Saturday, November 16, 2013

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update 15 November 2013

 WHO has been informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV). These include one laboratory-confirmed case from the United Arab Emirates and one laboratory-confirmed case from Qatar.

The patient reported from the United Arab Emirates is a national of Oman. He is 75 years old, with underlying medical conditions. He became ill on 1 October 2013, was hospitalized on 12 October 2013 and died on 10 November 2013.

The patient from Qatar is a 61-year-old man with underlying medical conditions. He became ill on 4 November 2013, and was hospitalised on 7 November 2013. He is in critical condition. Preliminary epidemiological investigation indicates that the patient had exposure to farms where livestock are kept.

Additionally, a previously laboratory-confirmed case from Oman has died.

Globally, from September 2012 to date, WHO has been informed of a total of 155 laboratory-confirmed cases of infection with MERS-CoV, including 66 deaths.

Death Toll From MERS-CoV Infection Rises To 66

GENEVA, Nov 16 (Bernama) -- Two more people have died from the Middle East respiratory syndrome coronavirus (MERS-CoV), bringing total death toll to 66, the World Health Organisation (WHO) said.

WHO said in a latest update on Friday that the United Arab Emirates (UAE) has reported confirmed cases of MERS-CoV infection, Xinhua news agency reported.

A 75-year-old man from Oman who became ill on Oct 1 was hospitalised on Oct 12 and died on Nov 10.

A previous case in Oman in the country's first confirmed case of the coronavirus infection has also died, WHO said.

A 61-year-old man from Qatar with underlying medical conditions fell ill on Nov 4 and was hospitalised on Nov 7 with critical condition.

WHO said a total of 155 confirmed cases of MERS-CoV infection were reported from September 2012 to date.

Friday, November 15, 2013

#H7N9 China - Dongguan, the first case of H7N9 bird flu patient discharged

The confirmed case, on Nov. 6th,  of the 3 year old, can be found at this post, here.
November 14, 2013

Dongguan, the first case of human infection with the H7N9 avian influenza confirmed cases have recovered. Yesterday, the Dongguan Municipal Health Bureau has conducted some briefing.
Informed that on November 5, Dongguan diagnosed one case of human infection with the H7N9 avian influenza, the case is in Dongguan routine sentinel surveillance of influenza-like illness found, and it is the first case of human infection with the H7N9 Dongguan confirmed cases of avian influenza. Children by the Dongguan City People's Hospital isolation and treatment, clinical symptoms, H7N9 avian influenza virus nucleic acid testing negative, people infected by the H7N9 avian influenza city medical treatment expert consultation concluded that children have recovered and was discharged on November 11 afternoon.
All 63 close contacts after a period of seven days of medical observation, no detection of influenza-like illness. 

Thursday, November 14, 2013

Qatar Reports New Case of #MERS #Coronavirus - November 14, 2013

Doha - 14 - 11 (KUNA) - The Supreme Council for the health of the country here today registered new cases of laboratory confirmed HIV (Corona) that causes AIDS Middle East respiratory for expatriate at the age of 61 years. said the Supreme Council of Health said in a statement that the patient is suffering from several chronic diseases and is currently receiving treatment in intensive care. pointed out that the patient presented to the country a month ago in search of work did not prove that he was mixing with confirmed indicating that the examination was conducted on all contacts of the patient and the initial results were negative. 

Cambodia MOH Update - November 14, 2013

[My list has been corrected in a major way, list located here.]
hat-tip Mike Coston, Avian Flu Diary

The Ministry of Health (MoH) of the Kingdom of Cambodia wishes to advise members of the public that
two new human cases of avian influenza have been confirmed for the H5N1 virus. These are the 25" and
26' cases this year
and the 46th and 47" people to become infected with the H5N1 virus in Cambodia. Case
25 is from Kampong Speu province and case 26 was from Pailin province. The Kampong Speu case is
currently in a critical condition whereas the Pailin case has died.
Of the 47 confirmed cases, 35 were
children under 14, and 27 of the 47 were female. In addition, only 13 cases out of the 26 cases this year
The 25"case, a 3-year-old boy from Veal Vong village, Sendey commune, Samrong Tang district, Kampong
Speu province, was confirmed positive for H5N1 human avian influenza on 9"November 2013 by Institut
Pasteur du Cambodge. The boy had onset fever on 5%ovember 2013, his parents sought treatment at a local
private practitioner on 6th~ovember, but his condition worsened.The boy was admitted to KanthaBopha
Hospital, Phnom Penh, on 8"~ovember 2013 with fever, cough, and dyspnoea. Laboratory samples were
taken on 8%ovember and Tamiflu administered the same day.

Investigations in the village by the Ministry of Health's Rapid Response Teams (RRT) and the Ministry of
Agriculture, Forestry and Fishery's (MAFF) Animal Health Task Force revealed chickens and ducks had
been sick andlor dead for approximately three weeks prior to the boy's onset of illness. The boy helped carry
dead chickens for his mother who was preparing a meal from the family. The mother regularly purchased
sick and dead chickens from a local poultry farm.
The 26' case, a 29-year-old male from KaunDemrei village, SteungTrang commune, Salakrao district, Pailin
province, was confirmed positive for H5N1 human avian influenza by Institut Pasteur du Cambodge on
9%ovember 2013.
The man had onset fever, chills and headache on 26' October 2013 where he sought
treatment at the local health centre. Treatment was provided to the case at a private clinic on l* November

until his condition continued to deteriorate. On 3%ovember the case was admitted to Battambang
Provincial hospital with fever, chills, headache, cough, chest pain. Laboratory samples were taken and
Tamiflu was administered on 6"November. He continued to deteriorate with further symptoms of diarrhoea,
vomiting, and seizures; hedied at the hospital on the 6%ovember.

