MERS-CoV vigilance rises in US

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Novel coronavirus renamed MERS-CoV: WHO
English.news.cn 2013-05-29 05:58:03

GENEVA, May 28 (Xinhua) -- The novel coronavirus was renamed Middle East Respiratory Syndrome Coronavirus (MERS-CoV) following the proposal of the Coronavirus Study Group of the International Committee on Taxonomy of Viruses, said the World Health Organization (WHO) on Tuesday.

WHO said that it has not convened a group to discuss the naming of this virus, and the proposed name MERS-CoV, representing a consensus acceptable to WHO, was built on consultations with numerous scientists.

Virus names that evade the region or place of the initial detection of the virus are generally prefered by WHO, which added that this approach was intended to minimize unnecessary geographical discrimination that could be based on coincidental detection rather than on the true area of emergence of a virus.

WHO said that several Middle East countries have been affected by this significant public health threat, including Jordan, Qatar, Saudi Arabia, and the United Arab Emirates, and cases with direct or indirect connection to the Middle East have also been reported by France, Germany, Britain and Tunisia.

WHO updated on May 23 that to date the global total of confirmed cases of human infections with MERS-CoV reached 44, including 22 deaths. Moreover, France confirmed its first death from the new deadly virus on Tuesday.

WHO recommended members to enhance surveillance and precautions for the testing and management of suspected cases and promptly notify the organization of any new case of infection with the new virus. The organization reclaimed that it is working closely with countries and international partners.


__________________________________________________________________________________
• WHO Middle East respiratory syndrome coronavirus (MERS-CoV) - update 21 July 2013

21 JULY 2013 - WHO has been informed of two additional laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia.

Both the cases are currently critically ill and hospitalized in ICUs. The first case is a 41-year-old Saudi male in Riyadh who presented to the hospital with symptoms on 15 July. The second patient is a 59-year-old Saudi female in the Al-Ahsa governorate. She presented with symptoms on 11 July.

Both patients have underlying medical conditions, but neither patient has had contact with known MERS-CoV confirmed cases or animals.

WHO is seeking more information from the National IHR Focal Point of Saudi Arabia.

Globally, from September 2012 to date, WHO has been informed of a total of 90 laboratory-confirmed cases of infection with MERS-CoV, including 45 deaths.

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.

Health care providers are advised to maintain vigilance. Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhea, in patients who are immunocompromised.

Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.

All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

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.

WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

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MERS-CoV risk: More transparency needed

UAE has always been leading the country in taking precautionary measures to counter this kind of virus

BY Cleofe Maceda, Senior Reporter
Published: 16:34 July 21, 2013
Gulf News

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The UAE needs to stay vigilant and exercise more transparency about the extent of the country’s risk to the MERS-CoV virus to avoid the situation from reaching epidemic levels, industry sources told Gulf News.

Sources said it is important to take some precautionary measures, considering the UAE’s proximity to Saudi Arabia, where the most number of cases have been reported.

“Dubai, in particular, is a major transit point for international travellers, so we should be more vigilant,” said one doctor at a clinic in Karama.

“There should be leaflets distributed to the public by now to educate the residents about the virus and how to avoid getting infected, for prevention purposes,” she added.

Article continues below

Dr Yuwa Hedrick-Wong, global economic adviser for MasterCard, said countries affected by any health epidemic should coordinate with the World Health Organisation (WHO) and exercise transparency.

“To me, the basic important procedures for any city are number one, transparency, and number two, work with WHO. Work with all the leading centres in the world in terms of disease prevention and control,” Wong said in an earlier interview with Gulf News.

“Uncertainty is always worse than the reality, because that tends to make people’s imagination go crazy. That’s why transparency and being factual are always the best remedy under those conditions,” he added.

The tourism sector, however, is confident that the UAE has always been at the forefront in disease prevention and control.

“The UAE has always been leading the country in taking precautionary measures to counter this kind of virus. It was the case a couple of years back when SARS and bovine disease invaded the Far East and other parts of the world,” said Wael Al Behi of Ramada Downtown Dubai..

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Article Date: 21 Jul 2013

MERS-CoV, the Middle East Respiratory Syndrome coronavirus may spread faster and deeper internationally during two mass pilgrim gatherings taking place this year in Saudi Arabia, Dr. Kamran Khan, an infectious disease physician, of St. Michael's Hospital, Toronto, Canada, and colleagues warned in the journal PLoS Currents: Outbreaks.

Two Muslim pilgrimages - Umrah and Hajj - attract millions of people from all over the world to the holy Saudi cities of Mecca and Medina.

Umrah can be done at any time of year. However, the bulk of travellers come during the month of Ramadan, which this year started on July 9th and ends on August 7th. Hajj, the major pilgrimage, takes place this year from October 13th to 18th.

Saudi Arabia expects over one million pilgrims from every corner of the globe during the next two to three weeks. In October, at least another three million will come.

Dr. Khan and colleagues are urging health care providers to learn from the experience of SARS. They emphasize that it is crucial for authorities and health care providers to anticipate rather than react to pilgrims coming home from the Middle East.

SARS was an unknown coronavirus that killed 800 people globally ten years ago. Forty-four people died in Toronto. The Canadian government says that SARS cost the nation's economy approximately $2 billion.

