Category: Biological Hazard


H7N9 case has drug- and non-resistant strains

Breaking News, World News and Taiwan News.

Poultry price could increase as a result of ban
This photo shows chicken that were dyed blue and will be destroyed in New Taipei, yesterday. New Taipei City government yesterday conducted an inspection in traditional markets and seized 150 chickens from some vendors that did not have certificates to show that the poultry is from a government-certified slaughterhouses. (CNA)

 

 

 

TAIPEI, Taiwan — The only H7N9 patient so far in Taiwan was carrying two strains of the same virus, with one being drug resistant and the other not, making it tricky to treat to him, doctors said yesterday.

Huang Li-min, a doctor from National Taiwan University Hospital (NTUH), explained that it was possible the avian flu virus was not drug resistant when the patient was first infected, but mutated later to become resistant to Tamiflu.

With Tamiflu failing, NTUH later switched to another intravenous drug, Huang said. Because of the presence of the two strains simultaneously, it was difficult for doctors to determine how much the virus’ drug resistance had undermined the therapy.

 

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The New Bird Flu: How Dangerous Is Avian Flu H7N9?

Beware the New Bird Flu (photo: wikipedia)

Until a few days ago, most of us had never heard of influenza A (H7N9), the new bird flu virus that’s suddenly killing people in China. Then on April 1st the death reports started to come in, and all of a sudden health experts began to sound awfully nervous.

That’s because although the virus has infected a very small number of people, it’s killed or critically sickened a high proportion of them.

The toll is rising daily, with new cases and deaths reported on the World Health Organization’s Disease Outbreak News site. As of today, 18 cases were laboratory confirmed, but of those infected, six have died and four are in critical condition.

I don’t have to tell you that a flu that kills or critically sickens more than half of those who contract it must be taken very seriously.

A Genetic Threat

The virulence of the H7N9 virus is not the only reason health officials around the world are scurrying to figure out the scope of the danger it poses. Genetic evaluation of the H7N9 virus shows it has the ability to mutate readily. Here’s how the World Health Organization (WHO) put it in a statement  released yesterday: “analysis of the genes of these viruses suggests that although they have evolved from avian (bird) viruses, they show signs of adaptation to growth in mammalian species.”

Should We Worry About Catching the H7N9 Avian Flu Here in the U.S.?

Right now, you’d be borrowing trouble. All the cases have been in China, either in Shanghai or the nearby provinces of Jiangsu and Anhui. And so far, H7N9 has not been found to be transmissable from human to human. All those who’ve contracted it have had contact with poultry. Both pigeons and chickens have tested positive for the virus.

As Forbes.com’s Russell Flannery reported yesterday, all poultry markets in Shanghai were closed yesterday as Chinese officials try to stop the spread of infection. Poultry dealers also began killing chickens from markets where birds had tested positive for the virus.

However, that could change. According to the CDC, however, this type of virus has “the potential to become a pandemic if it changed to become easily and sustainably spread from person to person.” Yesterday the CDC issued an official public health advisory on H7N9 under the auspices of emergency preparedness and response.

The CDC advises clinicians to be on the lookout for H7N9 in “patients with respiratory illness and an appropriate travel or exposure history.” In other words, if you come down with severe flu symptoms and you’ve recently been to China, let your doctor know right away.

There’s also the issue of the virus travelling with people who are already infected. Yesterday, six possible cases of H7N9 were reported in Taiwan. All were tested; four were found not to be H7N9 and two have yet to be confirmed.

 

Read Full Article Here

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Earth Watch Report  -  Biological Hazards

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18.05.2013 Biological Hazard USA State of New York, Marcellus Damage level
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Biological Hazard in USA on Saturday, 18 May, 2013 at 12:40 (12:40 PM) UTC.

Description
A raccoon found in the town of Marcellus has tested positive for rabies, the Onondaga County Health Department said Friday evening. “This is the first positive rabies findings of the season,” Commissioner Dr. Cynthia B. Morrow said in a news release. “It is important not to touch or feed wildlife because they may be rabid.” The raccoon was seen in the vicinity of West Seneca Turnpike. Rabies is a fatal disease that attacks the brain and spinal cord. It can take weeks or even months for rabies symptoms to appear, but early treatment after exposure can prevent rabies. The health department said any mammal can get rabies, but it’s most common in bats, raccoons, skunks and foxes.
Biohazard name: Rabies (raccoon)
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

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Earth Watch Report  -  Biological Hazards

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18.05.2013 Biological Hazard USA State of New Mexico, Albuquerque Damage level
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Biological Hazard in USA on Saturday, 18 May, 2013 at 21:42 (09:42 PM) UTC.

