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News Reports for November 30, 2012

by: NewsDiary

Sat Nov 24, 2012 at 15:14:45 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!

• Hong Kong probes respiratory illness cluster at animal facility (Link)

• Official: Bird flu kills 4,000 wild ducks in Russia (Link)

United States
• 2012 'State Fair' Swine Flu H3N2 Outbreak in U.S. Was Correctly Predicted by Increase in Genomic Replikin®Count Two Years Earlier (Link)
• MO: Missouri sees increase in reported flu cases earlier in season (Link)

• WHO cites 7th coronavirus case, gives surveillance guidance (Link)
• WHO Interim Revised (Coronavirus) Surveillance Recommendations (Link)
• Jordon: Fifth coronavirus death reported (Link)

• Recombinomics: WHO Confirms Third Fatal Novel Beta Coronavirus Cases (Link)
• Recombinomics: WHO Acknowledges Milder Novel Beta Coronavirus Cases (Link)
• Recombinomics: Jordan Fatal Novel Beta Coronavirus Cluster Confirms H2H (Link)

• H(Link)

NewsDiary :: News Reports for November 30, 2012

News for November 29, 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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Saudi Arabia: WHO cites 7th coronavirus case, gives surveillance guidance

CIDRAP: A third case in a family cluster of novel coronavirus infections has been confirmed, raising the global case count to seven, and the fourth illness in the family is now listed as a probable case, the World Health Organization (WHO) has announced.

In a statement dated yesterday, the WHO also indicated that only one death has been attributed to the novel virus so far, contradicting a Nov 23 announcement that reported two deaths among the first six cases.

The WHO also offered new surveillance recommendations for the novel virus. The agency called for testing of patients in any cluster of severe, unexplained respiratory infections, regardless of location or travel history, and testing of healthcare workers who suffer unexplained pneumonia after caring for patients with severe respiratory infections.

(Continued with updated/additional information on previously-reported cases, summarized below.)

Summary of confirmed cases
WHO Nov. 28 update is here.

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 60M, renal failure.  Died in June.

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: Riyadh, Saudi Arabia, 45M (a gym teacher).  The patient is a heavy smoker who has type 2 diabetes, a history of ischemic heart disease, and only one functioning kidney.  Three days before his illness onset, the man visited a farm near his home and had brief contact with farm animals. The report does not mention any illness among the animals. The man had not traveled outside Riyadh before his illness, but he had been in contact with one of his children, who had a mild cold. The patient fell ill on Oct 9, was seriously ill by Oct 12, and was moved to an intensive care unit (ICU) the next day. He needed breathing assistance for several days, and he received dialysis treatments for renal failure from Oct 15 to 23. He was finally released from the hospital Nov 4.

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

* The number of reported fatalities has been reduced from 2 to 1 in the Nov. 28 update, but the WHO report doesn't explain this discrepancy, and, as the CIDRAP report noted, WHO has "The WHO did not respond to a query about this point this afternoon."

[One of the two following cases has been confirmed, but the news reports don't identify which one.  However, since the number of reported fatalities has been reduced from 2 to 1, it's likely that it's the suspected case #8.]

?7?  Suspected, fatal: Riyadh, Saudi Arabia, 70M, renal failure.  Father of case 3.  

?8? Suspected: Another symptomatic case in the same family in Riyadh, Saudi Arabia (non-fatal), but tests were negative for novel coronavirus.

[ Parent ]
Suspected coronavirus cluster in Jordanian hospital in April
More from the CIDRAP report:

The report also raises the possibility-which has been mentioned before-that a cluster of unexplained respiratory illnesses in a Jordanian hospital ICU in April of this year might have been related to the novel virus.

"Still to be identified is the agent responsible for 11 cases of severe respiratory disease at an ICU in Zarqa, Jordan," it says. "The report by the Jordanian Minister of Health on April 17, 2012, noted that 8 cases were members of the healthcare staff."

In a report in May, the European Centre for Disease Prevention and Control (ECDC) said one nurse died in the Jordanian outbreak and that all the patients had high fever and lower respiratory symptoms. Jordanian health officials thought the outbreak was caused by a virus, but no lab results were available at the time.  