The MERS coronavirus is also a previously unknown one. It appears to have emerged in the Middle East last year and has spread to several countries in the area, as well as Europe and North Africa. Cases of MERS-CoV infection have been reported in Saudi Arabia, Jordan, Qatar, United Arab Emirates, France, Italy, Tunisia, Germany and the Untied Kingdom.

Over 80 cases of MERS-CoV human infection have been confirmed worldwide, 42 of them died - MERS has a mortality rate of over 50%. SARS death rate was about 10%.

Dr. Khan and colleagues gathered and analyzed international airline traffic and historic Hajj data to predict how many people will be moving in and out of Saudi Arabia during these two mass pilgrimages. Their aim is to help countries assess MERS-CoV introduction by returning pilgrims and travellers.

The researchers also used economic and per capita health expenditure data collected from the World Bank to help determine how able countries might be to "detect imported MERS in a timely manner and mount an effective public health response."

Dr. Khan is founder of a web-based technology - BioDiaspora - that predicts how infectious diseases can spread by analyzing global air traffic patterns. Several international agencies have used BioDiaspora to evaluate threats of emerging infectious diseases, including pilgrimages and sports events such as the Olympics. BioDiaspora has been used by WHO (World Health Organization), CDC (US Centers for Disease Control and Prevention) and ECDC (European Centre for Disease Prevention and Control).

Dr. Khan said:

"With millions of foreign pilgrims set to congregate in Mecca and Medina between Ramadan and the hajj, pilgrims could acquire and subsequently return to their home countries with MERS, either through direct exposure to the as-of-yet unidentified source or through contact with domestic pilgrims who may be infected."

In this study, Khan and colleagues found that of the 16.8 million people who flew on commercial flights out of Saudi Arabia, Jordan, Qatar and the United Arab Emirates (where MERS-CoV cases have been traced back to) from June to November 2012 (one month before Ramadan and one month after Hajj last year), 51.6% travelled to just 8 countries:

16.3% - India
10.4% - Egypt
7.8% - Pakistan
4.3% - United Kingdom
3.6% - Kuwait
3.1% - Bangladesh
3.1% - Iran
2.9% - Bahrain

Between June and November 2012, each of the following twelve cities received at least 350,000 commercial air travelers from those four countries where MERS-CoV probably originated:

Bahrain
Beirut (Lebanon)
Cairo (Egypt)
Dhaka (Bangladesh)
Istanbul (Turkey)
Jakarta (Indonesia)
Karachi (Pakistan)
Kozhikode (India)
Kuwait City
London (London)
Manila (Philippines)
Mumbai (India)

Unlike SARS, MERS might spread mainly to poorer nations...

Unlike SARS, where infected people traveled to mainly high-income nations through air travel, more than half the air travelers leaving Saudi Arabia, Qatar, Jordan and the United Arab Emirates (UAE) went to low or lower-middle income countries. Over 60% of all Hajj pilgrims come from low or lower-middle income nations.

Nearly one-third of all travellers flying out of Saudi Arabia, UAE, Qatar and Jordan have India, Bangladesh, Afghanistan, Nepal and Pakistan as their final destination.

Dr. Khan said:

"Given that these countries have limited resources, they may have difficulty quickly identifying imported MERS cases, implementing rigorous infection control precautions and responding effectively to newly introduced cases."

If health authorities are considering screening air travellers for MERS-CoV infection, Dr. Khan suggests doing so as they leave their source areas in the Middle East, instead of screening them at their destination airports. He believes this would be much more efficient and less disruptive to the world's air traffic.

Dr. Khan added "However, all countries receiving pilgrims and other travelers from known MERS areas should mobilize their infectious disease surveillance and public health resources in ways that are commensurate with their potential for MERS introduction."

Front-line health care providers need to be trained and prepared for the possibility of MERS-CoV infection in patients, Dr. Khan emphasized, because that is the first necessary step to implement effective infection control measures that can stem the spread of infectious disease.

SARS managed to spread within health care institutions because of delays in considering SARS diagnosis, which in turn led to delays in applying proper infection control measures.
Saudi authorities asking pilgrims to wear masks

Saudi Arabian health authorities are asking pilgrims to wear masks as a precaution against MERS-CoV infection.

Elderly individuals, people with chronic diseases, as well as patients with weak immune systems are being told to postpone their visits.

Travelers have also been reminded to follow careful hand hygiene procedures, to cough or sneeze into a paper handkerchief and dispose of it carefully, and to make sure all their vaccinations are up-to-date.

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Novavax Produces MERS-CoV Vaccine Candidate

Rockville, MD (June 6, 2013)–/GlobeNewswire, Inc. /-Novavax, Inc. (NASDAQ: NVAX)
announced today that it had successfully produced a vaccine candidate designed to provide
protection against the recently emerging Middle East Respiratory Syndrome Coronavirus
(MERS-CoV). The vaccine candidate, which was made using Novavax’ recombinant
nanoparticle vaccine technology, is based on the major surface spike (S) protein. The Company
believes that its MERS-CoV vaccine candidate may provide a path forward for a vaccine for this
emerging threat.

