admitted to other hospitals was not considered relevant because of the epidemic and that the number of these cases was not far from the rate of pneumonia known.



    In the view of slaves that the number of cases that were hit had receded but that does not mean non-compliance with infection control procedures, but that what happened in the blue should be an incentive to comply with infection control.



    For his part, Dr. Al Montaser Belbeisi, microbial infections specialist and head of internal diseases in a hospital in Jordan lung infections in hospitals and how they occur and their causes, diagnosis and methods of treatment and prevention.



    And said that the frequent use of antibiotics without censorship is one of the reasons for the resistance of some bacteria to these treatments may result in the failure. He also stressed the need to promote full compliance by medical staff and visitors of the means of preventing infection and the provision of expertise and specialists, and tools to prevent infection of the masks and isolation rooms in hospitals and to hold violators.





    Source: Fact International - Opinion
    5/3/2012 1:15:43 AM
    Last edited by sharon sanders; May 3, 2012, 07:50 PM. Reason: added bolding w/o underline

    Comment


    • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied

      Jordan unknown disease still has not been identified



      Hospital Blue: the return of the proportion of auditors to their normal daily

      <STYLE>.instructionsRate { Z-INDEX: 999; POSITION: absolute; BORDER-BOTTOM-STYLE: solid; MARGIN-TOP: 18px; BORDER-LEFT-STYLE: solid; WIDTH: 257px; DISPLAY: none; BORDER-TOP-STYLE: solid; BACKGROUND: #eeeeee 0px 0px; FLOAT: right; HEIGHT: 150px; BORDER-RIGHT-STYLE: solid; FONT-SIZE: 11px; FONT-WEIGHT: normal; MARGIN-RIGHT: 134px}.instructionsRate UL.rateStarDesc LI { MARGIN: 2px 9px 0px 0px; HEIGHT: 17px}.rateDesc { MARGIN-TOP: 3px; WIDTH: 250px; MARGIN-RIGHT: 8px}.closeRateDesc { MARGIN-TOP: -4px; FLOAT: left; MARGIN-LEFT: 7px; FONT-SIZE: 100%}.image_loader { DISPLAY: none}</STYLE>04/05/2012 at pm 10:30 (GMT +2)



      Citizens are reviewing emergency department in a hospital in the blue of the first government on Wednesday - (Photo: Osama Rifai)

      • Blue - eased "phobia" infection "pandemic" blue between blue state auditors hospital after their return gradually over the past days to review the various clinics and departments, after weeks of failure to do so for fear of taking infection disease, "mysterious".According to hospital director Dr. Marwan Iqbal Habashneh the patients to the hospital returned to normal day to various sections of the hospital.
        Habashneh and that "the competent staff at the hospital ended the sterilization process more than once, he did not register new cases confirmed or suspected.
        The sense of panic dominated the past few weeks to many people in the province of the blue due to the clarity of the type of "virus", which appeared last month in the hospital, and left one death and 11 injured.

      The panic seemed to clear erode the Board of the hospital clinics for the benefit of the private sector because of their fear of hospitalization, while the concerns of citizens emerged dramatically in the streets, who have used the masks in the areas surrounding the hospital and in the alleys and narrow streets and public places and private markets.
      Also caused the panic, which found no explanation of "convincing" for many citizens to cancel many of the patients to hospital appointments in blue and some other hospitals and primary health centers and comprehensive. And Prince Faisal Hospital has seen the government in the District of sidewalk up numbers reviewers and a rise of more than 20%, according to its director, Dr. Talal slaves because of the fear of some of the reviewers go to the hospital blue.

      However, the source of medical reviewers refer back to the hospital to the lack of alternatives for patients who did not find seemed to check out the blue hospital either for their economic conditions or the lack of another hospital.
      He added that the hospital most of the auditors are unable to conduct laboratory tests or X-ray clinic or visit a private doctor.
      According to official studies, lives a quarter of the province of blue below the poverty line, while the province has four pockets of poverty within the upper limits of the Ad-(52.2%), pyrene (42.3%), blue (40.3%), Jordan (29%).