Description
New Mexico health officials are urging parents to tell children not to handle wild animals. The warning comes after a bat found in northeast Albuquerque tested positive for rabies. A number of children were reportedly near the bat and took photographs of it on the evening of May 11, but it’s not clear if any of them touched or handled it. Letters were sent to the parents of children who attend two nearby schools and flyers have been posted in the neighborhood, but the state Health Department says no known exposures have been reported. Health Secretary Retta Ward says the state wants to make sure no children were inadvertently exposed to rabies. Rabies is a fatal disease if it is not treated before symptoms develop.
Biohazard name: Rabies (bat)
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

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Earth Watch Report  -  Biological Hazards

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18.05.2013 Biological Hazard China Multiple areas, [Provinces of Anhui, Jiangsu, Zhejiang, Hangzhou, Hunan, Jiangxi, Fujian and Capital City region] Damage level
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Biological Hazard in China on Sunday, 31 March, 2013 at 13:02 (01:02 PM) UTC.

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Updated: Saturday, 18 May, 2013 at 05:07 UTC
Description
Four more people have died from a new strain of bird flu in China, bringing the death toll from the H7N9 virus to 36 from 131 confirmed cases, the World Health Organisation (WHO) has said. The United Nations health agency said a written statement on Friday that the four deaths were from cases that had already been identified in laboratories. It said here had been no new cases of infection with H7N9 Since May 8. The WHO reiterated that there was no evidence that the new strain of bird flu, which was first detected in patients in China in March, was passing easily from human to human. If such a feature emerged it could spark a pandemic. But it said: “Until the source of infection has been identified and controlled, it is expected that there will be further cases of human infection with the virus.” The WHO said that Chinese health authorities had continued with enhanced surveillance, epidemiological investigations, close contact tracing, clinical management, laboratory testing and sharing of samples as well as prevention and control measures. The number of new cases has dwindled in some provinces and operations.

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China reports 4 more bird flu deaths

китай птичий грипп больница

Four more people in China have died from a new strain of bird flu, bringing the number of deaths from the mysterious H7N9 virus to 31, with the number of infections rising by two to 129, according to Chinese health authorities.

Among the deaths, two occurred in the eastern province of Jiangsu; one was from eastern Zhejiang; while another was from central Anhui, based on a Reuters analysis of the data provided by Chinese health authorities on Monday.

The government did not provide more details of the victims.

Chinese health authorities said two new infections were reported in the eastern coastal province of Fujian. The virus, which was mostly concentrated in the region around the commercial capital of Shanghai, spread to Fujian in late April.

The Geneva-based World Health Organization (WHO) has said it has no evidence that the new strain of bird flu, which was first detected in patients in China in March, is easily transmissible between humans.

Chinese scientists have confirmed that the H7N9 strain has been transmitted to humans from chickens. But the WHO has said 40 percent of people infected with H7N9 appear to have had no contact with poultry.

The head of the U.S. Center for Disease Control and Prevention said the current strain of bird flu cannot spark a pandemic in its current form – but he added that there is no guarantee it will not mutate and cause a serious pandemic.

Voice of Russia, Reuters

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Earth Watch Report  -  Epidemic  Hazards

 


New case of SARS-like virus detected in Saudi Arabia (© Reuters)

Riyadh: A new case of deadly coronavirus has been detected in Saudi Arabia where 15 people have already died after contracting it, the Health Ministry announced today on its Internet Web site. “One new case of novel coronavirus was recorded in the eastern region” where most of the kingdom’s cases have been registered, the Ministry said, which had this week created a special web page dedicated to the outbreak.

MSN News

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19 19.05.2013 Epidemic Hazard Saudi Arabia Eastern Province, Al-hasa Damage level
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Epidemic Hazard in Saudi Arabia on Thursday, 02 May, 2013 at 07:12 (07:12 AM) UTC.

