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  • Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

    Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

    Since the middle of March, 2014, more than 30 individuals have been infected with MERS-CoV in the city of Jeddah in Eastern Saudi Arabia as reported by the Kingdom of Saudi Arabia (KSA) Ministry of Health. Almost half of these cases have been officially reported in the past five days.

    The official information provided by KSA on these cases is inconsistent. Onset dates after March 28, 2014, have not been reported for any the remaining 25+ cases. With the exception, of a father-son family cluster, few details are provided about the nature of the relationship between cases. Of these cases, 17 are reported as health care workers suggesting that many of these cases are a result of nosocomial infection. Four or five of these healthcare workers are reported as asymptomatic.

    The cases range in age from 25 to 71 years old. The mean age is 40 years old and the median age is 33 years old. The infected individuals in Jeddah are on the average younger than previously reported cases from Saudi Arabia. The median age for all MERS-CoV cases in Saudi Arabia is about 50 with a median age 53.

    As least five of the individuals in this outbreak in Jeddah have died, although most of the cases are still being treated. With an overall case fatality rate approaching 40% for reported MERS-CoV cases, more deaths can be expected from this outbreak.

    With little information about onset dates and the relationship between cases is it difficult to determine whether this outbreak is continuing to grow.



    Additional links:

    Hospital clusters of MERS-CoV cases, Jeddah, Saudi Arabia (map)

    Is a younger cohort being infected with MERS on the Arabian Pennisula

    Posted by Laidback Al at <a class="timestamp-link" href="http://novel-infectious-diseases.blogspot.com/2014/04/current-status-of-mers-cov-outbreak-in.html" rel="bookmark" title="permanent link"><abbr class="published" itemprop="datePublished" title="2014-04-15T15:02:00-07:00">3:02 PM</abbr>
    http://novel-infectious-diseases.blogspot.com/

  • #2
    Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

    Impressive work Al. I am outraged at how long it takes from diagnosis to a very sketchy report of the disease.
    Please do not ask me for medical advice, I am not a medical doctor.

    Avatar is a painting by Alan Pollack, titled, "Plague". I'm sure it was an accident that the plague girl happened to look almost like my twin.
    Thank you,
    Shannon Bennett

    Comment


    • #3
      Re: Saudi Arabia - Jeddah cluster: 38 total cases: 39 in Saudi + 1 in Jordan, 4 total deaths - March 28+

      And there are more this morning....


      Cluster 13: The Jeddah Cluster

      Apparently there are 38 cases in this outbreak:

      Initial Outbreak = 11
      #211
      - Male, 26, Jeddah, currently receiving treatment in intensive care - possibly health care worker according to media reports - Jeddah, Saudi Arabia Please note: This case was reported by the MoH on March 28. Death note.
      #219 - Man, 70, from Jeddah, co-morbidities, died - Saudi Arabia Death
      #216-218 - 3 unidentified and asymptomatic healthcare workers who tested positive announce April 6, 2014 Jeddah, Saudi Arabia
      #220 - Man, son of case number 219 who tested positive but is asymptomatic. - Saudi Arabia
      #222 - Male, 35, asymptomatic, citizen - Jeddah, Saudi Arabia
      #223 - Female, 32, health care worker, asymptomatic, citizen - Jeddah, Saudi Arabia
      #224 - Male, 33, asymptomatic, resident - Jeddah, Saudi Arabia )
      #213 - Man - 26, from the province of Jeddah and works in the health care sector, currently receiving treatment in intensive care - Saudi Arabia Please note: This case was reported April 2.
      #221 - Male, 28, hospitalized in ICU, health "domain" worker, citizen - Jeddah, Saudi Arabia
      3 Announced April 10, 2014:
      #230 - Patient, 70, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
      #231 - Patient, 34, citizen, in stable condition - Jeddah, Saudi Arabia
      #232 - Patient, 29, citizen, in stable condition - Jeddah, Saudi Arabia
      4 Announced April 11, 2014
      #239 - Man, 52, onset March 25, treated in Jeddah, Saudi Arabia, hospitalized 2 April in stable condition. Jordan
      #240 - Patient, 45, resident, has died - Jeddah, Saudi Arabia Death
      #241 - Patient, 28, resident, health care worker - Jeddah, Saudi Arabia
      #242 - Patient, 25, citizen, health care worker - Jeddah, Saudi Arabia
      4 cases announced April 12, 2014
      #243 - Patient, 26, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
      #244 - Patient, 58, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
      #245 - Patient, 71, citizen, stable condition - Jeddah, Saudi Arabia
      #246 - Patient, 39, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
      5 cases announced April 14, 2014
      #248 - Patient, 70, resident, died - Jeddah, Saudi Arabia Death
      #249 - Patient, 51, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
      #250 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
      #251 - Patient, 45, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
      #252 - Patient, 56, resident, stable condition - Jeddah, Saudi Arabia
      5 cases announced April 15, 2014
      #257 - Patient, 30, resident, recovered - Jeddah, Saudi Arabia
      #258 - Patient, 59, citizen, died - Jeddah, Saudi Arabia Death
      #259 - Patient, 64, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
      #260 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
      #261 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
      6 Announced April 16, 2014
      #262 - Patient, 54, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
      #263 - Patient, 52,citizen, died - Jeddah, Saudi Arabia Death
      #264 - Patient, 41, resident, stable condition - Jeddah, Saudi Arabia
      #265 - Patient, 54, resident, stable condition - Jeddah, Saudi Arabia
      #266 - Patient, 28, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
      #267 - Patient, 35, resident, health care worker, stable condition - Jeddah, Saudi Arabia
      "May the long time sun
      Shine upon you,
      All love surround you,
      And the pure light within you
      Guide your way on."

