Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - Ju

[sharon sanders]

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

Source: WHO, http://www.who.int/csr/don/2013_06_01_ncov/en/index.html

What I want to know is:

What lab did the testing of the 10 cases reported yesterday? The same lab as the confirmed 45 year old? And where can I see this in writing? What kind of lab is this? A hospital lab? A major reference lab?

Apparently the ISS did the second tests. This is a WHO reference lab, yes?

 

[Giuseppe]

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

Source: WHO, http://www.who.int/csr/don/2013_06_01_ncov/en/index.html

The first three confirmed cases of Novel Coronavirus in Italy were confirmed through laboratory tests performed in a influenza reference labotory on behalf the infectious diseases department of ''Careggi'' hospital in Florence.

As stated in the June 1 2013 WHO update, the first round of test were performed at Tuscany influenza reference laboratory.

The additional suspected cases tested initally positive for the NCoV had likely followed the same path toward this laboratory.

The question is thus how it was possible that for the first three cases the laboratory had a correct results but for the (10) or (8) suspected cases not?

Is it an issue regarding a mismatch in case definition as seen in China for the asymptomatic boy (and probably even the mother) tested positive by PCR for H7N9 but that did not match clinical criteria for case definition?

There is need for more clarity and transparency and to clean the communication channel from rumors and unsubstantiated statement even from authoritative sources.

GM

 

[sharon sanders]

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - waiting for Ministry of Health confirmation - June 3, 2013

The first three confirmed cases of Novel Coronavirus in Italy were confirmed through laboratory tests performed in a influenza reference labotory on behalf the infectious diseases department of ''Careggi'' hospital in Florence.

As stated in the June 1 2013 WHO update, the first round of test were performed at Tuscany influenza reference laboratory.

The additional suspected cases tested initally positive for the NCoV had likely followed the same path toward this laboratory.

The question is thus how it was possible that for the first three cases the laboratory had a correct results but for the (10) or (8) suspected cases not?

Is it an issue regarding a mismatch in case definition as seen in China for the asymptomatic boy (and probably even the mother) tested positive by PCR for H7N9 but that did not match clinical criteria for case definition?

There is need for more clarity and transparency and to clean the communication channel from rumors and unsubstantiated statement even from authoritative sources.

GM

Ok so as I understand this:

1) Yesterday (or the day before) approximately 10 people tested positive for coronavirus nCoV at Careggi hospital lab which is a FluNet national lab - a large lab with experienced workers. The provincial Tuscany health authorities sent the 10 samples that had tested positive to the ISS lab for confirmation.

2) Today the ISS lab which is a large WHO reference lab retested those 10 samples and got 8 negative results.

 

[alert]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

There is clearly something unusual going on here. I believe the other 2 (of the 10) cases reported are not asymptomatic; they are the second and thrid symptomatic cofnirmed cases in isolation. One of the above articles indicates there are no asymptomatic confirmed cases.

So what happened?

Was there simply contamination of PCR tests?

Or were these other cases infected with a different human coronavirus? And if so, is it a known one?

Hat-tip Helen Branswell for this link for exactly what caused the false positive tests in the 2003 case:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2095096/pdf/JIDMM17330.pdf

 

[Catbird]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

I have a lot of questions about this.

1. In one of the articles that Giuseppe posted yesterday, and in other media reports, the original number of positive tests was 12: "...''A dozen of close contacts tested positive for the virus, but are currently asymptomatic,'' said the 'Careggi' Hospital Infectious Diseases Department Chief." Later media reports then said it was 10. So what's the actual number? Are 2 of these 12 the original close contact cases that are currently hospitalized? That would leave 10 additional close contact cases, of which 8 have now supposedly tested negative. What is the status of the other 2 of 10?

2. What was the initial testing method? Some media reports referenced "swabs", which to me implies a nasopharyngeal swab. Then, according to media reports, these results were supposed to be confirmed by sero testing of blood samples. What are the odds that ALL of the swabs turned out to be false positives? This implies some kind of issue with the testing process and makes the use of swabs pretty questionable.

3. In the article I posted earlier, it says "..."has so far not confirmed any positive to the virus in asymptomatic patients reported and await the final analysis." What final analysis? Does that mean retesting? Or some further analysis of the samples?

4. Why is the Italian MoH so slow in making an official statement on this? Even one that acknowledges that there is confusion in the test results and what is being done to resolve it would go a long way toward clearing up the confusion.