[ Parent ]
WHO Confirms Third Fatal Novel Beta Coronavirus Case
Recombinomics Commentary

The clinical picture in all cases was an acute respiratory infection presenting with signs and symptoms of pneumonia. Four patients developed acute renal failure; one of these died. The remaining three patients had pneumonia that required intensive support, without renal failure, and recovered. Three confirmed cases and the one probable case all belong to the same family and were living in the same household.

The above comments are from the WHO November 28 guidelines on surveillance testing for the novel betacoronavirus first reported in September.  The update increases the number of confirmed cases to seven and cites four cases with renal failure.  The first two cases had renal failure and media reports indicated the two fatal cases (70 year old father and his son) also had renal failure. Therefore the 7th confirmed case would be the father (70M) and the WHO comments above should read that one of the cases survived (the 49M from Qatar), instead of stating that only one died.


Renal failure in four of eight cases, as well as the death of 3 of the 4 cases with renal failure is remarkably similar to clinical presentation and outcomes for the most severe SARS CoV cases from 2003.  The intensive support for the other three confirmed cases also matches results for the SARS CoV outbreak, where almost 10% of lab confirmed cases died, and the deaths were concentrated in middle aged to older patients, which had ages similar to the four cases with renal failure.

Although the WHO has not released the ages for the cases without renal failure, all appear to be middle aged adults.

(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


Today's WHO update
... is here.

A case diary (work in progress) is here.

[ Parent ]
WHO Acknowledges Milder Novel Beta Coronavirus Cases
Recombinomics Commentary

As well, two of the more recent cases were not as sick as the first cases, Mounts notes. They were seriously sick - they needed mechanical help breathing for a time - but they didn't experience the kidney failure seen in the first two cases.

"So that indicates to us that there is a milder form of the disease. It doesn't always involve multi-organ failure and so on," Mounts says.

"But how mild it could be is unknown. And you know, that's basically because where we look for this is in hospitals. And people have not yet started to test milder cases in the area."

The above comments from WHO acknowledge milder cases infected with the recent novel betacornavirus, which was described in more detail in the updated WHO surveillance protocol, which increases the number of confirmed cases to 7 and classifies the 8th case as probable.  The newly confirmed case is the father (70M) of the 6th case, who was also fatally infected.  Like the first two cases, these fatally infected cluster members also had renal failure, while the three other confirmed cases did not.

These differences in clinical presentation and outcomes were expected, as more cases were confirmed.  (Snip) when the first two cases were announced, WHO maintained that the renal failure in the first two cases distinguished these cases from 2003 SARS CoV cases.  However, about 5% of the confirmed SARS CoV cases had renal failure and almost all died.  Overall, almost 10% of confirmed SARS cases died, and most fatal cases were older (>40 years of age).  (Snip) the initial cases had infected with the novel betacornavirus were at the severe/fatal end of the clinical spectrum and they also fell into the older category.

Although WHO has not released the ages of the recent cases, media reports indicated the 7th confirmed cases was the father of the other fatal case in the cluster. The father was 70 years old, so his son was likely >40.  The ages of the first to cases (60M and 49M) were also in the older category, suggesting many mild cases in younger victims have gone undetected.

The WHO update also noted that the more recent cases were from Riyadh, Saudi Arabia and Duha, Qatar, and the cases had not traveled supporting transmission from humans, not animals.  Therefore, WHO has recommended expanded testing. 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


2012 'State Fair' Swine Flu H3N2 Outbreak in U.S. Was Correctly Predicted by Increase in Genomic Replikin®Count Two Years Earlier
LONDON, Nov. 29, 2012 PRNewswire -- Bioradar UK Ltd today concluded that an increase in the genomic Replikin®Counts of H3N2 virus (Swine Flu) in the U.S. from 2008 to 2011 correctly predicted the 'State Fair' H3N2 swine flu outbreaks of this past summer in pigs and children . The same method measuring genomic H1N1 in Mexico also predicted the 2009 Pandemic a year before its emergence, and with H5N1 in Cambodia, two years before the recent outbreaks.

