Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 21, 19-25 May 2013
(?)
Novel Coronavirus (MERS-CoV) - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 23 May 2013
Epidemiological summary
The first described case of MERS-CoV infection was a 60-year-old male resident of Saudi Arabia who died of severe pneumonia complicated by renal failure in June 2012. A previously unknown coronavirus isolated from this patient was identified.
As of 23 May 2013, 44 laboratory confirmed cases have been reported by; Saudi Arabia (32), Jordan (two), Germany (two), United Kingdom (four), France (two) and Tunisia (two). Twenty two of these cases have died. All cases worldwide remain associated (including indirect association following secondary person-to-person transmission in the UK and France) with transmission in the Arabian Peninsula.The age of cases ranges from 24 to 94 years (age is unknown for four cases). Ten cases are female and 33 are male (gender is unknown for one case).
Since the beginning of May 2013, the Ministry of Health in Saudi Arabia has reported 22 cases including ten deaths. All cases were from the eastern provinces. The outbreak is primarily linked to a health care facility.
Two patients are healthcare workers who were exposed to patients with confirmed MERS-CoV.
On 21 May 2013 three cases were reported by the Ministry of Health of Tunisia. The probable index case, who died on 10 May 2013, was a 66-year-old man with underlying health conditions and a recent travel history to Qatar and Saudi Arabia. Infection with MERS-CoV was not confirmed.
The two laboratory confirmed cases, a 34-year-old man and a 35-year-old woman, who are siblings and children of the index case, both had mild respiratory illness and neither required hospitalisation. (These cases are not displayed on the map.)
(?)
ECDC assessment
The additional recent coronavirus cases reported by the Saudi Arabian authorities indicate an ongoing source of infection present in the Arabian Peninsula.
The first French case, described in week 20, ECDC CDTR, who presented with diarrhoea is a reminder of the possibility that presentations may not include respiratory symptoms initially, especially in those with immunosuppression or underlying chronic conditions. This needs be taken into account when revising case-finding strategies. The imported case in France is the second nosocomial transmission in Europe following one in the UK in February 2013, highlighting the risk of onward transmissions in Europe, in particular in healthcare settings. Both French patients had underlying conditions, and a degree of immunosuppression.
One of the transmissions in the UK was also to an immunosuppressed person. These underlying conditions may be increasing the vulnerability and the risk of transmission.
Information on many of the basic epidemiological indicators required for determining effective control measures are still missing for most cases that occurred in the Middle East, e.g. the reservoir of infection, risk groups, incubation period, period of infectivity and settings where infection has occurred.
The recent imported cases reported by Germany and France, following medical evacuation and travel, indicate that more imported cases may be expected in the EU in the immediate future.
Due to the large number of guest workers in Saudi Arabia attention must also be drawn to the possible importation of MERS-CoV to the South East and Pacific Asia.
Actions
ECDC published an updated rapid risk assessment on 17 May 2013 and an epidemiological update on 23 May 2013. The results of an ECDC-coordinated survey on laboratory capacity for testing the novel coronavirus in Europe were published in EuroSurveillance.
ECDC is closely monitoring the situation in collaboration with WHO and the European Union Member States.
(?)
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COMMUNICABLE DISEASE THREATS REPORT
Week 21, 19-25 May 2013
(?)
Novel Coronavirus (MERS-CoV) - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 23 May 2013
Epidemiological summary
The first described case of MERS-CoV infection was a 60-year-old male resident of Saudi Arabia who died of severe pneumonia complicated by renal failure in June 2012. A previously unknown coronavirus isolated from this patient was identified.
As of 23 May 2013, 44 laboratory confirmed cases have been reported by; Saudi Arabia (32), Jordan (two), Germany (two), United Kingdom (four), France (two) and Tunisia (two). Twenty two of these cases have died. All cases worldwide remain associated (including indirect association following secondary person-to-person transmission in the UK and France) with transmission in the Arabian Peninsula.The age of cases ranges from 24 to 94 years (age is unknown for four cases). Ten cases are female and 33 are male (gender is unknown for one case).
Since the beginning of May 2013, the Ministry of Health in Saudi Arabia has reported 22 cases including ten deaths. All cases were from the eastern provinces. The outbreak is primarily linked to a health care facility.
Two patients are healthcare workers who were exposed to patients with confirmed MERS-CoV.
On 21 May 2013 three cases were reported by the Ministry of Health of Tunisia. The probable index case, who died on 10 May 2013, was a 66-year-old man with underlying health conditions and a recent travel history to Qatar and Saudi Arabia. Infection with MERS-CoV was not confirmed.
The two laboratory confirmed cases, a 34-year-old man and a 35-year-old woman, who are siblings and children of the index case, both had mild respiratory illness and neither required hospitalisation. (These cases are not displayed on the map.)
(?)
ECDC assessment
The additional recent coronavirus cases reported by the Saudi Arabian authorities indicate an ongoing source of infection present in the Arabian Peninsula.
The first French case, described in week 20, ECDC CDTR, who presented with diarrhoea is a reminder of the possibility that presentations may not include respiratory symptoms initially, especially in those with immunosuppression or underlying chronic conditions. This needs be taken into account when revising case-finding strategies. The imported case in France is the second nosocomial transmission in Europe following one in the UK in February 2013, highlighting the risk of onward transmissions in Europe, in particular in healthcare settings. Both French patients had underlying conditions, and a degree of immunosuppression.
One of the transmissions in the UK was also to an immunosuppressed person. These underlying conditions may be increasing the vulnerability and the risk of transmission.
Information on many of the basic epidemiological indicators required for determining effective control measures are still missing for most cases that occurred in the Middle East, e.g. the reservoir of infection, risk groups, incubation period, period of infectivity and settings where infection has occurred.
The recent imported cases reported by Germany and France, following medical evacuation and travel, indicate that more imported cases may be expected in the EU in the immediate future.
Due to the large number of guest workers in Saudi Arabia attention must also be drawn to the possible importation of MERS-CoV to the South East and Pacific Asia.
Actions
ECDC published an updated rapid risk assessment on 17 May 2013 and an epidemiological update on 23 May 2013. The results of an ECDC-coordinated survey on laboratory capacity for testing the novel coronavirus in Europe were published in EuroSurveillance.
ECDC is closely monitoring the situation in collaboration with WHO and the European Union Member States.
(?)
-
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