MERS-CoV is a novel coronavirus first identified in September 2012 by an Egyptian virologist,
who isolated the previously unknown coronavirus from the lungs of a 60-year-old patient with
pneumonia and renal failure. To date, the World Health Organization (WHO) has reported a total
of 53 laboratory-confirmed cases of infection with MERS-CoV, including 30 deaths. The newly
emergent virus is a part of the coronavirus family that includes the severe acute respiratory
syndrome coronavirus (SARS-CoV), first recognized as a global threat in March 2003 and by
July 2003, had resulted in 8,098 SARS cases in 26 countries, with 774 deaths.

Novavax had previously produced a recombinant nanoparticle vaccine candidate for the SARSCoV virus which was similarly based on its major surface S protein. Novavax’ SARS-CoV
vaccine candidate study demonstrated immunogenicity and complete protection of animals in a
live viral challenge; the study was published in the journal Vaccine (online 14 July, 2011)
MERS-CoV was first reported in Saudi Arabia and has spread to Europe, including England,
France, Germany and most recently Italy. Health officials do not know how the newly
discovered MERS-CoV spreads, making the development of an effective vaccine an important
public health priority.

About Novavax

Novavax, Inc. (Nasdaq: NVAX) is a clinical-stage biopharmaceutical company creating vaccines
to address a broad range of infectious diseases worldwide. Using innovative recombinant
nanoparticle technology, as well as new and efficient manufacturing approaches, the company
produces vaccine candidates to combat diseases, with the goal of allowing countries to better
prepare for and more effectively respond to rapidly spreading infections. Novavax is committed
to using its technology platform to create geographic-specific vaccine solutions and is therefore
involved in several international partnerships, including collaborations with Cadila
Pharmaceuticals of India, LG Life Sciences of Korea and PATH. Together, these organizations.

[dothedd]

Mumbai may become India’s gateway for deadly MERS virus, scientists warn

July 22, 2013 Update

For the first time ever, scientists analyzed worldwide airline traffic and historic Haj data to predict population movements in and out of Saudi Arabia and the Middle East during two mass gatherings to help countries assess their potential for MERS introduction via returning travellers and pilgrims.

Scientists from St Michaels Hospital in Toronto have named India as among those facing the highest risk, with Mumbai and Kozhikode at the top of the list of susceptible cities.

Around 1.7 lakh Indian Muslims will visit Haj this year.

The MERS coronavirus, which appears to have emerged in the Middle East in early 2012, has spread to several countries in Western Europe and North Africa where there have been localized clusters of cases.

Worldwide about 80 cases have been confirmed, with a mortality rate of more than 50%.

The team found that of the 16.8 million travellers who flew on commercial flights out of Saudi Arabia, Jordan, Qatar and the United Arab Emirates between June and November 2012 (the period starting one month before Ramzan and ending one month after the Haj), 51.6% had destinations in just eight countries—India (16.3%), Egypt (10.4%), Pakistan (7.8%), Britain (4.3%), Kuwait (3.6%), Bangladesh (3.1%), Iran (3.1%) and Bahrain (2.9%).

Two cities from India—Mumbai and Kozhikode—were among the 12 like Cairo, Kuwait City, London, Bahrain, Beirut, Dhaka, Karachi, Manila, Istanbul and Jakarta that each received more than 350,000 commercial air travellers between June and November 2012 from the four countries where MERS cases have been traced back to.

Scientists therefore say there is high potential for the virus to spread faster and wider in India during two annual events that draw millions of domestic and foreign Muslims to Saudi Arabia.

The first is Umrah, a pilgrimage that can be performed at any time of year but is considered particularly auspicious during the month of Ramadan, which this year began on July 9 and ends on August 7. The second is the Haj, a five-day pilgrimage required of all physically and financially able Muslims at least once in their life. It takes place from October 13-18 this year and is expected to draw more than 3 million people.

The scientists say "collectively, India, Pakistan, Bangladesh, Afghanistan and Nepal represent the final destinations of nearly one-third of all international air travellers".

They also used World Bank economic and per capita health care expenditure data to help gauge individual countries' abilities to detect imported MERS in a timely manner and mount an effective public health response.

Researchers led by Dr Kamran Khan, an infectious disease physician said "With millions of foreign pilgrims set to congregate in Mecca and Medina between Ramadan and the Haj, pilgrims could acquire and subsequently return to their home countries with MERS, either through direct exposure to the as-of-yet unidentified source or through contact with domestic pilgrims who may be infected."

In contrast to SARS, where the disease was introduced into predominantly high-income countries through air travel, more than half of all air travellers departing Saudi Arabia, Jordan, Qatar and UAE have final destinations in low or lower-middle income countries. Two-thirds of all hajj pilgrims originate from low or lower-middle income countries.

"Given that these countries have limited resources, they may have difficulty quickly identifying imported MERS cases, implementing rigorous infection control precautions and responding effectively to newly introduced cases," Dr Khan said.

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Does the dangerous new Middle East coronavirus have an African origin?

June 24, 2013

s.ph-cdn.com/newman/gfx/news/2013/doesthedange.jpg

In this animal the scientists from the University Bonn (Germany) and from South Africa found a virus that ist genetically more closely related to MERS-CoV than any other known virus. Credit: M Corrie Schoeman/University of KwaZulu-Natal


The MERS-coronavirus is regarded as a dangerous novel pathogen: Almost 50 people have died from infection with the virus since it was first discovered in 2012. To date all cases are connected with the Arabian peninsula. Scientists from the University Bonn (Germany) and South Africa have now detected a virus in the faeces of a South African bat that is genetically more closely related to MERS-CoV than any other known virus. The scientists therefore believe that African bats may play a role in the evolution of MERS-CoV predecessor viruses. Their results have just been published online in the journal "Emerging Infectious Diseases".