      Has reached the population density in the province to 205 persons / km 2, the highest in the Kingdom, estimated population density of 60 persons / km 2, while the population is distributed to 52 urban areas with the most important of Reed City and the sidewalk, and a proportion of the population in urban areas 96% of the proportion of population of the province's 900 thousand people.
      The hospital was closed during the blue last month temporarily sections of intensive care and intensive twice because of an injury Mredihama mysterious virus, and that is a precaution and to carry out disinfection and sterilization in them, then re-opened,.
      And the number of workers in a hospital in the blue government refrained from carrying out their duties after a steady drumbeat of news about the death of their colleague nurse Balawi emotions, which was hit by the epidemic, according to medical sources at the hospital.
      The sources confirmed that a state of fear Antapt hospital staff and reviewers at the announcement of the death of one of the injured, the center of strong interest to wear protectors medical as a precaution to prevent infection.
      He was 9 of the blue hospital staff had recovered fully and left the Prince Hamzah Hospital after receiving treatment following the injury to "the unknown disease. .. http://translate.googleusercontent.com/translate_c?hl=en&langpair=ar%7Cen&rurl=translate. google.com&twu=1&u=http://www.alghad.com/index.php/article2/548477/%25D9%2585%25D8%25B3%25D8%25AA%25D8%25B4%25D9%2581 %25D9%2589-%25D8%25A7%25D9%2584%25D8%25B2%25D8%25B1%25D9%2582 %25D8%25A7%25D8%25A1-%25D8%25B9%25D9%2588%25D8%25AF%25D9%2587-%25D9%2586%25D8%25B3%25D8%25A8%25D9%2587-%25D8%25A7%25D9%2584%25D9%2585%25D8%25B1%25D8%25A7 %25D8%25AC%25D8%25B9%25D9%258A%25D9%2586-%25D8%25A7%25D9%2584%25D9%258A%25D9%2588%25D9%2585 %25D9%258A%25D9%2587-%25D8%25A7%25D9%2584%25D9%2589-%25D9%2585%25D8%25B9%25D8%25AF%25D9%2584%25D8%25A7 %25D8%25AA%25D9%2587%25D8%25A7-%25D8%25A7%25D9%2584%25D8%25B7%25D8%25A8%25D9%258A %25D8%25B9%25D9%258A%25D9%2587.html&usg=ALkJrhj6J0 0t6BbkbrnB1p8PWmUSRh
      CSI:WORLD http://swineflumagazine.blogspot.com/

      treyfish2004@yahoo.com

      Comment


      • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied

        Severe respiratory disease of unknown origin ? Jordan - Outbreak in ICU
        An outbreak of a respiratory illness was reported on 19 April 2012 by the Ministry of Health in Jordan in an intensive care unit in

        a hospital in Zarqa. Seven nurses and one doctor were among the 11 affected. One of the nurses died. The cause of this

        outbreak remains unknown to date.


        Opening date: 26 April 2012 Latest update: 3 May 2012
        ��
        Update of the week

        No additional cases detected this week.
        http://ecdc.europa.eu/en/publication...May%202012.pdf
        CSI:WORLD http://swineflumagazine.blogspot.com/

        treyfish2004@yahoo.com

        Comment


        • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied

          This is two weeks old, but I just found it today. It might be a report of a case we were not previously aware of, as the hospital and timing do not appear to match any previous report in this thread:



          Predicted the death of'' Amjad'' because of his unknown virus. Thursday, April 26, 2012 22:40 ..

          Way - Ahmed and Khalil Qandil Barqawi



          Denied the Department of Health and there is no relationship between the death of young Ashrana yesterday in a hospital Princess Hamza was suffering a disease in the membranes of the heart, and "virus unknown" that caused severe pneumonia to a number of cadres of hospital blue state, resulting in the death of nurse emotions Balawi.

          The Director of Primary Health Care Department at the Ministry Bassam Hijjawi for "the way" on Thursday, said the cause of death of the young man transferred from the hospital blue state a condition to attack Hamza Hospital, due to a bug hit the heart membranes.

          The conversion of the deceased young Prince Hamza Hospital before the discovery of "unknown virus" in the blue government hospital.

