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

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Nieuw onderzoek biedt inzicht in de overdacht van mens op mens van dit virus.

Transmission of MERS-Coronavirus in Household Contacts

Strategies to contain the Middle East respiratory syndrome coronavirus (MERS-CoV) depend on knowledge of the rate of human-to-human transmission, including subclinical infections. A lack of serologic tools has hindered targeted studies of transmission.

Methods
We studied 26 index patients with MERS-CoV infection and their 280 household contacts. The median time from the onset of symptoms in index patients to the latest blood sampling in contact patients was 17.5 days (range, 5 to 216; mean, 34.4). Probable cases of secondary transmission were identified on the basis of reactivity in two reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assays with independent RNA extraction from throat swabs or reactivity on enzyme-linked immunosorbent assay against MERS-CoV S1 antigen, supported by reactivity on recombinant S-protein immunofluorescence and demonstration of neutralization of more than 50% of the infectious virus seed dose on plaque-reduction neutralization testing.

Results
Among the 280 household contacts of the 26 index patients, there were 12 probable cases of secondary transmission (4%; 95% confidence interval, 2 to 7). Of these cases, 7 were identified by means of RT-PCR, all in samples obtained within 14 days after the onset of symptoms in index patients, and 5 were identified by means of serologic analysis, all in samples obtained 13 days or more after symptom onset in index patients. Probable cases of secondary transmission occurred in 6 of 26 clusters (23%). Serologic results in contacts who were sampled 13 days or more after exposure were similar to overall study results for combined RT-PCR and serologic testing.

Conclusions
The rate of secondary transmission among household contacts of patients with MERS-CoV infection has been approximately 5%. Our data provide insight into the rate of subclinical transmission of MERS-CoV in the home.

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http://www.salzburg.com/nachrichten/gesundheit/medizin/sn/artikel/mers-viruserkrankung-erster-fall-in-oesterreich-122652/

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WHO  @WHO

WHO Recommendation: Improve awareness about #MERS_CoV among pilgrims going for Hajj goo.gl/TG0mm0

8:48pm · 1 Oct 2014

WHO statement on the Seventh Meeting of the IHR Emergency Committee regarding MERS-CoV

Statement
1 October 2014

The seventh meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (IHR 2005) regarding the Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted with members and advisors of the Emergency Committee through electronic correspondence from 26 September 2014 through 30 September 2014.1

The WHO Secretariat provided an update on and assessment of epidemiological and scientific developments, including a description of recently reported cases and transmission patterns. Islamic Republic of Iran and Saudi Arabia provided an update on and assessment of MERS-CoV, including progress towards implementation of the Emergency Committee’s temporary recommendations. 2

The Committee noted that: (i) there have been significant efforts made to strengthen infection prevention and control measures, with an epidemiological situation that has not changed since the 6th meeting of the IHR EC; (ii) the number of cases has fallen since the April upswing, and cases continues to appear sporadically with no evidence of sustained human-to-human transmission in communities; (iii) although transmission in health care settings is still occurring in small clusters, transmission seems generally contained; (iv) activities conducted to reduce the international spread of MERS-CoV seem to be effective; and (v) the current data suggest that MERS-CoV transmission could be seasonal, with an upsurge expected next spring.

The Committee reiterated that its previous advice remains relevant and that significant efforts should be made to:

continue to strengthen infection prevention control (IPC) practices, build capacity of heath-care workers and provide protective equipment in vulnerable countries, especially African countries;
improve awareness about MERS-CoV among pilgrims going for Hajj, and conduct surveillance for MER-CoV among pilgrims during and after Hajj;
harmonise laboratory testing algorithms;
reinforce epidemiological surveillance in camels in the Middle East and in Africa, as well as surveillance in humans and address critical gaps in knowledge of human and animal transmission.
The Committee unanimously concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met.

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. The Emergency Committee will be reconvened in three months, or earlier if circumstances require.

