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

Re: Ten positive cases of 'new coronavirus' in Italy

Re: Ten positive cases of 'new coronavirus' in Italy

Source: La Stampa, full text in Italian: http://www.lastampa.it/2013/06/03/i...za-sintomi-urVEjt40bOnIcV5Rn3BBNP/pagina.html
Novel Coronavirus, a dozen of close contacts of first patient tested positive for the virus, currently asymptomatic

June 3 2013


The three hospitalized patients are in good condition.



''A dozen of close contacts tested positive for the virus, but are currently asymptomatic,'' said the 'Careggi' Hospital Infectious Diseases Department Chief.

(...)


-
-----
 
Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

If independently confirmed, these cases would represent one of the biggest human cluster of MERS-CoV infections detected since the discovery of the virus in the early 2012.

Also, the first confirmed imported case may be a feared 'super-spreader', like those seen during 2003 SARS outbreak.

Clearly, more details are eagerly awaited around the clinical course of these cases in the coming days.

GM
 
Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

The number of cases of suspected New Sars in Florence. ' I'm a dozen about people found to test positive ' explains professor Bartoloni, head of the Department of infectious diseases hospital of Careggi is completely asymptomatic but we have sent the samples to the National Institute of health to confirm. 'People found to be HIV-positive on the Professor-were not isolated and they are at home because they do not have any symptoms. We continue to take samples and examine them to determine how far the virus has spread. The behavior of the new Sars seems to have caught by surprise the experts. ' There was a conviction, according to the World Health Organization-20-fold continues-, that the virus is transmitted and is rather aggressive. What we're seeing so far seems to be, instead, just the opposite. The pattern has reversed.



http://firenze.repubblica.it/cronac...vi_i_risultati_dei_test-60296391/?ref=HREC1-2
 
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Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

communicated by TUSCANY REGION

CORONAVIRUS, samples SENT to the ISS to CONFIRM Any POSITIVE Coronavirus, the contacts of the three hospitalized cases were identified by the public health service of Asl in Florence, and then checked at the Hospital of Careggi samples are now at the Istituto Superiore di Sanità, for confirmation of a possible positive coronavirus. Meanwhile, the three patients (two at Careggi and Meyer) are in good condition. The crisis unit set up last Friday, constantly monitors the clinical and epidemiological situation. And tomorrow's technicians will be in Florence of the Ministry and the National Institute of health, to meet with fellow Tuscans. The clinical situation. The three patients – the index case and the woman who has had working contacts with him, both at Careggi, and granddaughter, Meyer – are in good condition and the symptoms that arise, however in quick mitigation, are not worrisome. The epidemiological situation. You are making all the necessary controls to check the spread of the virus. Starting from the three hospitalized cases, the Department of prevention of Florence, in agreement with the hospital wards for infectious diseases, sent to the laboratory of Virology at the University of Florence the swabs all subjects who have had close contact with the index case and with family members of the other two cases. The samples were sent to the National Institute of health to confirm any positive. The crisis unit. Already active since Friday 31 May, consists of technicians to the right to health, of two companies-University Hospital of Careggi and Meyer and 10 health company in Florence. Met this morning to review all data currently available and monitor both the clinical and epidemiological situation. According to the Istituto Superiore di Sanità, the Tuscan crisis unit is trying to study the behavior of the virus. 'We will expand the number of checks – say the crisis unit technicians – but so far we have verified that the virus is not particularly aggressive and does not involve serious symptoms, presenting a clinical symptoms of rapid resolution'. Tomorrow afternoon is expected in Florence a crisis unit meeting with the technicians of the Ministry and the ISS. the region will issue a daily bulletin, to give a constant update on

http://met.provincia.fi.it/cnews.aspx?n=146433
 
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Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

Machine translation:

"New Sars ten more cases
positive test, no symptoms

It is people who have come into contact with infected patients: they are at home

FLORENCE - Ten people on a dozen or so, subject to the buffer on the new Sars virus were positive. All people who had been in contact with the three patients who tested positive to the virus. To give the results of the analysis is Professor Alessandro Bartoloni, head of infectious diseases at the AOU Careggi, "I'm about a dozen people tested positive." But the special feature of these cases is that they are "completely asymptomatic." Samples collected through buffer on people who have had contact with the three patients with SARS were sent "Istituto Superiore di Sanit? to confirm a possible positivity. " "People with positive screening results - continues the professor - have not been isolated and are at home. We continue to take samples and examine them to see how far the virus has spread. "

The behavior of New SARS seems to have surprised the experts. "There was a belief, as indicated by the World Health Organization - continues the infectious disease - that the virus was transmitted recently and was quite aggressive. What we're seeing so far seems to be, however, just the opposite. The pattern is reversed. " The tests are then conducted on people who have had contact with someone who already is positive, although it does not present any symptoms. "In addition to the protection of persons - says Professor Bartoloni - this study will help us to understand what is the size of the phenomenon. The question at this point is: the virus has changed or is another virus? ?..."


xhttp://corrierefiorentino.corriere.it/firenze/notizie/cronaca/2013/3-giugno-2013/nuova-sars-si-attendono-risultati-tamponi-venticinque-persone-2221464294295.shtml
 
Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Wow. This might explain a lot. A dozen asymptomatic cases here would explain the sporadic nature of the severe cases, and drastically lower our estimates of the CFR of this virus. It would also explain why so many of the severe cases in Saudi Arabia are older and have so many pre-existing conditions; the virus is only detected when it reaches an individual in which it can cause severe disease. The few dozen confirmed cases so far might be only the most severe out of thousands of milder infections.

