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News Reports for November 24, 2012

by: NewsDiary

Sat Nov 17, 2012 at 21:43:03 PM EST


Reminder: Please do not post whole articles, just snippets and links, and do not post articles from the Las Vegas Review-Journal. Thanks!

Canada
• Alberta: Alberta flu immunizing clinics to wrap up Saturday (Link)

United Kingdom
• Scotland: Health chiefs issue warning on flu jab uptake as Lothian wards feel pressure (Link)

Research
• United Kingdom: Do men and women experience flu differently? (Link)

General
• Four new cases of SARS-like virus found in Saudi, Qatar (Link)
• Second coronavirus death reported (Link)
• WHO: Novel coronavirus infection - update (Link)

Commentary
• Recombinomics: Egypt H5N1 Matches In Fatal 2011 Cases Raise Concerns (Link)
• Recombinomics: WHO Suggests Broader Betacornavirus Testing (Link)
• Recombinomics: Betacornavirus Sequences in Saudi Arabia and Qatar Match (Link)
• Branswell: With little information shared, experts express concern about new coronavirus  (Link)
• Recombinomics: Renal Failure In Riyadh Betacornavirus Fatal Cluster (Link)
• Recombinomics: Disease Onset Gap Signals Betacornavirus H2H Transmission (Link)


• H (Link)

NewsDiary :: News Reports for November 24, 2012

News for November 23, 2012 is here.


Thanks to all of the newshounds!
Special thanks to the newshound volunteers who translate international stories - thanks for keeping us all informed!

Other useful links:
WHO A(H1N1) Site
WHO H5N1 human case totals, last updated August 10, 2012
Charts and Graphs on H5N1 from WHO
Google Flu Trends
CDC Weekly Influenza Summary
Map of seasonal influenza in the U.S.
CIDPC (Canada) Weekly FluWatch
UK RCGP Weekly Data on Communicable and Respiratory Diseases
Flu Wiki

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Egypt H5N1 Matches In Fatal 2011 Cases Raise Concerns
November 15, 2012

The CDC has released a series of H5N1 sequences from cases in Egypt.  Full sets of sequences were released for cases through the end of 2011.  The three most recent sets were from fatal cases who died in December, 2011.  The first case (F), A/Egypt/N11126/2011 was 24 weeks pregnant and developed symptoms on November 26 (which was also true for her young child, who was also H5N1 confirmed, but survived).  The mother died on December 3 (the sample was collected on December 1, when the mother was admitted) and was from Dakahlia Governorate.

full article

http://www.recombinomics.com/N...

United we stand: Divided we fall
www.flunewsnetwork.com


WHO Suggests Broader Betacornavirus Testing
Recombinomics Commentary

it is prudent to consider that the virus is likely more widely distributed than just the two 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 two 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.

The above comments are from the last WHO update on the novel betacornavirus (SARS-CoV like), which announces four more confirmed cases and two more suspect cases, which include two additional fatalities.  Four of the cases (two confirmed and two suspect) are from the same family, strongly supporting human to human transmission.

Although details on this cluster have not been released, the four member familial cluster reveals significant developments.  Although media reports continue to cite a lack of evidence supporting human transmission, the likelihood of four new cases, including two fatal cases, are due to a common source is remote.  Earlier reports had also cited symptomatic contacts with the second confirmed case (first in Qatar) which tested negative.  One of the symptomatic family members in the current cluster also tested negative, raising serious concerns about the surveillance and testing.

The first two cases were identified with a pan-coronavirus PCR test, which likely has a low sensitivity based on recent sequence data from the first two confirmed cases.  A new PCR test has been developed, using two regions from the novel betacoronavirus, which should increase sensitivity.  It is unclear if the new cases were confirmed with the new test, or with the earlier pan-coronavirus PCR test, but the negative data on the symptomatic family member raises ongoing testing concerns.

The WHO suggestion for increasing testing of symptomatic cases in countries with no previous case recognizes the likelihood of human transmission as well as an absence of confirmed cases due to limited testing.

(Snip) http://www.recombinomics.com/N...


Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


UK: Do men and women experience flu differently?
Are men unfairly castigated for having "man flu" and running to their sick beds at the merest sign of a sniffle?

Research suggests that women are at greater risk of getting flu than men because they tend to spend more time around children, who are more likely to have a flu-like illness in the first place.

A nationwide flu survey carried out by London School of Hygiene and Tropical Medicine during last winter found that women were 16% more likely to say they had flu symptoms. So is it really women who are making all the fuss about being unwell?

This winter, the online flu survey is up and running again and aiming to find out the answer. The survey needs people of all ages around the country to report any flu-like symptoms by filling in an online questionnaire. This data will be used to map the spread of flu across the country during the winter.

Researchers can then analyse how the virus spreads and who it affects.

How ill?

Dr Alma Adler, who runs the project, says they wanted to find out more about gender differences and flu in this year's survey. "We haven't found any evidence of 'man flu' yet. "The biggest risk factor is having children under the age of 18 and for this reason women are more at risk of flu.