 

[alert]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

Published Date: 2013-06-04 13:49:15
Subject: PRO/AH/EDR> MERS-CoV - Eastern Mediterranean (20): Italy, contact screening
Archive Number: 20130604.1754724

MERS-COV - EASTERN MEDITERRANEAN (20): ITALY, CONTACT SCREENING
***************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

Date: Tue 4 Jun 2013
From: Giovanni Rezza <giovanni.rezza@iss.it> [edited]


[Re: ProMED-mail MERS-CoV - Eastern Mediterranean (18): Italy, contact screening, RFI 20130603.1753321]
----------------------------------------------------------------------
With regard to rumours appeared on the press -- and published on ProMED -- about positivity for MERS-CoV among close contacts of confirmed cases detected in Florence, we would like to specify that the reference lab of Istituto Superiore di Sanita has not confirmed any of the samples from asymptomatic contacts of the cases.

Moreover, the virus has not been characterized yet. Thus, significant mutations in the viral genome that might explain changes in virulence on transmissibility cannot be confirmed as yet.

Clinical surveillance of close contacts contagiousness is ongoing.

--
Giovanni Rezza and Isabella Donatelli
Department of Infectious Diseases
Istituto Superiore di Sanita
Rome, Italy
<giovanni.rezza@iss.it>

[ProMED-mail would like to thank Drs Rezza and Donatelli for their rapid response to ProMED-mail posting MERS-CoV - Eastern Mediterranean (18): Italy, contact screening, RFI 20130603.1753321, requesting more information on the newswire reports mentioning positive tests for MERS-CoV among asymptomatic contacts of the 3 confirmed cases.

Our post did request further information, as the results were clearly indicating new findings that prior to these newswires had not been seen during the evolution of this emerging novel pathogen. We apologize for any misconceptions created by the prior post.

ProMED-mail awaits further results from continued investigations ongoing in Italy -- preferably from official sources in Italy. - Mod.MPP

 

[Nika]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

So - does that make it any clearer for anyone else? For me - not so much.

Were the reports yesterday rumors or press releases?

This is becoming more meta than it needs to be (all about the media process and nothing about the data, science, and medicine process).

 

[Giuseppe]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

There were not rumors at all!

The ten suspected cases were announced by the Chief of the Infectious Disease Department of Careggi Hospital in Florence and disseminated through ALL major media outlets in Italy notable the all news state-run channel RaiNews24 as reported in the cited sources sent do ProMed.

The above statement by Dr Rezza does not clarify nothing but add some substantial doutbs and questions, especially why the Chief of Hospital in Florence made a similar annoucement when not sure for the test results.

No Rumors! News from Public Television Channel!

 

[sharon sanders]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

The doctor in charge of infectious diseases at the large hospital where the original 3 confirmed cases are hospitalized gave an interview(s) saying 10(or 12?) additional people had tested positive for coronavirus.

His quotes were widely reported by all reliable Italian press. Then the world media picked this up and repeated his quotes. He is a reliable source who is currently involved in the coronavirus saga in Italy.

Test samples from the 10(or 12?) were then forwarded to the ISS lab which is a national lab and a WHO reference lab. Representatives of the ISS lab say above in a letter to ProMED that they have not tested any samples of the 10(or 12?) which have resulted in a positive result.

 

[Giuseppe]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

This is the rumor as appeared (and it appears currently on the site) on Italian Public Broadcasting Company all-news channel RaiNews24: http://www.rainews24.it/it/news.php?newsid=178492

<H1>Nuova Sars, una decina i positivi senza sintomi

"Sono una decina circa le persone risultate positive al test" per la Nuova Sars "ma completamente asintomatiche di cui abbiamo inviato i campioni all'Istituto Superiore di Sanita' per conferma" afferma il professor Alessandro Bartoloni, responsabile del reparto malattie infettive dell'Aou di Careggi

"Sono una decina circa le persone risultate positive al test" per la Nuova Sars "ma completamente asintomatiche di cui abbiamo inviato i campioni all'Istituto Superiore di Sanita' per conferma". Lo afferma il professor Alessandro Bartoloni, responsabile del reparto malattie infettive dell'Aou di Careggi.
"Le persone risultate positive al test - prosegue il professore - non sono state isolate e sono a casa perche' non presentano alcun sintomo. Continuiamo a prelevare campioni e ad esaminarli per capire fino a che punto il virus si e' diffuso". Il comportamento della Nuova Sars sembra aver colto di sorpresa gli esperti. "C'era la convinzione, secondo quanto indicato dall'Organizzazione Mondiale della Sanita' - prosegue l'infettivologo -, che il virus si trasmettesse poco e fosse piuttosto aggressivo. Quel che stiamo vedendo finora sembra essere, invece, esattamente il contrario. Lo schema si e' ribaltato".