Epidemiological investigations by the RRT and MAFF revealed that the case had direct contact with sick
and dead poultry one week prior to illness onset. During the investigation multiple influenza like illness
cases were detected in the village; laboratory testing of those cases to date indicated human influenza

The Ministry of Health's RRTs and the Ministry of Agriculture, Forestry and Fishery's Animal Health Task
Force are working together closely inboth villages to investigate and implement control measures. The RRTs
are trying to identify the case's close contacts, any epidemiological linkage among the 26 cases and initiate
preventive treatment as required.The Animal Health Task Force is investigating cases of poultry deaths in
the village.


Daily Tribune: Bird Flu Strain Infects Humans For The First Time

[Reports here at Pandemic Information News on H6N1 can be found here and here].

November 14, 2013

...Since the H5N1 bird flu strain first broke out in southern China in 1996, public health officials have been nervously monitoring its progress — it has so far killed more than 600 people, mostly in Asia. Several other bird flu strains, including H7N9, which was first identified in China in April, have also caused concern but none has so far mutated into a form able to spread easily among people. 

“The question again is what would it take for these viruses to evolve into a pandemic strain?” wrote Marion Koopmans, a virologist at the National Institute for Public Health and the Environment in the Netherlands, in a commentary accompanying the new report.
She said it was worrying that scientists had no early warning signals that such new bird flus could be a problem until humans fell ill. Scientists often monitor birds to see which viruses are killing them, in an attempt to guess which flu strains might be troublesome for humans — but neither H6N1 nor H7N9 make birds very sick.

Complete article:

Experimental H7N9 avian flu vaccine shows promise in early trial

November 14, 2013
The first human test of an experimental vaccine against a deadly strain of avian flu, using novel technology that could produce millions of doses very quickly, produced protective antibodies in the vast majority of those who received it, scientists said on Wednesday.
The encouraging results in the early stage trial from Novavax, a biopharmaceutical company based in Rockville, Maryland, were published online in the New England Journal of Medicine.
"These are very preliminary results, but it appears for the first time that we may have a vaccine that would work against an outbreak" of avian flu, said Robin Robinson, director of the Biomedical Advanced Research and Development Authority, or BARDA, the federal agency in charge of developing countermeasures against public health emergencies.


BBC: 'Unpredictable pandemics' warning

14 November 2013

The world needs to be prepared for "unpredictable pandemics" from viruses making the leap from animals to people, scientists in Taiwan say.
Their warning follows the first reported case of a common bird flu, H6N1, being detected in a woman, earlier this year.
The patient recovered and no other cases have been detected.
But the report published in the Lancet said the case highlighted the need for "intensive" monitoring of bird flu.
In May 2013, the first human case of an H6N1 bird flu was detected in a woman in Taiwan. One of her neighbours bred ducks, geese and chickens - although the precise source of the infection has not been detected.
Many sub-types of influenza, such as those that cause seasonal flu or the swine flu pandemic, are known to infect people, but H6N1 is not one of them.
The report, by the Centres for Disease Control in Taiwan, said: "The occurrence of a human case of H6N1 infection shows the unpredictability of influenza viruses.
"Our report highlights the need for influenza pandemic preparedness , including intensive surveillance for ever evolving avian influenza viruses."
Prof Wendy Barclay, from Imperial College London, said these infections may have happened in the past but improved technology had meant this one had been discovered.
She said: " Is this a truly new thing or are we now just better at seeing it?"
She told the BBC she expected far more of these cases to be reported in the next few years as more hospitals were geared up to look for novel bird flus.
Prof Barclay added: "This is a single case with no evidence of human transmission, but as always we should keep an eye on it and do studies to see how close it is to being able to spread between humans."

VDU Blog: The book of MERS has several chapters yet to write

November 14, 2013
From Virology Down Under Blog

The hallmark of, and big problem with, the MERS outbreak (an epidemic mostly for the Kingdom of Saudi Arabia [KSA]), is that testing has been LIMITED to those who have pneumonia, or another severe disease, and their close contacts. Back in August Memish noted that surveillance was focused on those with pneumonia which was again noted by a WHO representative yesterday.

Why, why oh why not test more people? Why?! Is it because "it's too costly to prospectively test people by RT-PCR unless they are (very) ill"? It might be for some nations, but the KSA is not one of those.

Complete Post:

Second MERS virus case found in Kuwait

November 14, 2013
KUWAIT CITY - Kuwait has reported its second case of the deadly MERS coronavirus for a man who just returned from abroad, the health ministry said.

In a statement cited by the official KUNA agency late Wednesday, the ministry said the new case was for a 52-year-old Kuwaiti national who was in a stable condition.
Media reports said the patient had just returned from a visit to neighbouring Saudi Arabia.

The announcement came hours after Kuwait reported its first case of the MERS virus for a 47-year-old Kuwaiti man who was in critical condition.

Kuwait is now the fifth state in the Gulf to report the disease.
The ministry said the latest case was not related to the first patient and both have been isolated at the country's Infectious Diseases Hospital. Relatives of the two patients had also been examined.

Wednesday, November 13, 2013

Kuwait Cases List & Comments #MERS #Coronavirus

Translations.  Ugly Translations.  From the previous articles on the first case, I am skirting the recent two articles, that are mixing me up, and have composed the following list.   It can always be changed accordingly.

Name:  52(M)
From:  Kuwait
Onset:  ?
Adm:  11/7  Al-Adan Hospital, high fever & cough
Adm:  11/13 Hospital Communicable Diseases, Al Farwaniyah Governorate
Status:  ICU Critical.  Respirator.  11/14:  Reassuring
Note:  Recently returned from Saudi Arabia
Confirmed:  11/13

Name:  47
From:  Kuwait
Onset:  ?
Adm:  ?
Status:  reassuring
Notes:  No contact with above patient.
Confirmed:  11/14

Register second injury Pfyrus "Corona" in Kuwait

November 14, 2013

After recording the first injury Pfyrus "Corona" in Kuwait, the Ministry of Health announced a second recording cases of the virus Kuwaiti citizen a 52-year-old and his condition is reassuring. The Ministry of Health announced the injury citizen at the age of 47 new Corona virus after it has been diagnosed by competent laboratories in Kuwait and being treated in a hospital. Said Head of the Unit for Combating epidemiologist at the Ministry of Health, Dr. Musab al-Saleh in a press conference today that the citizens have diabetes, high blood pressure and high level of fat in the body indicated that he was isolated patient in intensive care, hospital Adan and transferred this morning to a hospital contagious diseases for the isolation and treatment.