          But with the young deceased Amjad Akram livelihood leading to "the way" paper Marwsh of Prince Hamzah Hospital says "Enter the (young) to the hospital on 15/4 adapter from the hospital blue and he was suffering from symptoms of pneumonia and inflammation of the heart muscle (the membrane and muscle) and given the late necessary treatment and samples were taken for diagnosis with the possibility of a viral infection or pulmonary TB, and began treatment based on it. and go to Allah's mercy pm Wednesday, 25.04. "

          Comment


          • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

            In light of the discovery of a novel coronavirus in neighboring Saudi Arabia (http://www.flutrackers.com/forum/sho...d.php?t=192872), ProMED has issued the following post today.

            Even if the outbreak is not due to the coronavirus, perhaps someone will reply to ProMED with the actual diagnosis in this outbreak:

            Published Date: 2012-09-25 09:53:20
            Subject: PRO/AH/EDR> Novel coronavirus - Saudi Arabia (04): RFI, Jordan, April 2012
            Archive Number: 20120925.1308001

            NOVEL CORONAVIRUS - SAUDI ARABIA (04): REQUEST FOR INFORMATION, JORDAN, APRIL 2012
            ************************************************** ********************************
            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: Sun 23 Sep 2012
            From: Irene Lai [edited]


            I would be interested to know whether the outbreak of severe respiratory disease of unknown origin in Jordan in April [2012] is now being reviewed for evidence of this new coronavirus.

            The HPA UK reports (http://www.hpa.org.uk/NewsCentre/Nat...essidentified/) seem to indicate that the cases under review were only those that occurred since July [2012]. "We are also aware of a small number of other cases of serious respiratory illness in the Middle East in the past 3 months."

            This ECDC report from May [2012] (http://ecdc.europa.eu/en/publication...y%202012.pdf):
            Severe respiratory disease of unknown origin - Jordan - Outbreak in ICU
            Opening date: [26 Apr 2012] Latest update: 3 May 2012

            Epidemiological summary
            -----------------------
            An outbreak of a respiratory illness was reported on [19 Apr 2012] by the Ministry of Health in an intensive care unit in a hospital in Zarqa, Jordan. 7 nurses and one doctor were among the 11 affected. One of the nurses died. Jordan's Ministry of Health acknowledges the fatal case specifying she had underlying conditions and all cases had high fever and lower respiratory symptoms. According to the Ministry, the origin of the infection is likely to be viral. However, laboratory results are not available to date.

            ECDC assessment
            ---------------
            ECDC is following this event due to its severity including one fatality and the unusualness of the disease affecting healthcare staff. These cases drew high media attention this week [week of 3 May 2012].

            Actions
            -------
            ECDC contacted both Episouth, WHO, and US CDC for further information. Both WHO and US CDC are following this event.

            --
            Communicated by:
            Irene Lai MD
            Medical Director
            Medical Information and Analysis
            International SOS
            Level 3, 45 Clarence Street
            Sydney NSW 2000


            ******
            [2]
            Date: Sun 22 Apr 2012
            Source: Jordan Times [edited]



            Emergency team searching for cause of unidentified illness
            ----------------------------------------------------------
            The disease that broke out in the Intensive Care Unit of Zarqa Public Hospital late last week [week of 19 Apr 2012] has not yet been identified, but the outbreak is under control, Minster of Health Abdul Latif Wreikat said on Sunday [22 Apr 2012].

            The ministry on Friday [20 Apr 2012] closed the hospital's ICU after an unknown illness believed to be pneumonia affected 7 nurses, one of whom died on Thursday [19 Apr 2012], one doctor, and the brother of one of the nurses.

            The minister said that so far, only 11 people have been confirmed infected with the disease, 4 of whom are receiving treatment and responding positively to medication, while 6 others have already been discharged from the hospital.

            The ministry has set up an emergency team from its Communicable Diseases Directorate to investigate the cause of the illness, he said.

            "The ministry's team took samples from the infected citizens, who also underwent intensive care measures to identify the cause," Wreikat told reporters at a press conference on Sunday [22 Apr 2012], noting that the infected patients' symptoms are similar to those of pneumonia.

