SARS-achtig virus duikt op MERS (Middle East respiratory syndrome- coronavirus)

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CDC: First US case of deadly virus MERS reported in Indiana
MUNSTER, Ind. (May 2, 2014) — The first U.S. case of MERS-CoV has been reported in Indiana, the Centers for Disease Control and Prevention said Friday. The patient is currently being treated at Community Hospital in Munster.
MERS-CoV, short for Middle East Respiratory Syndrome, is a type of coronavirus. The incubation period for MERS is 5 days.
CDC  and the Indiana State Department of Heath are conducting a joint investigation of the first case of MERS-CoV in the United States. MERS-CoV, a virus new to humans, was first reported in the Arabian Peninsula in 2012.
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WHO experts probe Middle-Eastern respiratory syndrome coronavirus (MERS-CoV) in Jeddah, Saudi Arabia

2 May 2014

A team of experts from WHO started a two-day mission yesterday in Jeddah to assist national health authorities to investigate the recent increase in number of people infected by MERS-CoV.

From mid-March 2014, 111 people have tested positive in the Jeddah area; the biggest single surge in the MERS-CoV outbreak since the new virus was detected in April 2012. Thirty-one persons have died.

As a large proportion of infections in Jeddah occurred in health-care facilities, the WHO team began with analyzing transmission patterns in the city’s main hospitals.

“We need to understand how people got infected in health-care settings, and in the community; we are looking into possible infection routes and whether the virus has changed its ability to more easily infect people,” says Dr Jaouad Mahjour, WHO Team Leader, “but we know that the systematic application of basic infection prevention and control measures in health facilities is key to limiting transmission and protecting health-care workers and other patients.”

Following the confirmation of the first cases, health facilities increased laboratory testing of patients, close contacts and health-care workers and strengthened protective measures. One third of the people tested positive in the recent spate of cases are health-care workers with mild or no symptoms.

“Our priority is to stop the transmission inside the hospital by strengthening infection prevention and control activities,” says Dr Mohammed Al Ghamdi, an Infectious Disease Consultant at the King Fahd Hospital, the city’s main general hospital - where 78 people have tested positive so far. “WHO is helping us in getting answers on transmission routes not only in health facilities, but also in the community.”
Primary source of infection

Camels are increasingly being seen as the primary source of the MERS-CoV infecting humans, as recent studies showed that camels can harbour live virus. However, it is still unclear how exactly the virus is being transmitted to humans. Once infected, the person can pass the virus to other people, but no sustained chains of infection have been observed.

“Until we better understand how the virus transmits from camels or the environment to a human, we are likely to see more cases, and with travel, the virus is exportable,” said Dr. Mahjour. “Therefore, understanding this link is key to limiting the outbreak. There is an urgent need to conduct an in-depth epidemiological study of known cases to get this knowledge.”

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.

Until further information is gathered, it is prudent for persons at high risk of severe disease due to MERS-CoV (including those with diabetes, chronic lung disease, pre-existing renal failure, or those who are immunocompromised) to take appropriate precautions when visiting farm and market environments where camels are present. These measures might include avoiding contact with camels, good hand hygiene, and avoiding drinking raw milk or eating food that may be contaminated with animal secretions or products unless they are properly washed, peeled, or cooked.

For the general public, when visiting a farm, live animal markets or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.

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.

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First US MERS patient worked in Saudi Arabia healthcare
A person who recently worked in healthcare in Saudi Arabia and fell ill after flying to the United States on Apr 24 has the first confirmed US case of MERS-CoV (Middle East respiratory syndrome coronavirus), federal health officials announced today while asserting that there is very little risk to the public.

The patient, who was not identified, was admitted to Community Hospital in Munster, Ind., on Apr 28, tested positive for MERS this afternoon, and is in stable condition, the Centers for Disease Control and Prevention (CDC) announced. To protect the patient's family, the CDC did not reveal the person's gender, age, or whether he or she is a US or Saudi resident. lees verder

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Alert over spike in Middle East flu virus
DUBAI, 5 May 2014 (IRIN) - Health authorities around the world are on high alert after a sudden spike in the incidence of a deadly Middle Eastern flu bug that began in Saudi Arabia but has now spread to Asia and the USA.

As of 4 May, the Kingdom had recorded 411 cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and 112 deaths in two years.

Almost a third of these cases have emerged in the past two weeks, the biggest single surge of MERS-CoV since it was discovered in April 2012, prompting questions about whether the virus has the potential to escalate into a pandemic similar to Severe Acute Respiratory Syndrome (SARS), which swept through Asia in 2002-3, killing over 700 people.