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Updated: Sunday, 19 May, 2013 at 04:49 UTC
Description
A new case of the deadly coronavirus has been detected in the Kingdom, where 15 people have already died after contracting it, the Health Ministry announced on Saturday on its website. One new case of the novel coronavirus has been recorded in the Eastern Province, where most of the Kingdom’s cases have been registered, said the Ministry, which this week created a special web page dedicated to the outbreak. “One case of coronavirus has been recorded in the Eastern Region, and he is now under the medical healthcare receiving the proper treatment,” the web page in English reported. The latest case takes to 31 the number of officially recorded cases of the virus in Saudi Arabia since September. Fifteen of those have died.

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New case of coronavirus in EP: Health Ministry

Last updated: Saturday, May 18, 2013 8:10 PM

 


RIYADH — A new case of the deadly coronavirus has been detected in the Kingdom, where 15 people have already died after contracting it, the Health Ministry announced on Saturday on its website.

 

One new case of the novel coronavirus has been recorded in the Eastern Province, where most of the Kingdom’s cases have been registered, said the Ministry, which this week created a special web page dedicated to the outbreak.
“One case of coronavirus has been recorded in the Eastern Region, and he is now under the medical healthcare receiving the proper treatment,” the web page in English reported.
The latest case takes to 31 the number of officially recorded cases of the virus in Saudi Arabia since September. Fifteen of those have died.
On Wednesday, the Geneva-based World Health Organization reported that two Saudi health workers have contracted the deadly coronavirus from patients — the first evidence of transmission in a hospital setting.
“This is the first time health care workers have been diagnosed with nCoV (novel coronavirus) infection after exposure to patients,” the WHO said in a statement.
Since last September, the WHO says it has been informed of a global total of 40 laboratory confirmed cases of the virus, including 20 deaths.
While the virus has been deadliest in Saudi Arabia, cases have also been reported in Jordan, Qatar, Germany, Britain and France, where two patients are now in hospital in the northern city of Lille.
The virus is a cousin of Severe Acute Respiratory Syndrome (SARS), which triggered a scare 10 years ago when it erupted in east Asia, leaping to humans from animal hosts and eventually killing some 800 people. — AFP

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Mike Stobbe, The Associated Press
Published Thursday, May 16, 2013 8:18AM EDT
Last Updated Thursday, May 16, 2013 7:52PM EDT

NEW YORK — A deadly new respiratory virus related to SARS has apparently spread from patients to health care workers in eastern Saudi Arabia, health officials said Wednesday.

The Ministry of Health in Saudi Arabia told world health officials that two health care workers became ill this month after being exposed to patients with the virus. One is critically ill.

Since September 2012, the World Health Organization has been informed of 40 confirmed cases of the virus, and 20 of the patients have died. The deaths occurred in Britain, Germany, Saudi Arabia, and Jordan.

Coronavirus, SARS-linked, MERS

A transmission electron micrograph of novel coronavirus particles, colorized in yellow, is shown. (Handout/National Institute for Allergy and Infectious Diseases)

Experts have suggested calling the new virus MERS, for Middle East Respiratory Syndrome, but officials have not signed off on that yet.Experts are watching carefully for signs that the deadly virus can spread from person-to-person. Health officials say the virus has likely already spread between people in some circumstances, including hospital patients in France.

The new virus has caused severe respiratory disease in patients, some of them needing mechanical ventilators to help them breathe.

One of the Saudi health care workers is a 45-year-old man who is in critical condition. The other is a 43-year-old woman in stable condition. No other details about their jobs or where they work were released. Health workers were previously infected in a cluster in Jordan, though that was before the new coronavirus had been identified and before any special measures were taken to prevent its spread. That is not the case in Saudi Arabia and officials worry any new spread to health workers could suggest the virus is becoming more transmissible to people.

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WHO Reprimands Saudi Arabia Facility: New Coronavirus Is Spreading Patient-To-Nurse

Two nurses in Saudi Arabia are added to the country’s list of now 30 infected individuals.

By Susan Scutti | May 16, 2013 12:16 PM EDT

Coronavirus, SARS-linked, MERS

(Photo : CDC.gov) Common symptoms of the new coronavirus (nCoV) have been acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties.

Two health care workers, one now in critical condition, caught the new coronavirus (nCoV) from patients in their care at a health care facility in the Eastern part of Saudi Arabia, the World Health Organization (WHO) reports in an update late on Wednesday. WHO has noted that all of the most recent cases are linked to a particular Saudi Arabian health care facility, which continues to remain unidentified in its updates on the disease.