This finding gives new support to the remote possibiltiy that NCoV is NOT a zoonosis, but rather a circulating human pathogen, with a CFR closer to that of OC43 than to SARS.

Also, I hope the Italian authorities are sure that these people are indeed infected with NCoV and not OC43, as there is some potential for tests to be cross-reactive.
 
Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Remind that previous imported cases in Germany and France failed to spread the virus to unprotected close contacts, so that the virus must have undergone some changes or it is belonging to another lineage, with a different pattern of spread.

It is not clear at this joint what kind of test has been performed on these patients, if a throat swab or sputum analyzed through PCR or whether other technique were employed.

If the PRCs were positive the virus is replicating in these people, so that the clinical course may be only at the early stages.
 
Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

Catbird said:
Machine translation:


The behavior of New SARS seems to have surprised the experts. "There was a belief, as indicated by the World Health Organization - continues the infectious disease - that the virus was transmitted recently and was quite aggressive. What we're seeing so far seems to be, however, just the opposite. The pattern is reversed. " The tests are then conducted on people who have had contact with someone who already is positive, although it does not present any symptoms.


xhttp://corrierefiorentino.corriere.it/firenze/notizie/cronaca/2013/3-giugno-2013/nuova-sars-si-attendono-risultati-tamponi-venticinque-persone-2221464294295.shtml
Click to expand...

Gregory Hartl, a spokesperson for the WHO, "The outbreaks that we're seeing now would not likely be overlooked even if a country weren't looking very hard."

Finding 10 asymptomatic cases to a confirmed case does not change the striking presentation seen with outbreaks. Granted, the outbreaks with current demographics may not demonstrate the "general population" - but the disease DOES affect A population AND will be a large burden on THAT population if this virus becomes more easily transmissible.

The only difference between you and someone with co-morbidities or advanced age is time.

*** Please do not disregard this disease if it presents mildly for many, but not for others. ***
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

I think the head of the infectious department of the 'Careggi' hospital in Florence raised the suspicion that perhaps the virus has changed or belongs to another lineage at all since it has not demonstrated the properties seen so far in all other sporadic cases in EU and elsewhere, ie all cases presented with a mild- self-limiting disease.

It is early to say Beyond the scarce details about the kind of test battery used and the possible surge in viral load in these - for now asymptomatic - patients.
 
Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive cases of new coronavirus - June 3, 2013

Giuseppe Michieli said:
Remind that previous imported cases in Germany and France failed to spread the virus to unprotected close contacts, so that the virus must have undergone some changes or it is belonging to another lineage, with a different pattern of spread.

It is not clear at this joint what kind of test has been performed on these patients, if a throat swab or sputum analyzed through PCR or whether other technique were employed.

If the PRCs were positive the virus is replicating in these people, so that the clinical course may be only at the early stages.
Click to expand...


I'm also curious about the testing methods. The article posted by tetano above mentions swabs, but this early info may be incomplete. Hopefully, more details will be released soon, and confirmed by the MoH.


...Starting from the three hospitalized cases, the Department of prevention of Florence, in agreement with the hospital wards for infectious diseases, sent to the laboratory of Virology at the University of Florence the swabs all subjects who have had close contact with the index case and with family members of the other two cases.
Click to expand...
 
Re: Ten positive cases of new coronavirus in Italy

Re: Ten positive cases of new coronavirus in Italy

curiosity said:
Gregory Hartl, a spokesperson for the WHO, "The outbreaks that we're seeing now would not likely be overlooked even if a country weren't looking very hard."

Finding 10 asymptomatic cases to a confirmed case does not change the striking presentation seen with outbreaks. Granted, the outbreaks with current demographics may not demonstrate the "general population" - but the disease DOES affect A population AND will be a large burden on THAT population if this virus becomes more easily transmissible.

The only difference between you and someone with co-morbidities or advanced age is time.

*** Please do not disregard this disease if it presents mildly for many, but not for others. ***
Click to expand...

And that is the lesson from the 2009 H1N1 pandemic.

But, in the remote chance NCoV does have this characteristic, it would change the measures used to treat and contain it. There's not much point in quarantining healthy contacts of NCoV cases if there are thousands of infectious asymptomatic humans spreading the virus silently. I believe the human coronavirus OC43 has this behavior; in most people it produces only mild symptoms, but in 2003 it got into a nursing home and killed about 12 people:

http://www.who.int/csr/don/2003_08_25a/en/index.html

We don't yet know that this is the case (and everything in the past year argues against it!) but we cannot rule this out.
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

It has passed only few week after the French cases. They had surely tested some of the close contacts and HCWs. No further cases has been found.