            The minister, who visited the Zarqa hospital on Saturday [21 Apr 2012], said the ministry has confirmed that the outbreak has been brought under control and that the infected individuals are not in danger of spreading the disease to others.

            Meanwhile, the minister said, the hospital has been sterilised 3 times over the past 3 days as a precautionary measure, while its employees have received a short, intensive training course on preventing the disease from spreading.

            He also urged the media to be cautious and objective in reporting on the outbreak.

            [Byline: Hani Hazaimeh]

            --
            Communicated by:
            ProMED-mail
            <promed@promedmail.org>

            [ProMED-mail would like to thank Dr Lai for raising this very astute query and for alerting us to this prior report of an earlier outbreak of severe respiratory disease in the region. This moderator has checked the WHO archives and the ProMED-mail archives and could not find reports on the above mentioned outbreak. The ECDC report is the only formal report on this outbreak. A retrospective search of HealthMap Alerts from 2 Apr 2012 through 25 Apr 2012 looking for reports of pneumonia outbreaks that might be related to this current event only identified a report on the above mentioned outbreak in Jordan in April 2012.

            There are a series of newswire reports in the Jordanian Times on this event at the time of the outbreak -- the report above in [2] is a comprehensive discussion of the event. Another report the preceding day (21 Apr 2012) highlighted the fact that after the 1st severe case, staff were not using adequate infection control measures, especially an absence of use of masks (see http://jordantimes.com/zarqa-hospita...from-infection). From these reports, it appears as though the outbreak in Jordan was a nosocomial outbreak involving healthcare personnel working in an ICU where presumably a patient with a severe pneumonia had been hospitalized -- quite possibly related to deficiencies in respiratory infection control measures.

            It would be of interest to know if the etiology of the outbreak was ever identified, along with more information on the epidemiologic studies conducted at the time. Information on the index case in that outbreak would be of interest as well. - Mod.MPP]

            Comment


            • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

              Richard Knox, Health and Science correspondent with NPR has tweeted the following;

              Richard Knox ‏@DickKnox
              WHO tells me that new #coronavirus has been ruled out as cause of Jordan cluster of resp disease last spring.
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

              Comment


              • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

                Well did the WHO tell him what it was?
                CSI:WORLD http://swineflumagazine.blogspot.com/

                treyfish2004@yahoo.com

                Comment


                • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

                  There are actually two different ways WHO could know that, each with different consequences for the change of finding a diagnosis in this outbreak:

                  1. Someone sitll has samples from this outbreak, and just ran a test for the new coronavirus, and it came back negative. If that is the case, then as Treyfish pointed out, we might still get a diagnosis of some other illness by continued examination of the samples.

                  2. The test that ruled out SARS in April was actually a pancoronavirus tst, as was performed in Saudi Arabia on the initial coronavirus patient in June. The WHO is now just interpreting that negative result to exclude the novel coronavirus as well. If that is the case, this outbreak will remain permanently undiagnosed.

                  Comment


                  • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

                    From the moderator comments on today's ProMED post, raising the hope that someone will email ProMED with a diagnosis:



                    At present there are ongoing serosurveys being implemented to attempt to determine the possible background prevalence of antibodies to this novel coronavirus. We eagerly await the results of these studies.



                    In an earlier post on this novel coronavirus, Dr. Irene Lai mentioned a report on an outbreak of an as yet undiagnosed severe respiratory disease among health care workers in Jordan. The outbreak involved 11 cases including 7 nurses and 1 physician from an ICU (intensive care unit) in a hospital. There was one death associated with this outbreak. ProMED-mail had requested more information from knowledgeable sources on that outbreak. If that outbreak still remains "undiagnosed," it would be interesting to know results of serology for the novel coronavirus among the affected individuals. - Mod.MPP

                    Comment


                    • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012



                      [snip]

                      The report also raises the possibility?which has been mentioned before?that a cluster of unexplained respiratory illnesses in a Jordanian hospital ICU in April of this year might have been related to the novel virus.