A total of 21 patients, including nine deaths, have been reported in eastern Saudi Arabia from the outbreak since the beginning of May 2013 to date. The Ministry of Health in Saudi Arabia is conducting ongoing investigation of the outbreak, while WHO monitors the situation. Experts have suggested calling the new virus MERS, for Middle East respiratory syndrome, but officials have not yet signed off on it, Arab News reports.

“This is the first time health care workers have been diagnosed with (novel coronavirus) infection after exposure to patients,” WHO states of the two new laboratory-confirmed cases. Health care-associated transmission has been observed before with nCoV in Jordan last April, but this is a first for Saudi Arabia.

One of the two new patients is a 45-year-old man who became ill on May 2 and is currently in critical condition. The second patient is a 43-year-old woman with a coexisting health condition, who became ill on May 8 and is in stable condition.

In its update, WHO advises health care facilities providing care for patients with suspected nCoV infection to take appropriate measures to decrease the risk of transmission of the virus to other patients and health care workers. “Health care facilities are reminded of the importance of systematic implementation of infection prevention and control,” notes the United Nations Health Agency.

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Correction: New Virus story

Thursday, May 16, 2013

NEW YORK — In a story May 15 about a new SARS-like virus spreading from patients to health care workers in Saudi Arabia, The Associated Press reported erroneously the location of the 20 deaths attributed to the virus. There have been no deaths reported in France and Qatar, only in Saudi Arabia, Jordan, Germany and Britain.

The story also said that the spread to health care workers was new. Health workers were previously infected in a cluster in Jordan before the new coronavirus had been identified.

A corrected version of the story is below:

Saudi health workers sickened by SARS-like virus

2 Saudi Arabia health care workers get SARS-like virus; officials consider naming it MERS

By MIKE STOBBE

AP Medical Writer

NEW YORK (AP) — A deadly new respiratory virus related to SARS has apparently spread from patients to health care workers in eastern Saudi Arabia, health officials said Wednesday.

The Ministry of Health in Saudi Arabia told world health officials that two health care workers became ill this month after being exposed to patients with the virus. One is critically ill.

Since September 2012, the World Health Organization has been informed of 40 confirmed cases of the virus, and 20 of the patients have died. The deaths occurred in Britain, Germany, Saudi Arabia, and Jordan.

Experts have suggested calling the new virus MERS, for Middle East Respiratory Syndrome, but officials have not signed off on that yet.

Experts are watching carefully for signs that the deadly virus can spread from person-to-person. Health officials say the virus has likely already spread between people in some circumstances, including hospital patients in France.

Read Full Article Here

on 6 May 2013, 1:05 PM

A virus by any other name? Researchers have recommended a new name for a novel coronavirus (above) first found in the Middle East.
Credit: Rocky Mountain Laboratories, National Institute of Allergy and Infectious Diseases, NIH

New MERS cases. The MERS coronavirus. Or—if things turn really bad—the MERS pandemic. That’s how the world may soon be talking about the new virus that surfaced in the Arabian Peninsula last summer and that has been rattling health experts since. In a move that may end more than 7 months of confusion, an international group of scientists and public health officials will soon recommend that the new virus be called Middle East respiratory syndrome coronavirus (MERS-CoV).

The group plans to publish a paper recommending the new name, says Raoul de Groot, a veterinary virologist at Utrecht University in the Netherlands, who has coordinated the effort. De Groot chairs the Coronavirus Study Group of the International Committee on Taxonomy of Viruses (ICTV), which took the initiative to find a new, widely accepted name. The study group has no power to enforce use of the name, however; it will be up to researchers to decide whether to adopt the moniker.

News of the name comes as Saudi Arabia has reported 13 new cases of the virus, including seven deaths, in just the past 5 days. The wave—more than a month after the last reported case, a 73-year-old man from Abu Dhabi who died in Munich on 26 March—has sparked fresh worries that the virus might start spreading between humans and trigger a global outbreak. As of today, the total reported number of cases is 30, including 18 deaths.

Confusion had reigned over the new name since the virus was first reported by Ali Mohamed Zaki, an Egyptian microbiologist who isolated it in June 2012 from a patient at a hospital in Jeddah, Saudi Arabia, where he worked at the time. Zaki sent the virus to Ron Fouchier’s virology group at Erasmus MC in Rotterdam, the Netherlands, which characterized it further in a paper published in m Bio in November. Alexander Gorbalenya, a coronavirologist at Leiden University in the Netherlands and ICTV’s vice president, was a co-author, and the group provisionally called the virus HCoV-EMC/2012, short for human coronavirus-Erasmus MC.