Kuwait - Ministry of Health Announces 2nd Case of #MERS #Coronavirus

November 13, 2013
Kuwait on November 13 / us / announced the Kuwaiti Ministry of Health registered cases of a second virus "Corona" to a Kuwaiti citizen of the 52-year-old made ​​the newly travel abroad and said his health is reassuring now. said head of the anti-epidemic in the ministry, Dr. Musab al-Saleh told Kuwait News / PRNewswire / night it was confirmed diagnosis and convert the case to a hospital contagious diseases for isolation and treatment and is currently precautionary measures in accordance with technical guidance adopted. added Dr. Saleh that the second case does not have anything to do with the situation first, which was announced earlier today, stressing that all contacts of the first case are still enjoying good condition.and stressed that the Ministry of Health and the basis of the principle of transparency will continue announcement of any developments in this regard, first hand. was the Kuwaiti Ministry of Health has announced earlier today its first case of HIV, "Corona" in Kuwait, a Kuwaiti citizen-old 47-year-old have diabetes, high blood pressure and high level of fat in the body have been isolated in a hospital intensive care Adan and move it in the morning to Communicable Disease Hospital for isolation and treatment.>Us 2057 GMT 11/13/2013

Kuwait Case Map & Details

The map below depicts the location of the confirmed case, and the location of the hospital he was transferred to.  It was reported yesterday that he was in too poor of health to tranfer.  Today, it's reported he has been, and is on a respirator.  The hospital, Communicable Diseases Hospital, is located in Al Farwaniyah Governorate.

Name:  50(M)
From:  Kuwait
Onset:  ?
Adm:  11/7  Al-Adan Hospital, high fever & cough
Adm:  11/13 Hospital Communicable Diseases, Al Farwaniyah Governorate
Status:  ICU Critical.  Respirator.
Note:  Recently returned from Saudi Arabia
Confirmed:  11/13

Kuwait Ministry of Health announces its first case of #Coronavirus #MERS

November 13, 2013

Said the spokesman for the Committee of the virus, "Corona" in the Ministry of Health and head of the combat epidemics d. Musab good for the registration of the first case of a citizen virus Corona, stressing at the same time that the patient was isolated in a hospital in communicable diseases, pointing out that the situation is believed to be the product of travel .
said Saleh told a news conference held today at the Department of Public Health that medical teams had to limit contacts of the situation shows that there are no symptoms of the disease, and that one of the doctors suspected of being infected, but tests proved their safety .
explained the good that the patient Access Hospital Adan Day 7 of this month and was suffering from high fever and cough, was transferred to a hospital in communicable diseases and deposited Care Intensive isolated in a good place and conveniently away from the proliferation risks based on policies protocol to deal with such cases, pointing out that the patient's condition is critical which is on a respirator .
stressed the good that the patient's condition is under control and will continue to be the case in contact with him to make sure they are free from any symptoms of contentment their safety and this may take 14 days, noting that medical devices on alert and continue with all actors, whether public or private to monitor any communication باشتباه infected "Corona . "
and the good that the disease is new does not vaccinate him and the best way is to prevent it .

PLOS: State of Knowledge & Data Gaps of #MERS #Coronavirus (MERS-CoV) in Humans

November 12, 2013


Background: Between September 2012 and 22 October 2013, 144 laboratory-confirmed and 17 probable MERS-CoV cases from nine countries were notified to WHO.

Methods: We summarize what is known about the epidemiology, virology, phylogeny and emergence of MERS-CoV to inform public health policies.
Results: The median age of patients (n=161) was 50 years (range 14 months to 94 years), 64.5% were male and 63.4% experienced severe respiratory disease. 76.0% of patients were reported to have ≥1 underlying medical condition and fatal cases, compared to recovered or asymptomatic cases were more likely to have an underlying condition (86.8% vs. 42.4%, p<0.001). Analysis of genetic sequence data suggests multiple independent introductions into human populations and modelled estimates using epidemiologic and genetic data suggest R0 is <1, though the upper range of estimates may exceed 1. Index/sporadic cases (cases with no epidemiologic-link to other cases) were more likely to be older (median 59.0 years vs. 43.0 years, p<0.001) compared to secondary cases, although these proportions have declined over time. 80.9% vs. 67.2% of index/sporadic and secondary cases, respectively, reported ≥1 underlying condition. Clinical presentation ranges from asymptomatic to severe pneumonia with acute respiratory distress syndrome and multi-organ failure. Nearly all symptomatic patients presented with respiratory symptoms and 1/3 of patients also had gastrointestinal symptoms.

Conclusions: Sustained human-to-human transmission of MERS-CoV has not been observed. Outbreaks have been extinguished without overly aggressive isolation and quarantine suggesting that transmission of virus may be stopped with implementation of appropriate infection control measures.

Full Document:

ProMED - MERS-CoV - Eastern Mediterranean (85): animal reservoir, camel, susp, official

Published Date: 2013-11-12 13:01:10
Archive Number: 20131112.2051424

Date: Tue 12 Nov 2013
From: Ziad Memish <> [edited]

The Saudi Ministry of Health [MoH] continues to follow carefully all new cases of MERS-CoV diagnosed in KSA [Kingdom of Saudi Arabia] with routine contact tracing of all contacts inclusive of family contacts and HCWs [healthcare workers] who cared for the patient. On 7 Nov 2013 the Saudi MoH reported a new case: a 43-year-old male from Jeddah, who developed symptoms on 27 Oct 2013. He sought medical treatment on 3 Nov 2013. He is currently in an intensive care unit. The patient does not have any underlying chronic disease. He has no recent travel history outside of Jeddah. He had significant contact with animals but no contact with a known positive human case. To complete the investigation extensive environmental/animal contact sources were pursued. Camels owned by the patient which were symptomatic with fever and rhinorrhea were tested for MERS-CoV and tested positive.