"This year we have included some new questions, such as 'How bad do you feel?' "People can answer on a number scale of one to 10." Continued: http://www.bbc.co.uk/news/heal...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


Canada: Alberta flu immunizing clinics to wrap up Saturday
Another year, another flu season. For those who haven't yet visited a clinic to get their shot, time is running out.

Flu shot clinics have been offering both nasal-spray doses of the flu vaccine - FluMist - and the needle-based version since Oct. 15 in Edmonton, Sherwood Park and St. Albert. Last week, they extended their offer of FluMist to people over 17 years old when they realized the demand turned out to be lower than expected.

But starting Sunday and going until the end of March 2013, people who still need the shot will have to go to a local community health centre or public health office to get it as flu clinics close for the year.

Alberta Health Services (AHS) warns that the influenza virus is circulating in Alberta and they recommend everyone six months old and older get the shot, particularly those whose risk for complications from the flu are greatest. Continued: http://www.edmontonsun.com/201...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


Betacornavirus Sequences in Saudi Arabia and Qatar Match
Recombinomics Commentary

(Note from Carol@SC: see the phylogenetic tree chart on the website. The first three paragraphs there explain it. I have omitted those 3 paragraphs from this post.)

Thus, there is no data suggesting that the recent cases are linked to bat or other animal exposures, in part because all of the novel sequences or confirmed cases are from humans, including two confirmed and two suspect cases from the same family in Riyadh, Saudi Arabia, media reports notwithstanding.

All six confirmed novel betacoronavirus cases have been human, and no reported animal contacts have been reported as symptomatic or betacornavirus confirmed.  Moreover, the first two confirmed cases had renal failure suggesting they represented a small subset of severe cases with viral RNA levels sufficiently high enough to be detected by the pan-coronavirus PCR test.  The negative test in one of the current symptomatic cluster member suggests there are still sensitivity issues associated with the collection/testing of cases which are likely betacornovirus infected.  Negative test results were also reported for symptomatic contacts of the first Qatar case, which included health care workers.

The recent sequences clearly define a novel human pathogen, and the Riyadh cluster strongly suggests the novel hCoV is transmitting human to human in multiple countries, which has led to an WHO recommendation of broader testing. http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


Branswell: With little information shared, experts express concern about new coronavirus
With little information shared, experts express concern about new coronavirus
The World Health Organization has warned countries to heighten their surveillance for possible cases of infection with the new coronavirus, suggesting patients with unexplained pneumonias should be tested even if they don't have links to Saudi Arabia and Qatar.

The agency also suggested investigating clusters of severe respiratory infections, and clusters of such illnesses in health-care workers, regardless of where they happen in the world.

Up until now the WHO has said that testing for the new coronavirus should be restricted to patients with severe respiratory infections who had recently travelled to or who were residents of a country that had recorded cases. To date the only confirmed infections have been in Qatari and Saudi nationals.

That change in advice, the basis for which the WHO did not explain, raised eyebrows among some infectious diseases experts, who were quick to try to read between the lines.



Four new cases of SARS-like virus found in Saudi, Qatar
http://www.reuters.com/article...

By Kate Kelland
LONDON | Fri Nov 23, 2012 2:17pm EST
(Reuters) - A new virus from the same family as SARS which sparked a global alert in September has now killed two people in Saudi Arabia, and total cases there and in Qatar have reached six, the World Health Organisation said.

The U.N. health agency issued an international alert in late September saying a virus previously unknown in humans had infected a Qatari man who had recently been in Saudi Arabia, where another man with the same virus had died.

On Friday it said in an outbreak update that it had registered four more cases and one of the new patients had died.

"The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case)," the WHO said.
(continued)


WHO update on the novel coronavirus...
...is here.

Excerpts:

WHO has been notified of four 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. (snip)

So far, only the two 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. (snip)

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 two 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 two 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.  


[ Parent ]
Second coronavirus death reported
A second person has died from a new respiratory illness similar to the Sars virus, according to the World Health Organization.

The WHO said three fresh cases had also been reported bringing the total to six.

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.

http://www.bbc.co.uk/news/heal...


[ Parent ]
AlohaOR, how many is in your count of cases?
WHO says there are 6 confirmed cases. I keep coming up with a total of 7 cases in my head though. Wasn't there one in Saudi Arabia that died, wasn't laboratory confirmed but then WHO determined by his symptoms that he did die from this new coronavirus? If so, then they aren't officially counting him now. Was't he the 2nd case in Saudi Arabia and cases number 1 and 3 were laboratory confirmed? Then the case from Qatar was laboratory confirmed after he reached the hospital in the UK, correct?

I'm just trying to keep up with this because I have a feeling we are going to start seeing many more cases in the near future. I sure hope I'm wrong!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


[ Parent ]
Here's what WHO has reported, with additional details from news reports
Reported Sept. 23rd:

1. Confirmed: Qatar 49M, renal failure, history of travel to Saudi Arabia.  Developed symptoms Sept 3rd; recovering.  Family members were also symptomatic, but tested negative.

