Re: Saudi Arabia, Qatar: 6 confirmed cases (2 fatal) due to novel animal coronavirus
Re: Saudi Arabia, Qatar: 6 confirmed cases (2 fatal) due to novel animal coronavirus
Published Date: 2012-11-23 13:33:48
Subject: PRO/AH/EDR> Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster
Archive Number: 20121123.1421664
NOVEL CORONAVIRUS - SAUDI ARABIA (18): WHO, NEW CASES, FAMILY CLUSTER, FATALITY
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In this report:[1] Saudi Arabia - new cases, family cluster, WHO[2] Qatar - new case confirmed[3] Saudi Arabia - 2nd fatality******[1] Saudi Arabia - family cluster, WHODate: 23 Nov 2012
Source: WHO GAR reports
http://www.who.int/csr/don/2012_11_23/en/index.html
Novel coronavirus infection - update 23 Nov 2012
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WHO has been notified of 4 additional cases, including one death, due to infection with the novel coronavirus. The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case). This brings the total of laboratory confirmed cases to 6.
Investigations are ongoing in areas of epidemiology, clinical management, and virology, to look into the likely source of infection, the route of exposure, and the possibility of human-to-human transmission of the virus. Close contacts of the recently confirmed cases are being identified and followed-up.
So far, only the 2 most recently confirmed cases in Saudi Arabia are epidemiologically linked - they are from the same family, living in the same household. Preliminary investigations indicate that these 2 cases presented with similar symptoms of illness. One died and the other recovered.
Additionally, 2 other members of this family presented with similar symptoms of illness, where one died and the other is recovering. Laboratory results of the fatal case is pending, while the case that is recovering tested negative for the novel coronavirus.
WHO continues to work with the governments of Saudi Arabia, Qatar and other international health partners to gain a better understanding of the novel coronavirus and the disease in humans. Further epidemiological and scientific studies are needed to better understand the virus.
WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and is currently reviewing the case definition and other guidance related to the novel coronavirus. Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the 2 countries which have identified cases. Member States should consider testing of patients with unexplained pneumonias for the new coronavirus even in the absence of travel or other associations with the 2 affected countries. In addition, any clusters of SARI or SARI in health care workers should be thoroughly investigated regardless of where in the world they occur.
Of the 6 laboratory confirmed cases reported to WHO, 4 cases (including 2 deaths) are from Saudi Arabia and 2 cases are from Qatar.
[Links on WHO report page:
More information on coronavirus infections:
http://www.who.int/csr/disease/coronavirus_infections/en/index.html
Outbreak news on coronavirus infections:
http://www.who.int/csr/don/archive/disease/coronavirus_infections/en/index.html
Case definition for case finding severe respiratory disease associated with novel coronavirus:
http://www.who.int/csr/disease/coronavirus_infections/case_definition/en/index.html
Information regarding requirements and recommendations for the Hajj season in 2012
http://www.who.int/ith/updates/20120730/en/index.html
Testing protocol and reagents:
http://www.virology-bonn.de/index.php?id=40]
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[2] Qatar - new case confirmed
Date: 23 Nov 2012
Source: Seattle Times
http://seattletimes.com/html/health/2019745169_apeugermanynewvirus.html
German lab: Qatar man suffered from new virus
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A patient from Qatar has been confirmed with a new type of coronavirus, but it has shown no signs of being easily transmitted like the related virus that caused the 2003 global SARS outbreak, Germany's national health institute said Friday [23 Nov 2012].
As a precaution, the World Health Organization advised medical authorities around the world to test any patients with unexplained pneumonias for the virus. Previously, the organization had only advised testing patients who had been to either Qatar or Saudi Arabia - the 2 countries will all 6 reported [confirmed] cases.
"Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the 2 countries which have identified cases," the WHO said.
Germany's Robert Koch Institute said the patient fell ill in Qatar in October [2012] with severe respiratory problems. He was then brought to Germany for treatment in a specialty clinic and recovered after a month and was released this week [week of 19 Nov 2012].
Britain's Health Protection Agency confirmed based on samples that were sent from Qatar that he was sickened by a new coronavirus, the Koch Institute said.
The World Health Organization said of the 6 confirmed cases of the virus - 4 were from Saudi Arabia, including 2 deaths, and 2 from Qatar.
Unlike SARS, the Koch institute says there is no evidence of human-to-human transmission in the patient treated in Germany.
"The Robert Koch Institute's assessment of the risk remains that the possibility of becoming infected in Germany is very low," the institute said.
Still, WHO reported a cluster of cases in a family in Saudi Arabia, where one person died and the other recovered. Two other members of the same family fell ill with similar symptoms.
One person who recovered from the illness tested negative while lab results are pending for the other family member, who died. Health officials always keep a close eye on any clusters of unusual viruses within families, since they may suggest the possibility of human-to-human spread.