This is the 1st time that a camel related to a case tests positive for MERS-CoV by PCR. Further testing is ongoing to sequence the patient and the camel virus and compare genetic similarity level to conclude causality.

The Saudi MoH will continue to follow the situation carefully with the Ministry of Agriculture and keep the public health community informed of any new developments.

Ziad A Memish, MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia

[ProMED-mail is very grateful to Prof Ziad Memish for the firsthand, authoritative information above. It also adds data on the clinical signs observed in the camels owned by the human patient, as earlier requested by us. 'Rhinorrhea' is a medical term for 'runny nose' (from the Greek words "rhinos" meaning "of the nose" and "rhoia" meaning "a flowing"). The term commonly applied in veterinary medicine for such condition in animals is 'rhinitis' (in some instances, 'catarrh').

From previous, media-derived information, it appears that the tissue sampled was mucous or saliva; confirmation will help. In case the saliva includes the virus, the unpleasant habitude of camels to spit may add effectiveness and actual range to their potential role as virus disseminators.

Some perspective can be found at - Mod.AS]

[If the virus isolates are shown to be genetic matches, this will serve as the 1st confirmation of the previously suspected possibility of transmission from camels to humans.

As a reminder, the role of the camel in transmission of the MERS-CoV to humans was raised as a possibility early on in the history of this emerging disease. A Qatari national was treated in Germany for severe illness associated with MERS-CoV infection beginning in late October 2012. Investigations at that time noted that the case owned a camel and goat farm, with a number of the goats at that time noted to be ill as well as the animal caretaker (see ProMED-mail Novel coronavirus - East. Med. (07): Saudi Arabia, UK, Germany 20130221.1554109). In April 2013 there was a report of a UAE national with severe illness associated with MERS-CoV infection. This individual was the owner of racing camels. The possibility of transmission from the camels was raised at the time (see ProMED-mail Novel coronavirus - Eastern Mediterranean (15): camel exposure 20130405.1623188). We await the results of the genetic sequencing. - Mod.MPP

Tuesday, November 12, 2013

#MERS #Coronavirus Kuwait Suspected Case Recently Returned From KSA

November 12, 2013

Medical sources confirmed the presence of high - level almost certainly the case on suspicion of a citizen in the fifth decade of age infected with « Corona » Enter to Adan hospital last Friday and into intensive care.
Sources told the « news » Kuwaiti that the patient recently returned from Saudi Arabia, pointing out that it was converted to a hospital communicable diseases to receive the necessary attention there in the intensive care unit new fully equipped for such cases , and under the supervision of team doctors specialized consultants had issued their health agent earlier decision to deal with such cases.
The sources indicated that he was taking the necessary tests of the patient and sent to the laboratory viruses and Faculty of Medicine for authenticity , which will show results within two days to make sure that HIV infection or not, noting that the patient is suffering from high blood pressure , and developed symptoms of the virus , and was transferred on the track Adan Hospital , and then to communicable diseases. 

Kuwait 2 Cases Suspected #Coronavirus Patient and Doctor #MERS

" Rai " : the appearance of the first cases of HIV " Corona " in Kuwait
Wednesday 13 November 2013, last updated 00:13
Healthy sources revealed the newspaper " Al Rai " Kuwaiti appearance of the first cases of HIV " Corona " in Kuwait citizen lay in intensive care at Al-Adan Hospital , doctors described his condition as "serious".
The sources said he was also suspected of infecting the doctor supervising the patient , where she developed symptoms of high temperature .
The sources pointed out that Doctors Hospital of communicable diseases were not able to transfer the patient to the hospital due to his poor health , pointing to lift the state of emergency " in force " in anticipation of receiving infected cases , and joins Kuwait to the rest of the Gulf states, which appeared " Corona " with the exception of Bahrain.

#MERS #Coronavirus Kuwait Doctor Suspected Case Critical

November 13, 2013
I learned the " Gazette " informed sources that Adan Hospital yesterday saw the emergence of the first infected " Corona " in the country, a citizen in the fifth end of his contract , indicating that he was in serious condition and is very critical , and now lying in the isolation room , Department of Internal Medicine at the hospital said .

The sources said that the emergence of the first cases of " Corona " mobilized the Ministry of Health, which rushed Kiedyoha an urgent meeting yesterday afternoon to discuss the measures to be taken by the ministry, in fear of the increasing number of patients because of the advent of winter , which may help to increase HIV infection due to move to people across the breathing .

She explained that " preventive health " in the ministry will examine the contacts of the case , as well as a comprehensive survey of the patient's home and his family , noting that the Department of Public Health will awareness campaigns during the coming period to raise awareness of the disease and its modes of transmission and ways to combat and prevent it.

The sources said that the ministry will be equipped laboratories additional to examine samples of patients who may be suspected of having a future with the virus , as well as send some samples to laboratories reliable world to see results quickly, calling for coordination with the World Health Organization and invite some experts to stay in Kuwait period to deal with this virus and training medical staff to deal with him .