      "Where your talents and the needs of the world cross, lies your calling."
      Aristotle

      “In a gentle way, you can shake the world.”
      Mohandas Gandhi

      Be the light that is within.

      Comment


      • #4
        Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

        And more today...

        Cluster 13: The Jeddah Cluster -

        Apparently there are 45 cases in this outbreak:

        Initial outbreak = 11:

        #211 - Male, 26, Jeddah, currently receiving treatment in intensive care - possibly health care worker according to media reports - Jeddah, Saudi Arabia Please note: This case was reported by the MoH on March 28. Death note.
        #219 - Man, 70, from Jeddah, co-morbidities, died - Saudi Arabia Death
        #216-218 - 3 unidentified and asymptomatic healthcare workers who tested positive announce April 6, 2014 Jeddah, Saudi Arabia
        #220 - Man, son of case number 219 who tested positive but is asymptomatic. - Saudi Arabia
        #222 - Male, 35, asymptomatic, citizen - Jeddah, Saudi Arabia
        #223 - Female, 32, health care worker, asymptomatic, citizen - Jeddah, Saudi Arabia
        #224 - Male, 33, asymptomatic, resident - Jeddah, Saudi Arabia
        #213 - Man - 26, from the province of Jeddah and works in the health care sector, currently receiving treatment in intensive care - Saudi Arabia Please note: This case was reported April 2.
        #221 - Male, 28, hospitalized in ICU, health "domain" worker, citizen - Jeddah, Saudi Arabia
        3 Announced April 10, 2014:
        #230 - Patient, 70, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
        #231 - Patient, 34, citizen, in stable condition - Jeddah, Saudi Arabia
        #232 - Patient, 29, citizen, in stable condition - Jeddah, Saudi Arabia
        4 Announced April 11, 2014
        #239 - Man, 52, onset March 25, treated in Jeddah, Saudi Arabia, hospitalized 2 April in stable condition. Jordan
        #240 - Patient, 45, resident, has died - Jeddah, Saudi Arabia Death
        #241 - Patient, 28, resident, health care worker - Jeddah, Saudi Arabia
        #242 - Patient, 25, citizen, health care worker - Jeddah, Saudi Arabia
        4 cases announced April 12, 2014
        #243 - Patient, 26, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
        #244 - Patient, 58, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
        #245 - Patient, 71, citizen, stable condition - Jeddah, Saudi Arabia
        #246 - Patient, 39, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
        5 cases announced April 14, 2014
        #248 - Patient, 70, resident, died - Jeddah, Saudi Arabia Death
        #249 - Patient, 51, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
        #250 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
        #251 - Patient, 45, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
        #252 - Patient, 56, resident, stable condition - Jeddah, Saudi Arabia
        5 cases announced April 15, 2014
        #257 - Patient, 30, resident, recovered - Jeddah, Saudi Arabia
        #258 - Patient, 59, citizen, died - Jeddah, Saudi Arabia Death
        #259 - Patient, 64, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
        #260 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
        #261 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
        6 Announced April 16, 2014
        #262 - Patient, 54, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
        #263 - Patient, 52,citizen, died - Jeddah, Saudi Arabia Death
        #264 - Patient, 41, resident, stable condition - Jeddah, Saudi Arabia
        #265 - Patient, 54, resident, stable condition - Jeddah, Saudi Arabia
        #266 - Patient, 28, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
        #267 - Patient, 35, resident, health care worker, stable condition - Jeddah, Saudi Arabia
        7 announced April 17
        #271 - Patient, 72, died - Jeddah, Saudi Arabia Death
        #272 - Patient, 70, hospitalized in ICU - Jeddah, Saudi Arabia
        #273 - Patient, 60, hospitalized in ICU - Jeddah, Saudi Arabia
        #274 - Patient, 54, health care worker, in stable condition - Jeddah, Saudi Arabia
        #275 - Patient, 63, in stable condition - Jeddah, Saudi Arabia
        #276 - Patient, 40, in stable condition - Jeddah, Saudi Arabia
        #277 - Patient, 31, in stable condition - Jeddah, Saudi Arabia
        "May the long time sun
        Shine upon you,
        All love surround you,
        And the pure light within you
        Guide your way on."