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New Corona Virus case has been reported
The Supreme Council of Health (SCH) has announced that a new “Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been reported for Qatari patient aged 43 years old. The patient have had fever for few days and was transported by ambulance to the Emergency Department at Hamad General Hospital. Upon assessment and laboratory investigations, the patient was diagnosed with pneumonia and subsequently confirmed as MERS-CoV case. As soon as the Health protection Rapid Response Team got the notification, a series of standard investigation and contact tracing steps were implemented. These include verifying whether contacts have any symptoms and specimen collected. However, all contacts would be monitored for two weeks. Within the same framework, a joint team from human Health and animal resources started investigation process involving camels and individuals in contact with them for specimen collection and follow up. lees verder

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Reappearance of MERS cases due to arrival of winter, says Minister
DOHA: MERS — Middle East Respiratory Syndrome — cases have reappeared in Qatar due to the approaching winter when the virus is more likely to grow, the Minister of Public Health and Secretary-General, Supreme Council of Health H  E Abdullah bin Khalid Al Qahtani has said. lees verder

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Global Health MENA @MEGlobalHealth

#Saudi #MERS update @WHO 03/10/14, bit.ly/1xfsBlJ. 12 new cases in last 2 weeks of October, 5 deaths
8:00am · 7 Nov 2014

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Problemen met MERS-cov in Midden Oosten nog niet voorbij

Camel breeding season brings more coronavirus fears
JEDDAH — The command and control center of the Health Ministry has noted a rise in Middle East Respiratory Syndrome-Coronavirus infections from only four cases in September, with health experts blaming the camel breeding season for the increase. lees verder

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WHO @WHO

Middle East respiratory syndrome is a newly emerging disease that remains poorly understood goo.gl/1YjqqW #MERS
11:00pm · 2 Jun 2015

Middle East Respiratory Syndrome (MERS) in the Republic of Korea

MERS situation assessment
2 June 2015

The outbreak of Middle East Respiratory Syndrome, or MERS, in the Republic of Korea continues to evolve. WHO is in close contact with the country’s government and Ministry of Health, and is receiving information as soon as facts are confirmed.

The quality of reporting has allowed almost real-time insight into the dynamics of the outbreak. Aggressive contact tracing and testing for infection may help explain the rapid expansion of the outbreak. Human-to-human transmission has been documented. At this stage, WHO has no evidence of sustained transmission in the community.

Korea’s first, or “index”, case was confirmed on 20 May and notified to WHO the same day. The case occurred in a 68-year-old Korean national with a recent history of travel to four countries in the Middle East. The case was asymptomatic during his return flight to Korea on 4 May.

He developed symptoms on 11 May and subsequently sought care at two out-patient clinics and two hospitals, creating multiple opportunities for exposure among health care workers and other patients.

As the index case provided no history of potential exposure to the virus, MERS was not suspected and the patient was not treated in isolation. Efforts are under way to gather more information about exposures during the patient’s travels in the Middle East.

Expansion of the outbreak

The outbreak is the largest reported outside the Kingdom of Saudi Arabia, where the disease first emerged in April 2012 and the vast majority of cases have occurred.

To date, contact tracing has identified a total of 25 laboratory-confirmed cases, including the index case and among health care workers caring for him, patients who were being cared for at the same clinics or hospitals, and family members and visitors.

Some of these additional cases were in the same room as the index case; others were on the same ward. Though data are preliminary, exposure times that led to infection may have been as short as five minutes to a few hours.

To date, two of these cases have been fatal.

Given the number of clinics and hospitals that cared for the index case, further cases can be expected.

On 26 May, one of the confirmed cases with an exposure history in Korea travelled, against medical advice, to Guangdong, China, via Hong Kong. He was symptomatic at the time of travel. On 29 May, China informed WHO that the patient, who was isolated at a Huizhou hospital, tested positive for the MERS coronavirus.

The occurrence of such a large outbreak outside the Middle East is a new development, as is exportation of the disease to a third country. The Ministry of Health has further reported that two recently confirmed cases represent a third generation of transmission – from the index case, to someone exposed to that case, to a third person with no direct exposure to the index case.

Consistent application of adequate measures for infection prevention and control has halted other large clusters of cases associated with health care facilities. WHO recommends that droplet precautions be added to standard measures when providing care to patients with symptoms of acute respiratory infections.

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

MERS is a newly emerging disease that remains poorly understood. Much about the behaviour of the virus remains shrouded in scientific uncertainty, though evidence is mounting that dromedary camels can transmit the virus to humans through close contact.

WHO is confident that investigations under way in Korea, including the sequencing of viruses and sharing of the findings, will contribute to further scientific understanding of this disease.

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http://www.nu.nl/algemeen/4064123/zesde-mers-dode-in-zuid-korea-.html

Inmiddels zesde dode en 23 nieuwe besmettingen (totaal 87).
2300 personen in quarantaine.
Er zijn 1800 scholen dicht uit angst voor besmetting.

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...the government is trying to monitor people suspected of being infected after reports that some people were ignoring instructions to isolate themselves.
"We did cellphone tracking in a couple of cases. For those we need to find we will request location tracking and get the data,"...

Regering gaat door volgen mobiele telefoon isolatievoorschriften afdwingen.