Beyond Saudi Arabia the virus has a significant caseload in the United Arab Emirates (UAE) and in the past week other cases have been discovered in the US, Greece and Egypt for the first time, with 12 countries in total now affected.
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CIDRAP @CIDRAP

Saudis report 36 #MERS cases in 3 days; UAE adds 4 bit.ly/1kEIZ5F
1:28am · 6 May 2014

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WHO concludes MERS-CoV mission in Saudi Arabia
Cairo, Egypt 7 May, 2014 – A team of experts from the World Health Organization (WHO) completed a 5-day mission to Saudi Arabia to assist the national health authorities to assess the recent increase in the number of people infected by the Middle East respiratory syndrome coronavirus (MERS-CoV) in Jeddah.
As of 3 May, 489 cases, including 126 deaths, were reported to WHO globally and 406 cases, including 101 deaths, from Saudi Arabia. These numbers can change from one day to the next according to when Member States inform WHO.
The team looked into the epidemiological, disease prevention, organizational and communication aspects of this recent outbreak to understand the public health risk and transmission chain and to propose next steps and actions.
After meeting health officials in the capital, WHO experts visited two main hospitals in Jeddah to analyse transmission patterns and review infection control measures.
Key findings of the Jeddah outbreak include the following.
Current evidence does not suggest that a recent increase in numbers reflects a significant change in the transmissibility of the virus. The upsurge in cases can be explained by an increase, possibly seasonal, in the number of primary cases amplified by several outbreaks in hospitals due to breaches in WHO’s recommended infection prevention and control measures. There is no evidence of sustained human-to-human transmission in the community and the transmission pattern overall remained unchanged.
The majority of human-to-human infections occurred in health care facilities. One quarter of all cases have been health care workers.  There is a clear need to improve health care workers’ knowledge and attitudes about the disease and systematically apply WHO’s recommended infection prevention and control measures in health care facilities.
 The reasons for the increase in the number of primary community cases, as well as the infection route, remain unknown. Three quarters of all primary community cases have been male, the majority of whom have been over 50 years old. Secondary transmission in the community and households is much lower than in health care settings.
Some confirmed cases presented with mild or no symptoms.
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections and to carefully review unusual patterns.
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, including for upcoming pilgrimage travel to Saudi Arabia.

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Second U.S. case of MERS virus found in Florida, CDC says
A second case of the deadly MERS virus has been confirmed in the United States, the Centers for Disease Control and Prevention announced today.
The CDC said the disease was diagnosed Sunday in a patient at an Orlando, Florida, hospital. They said the man, from Saudi Arabia, was in the area visiting relatives when he fell ill last week. They noted that he had not visited at any Orlando-area theme parks.
This man -- like the first U.S. patient in Indiana earlier this month -- was a health care worker in a hospital in Saudi Arabia where MERS cases have been treated. Officials said the two U.S. cases are not related.

MERS-CoV -- which stands for Middle East respiratory syndrome coronavirus -- was first identified in Saudi Arabia in 2012. Since then at least 480 cases have been confirmed in Saudi Arabia and 139 people there have died. Cases have also been reported in several nearby countries including the United Arab Emirates, Egypt, Jordan and Lebanon.
The only cases identified so far in the U.S. or Europe have been in people who had recently traveled to the region.
Symptoms of MERS can include fever, breathing problems, pneumonia and kidney failure.
Health officials say they are working to track down people who may have come in contact with the Orlando patient during his travels, beginning on May 1 with flights from Jedda, Saudi Arabia, to London, then on to Boston, Atlanta, and finally Orlando
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WHO in spoed bijeen om dodelijk longvirus
De Wereldgezondheidsorganisatie (WHO) is dinsdag in Genève in een spoedzitting bijeengekomen om te overleggen over het stijgend aantal gevallen van het dodelijke MERS-virus.
Dit Middle East Respiratory Syndrome vormt volgens de WHO een ''internationaal zorgwekkende bedreiging op de gezondheid''.
Eerder werd op dinsdag een tweede besmetting met het MERS-virus geconstateerd in de Verenigde Staten. Bij twee ziekenhuismedewerkers die aan deze MERS-besmetting zijn blootgesteld, werden daarop griepverschijnselen geconstateerd. Dit voedt de onzekerheid over het mysterieuze longvirus.

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Eerste MERS-patiënt in Nederland
Op 13 mei hebben het RIVM en het Erasmus MC voor het eerst een infectie met het MERS-coronavirus vastgesteld bij een Nederlandse patiënt. Hij raakte besmet tijdens een bezoek aan Saoedi-Arabië en is op dit moment opgenomen in het Medisch Centrum Haaglanden, locatie MCH Westeinde. Hier wordt de patiënt in strikte isolatie verpleegd. Zijn gezondheidstoestand is stabiel. Alle mensen die contact hebben gehad met de patiënt worden in kaart gebracht. Van deze personen wordt de gezondheidstoestand in de gaten gehouden.