It is worth mentioning that the World Health Organization ( WHO ) launched a virus " Corona " Middle East virus , also known as the " new Corona virus " or " Nofal Corona " , a coronary virus was discovered on September 24, 2012. And he was at the beginning of a number of different names , such as SARS or SARS - like Saudi Arabia in some foreign

The first injury 'Corona' in Kuwait - Suspected Doctor with #MERS #Coronavirus

November 13, 2013
Alert in the 'force' after suspected transmission of the infection to the doctor
Informed sources revealed healthy for 'opinion' about the appearance of the first cases of HIV «Corona» citizen lying in the intensive care unit at Adan Hospital, doctors described his condition as 'serious'. 
The sources said he was also suspected of infecting the doctor supervising the patient, where she developed symptoms of high temperature. 
The sources pointed out that Doctors Hospital of communicable diseases were not able to transfer the patient to the hospital due to his poor health, referring to the lifting of the state of emergency in the «force» in anticipation of receiving infected cases, and joins Kuwait to the rest of the Gulf states, which appeared «Corona» the exception of Bahrain. 

Isolation of 7 More Camel in Jeddah for #MERS #Coronavirus

November 12, 2013

After confirming the injury a beauty virus Corona the day before yesterday, the Ministry of Agriculture for isolating 7 Ebel again after suspected bird flu in order to while making sure her through the necessary tests. 
said Undersecretary of the Ministry of Agriculture for Research and Agricultural Development, a spokesman for the ministry Eng Jaber Monthly that the Ministry of Health is The first injury was discovered by a beauty in one barn containing 8 camels, located south of Jeddah neighborhood winery. The monthly that has been treated with such beauty isolating infected animal first, and then isolate the camel suspected bird flu and so ensure safety of the virus, indicating that a team from the ministries of agriculture, health, the daily and periodically withdraw blood samples for Ebel eight and avoided them, isolate, isolation, completely humans and animals and control. 
and conduct revealed randomly on camels in the coming period, said Monthly: I do not anticipate events, We will make sure first that the camels are the main source of transmission of the virus and then there will be action taken by the ministry in coordination with the other parties to the camels. 
his part, said Assistant Undersecretary for livestock in the Ministry of Agriculture Engineer Sami Ben Solomon Alnhat's "home" The Ministry of Health is primarily responsible for this, because it relates to human beings, so they must make sure the virus and make necessary analysis, while The role of the Ministry of Agriculture in the development of camel suspected bird flu in an isolated place and follow veterinarians have sampling and make sure the owner and procedures pending completion of the procedures and Ministry of Health. 
, the Ministry of Health had announced the day before yesterday they discovered were newly infected with "Corona" However, the situation is not between humans, but for "camel", and this was considered by the ministry groundbreaking to find out the source of the virus that causes respiratory syndrome Middle East that resulted in the death of 53 cases in the Kingdom so far, while did not know the true source of the virus and the studies have been conducted on bats and camels, which numbers in the Kingdom with 900 thousand.

Viet Nam works to prevent H7N9 spread

November 12, 2013
HA NOI (VNS)— After another two people in China were found infected with H7N9, the flu virus strain that spreads via poultry, the General Department of Preventive Medicine on Sunday issued an urgent request to health departments nation-wide to prevent the spread of the virus.

The departments were asked to tighten surveillance on all passengers, vehicles and goods travelling through border gates, report any severe acute respiratory cases and increase patrolling for infected poultry.
According to Doctor Tran Duc Phu, Director of the General Department, China saw 139 H7N9 cases, killing 45 people, since the end of March this year. — VNS 

Monday, November 11, 2013

Saudi says camel tests positive for MERS Virus

November 12, 2013
Riyadh: The Saudi government says a camel has tested positive for MERS, in the first case of an animal infected with the coronavirus that has killed 64 people worldwide.  

A camel owned by a person diagnosed with the disease had "tested positive in preliminary laboratory checks", the health ministry said in a statement carried by SPA state news agency on Monday. The ministry said it was working with the ministry of agriculture and laboratories to "isolate the virus and compare its genetic structure with that of the patient's".
If the virus carried by the camel and that of the patient "prove to be identical, this would be a first scientific discovery worldwide, and a door to identify the source of the virus," it added.
In August, researchers pointed to Arabian camels as possible hosts of the SARS-like virus, which has hit hardest in the desert kingdom, where 53 people have died from the disease. Like SARS, MERS appears to cause a lung infection, with patients suffering from a temperature, cough and breathing difficulty. But it differs in that it also causes rapid kidney failure and the extremely high death rate has caused serious concern.

#MERS #Coronavirus MOH Saudi Arabia Acknowledges Confirms Camel Might Be Source of Infection

November 11, 2013
Order from the Ministry of Health on the lookout for everyone on the latest developments of the virus Corona virus that causes AIDS Middle East respiratory MERS-CoV and reference to the statement of the Ministry of Health, the former regarding recording cases of HIV Coruna in Jeddah, a citizen at the age of 43 years and who is still receiving treatment at a hospital the province, and within the work of Investigation epidemiological played by the ministry in a scientific and systematic lost ministry has examined contacts of infected according to scientific standards followed, as the ministry in its quest to find out and investigate the source of infection to take samples from the environment surrounding the patient including a range of beauty in a barn belonging to the patient, has shown a positive beauty to the initial laboratory tests for the virus.

The Ministry is currently in coordination with the Ministry of Agriculture and the scientific to confirm tests and virus isolation and compared in terms of genetic makeup with HIV patient, and, if proven match the virus infected the patient and phrases it discovers for the first time in the world and is open to know the source of this virus and will, God willing, in the knowledge of the world of epidemiological disease and its modes of transmission. 

#MERS #Coronavirus Case List & Map November 2013

Name:  61(F)
From:  Madrid, Moroccan Citizen
Onset:  10/15
Adm:  11/1 Spain
ER:  Mecca on Oct 28, 29
Status:  Stable
Notes:  Attended Haj.  Went to ER twice, diag w/pneumonia.  Refused adm.  Needed oxygen on flight back to Spain.

Name:  68(M)
From:  Al Dahkliya
Onset:  10/26
Adm:  Hospital in Nizwa
Status:  DOD  11/10
Confirmed:  10/29
Notes:  Contact with 2 son in-laws that attended the Haj.