                      "Still to be identified is the agent responsible for 11 cases of severe respiratory disease at an ICU in Zarqa, Jordan," it says. "The report by the Jordanian Minister of Health on April 17, 2012, noted that 8 cases were members of the healthcare staff."

                      In a report in May, the European Centre for Disease Prevention and Control (ECDC) said one nurse died in the Jordanian outbreak and that all the patients had high fever and lower respiratory symptoms. Jordanian health officials thought the outbreak was caused by a virus, but no lab results were available at the time.

                      British officials mentioned the Jordanian outbreak in an Oct 4 Eurosurveillance report on the Qatari patient treated in London for a coronavirus infection, but they said only that more information was needed.

                      In response to a CIDRAP News query today, a WHO spokesperson said the agency had no new information on the Jordanian outbreak but was hoping to get something soon.

                      Comment


                      • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 1 fatality - additional media reports of cases and fatalities denied, April 20 - May 2012

                        Unbelievable. Novel coronavirus confirmed:



                        Novel coronavirus infection - update
                        30 November 2012 - In addition to the fatal case of novel coronavirus in Saudi Arabia reported to WHO on 28 November, two fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to nine.

                        The latest confirmed case from Saudi Arabia occurred in October 2012 and is from the family cluster of the two cases confirmed earlier.

                        The two cases from Jordan occurred in April 2012. At that time, a number of severe pneumonia cases occurred in the country and the Ministry of Health (MOH) Jordan promptly requested a WHO Collaborating Centre for Emerging and Re-emerging Infectious Diseases (NAMRU ? 3) team to immediately assist in the laboratory investigation. The NAMRU-3 team went to Jordan and tested samples from this cluster of cases.

                        On 24 April 2012 the NAMRU-3 team informed the MOH that all samples had tested negative for known coronaviruses and other respiratory viruses. As the novel coronavirus had not yet been discovered, no specific tests for it were available.

                        In October 2012, after the discovery of the novel coronavirus, stored samples were sent by MOH Jordan to NAMRU-3. In November 2012 NAMRU-3 provided laboratory results that confirmed two cases of infection with the novel coronavirus.

                        The MOH Jordan has requested WHO assistance in investigating these infections. A mission from WHO Eastern Mediterranean Regional Office (EMRO) and headquarters arrived in Amman on 28 November 2012 to assist in further epidemiological surveillance and to strengthen the sentinel surveillance systems for severe acute respiratory infections (SARIs).

                        In summary, to date a total of nine laboratory-confirmed cases of infection with the novel coronavirus have been reported to WHO ? five cases (including 3 deaths) from Saudi Arabia, two cases from Qatar and two cases (both fatal) from Jordan.

                        Comment


                        • Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

                          [Source: World Health Organization, full page: (LINK). Edited.]
                          Background and summary of novel coronavirus infection – as of 30 November 2012



                          Over the past two months, WHO has received reports of nine cases of human infection with a novel coronavirus. Coronaviruses are a large family of viruses; different members of this family cause illness in humans and animals. In humans, these illnesses range from the common cold to infection with Severe Acute Respiratory Syndrome (SARS) coronavirus (SARS CoV).

                          Thus far, the cases reported have come from Qatar, Saudi Arabia and Jordan. All patients were severely ill, and five have died.

                          The two Qatari patients are not linked. Both had severe pneumonia and acute renal failure. Both are now recovering.

                          A total of five confirmed cases have been reported from Saudi Arabia.

                          The first two are not linked to each other; one of these has died.

                          Three other confirmed cases are epidemiologically linked and occurred in one family living within the same household; two of these have died.

                          One additional family member in this household also became ill, with symptoms similar to those of the confirmed cases. This person has recovered and tested negative, by polymerase chain reaction (PCR) tests, for the virus.

                          Two confirmed cases have been reported in Jordan. Both of these patients have died. These cases were discovered through testing of stored samples from a cluster of pneumonia cases that occurred in April 2012.

                          The two clusters (Saudi Arabia, Jordan) raise the possibility of limited human-to-human transmission or, alternatively, exposure to a common source. Ongoing investigation may or may not be able to distinguish between these possibilities.

                          The current understanding of this novel virus is that it can cause a severe, acute respiratory infection presenting as pneumonia. Acute renal failure has also occurred in five cases.

