Giuseppe
Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 9, 24 February-2 March 2013
(?)
Novel Coronavirus - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 15 February 2013
Epidemiological summary
The first case confirmed with the novel coronavirus was reported in a 60-year-old male resident of Saudi Arabia who died from severe pneumonia complicated by renal failure in Jeddah on 24 June 2012. The genome of the new coronavirus was isolated from this case, sequenced and the genetic code put in the public domain.
In September 2012, a second case, a 49-year-old male living in Qatar, presented with similar symptoms and was transferred for care in Europe. A virus was isolated from this case, which was almost identical to the virus from the case in Saudi Arabia.
In November 2012, additional cases with similar symptomatology were diagnosed in Qatar and Saudi Arabia, including a family cluster of three confirmed cases and one probable case.
Subsequently, two fatal cases were confirmed retrospectively in Jordan from within a cluster of 11 people with severe lower respiratory infections that were associated with a hospital in April 2012.
On 11 February 2013, the UK Health Protection Agency (HPA) published details of a male UK resident with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on 24 January 2013 and had arrived unwell in the UK on 28 January 2013. His condition deteriorated and he was admitted to hospital where he is in intensive care.
On 6 February 2013, a male household member who had contact with the patient from his arrival in the UK until hospital admission fell unwell. This patient had an existing medical condition that may have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital, where he subsequently died.
The third confirmed case is a younger female family member, who only had exposure to the original index case while he was in hospital. She became ill on 5 February 2013 with a typical flu-like illness, which did not require hospital admission and from which she has now fully recovered.
Unlike the source case, neither of these two contacts have travelled abroad recently. HPA is actively investigating the possible route of infection. Infection control measures around the three cases are following national UK guidance not detected any additional confirmed secondary cases by 18 February 2013.
The Ministry of Health in Saudi Arabia has reported another confirmed case of infection with the novel coronavirus. The patient was hospitalised on 29 January 2013 and died on 10 February 2013. The case was laboratory-confirmed on 18 February 2013.
Further investigation into this case is ongoing.
This brings the number of laboratory-confirmed cases of NCoV infections to thirteen globally, of which seven cases were fatal.
(?)
ECDC assessment
Research on the complete genome sequence of HCoV-EMC/2012 has characterised the virus as a new genotype that is closely related to bat coronaviruses that are distinct from SARS-CoV. The routes of transmission to humans have not yet been determined. This is a common problem with emerging zoonoses where there is often simultaneous possibilities including environmental, animal and human exposures.
The recent three cases detected in the UK have changed the assessment of the situation regarding this novel coronavirus. The fact that an infection has come to Europe on a commercial flight and then resulted in two probable human-to-human transmission episodes has increased the threat, although the cluster has been restricted to one family.
There are now two instances of documented human-to-human transmission within the recent UK cluster. However, it is important to quantify infectivity and there is also evidence suggesting low infectivity at a population level.
In Germany and the UK, follow-up of nearly 200 personal contacts and healthcare workers exposed to the first two imported confirmed cases has been completed and did not find evidence of human-to-human transmission.
The appearance of a milder secondary case might indicate that that milder cases could be present and potentially spread the infection but be missed in case-finding. This highlights the need for further work to document the spectrum of illness.
Actions
In light of the human-to-human transmission of the NCoV within the family cluster in the UK, ECDC has updated its rapid risk assessment, previously published on 7 December 2012.
The results of a survey to determine the laboratory capacity for testing for the novel coronavirus in Europe, conducted by ECDC in coordination with WHO Regional Office for Europe, was published recently in EuroSurveillance.
HPA has identified 100 people who had close contact with the cases in the family cluster and they were followed up.
To date all tests have been negative.
HPA has informed all countries whose residents may have been contacts of the index case during the flight from Jeddah to Heathrow (within 2 rows).
ECDC continues to closely monitor this event.
(?)
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COMMUNICABLE DISEASE THREATS REPORT
Week 9, 24 February-2 March 2013
(?)