I test vengono quindi condotti su persone che hanno avuto contatti con chi gia' risulta positivo, anche se non presenta alcun sintomo. "Oltre che a tutela delle persone - spiega il professor Bartoloni - questo studio ci servira' a capire quale e' la dimensione del fenomeno. L'interrogativo, a questo punto, e': il virus si e' modificato o e' un altro virus?".

</H1>

 

[tetano]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

Coronavirus, the three remaining cases, patients are doing well. The emergency is falling


General 20:24 today Regione Toscana audio body attachment article florenze Coronavirus, the three remaining cases, patients are doing well. The emergency is falling FLORENCE -' confirmed cases of coronavirus in Florence are and remain three. And patients are doing well. Some cases that yesterday at first seemed suspicious, they control today turned out to be negative. Clinical supervision put in place worked. Continue until all the people met with the three confirmed cases have not exceeded 10 days from first contact. We have recently concluded the crisis unit meeting with representatives of the Ministry and the National Institute of health to take stock of the situation of coronavirus, and the situation is much more reassuring than it appeared at first, although not yet concluded. The head of Luigi Marroni right to health held a press conference this afternoon, at the conclusion of the meeting in the Department between the crisis unit of the Tuscany region and representatives of the Ministry of health and the National Institute of health. With the Secretary, have made the situation Maria Grazia Pompa, Director of the infectious disease Bureau of the Ministry of health, and Gianni Rezza, Director of infectious diseases Department of the Istituto Superiore di Sanità.

So far have been guarded about 60 people, all those who came into contact with the three patients. The 8 cases that yesterday, at first screening done by the laboratory of Virology at the University of Florence were low positive results, are instead tested negative to a second control done by the Istituto Superiore di Sanità. Only one screening, explain the experts, is not considered sufficient, the protocols include two tests, made by two different laboratories. The ISS was done a second test, on different portions of the virus genome, which gave fail




http://www.firenzeonline.com/news/u...ti-stanno-bene-lemergenza-sta-rientrando.html

 

[Giuseppe]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

Are they saying politely that the first round of test were wrong?

That the algorithm used in the first instance was not proficient?

 

[Vibrant62]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

The recent study published in the Lancet that looked at the cases in France suggested that the incubation period may need to be increased to 9 - 12 days.

The post by IanM suggests that hospitalisation of the index case did not occur until 28th May, and at least half of the suspect cases that initially reported as positive were in healthcare workers (2 x doctors; 3 x nurses)

He was hospitalised on the 28th of May and is stable.

If the French data is correct, then any infected contacts may remain asymptomatic until @ the 5th to the 9th June.

In other words, additional testing over the coming days is going to be needed to conclusively rule these cases in or out, regardless of the data to date (false positives or otherwise).

 

[Giuseppe]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

WHO algorithm for NCoV PCR testing (full PDF: http://www.who.int/csr/disease/coronavirus_infections/LaboratoryTestingNovelCoronavirus_21Dec12.pdf )

 

[Vibrant62]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

I have a question: is there any evidence for recombination in coronaviruses?

The chances of a human dual infection e.g. with a common cold must be quite high...

 

[Vibrant62]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

:tiphat:BGW at FW

MERS-CoV coronavirus: should extend the quarantine period?
original link: http://www.ansa.it/web/notizie/spec...mismi-situazione-sotto-controllo_8817194.html

link to translated article: http://translate.google.com/transla...situazione-sotto-controllo_8817194.html&tl=en

[Google translated from French]

By Janlou Chaput, Futura-Sciences

A study based on two French patients infected with coronavirus MERS-CoV suggests that the incubation period of the virus could be longer than expected, and last 12 days instead of 9. This should encourage physicians to extend the quarantine periods. In parallel, the virus reaches a new country: Italy declares its first three cases in two days.

Snip

Provide three days of quarantine more?
The doctors are trying to learn more about the virus, as and when patients accumulate. French researchers have collaborated and recently published in The Lancet an inventory of information they could gather from the two patients found in France. This research provides new clues about the coronavirus and even suggests to increase the isolation time for those infected or suspected of being, because the incubation may be longer than expected.

Indeed, the first patient became ill after a trip to Dubai, before dying of his infection May 28 Hospitalized initially in Valenciennes, he shared his room between 27 and 29 April with another man then said the same symptoms , and in whom MERS-CoV was detected on May 7 The incubation period of the virus has lasted between 9 and 12 days, then we previously thought it did not exceed 9 days. Therefore caution in quarantine periods to observe.