                          WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with SARS. Although this novel coronavirus is distantly related to the SARS CoV, they are different. Based on current information, it does not appear to transmit easily between people, unlike the SARS virus.

                          WHO has closely monitored the situation since detection of the first case and has been working with partners to ensure a high degree of preparedness should the new virus be found to be sufficiently transmissible to cause community outbreaks.

                          Some viruses are able to cause limited human-to-human transmission under condition of close contact, as occurs in families, but are not transmissible enough to cause larger community outbreaks.

                          Actions taken by WHO in coordination with national authorities and technical partners include the following:
                          • Investigations are ongoing to determine the likely source of infection and the route of exposure. Close contacts of confirmed cases are being identified and followed up.
                          • An interim surveillance recommendation has been updated to assist clinicians to determine which patients should undergo laboratory testing for the presence of novel coronavirus.
                          • Laboratory assays for the virus have been developed. Reagents and other materials for testing are available, as are protocols, algorithms and reference laboratory services. WHO has activated its laboratory network to assist in testing and other services. WHO has also issued preliminary guidance for laboratory biorisk management.
                          • Guidance is available for infection control.
                          Based on the current situation and available information:
                          • WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
                          • Further, testing for the new coronavirus of patients with unexplained pneumonias should be considered, especially in persons residing in or returning from the Arabian peninsula and neighboring countries. Any new cases should be promptly reported both to national health authorities and to WHO.
                          • In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated, regardless of where in the world they occur. These investigations will help determine whether the virus is distributed more widely in the human population beyond the three countries that have identified cases.
                          • 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 work with Member States and international health partners to gain a better understanding of the novel coronavirus and the disease in humans and will continue to provide updated information. As the situation evolves, WHO will reassess its guidance and revise it accordingly.
                          -
                          ------
                          Last edited by sharon sanders; December 2, 2012, 09:32 AM. Reason: added red color

                          Comment


                          • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

                            Source: http://www.globalmontreal.com/health...714/story.html

                            New coronavirus caused infections in Jordan in April, retrospective tests show
                            Helen Branswell, Friday, November 30, 2012 1:58 PM

                            TORONTO - The World Health Organization has reported two additional cases of infection with the new coronavirus, the earliest on record.

                            The agency says retrospective testing of stored samples show two people who died in Jordan in April were infected with the virus, which is from the same virus family as SARS...

                            ...To date the case count is as follows: Jordan, two, both fatal; Saudi Arabia, five, three fatal and Qatar, two.

                            A report on the outbreak ? noted in a weekly disease report from the European Centre for Disease Control in May ? said seven nurses and a doctor were among 11 cases identified in the outbreak at a hospital in Zarqa, Jordan....

                            Comment


                            • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

                              I think the author of this piece is the same person who made the (now incorrect) tweet several posts above, almost exactly two months ago, that the coronavirus had been excluded:

                              The latest cases represent the oldest known so far. They push the SARS-like virus's timeline back three months from the first reported case involving a 60-year-old man who died in Jedda, Saudi Arabia, last June.


                              SARS-Like Virus Found In Jordan, Hunt Is On For Other Cases
                              The World Health Organization says a new Arabian coronavirus has killed two people in Jordan ? the third country where the novel microbe has been traced.

                              That brings lab-confirmed cases to nine, with five fatalities.

                              The latest cases are actually the oldest known so far. They push the SARS-like virus's timeline three months back from the first reported case involving a 60-year-old man who died in Jedda, Saudi Arabia, last June.

                              Jordan's cases were found through new testing of blood and tissue samples from patients in a cluster of pneumonias of unknown origin that occurred last April at a hospital in Zarqa, near Jordan's capital of Amman.

                              Until now known cases have occurred further south in Qatar and Saudi Arabia.

                              The Jordan cases are also significant because they're part of an 11-person cluster of pneumonia that involved seven nurses and a doctor.