Novel Coronavirus - Multistate - Severe respiratory syndrome
Opening date: 24 September 2012 Latest update: 15 February 2013
Epidemiological summary
The first case confirmed with the novel coronavirus was reported in a 60-year-old male resident of Saudi Arabia who died from severe pneumonia complicated by renal failure in Jeddah on 24 June 2012. The genome of the new coronavirus was isolated from this case, sequenced and the genetic code put in the public domain.
In September 2012, a second case, a 49-year-old male living in Qatar, presented with similar symptoms and was transferred for care in Europe. A virus was isolated from this case, which was almost identical to the virus from the case in Saudi Arabia.
In November 2012, additional cases with similar symptomatology were diagnosed in Qatar and Saudi Arabia, including a family cluster of three confirmed cases and one probable case.
Subsequently, two fatal cases were confirmed retrospectively in Jordan from within a cluster of 11 people with severe lower respiratory infections that were associated with a hospital in April 2012.
On 11 February 2013, the UK Health Protection Agency (HPA) published details of a male UK resident with confirmed novel coronavirus infection who had travelled to Pakistan and the Middle East, developed respiratory symptoms on 24 January 2013 and had arrived unwell in the UK on 28 January 2013. His condition deteriorated and he was admitted to hospital where he is in intensive care.
On 6 February 2013, a male household member who had contact with the patient from his arrival in the UK until hospital admission fell unwell. This patient had an existing medical condition that may have made him more susceptible to a severe respiratory infection. His respiratory condition deteriorated and he was admitted to hospital, where he subsequently died.
The third confirmed case is a younger female family member, who only had exposure to the original index case while he was in hospital. She became ill on 5 February 2013 with a typical flu-like illness, which did not require hospital admission and from which she has now fully recovered.
Unlike the source case, neither of these two contacts have travelled abroad recently. HPA is actively investigating the possible route of infection. Infection control measures around the three cases are following national UK guidance not detected any additional confirmed secondary cases by 18 February 2013.
The Ministry of Health in Saudi Arabia has reported another confirmed case of infection with the novel coronavirus. The patient was hospitalised on 29 January 2013 and died on 10 February 2013. The case was laboratory-confirmed on 18 February 2013.
Further investigation into this case is ongoing.
This brings the number of laboratory-confirmed cases of NCoV infections to thirteen globally, of which seven cases were fatal.
(?)
ECDC assessment
Research on the complete genome sequence of HCoV-EMC/2012 has characterised the virus as a new genotype that is closely related to bat coronaviruses that are distinct from SARS-CoV. The routes of transmission to humans have not yet been determined. This is a common problem with emerging zoonoses where there is often simultaneous possibilities including environmental, animal and human exposures.
The recent three cases detected in the UK have changed the assessment of the situation regarding this novel coronavirus. The fact that an infection has come to Europe on a commercial flight and then resulted in two probable human-to-human transmission episodes has increased the threat, although the cluster has been restricted to one family.
There are now two instances of documented human-to-human transmission within the recent UK cluster. However, it is important to quantify infectivity and there is also evidence suggesting low infectivity at a population level.
In Germany and the UK, follow-up of nearly 200 personal contacts and healthcare workers exposed to the first two imported confirmed cases has been completed and did not find evidence of human-to-human transmission.
The appearance of a milder secondary case might indicate that that milder cases could be present and potentially spread the infection but be missed in case-finding. This highlights the need for further work to document the spectrum of illness.
Actions
In light of the human-to-human transmission of the NCoV within the family cluster in the UK, ECDC has updated its rapid risk assessment, previously published on 7 December 2012.
The results of a survey to determine the laboratory capacity for testing for the novel coronavirus in Europe, conducted by ECDC in coordination with WHO Regional Office for Europe, was published recently in EuroSurveillance.
HPA has identified 100 people who had close contact with the cases in the family cluster and they were followed up.
To date all tests have been negative.
HPA has informed all countries whose residents may have been contacts of the index case during the flight from Jeddah to Heathrow (within 2 rows).
ECDC continues to closely monitor this event.
(?)
-
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