The reference to the Dutch lab didn’t sit well with Saudi health officials, who said that Zaki lacked authorization to send the virus to Rotterdam in the first place. Still, most researchers have accepted HCoV-EMC as the name to use. Some have dropped the “EMC,” however, and called the virus simply HCoV, a name that might cause confusion because there are five other human coronaviruses. The World Health Organization (WHO) has adopted the more neutral “novel coronavirus”—abbreviated initially as NCoV but more recently as nCoV—a name that by its very nature was not meant to last.

 

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16 May 2013
Information is reviewed on a regular basis and updated as required.

Risk Assessment

  • The public health risk posed by HCoV-EMC/2012 to Canada is considered low at this time. There have been a limited number of cases reported to date, and while there is evidence of limited capacity for human-to-human transmission, zoonotic transmission is still presumed to be the source of infection.
  • Updated risk assessments will be conducted as new evidence becomes available.

Event Summary

Cases of Novel Coronavirus (nCoV) – subsequently identified and named Human Coronavirus Erasmus Medical Centre (HCoV-EMC/2012) have been reported in Saudi Arabia, Qatar, Jordan, the United Arab Emirates, the United Kingdom and France since the Fall of 2012.

As of 14 May 2013, 34 laboratory-confirmed cases of human infection with novel coronavirus (nCoV) have been reported to WHO: two from Jordan, two from Qatar, 25 from Saudi Arabia, two from the United Kingdom (UK), one from the United Arab Emirates and two from France. Most patients are male (82%; 27 of 33 cases with sex reported) and range in age from 24 to 94 years (median 56 years). Most patients presented with severe acute respiratory disease requiring hospitalization and eventually required mechanical ventilation or other advanced respiratory support. Eighteen patients have died (case fatality rate 53%). Animal exposures were of concern in earliest cases, but the majority of recent cases do not have that history. For the latest updates on the total number of cases and deaths please visit the Global Alert and Response websiteExternal Link.

Since 14 April 2013, 15 new cases of infection have been confirmed and reported in Saudi Arabia, seven of these have died. All patients were reported to have at least one comorbid medical condition and most had more than one. Most of the cases were patients at a single health care facility. Two were family members of two patients from that facility; no health care workers have been affected. Preliminary investigations indicate that a small number of these cases had contact with animals in the time leading up to their illness.

On May 8, 2013, The Ministry of Social Affairs and Health in France reported one confirmed case with infection of nCoV. The patient was hospitalized and preliminary investigations revealed that the patient had a history of travel to Dubai, United Arab Emirates. A secondary case was reported on May 12, 2013 in a patient who shared a hospital room with the first laboratory-confirmed case. Among 120 persons identified as contacts of the first laboratory-confirmed case in France, laboratory tests were conducted on five suspected cases, of which four tested negative, one (mentioned above) tested positive. No healthcare workers have been affected to date.

Several cases have occurred in clusters, including in a health care setting in Jordan in April 2012, in the UK among family members of an infected patient who had recently arrived from Saudi Arabia, the cluster in Saudi Arabia and now the cluster in France. Nosocomial transmission has occurred once and possibly two other occasions (investigations ongoing); and the UK and France clusters confirmed the potential of the virus to transmit between humans with close contact. In neither instance did transmission appear to go beyond the immediate outbreak into the community, and the likely current scenario is multiple introductions into humans with local spread rather than persistent low human transmission.

No vaccine is currently available for novel coronavirus.

The National Institutes of Health has found that a combination of two antiviral drugs, ribavirin and interferon-alpha 2b, can inhibit replication of the virus in cell culturesFootnote 1.

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Toronto SARS expert to go to Saudi Arabia to help with coronavirus

Dr. Allison McGreerDr. Allison McGeer in a laboratory at Mount Sinai Hospital in Toronto on Tuesday January 27, 2004. (/Frank Gunn / The Canadian Press)

Helen Branswell, The Canadian Press
Published Wednesday, May 8, 2013 1:37PM EDT
Last Updated Wednesday, May 8, 2013 5:02PM EDT

Authorities in Saudi Arabia have invited outside experts to help it deal with a large outbreak of the new coronavirus in the eastern Saudi city of al Hofuf, and a Canadian infectious diseases specialist is among them.