        "Where your talents and the needs of the world cross, lies your calling."
        Aristotle

        “In a gentle way, you can shake the world.”
        Mohandas Gandhi

        Be the light that is within.

        Comment


        • #5
          Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

          The man from Malaysia who died (link) should be considered another case in the Jeddah outbreak. According to the World Health Organization (WHO) report today (link) the man visited Jeddah in the last half of March, during the same period that several cases in Jeddah experienced onset. The WHO notes that this individual visited a camel farm and drank camel milk in Saudi Arabia on March 26th. I believe this is the only MERS case in the Jeddah outbreak that has been reported to have animal contact. The lack of more details from the Ministry of Health about infection sources could lead to more speculation about sustained human-to-human transmission.
          http://novel-infectious-diseases.blogspot.com/

          Comment


          • #6
            Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

            Good idea Al. I added that case:

            Cluster 13: The Jeddah Cluster -

            Apparently there are 46 cases in this outbreak:

            Initial outbreak = 11:

            #211 - Male, 26, Jeddah, currently receiving treatment in intensive care - possibly health care worker according to media reports - Jeddah, Saudi Arabia Please note: This case was reported by the MoH on March 28. Death note.
            #219 - Man, 70, from Jeddah, co-morbidities, died - Saudi Arabia Death
            #216-218 - 3 unidentified and asymptomatic healthcare workers who tested positive announce April 6, 2014 Jeddah, Saudi Arabia
            #220 - Man, son of case number 219 who tested positive but is asymptomatic. - Saudi Arabia
            #222 - Male, 35, asymptomatic, citizen - Jeddah, Saudi Arabia
            #223 - Female, 32, health care worker, asymptomatic, citizen - Jeddah, Saudi Arabia
            #224 - Male, 33, asymptomatic, resident - Jeddah, Saudi Arabia
            #213 - Man - 26, from the province of Jeddah and works in the health care sector, currently receiving treatment in intensive care - Saudi Arabia Please note: This case was reported April 2.
            #221 - Male, 28, hospitalized in ICU, health "domain" worker, citizen - Jeddah, Saudi Arabia
            3 Announced April 10, 2014:
            #230 - Patient, 70, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
            #231 - Patient, 34, citizen, in stable condition - Jeddah, Saudi Arabia
            #232 - Patient, 29, citizen, in stable condition - Jeddah, Saudi Arabia
            4 Announced April 11, 2014
            #239 - Man, 52, onset March 25, treated in Jeddah, Saudi Arabia, hospitalized 2 April in stable condition. Jordan
            #240 - Patient, 45, resident, has died - Jeddah, Saudi Arabia Death
            #241 - Patient, 28, resident, health care worker - Jeddah, Saudi Arabia
            #242 - Patient, 25, citizen, health care worker - Jeddah, Saudi Arabia
            4 cases announced April 12, 2014
            #243 - Patient, 26, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
            #244 - Patient, 58, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
            #245 - Patient, 71, citizen, stable condition - Jeddah, Saudi Arabia
            #246 - Patient, 39, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