2.  Confirmed, fatal: Saudi Arabia 60yo, renal failure.  No dates or gender given.

Reported Nov. 23rd:

3.  Confirmed, fatal: Riyadh, Saudi Arabia adult M, renal failure.  Son of suspected case #7; family member of case #4. (No dates given.)

4.  Confirmed: Riyadh, Saudi Arabia, family member of case #3 & suspected case #7.  (No dates, age, gender given.)

5.  Confirmed: Saudi Arabia.  No reported connection to other cases.  (No dates, age, gender given.)

6.  Confirmed: Qatar.  No reported connection to other cases.  (No dates, age, gender given.)

7?  Suspect, fatal: Riyadh, Saudi Arabia, 70M, renal failure.  Father of case 3.  Tests are pending.
There was another suspect (symptomatic) case in the same family in Riyadh, Saudi Arabia (non-fatal), but tests were negative for novel coronavirus.


[ Parent ]
Thanks for the details. That helps a lot.
I just wish I could remember the information I saw on a suspected case in the early days of this all coming to light. The only reason it bothers me is that it makes me wonder if any cases have occurred under the radar. I hope the test method has been improved enough now that none are missed!

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


[ Parent ]
Renal Failure In Riyadh Betacornavirus Fatal Cluster
Recombinomics Commentary

WHO reported a cluster of four cases in October in a family living in the same household in Saudi Arabia, in which a father and son both fell ill with symptoms including pneumonia, fever and respiratory problems. The father, 70, died after developing renal failure. His son was hospitalized shortly afterward and died four days later after multiorgan failure. The son was confirmed with the coronavirus while the father's results are pending.

The above comments provide additional detail on the Riyadh fatal cluster, which support human to human transmission.  The detail includes the time gap between disease onset / hospitalization dates, which supports infection of the son by his father.  Moreover the report of renal failure in both cases further support novel betacoronavirus infection, even though lab confirmation in the father has not been reported.

The first two confirmed cases also had renal failure.  The case in Saudi Arabia died, while the Qatar case was placed on an ECMO machine to assist breathing after both lungs were severely damaged. Reports of renal failure in all three fatal cases, as well as severe confirmed cases bear striking similarities to the 2002/2003 SARS cases.  Renal failure was reported in 5-6% of the cases and the vast majority of such cases were fatal.

Thus, the report of renal failure in at least 4 of the 8 confirmed / suspect cases strongly suggests that a much larger number of cases have not been reported / detected.  The failure to confirm the novel coronavirus in one of the symptomatic family members raises additional testing concerns. Continued: http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


UK: Health chiefs issue warning on flu jab uptake as Lothian wards feel pressure (Scotland)
DOCTORS have fired a winter warning to Lothian residents following concerns over a low uptake of flu jabs and a surge in norovirus cases.

The latest figures have revealed that only 42 per cent of under-65s in at-risk groups have so far received their flu jab, putting them at increased danger of the illness and potential complications.

The threat comes as the region experiences unusually high levels of the unrelated norovirus winter vomiting bug - which has led to the closure of four wards in NHS Lothian hospitals this week, with 93 patients and 29 staff members struck down by the illness.

The level of norovirus in the Lothian region is the highest in Scotland, with wards at the Royal Infirmary, Liberton Hospital, the Western General Hospital and the Sick Kids hit. The increased pressure caused by the ward closures is one of the reasons behind NHS Lothian's decision to reopen wards in the Royal Victoria Hospital, which was shut in August.

(Snip)

"Flu can strike suddenly and if you are in one of the at-risk groups, then the impact of the virus can be even more serious, with symptoms hitting you harder and lasting longer. You could end up in hospital, or contract pneumonia or bronchitis." Continued: http://www.scotsman.com/news/h...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


Disease Onset Gap Signals Betacornavirus H2H Transmission
Recombinomics Commentary

Chaib said if there was human-to-human spread in this case it looks like it petered out. She said work is underway to try to tease out whether the people were all infected from a single non-human source, or if one member of the household picked up the infection and passed it along.

"The timing of the cases in the Saudi cluster does raise that concern but when a cluster occurs in a setting such as a household where everyone has similar environmental exposures it can be very difficult to separate out exposure to the same environmental source versus spread from one person to another," she said.

The above WHO comments acknowledge the gap in betacoronavirus disease onset dates between the Riyadh family members.  This gap was also suggested in an updated AP report which noted that the fatally infected son of the fatally infected father was hospitalized after the father died, suggesting the father infected his son.  Both cases died after they developed renal failure. (Snip) the renal failure and death in both cases leaves little doubt that both were infected with the same novel coronavirus.

The renal failure in severe and fatal cases was also seen in the 2002 SARS CoV outbreak.  These similarities leave little doubt that the coronavirus is transmitting human to human (H2H) and is far more widespread and common than the six confirmed and two suspect cases (Snip).  http://www.recombinomics.com/N...

Life is not measured by the number of breaths we take, but by the moments that take our breath away. --Unknown

     


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