So, or the virus changed dramatically, or there's a superspreader or the virus belongs to another lineage and finally Italian labs performed wrongly tests...
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

This is exactly like that August 2003 "SARS" OC43 outbreak in British Columbia linked above; the presentation is too mild, the epidemiology is not consistent, but the laboratory results are coming back positive. And we are asking the same questions:

- Did the virus mutate?

- Did we just discover yet another previously unknown coronavirus?

- Does everything we thought we knew about the old SARS virus (NCoV this time) go out the window?

- Or is this just a laboratory error?

For a week in 2003, the world asked themselves these questions over and over, until the answer was ultimately determined to be the latter case: a laboratory error.

We will see what the explanation is this time.
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

The clinical course of the 3rd patient - a female coworker of the index case - is even more disturbing:

According the daily newpaper La Repubblica (in Italian, http://firenze.repubblica.it/cronac...vi_i_risultati_dei_test-60296391/?ref=HRER1-1 ):

''[the woman] might be discharged later this day or early Tomorrow. Her conditions are good and she does not need longer hospital care, according her doctors.''

I wonder whether her PCRs turned negative so early in the course of illness. Other reported cases elsewhere had a prolonged and high viral load.

The situation is very concerning.
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

More confusion:

http://www.lanazione.it/firenze/cronaca/2013/06/03/898325-nuova-sars-due-casi.shtml

Florence, June 3, 2013 - WAS A LONG TIME that the laboratories of the department of infectious diseases of the AOU Careggi were ready to face the new Sars, explains Alessandro Bartoloni, head of the department of infectious and tropical diseases hospital in Florence.
"The international epidemiological alert was triggered more than a year ago, in April of 2012, just from Jordan. We were so ready for a long time for this virus. When he arrived at the hospital the first patient, who had just returned from Jordan, and with all the symptoms, we immediately submitted to the buffer, and we have identified the coronavirus. "
Dr. Bartoloni, therefore patients are doing well.
"Yes Are hospitalized and under observation as a precaution.
When the virus will be negative, they can return home, but we have concerns. "
From 14 months talking about this virus, but it has never been isolated in Italy. It means that in all this time there has never been?
"No, it does not. It 'a less severe than the SARS virus in 2003, which had caused so many deaths. These three cases Florentines, the only Italian for now, they are most likely just the tiny tip of the iceberg of a much broader diffusion that occurs in our country for a long time. But in the past never gave symptoms giving rise to further verification and lead to the identification and isolation of coronavirus. "
The symptoms are not so obvious?
"It comes with high fever, cold, cough strong. Symptoms that are very similar to many non-specific viral infections that throughout the winter but also in recent weeks have hit a large part of the population. For this reason, specific controls on the coronavirus were conducted only in very close contact of the three patients, who have spent a lot of time with them. "
Who are the people who have been screened?
"There are about 50 individuals between the families of three patients and between two adults of the common colleagues. Together with them we did also checks on doctors, nurses and practitioners who provided first aid. We talked to everyone and made the pad only to those who had symptoms of cough or cooling. "
What is this analysis?
"This is a withdrawal from the nose and throat with a stick like a cotton swab, not painful, just annoying."
How long does it take to get the results that you have made in the afternoon?
"If the session has been corrected and the machines worked without problems, the results are expected within a few hours. Even just half a day. "
Are you worried? And there is concern among the population?
"No, for now the situation is not alarming, but we await the data analysis. Who has been in contact with patients, he knows he can call for any symptom. There is however no alarm among the people: a few have turned to the emergency room for fear of having contracted the New Sars, but it was explained to them that there is no danger for those who are not from those countries or not contact with infected people. "
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

It is 10:21 pm in Italy. I am not sure what else we will discover tonight. We might have to wait until the morning for any more news.
 
Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

Re: Italy - 10 - 12 positive asymptomatic cases of new coronavirus - June 3, 2013

alert said:
We talked to everyone and made the pad only to those who had symptoms of cough or cooling. "
Click to expand...

We are told that all cases are asymptomatic, but this contradicts the statement quoted


In the french cases:
"The timing of transmission to a second patient in the same hospital room provided an estimated incubation time of between 9 and 12 days, based on exposure to the first patient"

Isn' t too early to say that contacts are well?
 
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

04 Jun 2013 4:44 AM

10 test positive for SARS-like virus in Italy: report

Around 10 people in Italy have tested positive for a SARS-like virus but have presented no symptoms and have not been quarantined, an infectious diseases specialist told the ANSA news agency on Monday

ROME: Around 10 people in Italy have tested positive for a SARS-like virus but have presented no symptoms and have not been quarantined, an infectious diseases specialist told the ANSA news agency on Monday.

"They have not been isolated because they are not presenting with any symptoms," Alessandro Bartoloni of the Infectious Diseases clinic at Careggi hospital in Florence was quoted as saying.

Samples of their blood have been sent to the Superior Health Institute in Rome for confirmation, he added.

More: Channel News Asia
 
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