United Arab Emirates (UAE)
Name:  75(M)
From:  Oman.  Visiting Abu Dhabi
Adm:  ?  Oct.
Status:  DOD 11/8

Saudi Arabia
Name:  72(M)
From:  Riyadh
Onset:  10/23
Adm:  10/31
Status:  ICU
Notes:  No history of travel outside KSA.

Saudi Arabia
Name:  43(M)
From:  Jeddah
Onset:  10/27
Adm:  11/3
Status:  ICU
Notes:  No history of travel outside KSA.

Name:  48(M)
From:  Doha
Onset:  10/25
Adm:  10/31
Status:  ICU
Notes:  Visited animal barns.  No travel.  No contact with previous confirmed people.

#MERS #Coronavirus Omani Visitor in Abu Dhabi Dies

11 November 2013

Abu Dhabi: An Omani man diagnosed with the Middle East Respiratory Syndrome (Mers) coronavirus died in Abu Dhabi on Friday, an Abu Dhabi Government official said on Sunday.

The victim, 75, had been visiting Abu Dhabi in October when he was diagnosed with the virus. He was admitted to a public hospital for treatment but succumbed to the disease, the source told Gulf News.
Following his death, the patient’s body was repatriated to Oman.
The patient’s diagnosis with Mers was earlier confirmed to the World Health Organisation (WHO) by the Health Authority Abu Dhabi, the source added.
As reported by Gulf News, another Omani patient, who represents the first known case of the virus diagnosed in Oman, also died in the country’s northwest region on Sunday. He was 68 years old, and had been running a persistent fever before being diagnosed with Mers 12 days ago.


WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update 11 November 2013

WHO has been informed of two additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia.

The first patient is a 72-year-old man from Riyadh with underlying medical conditions. He became ill on 23 October 2013, and has been hospitalised since 31 October 2013. The second patient is a 43-year-old man from Jeddah. He became ill on 27 October 2013 and has been hospitalised since 3 November 2013. 

Globally, from September 2012 to date, WHO has been informed of a total of 153 laboratory-confirmed cases of infection with MERS-CoV, including 64 deaths.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.


Oman widens health checks after country's first death linked to #MERS virus

Excerpt, editing below is mine:

MUSCAT, Oman - Oman says officials are widening health checks following the country's first death blamed on a SARS-like virus that has been centred in neighbouring Saudi Arabia.

Oman's Health Ministry said on Monday that teams would conduct investigations, including checking for signs of the virus in people who came in contact with the deceased 68-year-old man. His death was reported on Sunday by the official Oman News Agency.

#MERS #Coronavirus Confirmed Oman Case Contact With 2 Returnees From Haj

November 11, 2013

Muscat: The Ministry of Health has announced the first death in Oman on account of the Middle East Respiratory account of Syndrome Coronavirus (MERS-CoV). 

A 68-year-old Omani citizen suffering from several chronic diseases including diabetes, blood pressure and heart failure, died at a hospital in Nizwa on Saturday morning. His health had also deteriorated due to lung failure. 

"The person had no history of travel but was in contact with his two sons-in-law who had returned from Haj. On October 29, he was suspected of suffering from viral pneumonia and tested positive for MERS-CoV," a senior official at the health ministry said.

Meanwhile, the tests carried out on all those who had contacted the victim showed negative results.

The Ministry of Health said it has taken all precautionary measures in accordance with the recommendations and standards of the World Health Organisation (WHO), including the epidemiological investigation of contacts. 

Also, as part of the screening effort, authorities are working to track down healthcare workers who may have first attended to the 68-year-old patient at a local health centre before he was transferred to the Nizwa Hospital.

The objective, according to the officials, was to make sure that none of these contacts have been exposed to the deadly virus. 

With inputs from ONA 

Sunday, November 10, 2013

WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update 10 November 2013

[hat-tip Avian Flu Diary]

WHO has been informed of an additional laboratory-confirmed case of infection with Middle East respiratory syndrome coronavirus (MERS-CoV in Qatar.

The patient is a 48-year-old man with underlying medical conditions.  He became ill on 25 October 2013 and was admitted to a hospital on 31 October 2013.  He is in currently in a critical condition.  Preliminary investigations reveal that he frequently visited animal barns.  The patient did not recently travel and has had no contact with a previously laboratory-confirmed case with MERS-CoV.

Globally, from September 2012 to date, WHO has been informed of a total of 151 laboratory-confirmed cases of infection with MERS-CoV, including 64 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.

Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.

All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

Cambodia Human Case List 2013

Report Date/Province/District/ Con. Date /Name/DOD
Jan 27/Kampong Speu/Kong Pisei/1-23/35(M)/DOD 1-21
Jan 27/Takeo/Prey Kabass/1-22/15(F)/DOD 1/21
Jan 27/Phnom Penh/Porsenchey/1-22/8(mos)/Recovered
Jan 28/Kampong Speu/Kong Pisei/1-26/17(mos)/DOD 1-28
Jan 29/Kampot/Teouk Chhou/1-28/9(F)/DOD 1-28
Feb 8/Takeo/Prey Kabass/1-22/5(F)/DOD 2-7
Feb 13/Kampot/Angkor Chey/2-11/3 (F)/DOD 2-13
Feb 21/Kampot/Angkor Chey/2-19/2 (M)/DOD 2-19
Feb 26/Kampong Cham/Trung Trang/2-23/35(M)/DOD 2-25
Apr 3/Kampot/Phnom Penh/4-2/5(M)/
May 24/Kampong Speu/Thpong/5-2/5(F)/Recovered
Jul 2/Phnom Penh/Khan Roeusey Keo/6-21/58(M)/Recovered Co-infected
Jul 2/Kampot/Bantheay Meas/6-28/6(F)/DOD 6-28
Jul 12/Prey Veng/Kampong Trabek/7-10/3(M)/Stable
Aug 13/Battambang/8-9/9(M)/DOD-8-19
Aug 13/Kandal/8-10/5(F)/Critical Condition-8/22 Recovered
Aug 22/Kandal/Stung/8-17/6(M)/Recovered
Sept 4/Phnom Penh/Russei Keo/8-30/15mos (M)/Stable
Sept 19/Takeo/5(F)/Serious
Sept 19/Kampot/2(F)/DOD 9-18
Oct 11/Kampong Thom/Baray/8(F)/Stable
Oct 19/Battambang/Phnom Preuk/6(F)/Stable
Oct 17/Pursat/Bakane/2(F)/DOD 10-25