About 8500 people were affected by SARS, or Severe Acute Respiratory Syndrome, in 2003 and about 900 died.
The WHO said it was continuing to work with the governments of Saudi Arabia, Qatar and other international health partners to gain a better understanding of the virus.
"Further epidemiological and scientific studies are needed to better understand the virus," the organization said.
[Byline: David Rising]
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[3] Saudi Arabia - 2nd fatality
Date: 23 Nov 2012
Source: BBC [edited]
http://www.bbc.co.uk/news/health-20468478
Second coronavirus death reported
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A 2nd person has died from a new respiratory illness similar to the Sars virus, according to the World Health Organization.
The WHO said 3 fresh cases had also been reported bringing the total to 6.
All are linked to either Saudi Arabia or Qatar. However, one man has been transferred to the UK for treatment.
Doctors say the virus does not appear to readily spread from person to person.
Both reported deaths were in Saudi Arabia.
Coronaviruses are a group of viruses ranging from the common cold to the SARS (severe acute respiratory syndrome) virus. They infect a wide range of animals.
In 2002 [and 2003] an outbreak of the SARS coronavirus killed about 800 people after it spread from Hong Kong to more than 30 countries around the world.
The WHO is still trying to work our where the infection came from. Studies show that the virus it is closely related to one found in some species of bats.
It said in a statement: "Until more information is available, it is prudent to consider that the virus is likely more widely distributed than just the 2 countries which have identified cases."
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[To summarize what appears to be going on right now is that there are now 6 cases of illness with the novel coronavirus [nCoV] confirmed and reported to WHO. Of these 6 cases, 4 have occurred in Saudi Arabian citizens and 2 have occurred in Qatari citizens. ProMED-mail has reported on 4 of these cases in prior reports -- 3 in Saudi Arabian citizens and 1 in a Qatari citizen (see prior ProMED-mail reports Novel coronavirus - Saudi Arabia (17): 4th case, RFI 20121121.1418018, Novel coronavirus - Saudi Arabia (15): new case 20121104.1391285, Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar 20120923.1305982, Novel coronavirus - Saudi Arabia (02): additional cases, RFI 20120923.1305931, Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733). Of these 6 cases, 2 had fatal outcomes (the 1st reported case mentioned in ProMED-mail archive 20120920.1302733, and one of the newly reported cases in the above reports of this update). In addition, the WHO report mentions that 2 of the newly confirmed cases were epidemiologically linked as family members (one case recovered and one fatality), and that there were 2 additional family members with similar clinical presentations of whom one was found negative for the nCoV while the other (a fatality) was still pending laboratory results.
Information on the full clinical presentations of cases has only been available for the 1st 2 cases reported in September 2012 -- severe pneumonia with renal failure. Detailed clinical information on the more recent cases reported this month (November 2012) are not as yet available. At present it appears as though "severe acute respiratory infections (SARI)" is the operative clinical description that should lead clinicians to obtain specimens for testing for infection with this nCoV.
The presence of cases in the same family can either be a sign of human to human transmission or could be related to exposure of the family members to the same common source such as farm animals or bat excreta or other bat bodily fluids (the nCoV is genetically related to known bat CoVs (coronaviruses)). To date, it does appear as though this new nCoV is not easily transmitted from human to human (the absence of prior secondary cases in close contacts at home, in the community and among healthcare workers caring for the cases). If human to human transmission is identified in the above mentioned family cluster, one wonders if there would be a similar situation as had been seen with the SARS CoV where there were some individuals who were responsible for "super spreading events" and were responsible for infecting many other individuals, while the majority of individuals were not. (see the Consensus document on the epidemiology of severe acute respiratory syndrome (SARS) available at:
http://www.who.int/csr/sars/en/WHOconsensus.pdf). Early attention to universal precautions including respiratory secretions and bodily fluids should prevent these superspreading events from occurring in the healthcare environment where nosocomial transmission is always a concern.
The decision to increase heightened surveillance for SARI related to infection with this nCoV worldwide, irrespective of known travel history or known contact with travelers is a prudent decision. As there are more questions than answers about the epidemiology and transmission of this nCoV, the possibility of having had more "silent" spread with less severe clinical presentations separating the chain of identifiable transmission between infected individuals needs to be considered early on in the investigations related to this novel new agent. Epidemiologically there has been a major population movement through this region recently. This moderator also wonders if specimens were available to retrospectively test for this nCoV infection in the cluster of SARI cases reported in a hospital based outbreak in Jordan in April 2012 mentioned in the prior ProMED-mail report Novel coronavirus - Saudi Arabia (04): RFI, Jordan, April 2012 20120925.1308001.
We await further information on the results of laboratory and epidemiologic investigations as well as clinical presentations of the confirmed cases.
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