Infection with the novel "Middle East Respiratory Syndrome Coronavirus" or MERS-CoV has been diagnosed in 90 patients so far, half of whom have died. In severe cases, patients develop pneumonia and acute kidney failure. All cases so far are – sometimes indirectly through infected family members or close contacts – connected with the Arabian peninsula.

A collaboration of researchers from the Institute of Virology at the University Bonn, Germany, the University of Stellenbosch and several other South African institutions have recently found evidence that MERS-CoV could possibly originate from bats occurring in southern Africa. The South African scientists, headed by Prof. Wolfgang Preiser, tested faecal material from a total of 62 bats from 13 different species for coronaviruses. In collaboration with their colleagues in Bonn, headed by Dr. Jan Felix Drexler, they investigated the genetic material of the viruses that they found.

In a faecal sample from a bat of the species Neoromicia cf. zuluensis they found a virus that is genetically more closely related to MERS-CoV than any other known virus. They believe that MERS-CoV may originally come from bats and may have reached the human population via other animals acting as intermediate hosts.

Search for MERS-CoV progenitor should include Africa

This finding was made in one individual bat only, but nevertheless serves as an important pointer. When searching for the origin of MERS-CoV, Africa should be taken into account, in addition to the Arabian peninsula. This work is as important as searching for treatment, because once the origin and modes of spread are known, the risk for human beings can be minimised. An example for the spread of MERS-CoV could be Rift Valley fever that, coming from East Africa, caused outbreaks in Saudi Arabia and Yemen in 2000.

Further studies of bats and potential interim hosts are urgently needed to elucidate the origin of MERS-CoV. Finding a closely related virus in a bat does not mean that human beings can become infected directly through exposure to the bats. It should not be misunderstood as indicating a health risk from bats and does by no means justify their persecution; on the contrary, bats provide value to ecosystems in several respects and should enjoy strict protection. It is however likely that bats are the natural hosts for the virus, and that human infections are the result of contact with other animals such as camels acting as intermediate hosts. At this stage there is probably also direct human-to-human transmission.

[dothedd]

Support high for travel screening to stem MERS spread: poll
•
• NEW YORK | Wed Jul 24, 2013 8:48am EDT
An Ipsos online survey of more than 19,000 people in 24 countries showed that fewer than half of people questioned knew much about the disease known as Middle East Respiratory Syndrome coronavirus, or MERS, which has infected 88 people and killed 45 people.

Although awareness is low, most people said they are concerned about how prepared their nations are and would alter travel plans to avoid countries where cases have been reported.

"The two important things about this research are that it (MERS) is not at a level yet where it is on a lot of people's radar screens," said John Wright, a senior vice president at the global polling company Ipsos.

"The world isn't panicking over this," he added in an interview, "but they want to know that officials are taking steps to deal with it."

More than 80 percent of people questioned in developed countries said inbound travelers from countries with cases of MERS should be screened for the illness. The number rose to 90 percent in less industrialized countries.

Support was highest in China, Indonesia and Saudi Arabia, where the illness has been reported, and Italy, which has also been affected, as well as in Australia, Canada and Argentina.

Awareness about how to prevent infection was also low in many countries.

Last week the World Health Organization (WHO) reported six new cases of MERS in United Arab Emirates and Saudi Arabia, including five health workers and one person who had been in contact with an infected person.

The illness, which can cause fever, coughing and pneumonia, has also surfaced in Jordan, Qatar, the United Arab Emirates, Tunisia, Britain, France, and Germany.

Travel was also a big concern with the majority of people questioned in the poll saying they would cancel or delay travel to a country affected by the illness.

The WHO has said the illness has not reached the level of a pandemic and may just die out. So far it has not recommended restrictions on travel.

The global health organization said it is drawing up advice on travel in relation to coronavirus.

"Clearly travel is going to be affected the most as a priority for people to look into," said Wright.

Ipsos conducted the poll from June 4 to 18, questioning about 500 or 1,000 people in each country. A poll of 1,000 is accurate of plus or minus 3.5 percentage points and one of 500 to plus or minus 5.0.

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Awareness Not Yet Widespread but Support for Screening Travelers, Reconsidering Travel Plans is High

Wednesday, July 24, 2013

New York — On the heels of being declared to not yet be a health emergency by the World Health Organization, majorities in 24 countries nonetheless express concern that there might be cases of Middle Eastern Respiratory Syndrome (MERS) in their country in the near future. MERS is an outbreak in certain countries of a virus that people are comparing to SARS which occurred in 2003. The poll, released by global company Ipsos provided exclusively to Reuters, finds that awareness is still not high as only minorities in all but six of all countries studied have seen, read or heard about MERS.

The study was conducted online in 24 countries and will be viewed as a benchmark for future studies. The 24 countries are analyzed as two separate cohorts: “developed nations” and “developing nations.”