Toronto SARS expert Dr. Allison McGeer arrived in the Middle Eastern country on Wednesday, travelling at the request of the kingdom’s government, a source revealed.

The outbreak, which involves at least 13 cases, has ratcheted up worry about the coronavirus, the World Health Organization acknowledged in an update on the virus, which is from the same family as the SARS coronavirus.

“The reappearance of this virus and the pattern of transmission currently being observed in Saudi Arabia increase the level of concern regarding this novel pathogen,” the statement said.

“The questions of the exposures that result in human infection, the mode of transmission, the source of the virus and the extent of infection in the community urgently need to be answered and are being actively pursued by the Ministry of Health of Saudi Arabia.”

In addition to McGeer, two officials of the World Health Organization were in or travelling to the country to meet with senior officials of the ministry of health in the capital, Riyadh.

“It’s likely they will also visit al Hofuf,” WHO spokesperson Gregory Hartl said. He would not reveal the names of the WHO personnel.

The news came on the same day as France reported it had confirmed a case in one of its citizens, a 65-year-old man who got sick in late April after travelling to Dubai in the United Arab Emirates. His infection was confirmed May 7.

It was reported that the man was in the Middle Eastern country on a package tour, a fact that suggests his case may help disease investigators in their efforts to track down the source of the virus. That key fact has to date evaded detection.

Piecing together possible exposures with this coronavirus has been tough. Of the 31 confirmed cases, 18 have died. Of the others, many remain in hospital in critical condition, often on breathing machines. So questioning cases about what they did in the days before they fell ill can be difficult or impossible.

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May 16, 2013 (CIDRAP News) – Though the steady stream of new H7N9 cases has tapered, the pace of publications on the new virus is still brisk, with new reports today on Taiwan’s case, a link between markets and human cases, and risk assessment and planning for possible scenarios in Europe.

All three reports were published in today’s issue of Eurosurveillance.

Lessons from Taiwan’s H7N9 case
In the report on Taiwan’s only case, officials from the Taiwan Centers for Disease Control wrote that they learned several useful lessons from the case involving a man in his 50s who got sick in the middle of April after traveling for work to China’s Jiangsu province, where the virus had already sickened people and been detected in live-market poultry.

Within days of the announcement of the first cases in China, Taiwanese officials made H7N9 a notifiable disease and prepared for suspected cases to be detected through its influenza surveillance system, as well as the surveillance system for community-acquired pneumonia of unknown cause.

The enhanced surveillance activities helped flag the man’s illness. His was the only H7N9 infection confirmed in Taiwan among 358 suspected cases and 41 severe pneumonia illnesses from Apr 3 through May 10.

The authors noted that the man did not have a cough and didn’t meet the official case definition, but his doctors reported his illness as a suspected infection anyway, given his recent travel to China’s outbreak area. They suggested that physicians be allowed to report suspected cases that don’t fully meet case definitions.

The patient’s throat swabs were negative for the H7N9 virus on day 4 and 9 after his illness onset, but an endotracheal aspirate collected on day 8 was positive for the new virus. Taiwan officials wrote that the testing experience led them to revise their sampling guidance.

No H7N9 infections have been found in any of the man’s 139 contacts, including three healthcare workers who had respiratory symptoms a few days after they were exposed to the patient. The team noted the healthcare workers who had symptoms provided routine care using N95 respirators, goggles, gloves, and protective clothing.

Strong link between human cases, poultry
Meanwhile, health workers involved in outbreak response in Huzhou City, located in China’s Zhejiang province, found a strong link between illnesses in 12 patients and local poultry in different settings, according to another Eurosurveillance report.

They described 12 patients whose H7N9 cases were confirmed from late March to May 10. Ages ranged from 32 to 81. Ten had underlying medical conditions such as hypertension, bronchitis, and heart disease.

Nine of the 12 patients had visited live-poultry markets within 10 days of getting sick. The three others had a history of direct contact with poultry shortly before they started having symptoms. One had culled poultry from the live markets, one had purchased live poultry from a vendor and raised them with a neighbor in a courtyard, and one was the spouse of a man who had bought live birds from a market and brought them home to raise.

Researchers collected poultry and/or environmental samples from nine poultry markets linked to the cases, the home settings where case-patients kept their birds, and seven other live-poultry markets in the area that the patients had not visited. Evidence of H7N9 was found in samples from all of the settings.