            5 cases announced April 14, 2014
            #248 - Patient, 70, resident, died - Jeddah, Saudi Arabia Death
            #249 - Patient, 51, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
            #250 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
            #251 - Patient, 45, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
            #252 - Patient, 56, resident, stable condition - Jeddah, Saudi Arabia
            5 cases announced April 15, 2014
            #257 - Patient, 30, resident, recovered - Jeddah, Saudi Arabia
            #258 - Patient, 59, citizen, died - Jeddah, Saudi Arabia Death
            #259 - Patient, 64, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
            #260 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
            #261 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
            6 Announced April 16, 2014
            #262 - Patient, 54, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
            #263 - Patient, 52,citizen, died - Jeddah, Saudi Arabia Death
            #264 - Patient, 41, resident, stable condition - Jeddah, Saudi Arabia
            #265 - Patient, 54, resident, stable condition - Jeddah, Saudi Arabia
            #266 - Patient, 28, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
            #267 - Patient, 35, resident, health care worker, stable condition - Jeddah, Saudi Arabia
            7 announced April 17
            #271 - Patient, 72, died - Jeddah, Saudi Arabia Death
            #272 - Patient, 70, hospitalized in ICU - Jeddah, Saudi Arabia
            #273 - Patient, 60, hospitalized in ICU - Jeddah, Saudi Arabia
            #274 - Patient, 54, health care worker, in stable condition - Jeddah, Saudi Arabia
            #275 - Patient, 63, in stable condition - Jeddah, Saudi Arabia
            #276 - Patient, 40, in stable condition - Jeddah, Saudi Arabia
            #277 - Patient, 31, in stable condition - Jeddah, Saudi Arabia
            1 Previously announced case added to this list April 17
            #269 - Man, 54, underlying health conditions, travel history to Jeddah, Saudi Arabia died on 13 April in Malaysia - Saudi Arabia Death

            "May the long time sun
            Shine upon you,
            All love surround you,
            And the pure light within you
            Guide your way on."

            "Where your talents and the needs of the world cross, lies your calling."
            Aristotle

            “In a gentle way, you can shake the world.”
            Mohandas Gandhi

            Be the light that is within.

            Comment


            • #7
              Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

              This outbreak appears to be growing, but without more details about the cases, it is difficult to know as Mike Coston points out in his blog yesterday. (link)

              A media report indicates that two traveling companions of the infected Malaysian man who visited Jeddah are now symptomatic in Malaysia. (link) If infected, these two individuals will increase the size of this outbreak and may represent a new separate geographic MERS cluster.

              hat tip to Shiloh
              http://novel-infectious-diseases.blogspot.com/

              Comment


              • #8
                Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                Now a case that flew to Greece...

                There are 53 known cases in this outbreak - April 18, 2014:

                Initial outbreak = 11:

                #211 - Male, 26, Jeddah, currently receiving treatment in intensive care - possibly health care worker according to media reports - Jeddah, Saudi Arabia Please note: This case was reported by the MoH on March 28. Death note.
                #219 - Man, 70, from Jeddah, co-morbidities, died - Saudi Arabia Death
                #216-218 - 3 unidentified and asymptomatic healthcare workers who tested positive announce April 6, 2014 Jeddah, Saudi Arabia
                #220 - Man, son of case number 219 who tested positive but is asymptomatic. - Saudi Arabia
                #222 - Male, 35, asymptomatic, citizen - Jeddah, Saudi Arabia
                #223 - Female, 32, health care worker, asymptomatic, citizen - Jeddah, Saudi Arabia
                #224 - Male, 33, asymptomatic, resident - Jeddah, Saudi Arabia
                #213 - Man - 26, from the province of Jeddah and works in the health care sector, currently receiving treatment in intensive care - Saudi Arabia Please note: This case was reported April 2.
                #221 - Male, 28, hospitalized in ICU, health "domain" worker, citizen - Jeddah, Saudi Arabia
                3 Announced April 10, 2014:
                #230 - Patient, 70, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                #231 - Patient, 34, citizen, in stable condition - Jeddah, Saudi Arabia
                #232 - Patient, 29, citizen, in stable condition - Jeddah, Saudi Arabia
                4 Announced April 11, 2014
                #239 - Man, 52, onset March 25, treated in Jeddah, Saudi Arabia, hospitalized 2 April in stable condition. Jordan
                #240 - Patient, 45, resident, has died - Jeddah, Saudi Arabia Death
                #241 - Patient, 28, resident, health care worker - Jeddah, Saudi Arabia
                #242 - Patient, 25, citizen, health care worker - Jeddah, Saudi Arabia
                4 cases announced April 12, 2014
                #243 - Patient, 26, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
                #244 - Patient, 58, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                #245 - Patient, 71, citizen, stable condition - Jeddah, Saudi Arabia
                #246 - Patient, 39, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                5 cases announced April 14, 2014
                #248 - Patient, 70, resident, died - Jeddah, Saudi Arabia Death
                #249 - Patient, 51, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                #250 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
                #251 - Patient, 45, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                #252 - Patient, 56, resident, stable condition - Jeddah, Saudi Arabia
                5 cases announced April 15, 2014
                #257 - Patient, 30, resident, recovered - Jeddah, Saudi Arabia
                #258 - Patient, 59, citizen, died - Jeddah, Saudi Arabia Death
                #259 - Patient, 64, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                #260 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
                #261 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
                6 Announced April 16, 2014
                #262 - Patient, 54, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                #263 - Patient, 52,citizen, died - Jeddah, Saudi Arabia Death
                #264 - Patient, 41, resident, stable condition - Jeddah, Saudi Arabia
                #265 - Patient, 54, resident, stable condition - Jeddah, Saudi Arabia
                #266 - Patient, 28, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                #267 - Patient, 35, resident, health care worker, stable condition - Jeddah, Saudi Arabia
                7 announced April 17
                #271 - Patient, 72, died - Jeddah, Saudi Arabia Death
                #272 - Patient, 70, hospitalized in ICU - Jeddah, Saudi Arabia
                #273 - Patient, 60, hospitalized in ICU - Jeddah, Saudi Arabia
                #274 - Patient, 54, health care worker, in stable condition - Jeddah, Saudi Arabia
                #275 - Patient, 63, in stable condition - Jeddah, Saudi Arabia
                #276 - Patient, 40, in stable condition - Jeddah, Saudi Arabia
                #277 - Patient, 31, in stable condition - Jeddah, Saudi Arabia
                1 Previously announced case added to this list April 17
                #269 - Man, 54, underlying health conditions, travelled history to Jeddah, Saudi Arabia died on 13 April in Malaysia - Saudi Arabia Death
                7 announced April 18
                #288 - Patient, 53, resident, died - Jeddah, Saudi Arabia Death
                #289 - Patient, 49, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                #290 - Patient, 60, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                #291 - Patient, 26, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                #292 - Patient, 38, resident, contact with a confirmed case, symptomatic - Jeddah, Saudi Arabia
                #293 - Patient, 13, resident, asymptomatic - Jeddah, Saudi Arabia
                #294 - Man, 69, Greek citizen with Saudi residency from Jeddah, arrived in Greece and was hospitalized on April 17 - Jeddah, Saudi Arabia
                "May the long time sun
                Shine upon you,
                All love surround you,
                And the pure light within you
                Guide your way on."

                "Where your talents and the needs of the world cross, lies your calling."
                Aristotle

                “In a gentle way, you can shake the world.”
                Mohandas Gandhi

                Be the light that is within.

                Comment


                • #9
                  Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                  Among the problem with outbreaks of severe respiratory illnesses in ME settings, the WHO released this recommendations:

                  [Source: World Health Organization, Weekly Epidemiological Record, full PDF document: http://www.who.int/wer/2014/wer8916.pdf?ua=1. Edited.]