The first cohort includes the views of those in 15 developed nations: Argentina, Australia, Belgium, Canada, France, Germany, Great Britain, Hungary, Italy, Japan, Poland, South Korea, Spain, Sweden and the United States. In these countries, the samples are reflective of the general population.

The second cohort includes the views of those in 9 developing nations: Brazil, China, India, Indonesia, Mexico, Russia, Saudi Arabia, South Africa and Turkey. In these countries the online respondents are more likely to have higher levels of income and education compared to their respective populations. As such, this vanguard population is more likely to be tuned into reports of MERS due to their access to the internet and other media/information and also because they are likely to be more engaged in the economy and travel as “Upper Deck Consumer Citizens.”

In the 15 more developed nations studied, four in ten (39%) are aware of MERS, while in the 9 developing countries of upper deck consumer citizens, half (49%) are aware. A majority in both cohorts – 59% generally (and 65% of those aware) across the 15 countries and 70% generally (and 78% of those aware) across the 9 countries – are concerned that MERS may come to their country in the near future. In both regions, awareness of MERS increases likelihood of concern.

Only two in ten (18%) generally of all in the 15 countries (28% of those aware), but double (40%) the general upper deck consumer population in the 9 developing nations (55% of those aware), agree they “know enough about MERS to protect their families and themselves”.

The vast majority of respondents in both country groupings agree (strongly and somewhat) that travelers entering their country who have been in MERS-affected countries should be screened by health professionals first (80% of the aggregate of the 15 countries, 90% of the 9).

Majorities in all countries studied agree that they would consider cancelling or delaying travel if they found out the country they wanted to visit has experienced any cases of MERS (72% of the aggregate of the 15 countries, 82% of the 9).

Four in ten in the general populations of those in the 15 more developed nations (38%– 42% among those aware of MERS) and six in ten of the general upper deck consumer citizens (57%– 60% among those aware of MERS) in the nine countries surveyed agree that their government has taken appropriate steps to screen travelers entering their country to prevent spread of MERS.

Only Minorities Aware of MERS…

There has been some reference recently to an outbreak in certain countries of a virus that people are comparing to SARS which occurred in 2003. In the past couple of weeks, the World Health Organization and the European Centre for Disease Control issued assessments of a coronavirus outbreak in the Middle East, which has been recently named MERS, for Middle Eastern Respiratory Syndrome. There are concerns that the virus may be spreading from person to person and some have called for urgent investigations to find the source of the virus and how it is infecting people. At the time of fielding of the survey, there were 40 confirmed infections with the virus as of early June. Of those cases, 20 were fatal. Most of the cases have been in Saudi Arabia, other countries that have reported cases are Jordan, Qatar, the United Arab Emirates, Germany, Britain and France.

Four in ten (39%) of those in the 15 more developed nations studied are aware of MERS while half (49%) in the 9 developing countries of upper deck consumer citizens are aware.

Awareness among the 15 developed nations surveyed is highest in France (59%), Sweden (51%) and Italy (49%) and lowest in Australia (20%), Spain (26%) and Hungary (28%). In the nine developing countries surveyed awareness is highest in China (67%), India (63%) and Saudi Arabia (62%) and lowest in South Africa (35%), Mexico (35%) and Brazil (35%).

…Yet Concern is High…

Respondents were asked the extent to which they concerned that there might be cases of MERS in their country in the near future and majorities agree. In fact, a majority in both cohorts – 59% generally (and 65% of those aware) across the 15 countries and 70% generally (and 78% of those aware) across the 9 countries – are concerned. In both regions, awareness of MERS increases likelihood of concern.

In the developed nations, the most concerned are from: Argentina (77%), Spain (65%) and Italy (64%) while the least concerned are from: Sweden (39%), Poland (47%) and Germany (51%). Of the upper deck consumer citizens, the strongest concern is found in: Indonesia (84%), Mexico (78%) and India (75%) while the weakest concern is found in: China (52%), Saudi Arabia (62%) and South Africa (63%).

Majorities Feel Unprepared…

At the point of fielding, only two in ten (18%) of those in the 15 developed countries (28% of those aware) agree they “know enough about MERS to protect their families and themselves.” These numbers double among the developing nations as four in ten (40%) of the general upper deck consumer population in the nine developing nations (55% of those aware) agree. Argentina (26%), South Korea (25%) and Italy (22%) are most likely to agree among the 15 developed nations while Spain (12%), Belgium (14%) and Australia (14%) are least likely. China (58%), Indonesia (58%) and India (56%) and Saudi Arabia (56%) are most likely among the nine developing nations to agree while South Africa (21%), Turkey (24%) and Russia (27%) are least likely to agree.

Travel Considerations Deemed Important…

Respondents seem to view travel as an important factor as they express concern for both incoming travelers entering their country and for themselves as potential outgoing travelers to affected regions.

The vast majority of respondents in both country groupings agree (80% of the aggregate of the 15 countries, 90% of the 9) that “travelers entering my country who have been in any of the countries where MERS has been present should be screened by a health professional before entering.” Those most likely to agree, in the 15 countries, are from Australia (89%), Italy (89%), Canada (88%) and Argentina (88%). Those least likely to agree are from South Korea (55%), Sweden (62%) and Poland (77%). Those most likely to agree, in the 9 countries, are from China (93%), Indonesia (93%) and Saudi Arabia (93%). Those least likely to agree are from Brazil (84%), India (85%) and Mexico (87%).