MERS-infecties kunnen ernstige luchtwegklachten veroorzaken, vooral bij mensen met andere gezondheidsproblemen. Ook kunnen diarreeklachten voorkomen. Mens-op-mensoverdracht van het MERS-coronavirus komt weinig voor, behalve bij nauw contact met patiënten en bij onbeschermde verpleging van ernstig zieke personen.

Sinds 2012 is er een uitbraak van het nieuwe MERS-coronavirus (Middle East Respiratory Syndrome) in het Midden-Oosten. Inmiddels zijn ruim 500 patiënten in het Midden-Oosten gemeld bij de Wereldgezondheidsorganisatie. In april en mei 2014 is er een forse toename in het aantal meldingen in het Midden-Oosten. Verreweg de meeste meldingen komen uit deze regio (vooral Saoedi-Arabië, maar ook Qatar, Jordanië, Oman, Jemen en Verenigde Arabische Emiraten). Sinds vorig jaar zijn er ook enkele patiënten vastgesteld in het Verenigd Koninkrijk, Frankrijk, Italië, Griekenland, Filippijnen, Maleisië, Koeweit, Tunesië, Duitsland, Egypte en de Verenigde Staten. Dit waren reizigers die besmet zijn geraakt in het Midden-Oosten. Het is niet onverwachts dat er nu ook een patiënt in Nederland is. MERS-coronavirus was daarom al een meldingsplichtige infectieziekte.

Het Medisch Centrum Haaglanden is voor opnames en afspraken geopend voor patiënten en bezoekers.

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WHO in spoed bijeen om dodelijk longvirus

WHO statement on the Fifth Meeting of the IHR Emergency Committee concerning MERS-CoV

WHO statement
14 May 2014

The fifth meeting of the Emergency Committee convened by the Director-General under the International Health Regulations (2005) concerning Middle East respiratory syndrome coronavirus (MERS-CoV) was held by teleconference on Tuesday, 13 May 2014, from 12:07 to 17:12 Geneva time (CEST).

In addition to Members of the Emergency Committee, three expert advisors participated in the informational session only1. These advisors did not participate in the formulation of advice to the Director-General.

Thirteen affected States Parties reporting cases of MERS-CoV or evidence of infection since December 2013, were also on the first part of the teleconference: Egypt, Greece, Jordan, Kuwait, Lebanon, Malaysia, Oman, Philippines, Qatar, Saudi Arabia, United Arab Emirates, United States of America, and Yemen.

The WHO Secretariat provided an update on and assessment of epidemiological and scientific developments, including a description of the recent increase in cases in communities and in hospitals, transmission patterns, and the main observations of a WHO mission to Saudi Arabia, conducted 28 April – 5 May 2014.

Affected countries gave information about recent events in their countries, including measures taken and their concerns about the current situation.

The Members of the Committee discussed the information provided. Based on current information, the Committee indicated that the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission. As a result of their deliberations, the Committee concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met.

However, the Committee emphasized that its concern about the situation had significantly increased. Their concerns centred on the recent sharp rise in cases; systemic weaknesses in infection prevention and control, as well as gaps in critical information; and possible exportation of cases to especially vulnerable countries. The Committee strongly urged WHO and Member States to take immediate steps to:

    improve national policies for infection prevention and control, and implement them in health-care facilities in all countries; this is most urgent for affected countries;
    initiate and accelerate critical investigations, including case-control, serological, environmental, and animal studies, to better understand the epidemiology, especially risk factors and assess the effectiveness of control measures;
    support countries that are particularly vulnerable, especially in sub-Saharan Africa, taking into account the regional challenges;
    strengthen case and contact identification and management;
    greatly enhance awareness and effective risk communication concerning MERS-CoV to the general public, health professionals, at-risk groups, and policy makers;
    strengthen intersectoral collaboration and information sharing across ministries and with relevant international organizations, especially with the World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO);
    develop and disseminate advice regarding mass gatherings to prevent further spread of MERS-CoV;
    share information in a timely manner with WHO, in accordance with the International Health Regulations (2005).

Based on the Committee’s advice, and information currently available, the Director-General accepted the Committee’s assessment. She thanked the Committee for its work.

The WHO Secretariat will continue to provide regular updates to the Committee Members and Advisors. In view of the Committee’s concerns, the Emergency Committee will be reconvened in June 2014 or earlier if circumstances require.