                  Weekly epidemiological record / Relevé épidémiologique hebdomadaire - 18 APRIL 2014, 89th year / 18 AVRIL 2014, 89e année, No. 16, 2014, 89, 161–164 / http://www.who.int/wer


                  Severe atypical pneumonia outbreak associated with influenza A(H1N1)pdm09 in Egypt, 2013–2014 season

                  (...)


                  This outbreak investigation yielded several notable lessons and revealed the need for WHO recommendations for monitoring and controlling influenza outbreaks in resource-constrained settings:
                  • (i) Of the large numbers of samples collected from patients with SARI, the great majority of those submitted to CPHL and NAMRU were naso-pharyngeal swabs.
                    • The importance of obtaining lower respiratory tract (LRT) specimens for the diagnosis of SARI has been increasingly stressed in scientific literature, suggesting upper respiratory tract specimens are inadequate, especially for severe influenza virus and MERS-CoV infection;
                    • however, such specimens were rarely collected.
                    • In areas without equipment or capability to safely perform certain LRT sampling procedures, “induced sputum»” is a potential alternative, which is commonly used for tuberculosis testing.
                  • (ii) The samples collected were often of suboptimal quality.
                    • Successful laboratory diagnosis relies on sample quality, and it is important to obtain specimens using appropriate collection methods and transport them to the laboratory in good condition in a timely fashion.
                    • Recognizing the presence of MERS-CoV and avian influenza A(H5N1) virus in the region, there is an urgent need to raise awareness of clinicians on LRT specimen collection, training and equipment, to promote early and accurate laboratory diagnosis.
                  • (iii) The vulnerability of pregnant women to influenza A(H1N1)pdm09 was confirmed this season in Egypt, as has been observed in earlier epidemic waves elsewhere, supporting the recommendation made by the WHO Strategic Advisory Group of Experts on immunization concerning pregnant women;
                    • as a direct result a targeted vaccination strategy is being discussed for this at-risk group. However, a large annual demand for seasonal vaccine to cover an estimated 2 million pregnancies poses challenges for countries with competing health priorities.
                  • (iv) In accordance with WHO clinical management guidance, provision of both empiric antiviral treatment and concomitant empiric antimicrobial treatment to patients with undifferentiated severe acute respiratory infection, pending further test results, is recommended when community circulation of the virus is known.
                  • (v) It is important to establish a communication channel and strategy to connect clinicians, laboratories, and public health officials in order to enhance appreciation of influenza activity and clinical diagnostic suspicion, a rapidly shifting balance of capacity and demand in the health-care system, and facilitate evidence-based clinical decision-making.
                  • (vi) Effective communication in the delivery of public health messages is a powerful tool in facilitating control and prevention efforts.
                  (...)

                  -
                  ------

                  Comment


                  • #10
                    Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                    From the above article, it may be recognized that:

                    -- some severe pneumonia cases in the ME region may be related both to H1N1pdm09 & other respiratory viruses (included MERS-CoV, H5N1),

                    -- however, since lower respiratory tract samples aren't collected routinely and in proper manner,

                    -- such viruses (H5N1, MERS) may not be detected timely.

                    Consequently, co-infection with H1N1pdm09 & / or MERS & / or other respiratory viruses cannot be excluded during outbreaks of severe respiratory illness in Middle East Region.

                    gm

                    Comment


                    • #11
                      Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                      The Saudi Arabia Ministry of Health announced another seven MERS cases from Jeddah today (link). It would seems that this MERS cluster is continuing to expand. The Jeddah outbreak is by far the largest geographic cluster of MERS cases in such a short time. Fewer health care workers are being identified in the most recent official media reports, so the currently reported cases no longer seems have resulted solely from nosocomial infections (link).
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                      • #12
                        Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                        This is no longer a "cluster". It is a city outbreak. With new case numbering here is the to date of known Jeddah cases:

                        82 total cases to date in this outbreak

                        Initial Outbreak = 11

                        #211 - Male*, 26, Jeddah, currently receiving treatment in intensive care - possibly health care worker according to media reports - Jeddah, Saudi Arabia Please note: This case was reported by the MoH on March 28. Death note.
                        #213 - Man - 26, from the province of Jeddah and works in the health care sector, currently receiving treatment in intensive care - Saudi Arabia Please note: This case was reported by the MoH on April 2.
                        #216-218 - 3 unidentified and asymptomatic healthcare workers who tested positive announce April 6, 2014 Jeddah, Saudi Arabia
                        #219 - Man, 70, from Jeddah, co-morbidities, died - Saudi Arabia Death
                        #220 - Man, son of case number 219 who tested positive but is asymptomatic. Jeddah - Saudi Arabia
                        #221 - Male, 28, hospitalized in ICU, health "domain" worker, citizen - Jeddah, Saudi Arabia
                        #222 - Male, 35, asymptomatic, citizen - Jeddah, Saudi Arabia
                        #223 - Female, 32, health care worker, asymptomatic, citizen - Jeddah, Saudi Arabia
                        #224 - Male, 33, asymptomatic, resident - Jeddah, Saudi Arabia

                        3 announced April 10
                        #230 - Patient, 70, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #231 - Patient, 34, citizen, in stable condition - Jeddah, Saudi Arabia
                        #232 - Patient, 29, citizen, in stable condition - Jeddah, Saudi Arabia

                        4 announced April 11
                        #239 - Man, 52, onset March 25, treated in Jeddah, Saudi Arabia, hospitalized 2 April in stable condition. Jordan
                        #240 - Patient, 45, resident, has died - Jeddah, Saudi Arabia Death
                        #241 - Patient, 28, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #242 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia

                        4 announced April 12
                        #243 - Patient, 26, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #244 - Patient, 58, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                        #245 - Patient, 71, citizen, stable condition - Jeddah, Saudi Arabia
                        #246 - Patient, 39, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia

                        5 announced April 14
                        #248 - Patient, 70, resident, died - Jeddah, Saudi Arabia Death
                        #249 - Patient, 51, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #250 - Patient, 28, citizen, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #251 - Patient, 45, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #252 - Patient, 56, resident, stable condition - Jeddah, Saudi Arabia

                        5 announced April 15
                        #257 - Patient, 30, resident, recovered - Jeddah, Saudi Arabia
                        #258 - Patient, 59, citizen, died - Jeddah, Saudi Arabia Death
                        #259 - Patient, 64, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                        #260 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia
                        #261 - Patient, 27, health care worker, asymptomatic, Jeddah, Saudi Arabia

                        6 announced April 16
                        #262 - Patient, 54, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #263 - Patient, 52,citizen, died - Jeddah, Saudi Arabia Death
                        #264 - Patient, 41, resident, stable condition - Jeddah, Saudi Arabia
                        #265 - Patient, 54, resident, stable condition - Jeddah, Saudi Arabia
                        #266 - Patient, 28, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                        #267 - Patient, 35, resident, health care worker, stable condition - Jeddah, Saudi Arabia

                        8 announced April 17
                        #269 - Man, 54, underlying health conditions. He travelled to Jeddah, Saudi Arabia with a pilgrimage group of 18 people from 15 to 28 March 2014 and became ill on 4 April. He sought treatment in a private clinic in Johor, Malaysia on 7 April and went to a hospital on 9 April. The patient died on 13 April. The patient visited a camel farm on 26 March, during which he consumed camel milk. Saudi Arabia Death
                        #271 - Patient, 72, died - Jeddah, Saudi Arabia Death
                        #272 - Patient, 70, hospitalized in ICU - Jeddah, Saudi Arabia
                        #273 - Patient, 60, hospitalized in ICU - Jeddah, Saudi Arabia
                        #274 - Patient, 54, health care worker, in stable condition - Jeddah, Saudi Arabia
                        #275 - Patient, 63, in stable condition - Jeddah, Saudi Arabia
                        #276 - Patient, 40, in stable condition - Jeddah, Saudi Arabia
                        #277 - Patient, 31, in stable condition - Jeddah, Saudi Arabia