Softer majorities agree they “will consider cancelling or delaying travel if I found out the country I wanted to visit had experienced any cases of MERS” (72% of the aggregate of the 15 countries, 82% of the 9). Those most likely to agree, in the 15 countries, are from Hungary (81%), Japan (78%) and South Korea (78%) while those least likely to agree are from Poland (62%), Belgium (63%) and Great Britain (63%). Those most likely to agree, in the 9 countries, are from China (96%), Indonesia (87%) and Russia (86%) while those least likely to agree are from Brazil (75%), Saudi Arabia (76%) and South Africa (78%).

Minority in Developed, Majority in Developing Countries Agree Governments Have Taken Proper Steps…

Four in ten in the general populations of those in the 15 more developed nations (38%– 42% among those aware of MERS) agree that their “government has taken appropriate steps to screen travelers coming into my country to prevent the spread of MERS”. Confidence on this measure appears considerably higher among the developed nine, as six in ten of the general upper deck consumer citizens (57%– 60% among those aware of MERS) agree with the statement.

Those most likely to agree, in the 15 countries, are from South Korea (56%), Argentina (44%) and Japan (44%) while those least likely to agree are from Great Britain (28%), Spain (31%) and Italy (33%). Those most likely to agree, in the 9 countries, are from China (90%), Saudi Arabia (77%) and Indonesia (62%) while those least likely to agree are from South Africa (25%), Mexico (46%) and Turkey (50%).

These are findings of the Global @dvisor wave fielded June 4th to June 18th, 2013. The monthly Global @dvisor data output is derived from a balanced online sample in 24 countries around the world via the Ipsos Online Panel system. For the results of the survey presented herein, an international sample of 19,014 adults aged 18-64 in the US and Canada, and age 16-64 in all other countries, were interviewed. Approximately 1000+ individuals participated on a country by country basis via the Ipsos Online Panel with the exception of Argentina, Belgium, Finland, Hungary, Indonesia, Mexico, Netherlands, Poland, Russia, Saudi Arabia, South Africa, South Korea, Sweden and Turkey, where each have a sample approximately 500+. The precision of Ipsos online polls are calculated using a credibility interval. In this case, a poll of 1,000 is accurate to +/- 3.5 percentage points and one of 500 is accurate to +/- 5.0 percentage points in their respective general populations. In countries where internet penetration is approximately 60% or higher the data output is weighted to reflect the general population. Of the 24 countries surveyed, 15 yield results that are representative: Argentina, Australia, Belgium, Canada, France, Germany, Hungary, Italy, Japan, Poland, South Korea, Spain, Sweden, United Kingdom and United States. The nine remaining countries surveyed –Brazil (45.6% Internet penetration among the citizenry), China (41%), India (11.4%), Indonesia (22.1%), Mexico (36.5%), Russia (47.7%), Saudi Arabia (49%), South Africa (17.4%) and Turkey (45.7%)—have lower levels of connectivity therefore cannot be weighted to be general population representative; however, the online sample in these countries are particularly valuable in their own right as the are more urban/educated/income than their fellow citizens and are often referred to as “Upper Deck Consumer Citizens”.

[dothedd]

How the Deadly MERS Coronavirus Could Be Spread Around the World by Pilgrims

This is a story about deadly disease flying on the wings of modern, globalized air travel. A new study published in PLoS Currents: Outbreaks outlines the route by which the deadly new MERS coronavirus could be spread around the world. It comes down to two important Muslim pilgrimages in Saudi Arabia and where the majority of those people flying into the region are coming from.

MERS stands for Middle East Respiratory Syndrome. Caused by a coronavirus, it emerged early in 2012 and spread to several countries in Europe and North Africa. In total, 80 cases have been confirmed globally. That doesn't sound too bad, until you realize that half of those cases have proven fatal.

CONTINUED:
Read more: motherboard.vice.com/blog/how-the-deadly-mers-coronavirus-could-be-spread-around-the-world-by-pilgrims#ixzz2a41A5c1z

[dothedd]

MERS virus fear spreads in UK

Jul 25, 2013

LONDON: Pilgrims aged 65 years or above in Britain have been officially asked to drop their Haj plans this year.

UK has become the first country to formally issue a notification asking those above 65 years of age, those suffering from chronic diseases such as heart, kidney or respiratory disease, diabetes, immune deficiency and cancer to postpone their visit to the annual pilgrimage for fear of the Middle East Respiratory Syndrome coronavirus (MERS-CoV).

Pregnant women and children under 12 years of age have also been asked to cancel their plans as they are the most-vulnerable to getting infected with the deadly SARS-like virus. The recommendations came to UK from the ministry of health in Saudi Arabia

Public Health England (PHE) and National Travel Health Network and Centre have come up with the notification for people planning to travel to Saudi Arabia for the annual Haj pilgrimage.

The Haj is the largest annual international gathering with more than three million Muslims travelling from around the world to make the pilgrimage including thousands from the UK.

Dr Brian McCloskey, director of global health at PHE, said: "A large population from around the world confined to one area has historically increased the risk of infectious disease outbreaks, in particular meningitis and respiratory infections, which is why getting the relevant travel advice and vaccinations in advance of your departure is so important."