In the recent 'State Fair' summer 2012 outbreaks, the contacts between pigs and children was well documented as was the emergence of viral disease. In the present study, 7,804 replikins infectivity gene sequences and 7,112 replikins lethality gene sequences were analyzed, all that were present in Pubmed bank listings from 1968 to 2011. The evolution of H3N2 virus infectivity gene Replikin®Counts in the USA, were relatively constant at a low level of rapid replication, that is with Counts below 4.0 Replikins (per 100 genomic amino acids).

The Counts increased markedly from 2008 to 2011 so that in 2011, 21.9% of the sequences in the virus population had Counts greater than 4.0, the highest on Pubmed record since 1968 and sixty times higher than the Counts 1968-1997. This peak Count of 2011 was followed by the H3N2 outbreak in 2012 . As in other influenza strains, some Replikin sequences in H3N2 genes were found to be conserved back to the 1960s, the earliest dates of H3N2 sequences reported on Pubmed, helping in the formulation of lasting vaccines.

No instance has been observed to date in which a statistically significant (p<0.001) increase or decrease in Replikin®Counts did not correlate with an outbreak or clinical decrease respectively and there were no 'false negatives':  H1N1 (2008 prediction for the 2009 pandemic, 2010 for the 2010 outbreak, 2011 for 2012 outbreak); H5N1 (1996 for 1997, 2005 for 2006-07, 2009 for 2011 outbreak); three influenza pandemics of the past century; SARS (2003 for 2004); Foot and Mouth Disease (2010 for 2011-12); E. Coli (2005-2010 for 2011); and malaria (for 1998-2006 decrease in mortality).


Since the geographic site of the outbreak is for the first time predictable by the Replikin Counts, as shown by Bioradar in Mexico, in Indonesia, in Cambodia, and now in the U.S., it is hoped that national governments, medical schools, and pharmaceutical companies now will join with Bioradar UK Ltd. to test the possibility that the development of outbreaks and pandemics in their geographic site may actually be prevented.

Synthetic Replikin TransFlu®Vaccines (including H3N2 2012) are available to institutions for testing. http://www.prnewswire.com/news...  

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


US: Missouri sees increase in reported flu cases earlier in season
COLUMBIA - The number of reported flu cases has seen a steep increase in October and November compared to the same period last year, according to The Missouri Weekly Influenza Report.

A total of 2,088 flu cases have been reported throughout Missouri since the beginning of October - a 880.3 percent increase from the past five-season median of the same time interval.

The number of flu cases reported each week grew from eight cases in the week ending Oct. 6 to 451 cases in the week ending Nov. 24.

The flu season started early this year, said Sarah Rainey, the epidemiologist at Columbia/Boone County Department of Public Health and Human Services. The early start of the flu season doesn't necessarily mean that this year will be worse in terms of the number of cases, health specialists said. Flu epidemics are difficult to predict in advance because they are influenced by several disparate factors such as the type of viruses and the number of people who get the vaccine.

"We have seen an increase in cases compared to this time last year; however, influenza is cyclical and the peak can vary from season to season. It is too early to determine what this season will look like compared to previous years," Gena Terlizzi, director of communications at Missouri Department of Health and Senior Services, wrote in an email.


In Boone County, there have been 456 flu cases reported since August, Rainey said. There was a spike in cases toward the end of October. A total of 866 cases were reported in the 2011-2012 flu season, of which only 32 occurred in October and November, Rainey said.

Rainey said that even though fewer cases were reported in the past few weeks, it's not "a significant decline." Continued: http://www.columbiamissourian....

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


Comment: This is not flu news but I think it is an important new finding.....
bgw in MT found and sent this article to me and I thought it important to share it with everyone. It's about a more aggressive form of West Nile Virus in the US causing severe brain damage to people who contract it. It's titled:

"Doctors fear West Nile virus has mutated into more damaging form"

Most of us have to deal with mosquitos a large portion of the year and we all need to take precautions. I posted it in the "Not Influenza But Close" Diary http://www.newfluwiki2.com/dia...