                              [snip]

                              Comment


                              • Re: Jordan - Cluster of approximately 11 people with acute pneumonia type illness, 2 fatalities - April 20 - May 2012 - Novel coronavirus confirmed

                                Who is the second confirmed fatality? The first is obviously the 40F nurse in this thread, but is the second one the doctor (that has been repeatedly denied as a false report) or an index patient that was never reported in April?

                                Published Date: 2012-11-30 15:05:39
                                Subject: PRO/AH/EDR> Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI
                                Archive Number: 20121130.1432498

                                NOVEL CORONAVIRUS - EASTERN MEDITERRANEAN: WHO, JORDAN, APRIL 2012, CONFIRMED, REQUEST FOR INFORMATION
                                ************************************************** ************************************************** **
                                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.


                                In this update:[1] WHO GAR report - Jordan April 2012[2] WHO summary of nCoV as of 30 Nov 2012******[1] WHO GAR report - Jordan April 2012Date: 30 Nov 2012
                                Source: WHO GAR



                                Novel coronavirus infection - update [30 Nov 2012]
                                ---------------------
                                In addition to the fatal case of novel coronavirus in Saudi Arabia reported to WHO on [28 Nov 2012], 2 fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to 9.

                                The latest confirmed case from Saudi Arabia occurred in October 2012 and is from the family cluster of the 2 cases confirmed earlier.

                                The 2 cases from Jordan occurred in April 2012. At that time, a number of severe pneumonia cases occurred in the country and the Ministry of Health (MOH) Jordan promptly requested a WHO Collaborating Centre for Emerging and Re-emerging Infectious Diseases (NAMRU - 3) team to immediately assist in the laboratory investigation. The NAMRU-3 team went to Jordan and tested samples from this cluster of cases.

                                On [24 Apr 2012] the NAMRU-3 team informed the MOH that all samples had tested negative for known coronaviruses and other respiratory viruses. As the novel coronavirus had not yet been discovered, no specific tests for it were available.

                                In October 2012, after the discovery of the novel coronavirus, stored samples were sent by MOH Jordan to NAMRU-3. In November 2012 NAMRU-3 provided laboratory results that confirmed 2 cases of infection with the novel coronavirus.

                                The MOH Jordan has requested WHO assistance in investigating these infections. A mission from WHO Eastern Mediterranean Regional Office (EMRO) and headquarters arrived in Amman on 28 November 2012 to assist in further epidemiological surveillance and to strengthen the sentinel surveillance systems for severe acute respiratory infections (SARIs).

                                In summary, to date a total of 9 laboratory-confirmed cases of infection with the novel coronavirus have been reported to WHO - 5 cases (including 3 deaths) from Saudi Arabia, 2 cases from Qatar and 2 cases (both fatal) from Jordan.

                                --
                                Communicated by:
                                ProMED-mail Rapporteur Marianne Hopp

                                ******
                                [2] WHO summary of nCoV as of 30 Nov 2012
                                Date: 30 Nov 2012
                                Source: WHO GAR



                                Background and summary of novel coronavirus infection - as of [30 Nov 2012]
                                -------------------------
                                Over the past 2 months, WHO has received reports of 9 cases of human infection with a novel coronavirus. Coronaviruses are a large family of viruses; different members of this family cause illness in humans and animals. In humans, these illnesses range from the common cold to infection with Severe Acute Respiratory Syndrome (SARS) coronavirus (SARS CoV).

                                Thus far, the cases reported have come from Qatar, Saudi Arabia and Jordan. All patients were severely ill, and 5 have died.

                                The 2 Qatari patients are not linked. Both had severe pneumonia and acute renal failure. Both are now recovering.

                                A total of 5 confirmed cases have been reported from Saudi Arabia. The 1st 2 are not linked to each other; one of these has died. Three other confirmed cases are epidemiologically linked and occurred in one family living within the same household; 2 of these have died. One additional family member in this household also became ill, with symptoms similar to those of the confirmed cases. This person has recovered and tested negative, by polymerase chain reaction (PCR) tests, for the virus.

                                Two confirmed cases have been reported in Jordan. Both of these patients have died. These cases were discovered through testing of stored samples from a cluster of pneumonia cases that occurred in April 2012.