Nov 8/Kampot/Dang Tong/11-7/10(M)-DOD 11-9
Nov 9/Kampot/Samrong Tang/11-9/3(M)/Critical
Nov 14/Pailin/Salakrao/11-9/29(M)/11-6

Kampong Speu
Date 1/27/13
Name:  35(M)
Trapeang Sla village, Preah Nipean commune,  Kong Pisey district, Kampong Speu
Onset:  1/13
Adm:  Treated by private practioner
Adm:  1/21
Hospital:  Khmer-Soviet Friendship Hosp. Phnom Penh, sym's fever, dyspnea
Notes:  Prepared sick chicken for food prior to being sick.
Confirmation:  1/23/13 - Positive
Date:  1/27/13
Name:  15(F)
Snao village, Prey Kabass district, Takeo Province
Onset:  1/11/13
Adm:  Treated by private practioner.
Hospital:  Kantha Bopha
Adm:  1/17/13 sym's fever & shortness of breath.
DOD:  1/21/13
Notes:  Previous dead poultry in village.  Prepared sick chicken for food prior to being sick.
Confirmed:  1/22/13 - Positive
Phnom Penh
Date:  1/27/13
Name:  8 month male
Chrey Korng Village, Sangkat Chorm Chao, Khan Porsenchey district, Phnom Penh
Onset:  1/8/13
Hospital:  National Pediatric Hosp.
Adm:  1/9 sym's fever, cough, runny nose, vomiting.
Notes:  Samples sent on 1/11.  History of contact with poultry.
DOD:  survived and recovered
Confirmed:  1/22/13 - positive
Kampong Speu
Date 1/28/13
Name:  17 month girl
From:  Kong Pisei district,
Prey Nhat commune, Kampong Speu
Onset:  1/13, fever, runny nose, vomiting
Adm:  private practitioner
1/17 fever, cough, somnolence & dyspnoea 
Hospital: Kantha Bopha Phnom Penh
Notes:  Recent poultry death in village.  Contact with poultry.
DOD:  1/28
Confirmed:  Positive 1/26
Kampot Province
Date 1/29/13
Name:  9 yo girl
From:  Thmei village, Thmei commune, Toeuk Chhou district, Kampot Province
Onset:  1/19, fever, cough
Adm:  Initially treated by a private practitioner
Adm:  1/27
Hospital:  Kantha Bopha with fever, cough, somnolence and dyspnoea
DOD:  1/28
Notes:   Poultry dead around village.
Confirmed:  Positive - 1/28

Takeo Province
Date  2/8/13
Name:  5 yo female
From:  Angk Krasang Village, Prey Lvea commune, Prey Kabass district, Takeo Province.
Onset:  1/25
Adm:  local private practitioner
Adm:  1/31 with fever, cough & dyspnoea
Hospital:  Kantha Bopha Hospital
Confirmed:  Positive, diagnosed on 2/7
DOD:  2/7
Notes:  recent deaths of poultry in village.  Touched & ate dead chicken. 

Kampot Province
Date:  2/13/13
Name:  3 yo female
From:  Trapeang Kamphleanh village, Ang Phnom Toch commune, Angkor Chey District, Kampot Province
Adm:  2/6
Hospital:  Kantha Bopha Hospital, fever, abdominal pain, drowsiness
Onset:  2/3 red rash, initially treated by private practioner
Notes:  Recent death of poultry in village, history of contact.  Critical Condition w/severe breathing problems.
Confirmation:  2/11/13
DOD:  2/13/13

Kampot Province
Date:  2/21/13
Name:  20 month old male
From:  Ang Romduol Village, Angkor Chey commune, Angkor Chey district, Kampot Province
Onset:  2/6, runny nose & fever.  Treated by local private practioner.
Adm:  2/18 Kantha Bopha Hospital, Phnom Penh with fever, cough, dyspnea
Confirmation:  2/19/13
DOD:  2/19/13 (18 hours after admission)
Note:  Poultry death in Village.  Eighth death this year.  29th person to become infected.  26th to die.  Of the 29 confirmed Cases, 20 were children under 14.  19 of the 29 were Female.

Kampong Cham Province
Date:  February 26, 2013
Name:  Thoeun Doeun (35) (Male)
From:  Kbl Ou Village, Me Sar Chrey commune, Stueng Trang, Kampong Cham Province
Onset:  2/8  fever; worsened on 2/10 w/frequent cough, dypsnea
Adm:  Local practitioner
Adm:  2/13 Kampong Cham Hosp.  Treated with Tamiflu
Adm:  2/19, Hospital Benh Calmete, Phnom Penh  (MOH Statement says 2/21)  Developed pneumonia
Notes:  Contact with dead Ducks and eating. 
Confirmation:  Positive on 2/23/19
Phnom Penh site:  Onset:  2/6; Health Clinic 2/13; & adm to Provincial Hosp. immediately, adm Calmette Hosp 2/22.
DOD:  2/25

Kampot Province
Date:  4/3/13
Name:  5(M)
From:  Boeung Tapream vill., Sangkat Treuy Kors, Kampong Bay dist., Kampot Province
Onset:  3/27 Fever, convulstions, shortness of breath
Adm:  3/29 Treuy Kors Health Centre
Adm:  3/29 Kampot Prov. Hospital
Adm:  3/31 Kantha Bopha Hospital, Phnom Penh, treated w/Tamiflu
Confirmation:  4/2/13
Note:  Critical condition.  Not known if contact with poultry.
Update:  Improved, out of ICU  4/8/13.