Snip

 

[Giuseppe]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

The misconception arose around this incident for the Readers may be of hurt of credibility of the sources of the 'rumors' and the subsequent amplifyier such as FluTrackers.com.

But I think is one of our obligations to report from any reasonably reliable source the news about an emerging threat like MERS-CoV.

In addition, when a public broadcasting company disseminated the same information, how can we overlook them without do harm the confidence from our Readers?

These moments make the job of flu-seekers very disadvantageous.

 

[Treyfish]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

[SIZE=+0][SIZE=+0]Late to the party, but I see that it is all false positives now?:magnify:[/SIZE][/SIZE]

[SIZE=+0][SIZE=+0][/SIZE][/SIZE]

[SIZE=+0][SIZE=+0]New Sars, ten other cases in Florence: "Relief mobilized, ready to patients very serious"[/SIZE][/SIZE]

[SIZE=+0][SIZE=+0]But the authorities shall avoid alarmism: "Cast out all fear"[/SIZE][/SIZE]

[SIZE=+0][SIZE=+0]Video[/SIZE][/SIZE][SIZE=+0][SIZE=+0] Three outbreaks / Vd[/SIZE][/SIZE]
[SIZE=+0][SIZE=+0]Griffins, director of the emergency department of Careggi, "But I invite everyone to calm, there are no grounds for alarm '- [/SIZE][/SIZE][SIZE=+0][SIZE=+0]ILARIA Ulivelli[/SIZE][/SIZE]
[SIZE=+0][SIZE=+0]Florence, June 4, 2013[/SIZE][/SIZE]
[SIZE=+0][SIZE=+0] "prepared for any emergency. [SIZE=+0]For this reason, we start by saying one thing: [/SIZE][SIZE=+0][SIZE=+0]the alarm Sars[/SIZE][/SIZE][SIZE=+0][SIZE=+0] does not apply to everyone, but only those who have had prolonged contact with the people who are found to be infected and those who are now under observation. " [/SIZE][/SIZE][SIZE=+0][SIZE=+0]Stephen Griffin, director of the emergency room Careggi[/SIZE][/SIZE][SIZE=+0][SIZE=+0] , is clear and adamant [/SIZE][/SIZE][SIZE=+0][SIZE=+0]ward off ghosts[/SIZE][/SIZE][SIZE=+0][SIZE=+0] . [/SIZE][/SIZE][/SIZE][/SIZE]
[SIZE=+0][SIZE=+0][SIZE=+0][SIZE=+0]Immediately. [/SIZE][SIZE=+0]One of the first concerns in these situations, is widespread panic. [/SIZE][SIZE=+0]"We must dispel the fears first of all because the virus, to what the infectious disease have been observed so far, it manifests with characteristics similar to those of influenza: people who are sick are all good. [/SIZE][SIZE=+0]I'm still in hospital just to check the disappearance of the virus and to prevent any further risk of transmission... "[/SIZE][/SIZE]
:tiphat:http://www.lanazione.it/cronaca/2013/06/04/898934-firenze-paura-contagio-sars-allarme.shtml[/SIZE][/SIZE]
[SIZE=+0][SIZE=+0][/SIZE][/SIZE]
[SIZE=+0][SIZE=+0]
[/SIZE][/SIZE]

 

[Treyfish]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

SARS-like virus tests in Italy were false positives

<!-- /tab-gallery-area -->ROME: Eight people initially thought to have contracted a SARS-like virus in Italy tested negative on Tuesday after a second round of controls, according to Italy's Superior Health Institute (ISS).
An infectious diseases clinic in Florence on Monday said around 10 people had tested positive for the virus, but added that the results would have to be double checked at the Health Institute.
Those concerned had been tested because they had come into contact with a sick man who brought the disease back from Jordan, but they did not show any symptoms and had not been quarantined.
"There are no new clinical cases but surveillance of people who came into contact with the sick continue," said the head of the ISS's infectious disease clinic Gianni Rezza...:tiphat:http://www.channelnewsasia.com/news/world/sars-like-virus-tests-in-italy-were-fals/697996.html

 

[alert]

Re: Italy - 8 of 10 initially positive asymptomatic cases of new coronavirus test negative in 2nd round - waiting for Ministry of Health confirmation - June 3, 2013

It seems clear that the reports yesteray were not rumors, but in fact false positives.

It is VERY important though, that scientists determine the reason for hte false positive. Was Dr. Koopmans right and the doctors merely contaminated the PCR test? Is NCoV cross-reactive with OC43 in the same way SARS was? Or have they just accidentally discovered a novel seasonal human coronavirus?