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


CIDRAP: Hong Kong probes respiratory illness cluster at animal facility
Authorities in Hong Kong are investigating a cluster of respiratory infections in five men who work at an animal management center in Sheung Shui, (Snip)

The men, who range in age from 27 to 64, got sick from Nov 6 to Nov 24. All were hospitalized, some with pneumonia, and one-the 27-year-old-was discharged on Nov 22 in stable condition. So far diagnostic tests have not pinpointed the cause of the infection, and specimens from a 55-year-old man were negative for novel coronavirus. The CHP said monitoring of family contacts has turned up no other similar infections. It said that 16 seized parrots were being housed at the animal facility, and 10 of the birds were culled after 3 of them died. Continued:  http://www.cidrap.umn.edu/cidr...

Nov 26 CHP statement http://www.info.gov.hk/gia/gen...

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


Official: Bird flu kills 4,000 wild ducks in Russia
MOSCOW: Around 4,000 wild ducks have been found dead in Russia's southern Krasnodar region, officials said (Snip), blaming H5 bird flu for the mass deaths. "This is the H5 virus, the strain is being confirmed," (Snip).

The birds' remains were now being tested, (Snip). The dead birds have been found on lakes near the Black Sea resort town of Anapa.

The region has gone on high alert, with poultry and humans now being vaccinated. "All of these are protective measures, it's better to be on the safe side," the spokeswoman added. http://thestar.com.my/news/sto...

(Note: "humans now being vaccinated"???)

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


Jordan Fatal Novel Beta Coronavirus Cluster Confirms H2H
Recombinomics Commentary

In addition to the fatal case of novel coronavirus in Saudi Arabia reported to WHO on 28 November, two fatal cases in Jordan have been reported to WHO today, bringing the total of laboratory-confirmed cases to nine.

The two cases from Jordan occurred in April 2012. At that time, a number of severe pneumonia cases occurred in the country and the Ministry of Health (MOH) Jordan promptly requested a WHO Collaborating Centre for Emerging and Re-emerging Infectious Diseases (NAMRU - 3) team to immediately assist in the laboratory investigation.

The above comments are from a WHO update confirming two of the pneumonia cases in an ICU ward in Zarqa, Jordan in April, 2012 were due to the novel betacornavirus currently circulating in Saudi Arabia and Qatar.  This outbreak involved at least seven nurses and a doctor among the 11 cases cited.  Media reports indicated the actual number was larger than the numbers cited in an ECDC report, which noted the death of one of the nurses.

The failure of NAMRU-3 to detect this outbreak last spring raises concerns (Snip).

The ICU cluster clearly demonstrates that this novel betacoronavirus transmits human to human (H2H) and has striking similarities to the SARS CoV outbreak in 2003. http://www.recombinomics.com/N...

Note: "This outbreak involved at least seven nurses and a doctor among the 11 cases cited." That is very troubling news. Investigations into unusual illnesses and deaths in the general population and the medical communities needs to be expanded. Testing also needs to be expanded worldwide on patients who exhibit the same symptoms as the confirmed cases, to discover if this virus is more widespread now, especially since the 2012 Hajj.  

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


Bronco Bill, it's Friday joke time!
Your giggles are here: http://www.newfluwiki2.com/dia...

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


Fifth coronavirus death reported
A fifth person has died from a new respiratory illness similar to the Sars virus, according to the World Health Organization.

The WHO said the two latest deaths were in Jordan. The disease had previously been detected only in Saudi Arabia and Qatar, although one patient was transferred to the UK for treatment.

It brings the total number of cases of the infection to nine.

There may also be evidence of human to human spread of the virus.

It causes pneumonia and sometimes kidney failure.

There was a series of severe cases of pneumonia in Jordan earlier in the year. However, the novel coronavirus had not been discovered at the time so did not appear in routine tests.

Two of the deaths in April have now been confirmed as being part of the outbreak.


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