The World Health Organization has expressed worry over the threat of the MERS virus spreading across the world following Haj in October. Around 1.7 lakh Indian Muslims will visit Haj this year. Till now, there have been 79 cases and 42 deaths caused by MERS-CoV.

Dr Keiji Fukuda, assistant director general for health security at WHO, admitted: "Are we worried? Yes, I think we're worried in a globalized world that infection can travel quickly from one country to another. I mean we see that with the evidence of some of the infections in Europe being related to travel to the Middle East."

The fatality for this infection still remains pretty high, running around 60%. WHO says compared to the SARS outbreak a decade ago, there are many fewer healthcare workers who have gotten infected with MERS Coronavirus.

WHO said: "In terms of person to person transmission, we are not seeing it sweep through communities. In the past three months we have basically been seeing a steady number of cases. So, if we look over the last three months, in April we had 19 cases, in May we had 21 cases and then in June we had 22 cases. So, basically a kind of steady pattern to cases with no big explosions going on right now".

[dothedd]

Virus fears, Mecca work force cut in Saudi hajj pilgrimage
 
Jul 25, 2013
12:55 PM

A colourised transmission of the Middle East respiratory syndrome (Mers) coronavirus that emerged in 2012 is shown in this photo provided by the National Institute for Allergy. Fears of an outbreak of the deadly Mers virus in Saudi Arabia and construction in the holy city of Mecca have forced cuts in the numbers of pilgrims permitted to perform this year's hajj. -- FILE PHOTO: AP

www.straitstimes.com/breaking-news/world/story/virus-fears-mecca-work-force-cut-saudi-hajj-pilgrimage-20130725

HABTOR JEDDAH, Saudi Arabia (AFP) - Fears of an outbreak of the deadly Mers virus in Saudi Arabia and construction in the holy city of Mecca have forced cuts in the numbers of pilgrims permitted to perform this year's hajj.

Millions of Muslims during the annual pilgrimage head to Mecca and Medina, Islam's two holiest sites, providing a possible means for Mers to spread around the globe as pilgrims who may become infected return to their home countries.

Fearful of such a scenario, the authorities have reduced by half the number of pilgrims coming from within Saudi Arabia, and by about 20 percent those from abroad.

"This is an exceptional and temporary decision," Hajj Minister Bandar Hajjar announced last month.

[dothedd]

China, Poultry-related Firms Hit by H7N9 Virus

25 July 2013

CHINA - The latest case of H7N9 confirmed on 20 July in Beijing is expected to delay further the financial recovery of poultry-related companies.

The 61-year-old female patient from Langfang, Hebei province, is still in a critical condition after being infected with the virus, which was the only diagnosed case in China in July.

In April, the government closed many markets in some areas, including Zhejiang and Jiangsu provinces, to prevent the spread of the disease. They began to reopen from the end of June.

The total losses of poultry-related companies all over the country up until the end of June exceeded 600 billion yuan ($92.2 billion) since the first case of H7N9 virus was discovered by the authorities at the end of March, according to the latest statistics from the National Poultry Industry Association.

"The monitoring system of updated figures on losses was shut down and poultry markets gradually started to reopen at the end of June because there were no more new cases discovered until 20 July," said Liang Zhong, an officer in charge of the pigeon industry at the National Poultry Industry Association.

Mr Zhong added the association would wait for responses from businesses on the further effects of this latest case to decide whether the monitoring system would restart.

The previous outbreak brought the industry to a standstill because fewer people were willing to buy poultry-related products. It led to a sharp fall in the prices of chickens, pigeons, ducks and even eggs.

The average selling price of a pigeon dropped from 11.5 yuan in March to its current 6.5 yuan while the price of chicken dropped from 12 yuan a kilo to 4 yuan.

"There was a slight recovery in prices from the end of June when the poultry markets were gradually reopened in Zhejiang and Jiangsu provinces but the newly found case would probably bring about another slowdown in the industry," said Mr Zhong.

Because all poultry stands were shut down between April and June in the regions where people were found to be carrying the H7N9 virus, the breeders, suppliers and sellers of poultry are keen to make up the huge losses as soon as possible.

Although poultry markets - but not those where birds were slaughtered upon request - were reopened, poultry breeders are still suffering hard times with very few people willing to buy chickens from them.

"Because live poultry-slaughter stands in the city are still temporarily shut down we haven't seen any growth in the sales of chickens to make up for our huge losses yet," said Ye Enlin, managing director of the Wenzhou Minxin Poultry Cooperative in Tengqiao village, Wenzhou, Zhejiang province, an area well-known for smoked chicken products.

Ye lost nearly 3 million yuan between March and June and was forced to slaughter and freeze more than 1.2 million chickens valued in excess of 12 million yuan during the period.

"The partial reopening of the poultry market enabled me to sell only 15 per cent of the frozen chicken stock. I'll now probably be affected again by the newly confirmed case of the H7N9 virus," said Ye, who used to buy 200,000 to 300,000 baby chickens for breeding purposes every month. He bought just 20,000 to 40,000 a month between April and July.

Mr Enlin added that he might shut down the cooperative if the situation in the live poultry industry doesn't recover rapidly by the end of the year because he won't have enough money to survive.