                                The 2 clusters (Saudi Arabia, Jordan) raise the possibility of limited human-to-human transmission or, alternatively, exposure to a common source. Ongoing investigation may or may not be able to distinguish between these possibilities.

                                The current understanding of this novel virus is that it can cause a severe, acute respiratory infection presenting as pneumonia. Acute renal failure has also occurred in 5 cases.

                                WHO recognizes that the emergence of a new coronavirus capable of causing severe disease raises concerns because of experience with SARS. Although this novel coronavirus is distantly related to the SARS CoV, they are different. Based on current information, it does not appear to transmit easily between people, unlike the SARS virus.

                                WHO has closely monitored the situation since detection of the 1st case and has been working with partners to ensure a high degree of preparedness should the new virus be found to be sufficiently transmissible to cause community outbreaks. Some viruses are able to cause limited human-to-human transmission under condition of close contact, as occurs in families, but are not transmissible enough to cause larger community outbreaks. Actions taken by WHO in coordination with national authorities and technical partners include the following:

                                Investigations are ongoing to determine the likely source of infection and the route of exposure. Close contacts of confirmed cases are being identified and followed up.
                                An interim surveillance recommendation has been updated to assist clinicians to determine which patients should undergo laboratory testing for the presence of novel coronavirus.

                                Laboratory assays for the virus have been developed. Reagents and other materials for testing are available, as are protocols, algorithms and reference laboratory services. WHO has activated its laboratory network to assist in testing and other services. WHO has also issued preliminary guidance for laboratory biorisk management.
                                Guidance is available for infection control.

                                Based on the current situation and available information:

                                - WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
                                Further, testing for the new coronavirus of patients with unexplained pneumonias should be considered, especially in persons residing in or returning from the Arabian peninsula and neighboring countries. Any new cases should be promptly reported both to national health authorities and to WHO.

                                - In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated, regardless of where in the world they occur. These investigations will help determine whether the virus is distributed more widely in the human population beyond the 3 countries that have identified cases.

                                - 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 work with Member States and international health partners to gain a better understanding of the novel coronavirus and the disease in humans and will continue to provide updated information. As the situation evolves, WHO will reassess its guidance and revise it accordingly.

                                --
                                Communicated by:
                                ProMED-mail
                                <promed@promedmail.org>

                                [The above WHO report now increases the official number of laboratory confirmed cases of severe acute respiratory illness (SARI) due to infection with the novel coronavirus (nCoV) to 9, with 5 fatalities.

                                In a prior ProMED-mail report on this nCoV, Dr. Irene Lai had reported on an as yet undiagnosed outbreak of SARI in Jordan, querying if that outbreak would be reviewed to see if perhaps this nCoV was the etiology of the outbreak.

                                Information available at that time came from an ECDC report from May 2012 available at http://ecdc.europa.eu/en/publication...ay%202012.pdf:

                                "Severe respiratory disease of unknown origin - Jordan - Outbreak in ICU
                                Opening date: 26 April 2012 Latest update: 3 May 2012

                                An outbreak of a respiratory illness was reported on 19 April 2012 by the Ministry of Health in Jordan in an intensive care unit in a hospital in Zarqa. Seven nurses and one doctor were among the 11 affected. One of the nurses died. The cause of this
                                outbreak remains unknown to date."

                                From the above reports it appears as though the outbreak in Jordan in April 2012 was due to this nCoV, and most likely does represent limited human-to-human transmission -- involving the ICU healthcare personnel caring for a patient with SARI. With respect to the family cluster reported in Saudi Arabia, more information on the epidemiology of this outbreak including dates of onsets of cases, locations of contact between the family members (were they all from a common household, were any caretakers for earlier onset illness cases) might help in ascertaining if that cluster involved person-to-person transmission or if there had been a common source exposure in the household setting.

                                More information on results of testing of the other members of this cluster of cases in Jordan would be greatly appreciated. If the recovered cases are negative through currently available laboratory tests, it would add to an observation that milder cases are not "detected" through the currently available laboratory techniques.

                                If one looks at a map of the region, one sees that Saudi Arabia shares a border with Jordan to the Northwest and Qatar to the Southeast. - Mod.MPP]

                                Comment

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