                        7 announced April 17
                        #288 - Patient, 53, resident, died - Jeddah, Saudi Arabia Death
                        #289 - Patient, 49, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #290 - Patient, 60, citizen, health care worker, stable condition - Jeddah, Saudi Arabia
                        #291 - Patient, 26, resident, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #292 - Patient, 38, resident, contact with a confirmed case, symptomatic - Jeddah, Saudi Arabia
                        #293 - Patient, 13, resident, asymptomatic - Jeddah, Saudi Arabia
                        #294 - Man, 69, Greek citizen with Saudi residency from Jeddah, arrived in Greece and was hospitalized on April 17 - Jeddah, Saudi Arabia

                        and 29 more cases announced through April 23

                        #295 - Patient, 64, resident, died - Jeddah, Saudi Arabia Death
                        #296 - Patient, 44, resident, died - Jeddah, Saudi Arabia Death
                        #297 - Patient, 62, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #298 - Patent, 47, citizen, hospitalized in ICU - Jeddah, Saudi Arabia
                        #299 - Patient, 52, citizen, stable - Jeddah, Saudi Arabia
                        #300 - Patient, 54, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #301 - Patient, 54, health care worker, asymptomatic - Jeddah, Saudi Arabia
                        #302 - Patient, 49, died, Jeddah resident - Saudi Arabia Death
                        #303 - Patient, 57 years, Jeddah resident, currently in intensive care - Saudi Arabia
                        #304 - Patient, 32, Jeddah resident, in stable condition - Saudi Arabia
                        #305 - Patient, 53, Jeddah resident, in stable condition - Saudi Arabia
                        #306 - Patient, 54, Jeddah resident, in stable condition - Saudi Arabia
                        #307 - Patient, 23, Jeddah resident, asymptomatic - Saudi Arabia
                        #308 - Patient, 37, health care worker, in stable condition, Jeddah - Saudi Arabia
                        #316 - Patient, 45, resident, health care worker, hospitalized in ICU - Jeddah, Saudi Arabia
                        #317- Patient, 90, resident, receiving treatment in ICU - Jeddah, Saudi Arabia
                        #318 - Patient, 53, resident, in stable condition - Jeddah, Saudi Arabia
                        #319 - Patient, 60, resident, in stable condition - Jeddah, Saudi Arabia
                        #320 - Patient, 42, resident, asymptomatic - Jeddah, Saudi Arabia
                        #321 - Patient, 24, resident, contact of a confirmed cases, asymptomatic - Jeddah, Saudi Arabia
                        #322 - Patient, 17, resident, contact of a confirmed case, asymptomatic - Jeddah, Saudi Arabia
                        #338 - Patient, 13, resident, contact of a positive case, asymptomatic - Jeddah, Saudi Arabia
                        #339 - Patient, 71, resident, with several chronic illnesses, currently in intensive care - Jeddah, Saudi Arabia
                        #340 - Patient, 67, resident, with several chronic illnesses, currently in intensive care - Jeddah, Saudi Arabia
                        #341 - Patient, resident, health care worker, 45 years old, currently in intensive care. - Jeddah, Saudi Arabia
                        #342 - Patient, 55, resident, with several chronic illnesses, currently in intensive care - Jeddah, Saudi Arabia
                        #344 - Patient, 48, health care worker, receiving intensive care. - Jeddah, Saudi Arabia
                        #358 - Patient, 41, contact of a confirmed cases in Jeddah, no symptoms Jeddah, Saudi Arabia
                        #359 - Patient, 74, entered the King Faisal Specialist Hospital in Jeddah on 14.04.2014 AD suffer from the symptoms of anemia, showed symptoms of pneumonia on 4/20/2014, ICU - Jeddah, Saudi Arabia


                        I am not going to update this list any further. For future cases in Jeddah please see our main case list:

                        http://www.flutrackers.com/forum/sho...d.php?t=205075
                        "May the long time sun
                        Shine upon you,
                        All love surround you,
                        And the pure light within you
                        Guide your way on."

                        "Where your talents and the needs of the world cross, lies your calling."
                        Aristotle

                        “In a gentle way, you can shake the world.”
                        Mohandas Gandhi

                        Be the light that is within.

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                        • #13
                          Re: Current Status of the MERS-CoV Outbreak in Jeddah, Saudi Arabia

                          Gosh - look at all those residents in the ICU - NEVERMIND - I thought they were HCW residents :-) They are city residents
                          Nika

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