Kapong Speu
Date:  5/24/13
Name:  5(F)
From:  Tep Phirom village, Veal Pon Commune, Thpong District, Kampong Speu
Onset:  1/28/13
Note:  Patient was enrolled in a fever surveillance study of the US Naval Medical Research Unit.  She is alive and exposure to poultry is being investigated.

Phnom Penh
Date:  7/2/13
Name:  58(M)
From:  Sangkat Chroy Chorng Va, Khan Roeusey Keo, Phnom Penh
Adm:  Khmer-Soviet Friendship Hospital
Confirmed:  6/21
Tested Positive for Influenza on 1/9
Note:  Recovered.  12th case.  Confirmed after routine testing of samples.

Kampot Province
Date:  7/2/13
Name:  6(F)
From:  Preyleu Village, Meas Commune, Bantheay Meas District, Kampot Province
Adm:  6/28 Kantha Bopha Hospital, fever, dyspnea & cough
Reconciled:  6/26 Private Clinic, cough & dyspnea
Onset:  6/24 fever, headache
Confirmed:  6/28
DOD:  6/28/13
Note:  13th Case this year.  9th death this year. 

Prey Veng Province
Date:  7/12/13
Name:  3(M)
From:  Kampong Trabek district, Prey Veng Province
Adm:  7/8  Kantha Bopha Hospital in Phnom Penh
Sym’s on adm: fever, cough, dyspnea
Confirmed:  7/10
Note:  14th case this year.  Recent poultry deaths in village.

Battambang Province
Date:  8/13/13
Name:  9(M)
From:  Damnak Dangkor Village, Battambang Province
Adm:  8/4  Jayavarman VII Hospital
Confirmation:  8/9
Note:  Stable condition.  15th Case for 2013.  Boy carried dead & sick chickens & ducks from cage for food preparation.  Fever, abdominal pain & dyspnea.  Stable condition treatment w/Tamiflu.
DOD:  8/19

Kandal Province
Date:  8/13/13
Name:  5(F)
From:  Knong Prek Village, Kandal Province
Adm:  8/9 Kantha Bopha Hospital
Confirmation:  8/10
Note:  Critical condition.  16th Case for 2013.  Recent deaths of poultry in her village.  Fever, abdominal pain, diarrhea & dyspnea. 

Kandal Province
Date:  8/22/13
Name:  6(M)
From:  Stung District, Kandal Province
Onset:  6/21
Note:  Quickly enrolled in Acute Febrile Illness Surveillance (FSS) Study in Kandal
Confirmation:  8/16
17th Case.  Contact w/sick poultry.

Phnom Penh
Date:  9/4/13
Name:  15mos (M)
From:  Russei Keo district, Phnom Penh
Adm:  Kantha Bopha Hospital, fever, cough, diarrhea, lethargy & dyspnea
Note:  Stable condition
Confirmed:  8/30/13

Date:  9/19/13
Name:  5(F)
From:  Takeo province
Adm:  Serious condition
Note:  19th case this year

Date:  9/19/13
Name:  2(F)
From:  Kampot
Adm:  Kantha Bopha Children’s Hospital
Note:  20th case this year
DOD:  9/18/13

Kampong Thom
Date:  10/11/13
Name:  8(F)
From:  O-Raing Village, Pung Ror Commune, Baray Dist.
Adm:  10/11
Onset:  10/8
Note:  Stable Condition.

Date:  10/19
Name:  6(F)
From:  Romdoul Village, O Romdoul Commune, Phnom Preuk Dist.
Adm:  10/19
Onset:  1014
Notes:  Stable Condition

Date:  10/25
Name:  2(F)
From:  Svay Chrum Village, Borng Bort Kandal commune, Bakane Dist.
Adm:  10/25
Onset:  10/17
DOD:  10/26
Note:  23 Cases ; 12 Deaths 2013

Name:  10(M)
From:  Sdok Thlok Village, To Tung Comm., Dang Tong Dist., Kampot Prov.
Onset:  10/28
Adm:  10/29 Private Practioner
Adm:  10/7 Kantha Bopha Hospital, Phnom Penh
Sym’s on Adm: fever, cough, sore throat, distended abdomen & dyspnea.
Conf:  11/7, & Tamiflu given.
Notes:  24th case 2013.  30 chickens died about 1 month prior to onset.  Helped carry dead poultry to mother for cooking.
MOH Link:
DOD:  11/9/13

Kampong Speu
Date:  11/9/13
Name:  3(M)
From:  Veal Vong Fillage, Sendey Commune, Samrong Tang district, Kampong Speu Province
Onset:  11/5
Adm:  11/6 Local Private Practioner
Adm:  11/8 Kantha Bopha Hospital, Phnom Penh
Syms on Adm: fever, cough, sore throat, distended abdomen, dyspnea.  Tamiflu given.
Confirmed:  11/9/13
Note:  1 month before, about 30 chickens died in his village.  Victim was in contact w/dead chicken, brought to brother who cooked them.
25th case for 2013 13 deaths for 2013
Link:  MOH Update 11/14/13

Date:  11/14/13
Name:  29(M)
From:  Kaun Demrei Village, Steung Trang Commune, Salakrao District, Pailin Province
Onset:  10/26
Adm:  10/26 Local Health Center
Sym’s on Adm:  fever, chills & headache
Adm:  11/1 Private Clinic
Adm:  11/3 Battambang Provincial Hospital
Sym’s: fever, chills, headache, cough, chest pain
Note:  Tamiflu given 11/6.  Direct contact with sick/dead poultry 1 week prior to onset.  Multiple ILI cases detected in village, diag:  H1N1
DOD:  11/6