The team wrote that the findings support the hypothesis that poultry are the source of the H7N9 virus, and they noted that no new cases in Huzhou City have been reported since live markets were shuttered there in the middle of April.

A reported lack of poultry exposure in some of the earlier cases in the outbreak might stem from some patients forgetting details of their exposure history or because they are too sick to provide the details. “It may therefore be possible that patients with no documented exposure may have in fact been exposed to poultry,” they wrote.

Testing of 339 close contacts found no other H7N9 infections, and although throat swabs might not yield the virus as reliably as deep sputum samples, the patients had no obvious symptoms, the authors wrote.

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Earth Watch Report  -  Biological Hazards

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15.05.2013 Biological Hazard Nepal Capital City, Kathmandu Damage level Details

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Biological Hazard in Nepal on Wednesday, 15 May, 2013 at 19:29 (07:29 PM) UTC.

Description
A rapid response team comprising vet officials and technicians on Wednesday evening culled 200 chickens following confirmation of avian flu (H5N1) in a poultry farm owned by Bhim Prasad Lamichhane of Kirtipur -1 Tyanglaphant, Kathmandu. The Directorate of Animal Health (DoAH) said that it is the second outbreak over the last two days. Earlier on Monday evening, vet technicians had culled 1,465 chickens in a poultry farm owned by Amar Karki of Mulpani-3, Kathmandu following detection of bird flu virus. DoAH said the chickens in Lamichhane’s farm tested positive for bird flu on Tuesday evening. Dr Bijaya Kant Jha, Director General (DG) at DoAH said that the office could not deploy rapid response team immediately to Lamichhane’s farm as they were all busy in disinfecting Karki’s farm at Mulpani. “We will complete disinfection by Wednesday evening,” said Dr Jha. He said Lamichhane brought samples of dead chicken for laboratory examination after chickens stopped eating feed and started dying. Bol Raj Acharya, chief of district veterinary office, Kathmandu said that surveillance has been intensified across the country. He said surveillance officer deployed by DoAH have been collecting suspicious samples. DoAH has urged all poultry farmers to take proper care of their chickens. The office has urged poultry farmers to immediately inform vet officials if chickens demonstrate suspicious behavior. Chickens infected with bird flu virus avoid feed, stand still with their head down and drool.
Biohazard name: H5N1 (highly pathogenic avian influenza)
Biohazard level: 4/4 Hazardous
Biohazard desc.: Viruses and bacteria that cause severe to fatal disease in humans, and for which vaccines or other treatments are not available, such as Bolivian and Argentine hemorrhagic fevers, H5N1(bird flu), Dengue hemorrhagic fever, Marburg virus, Ebola virus, hantaviruses, Lassa fever, Crimean-Congo hemorrhagic fever, and other hemorrhagic or unidentified diseases. When dealing with biological hazards at this level the use of a Hazmat suit and a self-contained oxygen supply is mandatory. The entrance and exit of a Level Four biolab will contain multiple showers, a vacuum room, an ultraviolet light room, autonomous detection system, and other safety precautions designed to destroy all traces of the biohazard. Multiple airlocks are employed and are electronically secured to prevent both doors opening at the same time. All air and water service going to and coming from a Biosafety Level 4 (P4) lab will undergo similar decontamination procedures to eliminate the possibility of an accidental release.
Symptoms:
Status: confirmed

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REPUBLICA

KATHMANDU, May 15: A rapid response team comprising vet officials and technicians on Wednesday evening culled 200 chickens following confirmation of avian flu (H5N1) in a poultry farm owned by Bhim Prasad Lamichhane of Kirtipur -1 Tyanglaphant, Kathmandu.

The Directorate of Animal Health (DoAH) said that it is the second outbreak over the last two days.

Earlier on Monday evening, vet technicians had culled 1,465 chickens in a poultry farm owned by Amar Karki of Mulpani-3, Kathmandu following detection of bird flu virus. DoAH said the chickens in Lamichhane´s farm tested positive for bird flu on Tuesday evening.

Dr Bijaya Kant Jha, Director General (DG) at DoAH said that the office could not deploy rapid response team immediately to Lamichhane´s farm as they were all busy in disinfecting Karki´s farm at Mulpani. “We will complete disinfection by Wednesday evening,” said Dr Jha. He said Lamichhane brought samples of dead chicken for laboratory examination after chickens stopped eating feed and started dying.

 

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