Sales of chicken dishes in restaurants also dropped rapidly between April and June because of fears about the virus.

Xiao Nan Guo Restaurant Holdings Ltd suffered an 80 per cent decrease in the sales of chicken dishes between April and June. They have slowly recovered to between 50 to 60 per cent of pre-virus figures.

"The newly found case of the H7N9 virus should be a one-off because the current hot weather is not the peak season for the spreading of viruses," said Huang Wei, media manager for Xiao Nan Guo.

Listed companies related to the live poultry industry faced huge losses, as expected.

According to the half-year report released on July 15 by Fujian Sunner Development Co Ltd, a leading chicken product supplier in China, the company suffered losses of about 239 million yuan in net profit, down 295 per cent annually.

[dothedd]

Published On: Thu, Aug 1st, 2013

Saudi Arabia Confirms Three More MERS Coronavirus Cases, Brings Global Total To 94

The Saudi Arabia Health Ministry has notified the World Health Organization (WHO) of three additional laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV), according to a WHO outbreak update.

The cases include a 67-year-old woman from Riyadh with underlying medical conditions. She became ill on 25 July 2013. She has no known exposure to animals or to a case confirmed with MERS-CoV infection. She is currently hospitalized.

The other two patients are female health workers from Assir and Riyadh regions . Both of them have mild symptoms and were exposed to patients who were laboratory-confirmed cases.

Globally, from September 2012 to date, WHO has been informed of a total of 94 laboratory-confirmed cases of infection with MERS-CoV, including 46 deaths.

MERS-CoV was first reported in 2012 in Saudi Arabia. MERS-CoV used to be called “novel coronavirus,” or “nCoV”. It is different from other coronaviruses that have been found in people before.

Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness.

MERS-CoV has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in Saudi Arabia, Jordan, the UK, France, Tunisia, and Italy are being investigated.

MERS Cases and Deaths,
April 2012 – Present

Current as of August 01 2013, 9:00 AM EDT

Countries Cases (Deaths)
France 2 (1)
Italy 3 (0)
Jordan 2 (2)
Qatar 2 (1)
Saudi Arabia 74 (39)
Tunisia 2 (0)
United Kingdom (UK) 3 (2)
United Arab Emirates (UAE) 6 (1)
Total 94 (46)


www.theglobaldispatch.com/wp-content/uploads/2013/06/15906_lores-300x289.jpg

[dothedd]

Saudi Arabia Reports 3 New MERS Cases, 2 Health Workers Included: Will WHO Declare It A Global Threat?

In Saudi Arabia where the MERS virus has been most prevalent in infections, two health staff workers have now contracted the deadly disease.

Aug 02, 2013 11:17 AM EDT

MERS, infectious disease, Saudi Arabia, SARS

Two female health workers treating patients for the Middle East respiratory syndrome (MERS) virus have contracted the infection. MERS, which originated in Saudi Arabia, currently has 94 cases throughout the world and has caused 46 deaths, according to the Centers for Disease Control and Prevention (CDC). MERS is a respiratory disease caused by the coronavirus MERS-CoV and is, according to reports, easily transferrable, especially in Saudi Arabian hospitals.

(Photo : NIAID, CC By-ND 2.0) In Saudi Arabia where the MERS virus has been most prevalent in infections, two health staff workers have now contracted the deadly disease.

Enlarge
(Photo : NIAID, CC By-ND 2.0) In Saudi Arabia where the MERS virus has been most prevalent in infections, two health staff workers have now contracted the deadly disease.

The World Health Organization (WHO) announced on Thursday that the two female health workers, from the Saudi regions of Assir and Riydh, both developed mild symptoms of MERS, in addition to a third new case of a 67-year-old woman who is in a more life-threatening condition.

According to Reuters, the WHO warned clinics and hospitals that are caring for patients with suspected or confirmed MERS infections to be careful. Health staff "should take appropriate measures to decrease the risk of transmission...to other patients, healthcare workers and visitors," according to the WHO.

An international team of infectious disease experts visited Saudi Arabia in May in order to assess the level of danger posed by MERS. After analyzing the outbreak's symptoms and contagious characteristics, they deemed MERS infection as a "serious risk" in hospitals because of its easy transmission in healthcare settings.

As MERS is caused by the coronavirus MERS-CoV, it is a cousin of the severe acute respiratory syndrome (SARS) that plagued the world in 2003 and infected over 8,000 people, of which 800 died. Considering MERS is continually infecting people and has a much high mortality rate than SARS, it has caused a consensus of fear among the public.

MERS was first reported in Saudi Arabia in September 2012, and there is still little known about the disease, but because of the ease at which the virus moves from person to person through healthcare facilities, leading health authorities are demanding more testing and better recordkeeping of the outbreaks.

The virus most noticeably causes coughing, fever, and pneumonia in those infected. With reasonable fear of fatality, the United Nations health agency issued travel and health advice for the millions of pilgrims who travel to Saudi Arabia's Mecca and Medina for Ramadan between July and August. An overwhelming majority of the MERS infection cases were in Saudi Arabia, and out of the 74 infections, 39 people died. France, Italy, Jordan, Qatar, Tunisia, the United Kingdom, and the United Arab Emirates have also all seen more than one case of MERS in their countries.

When the WHO emergency committee held its second meeting on July 17, the members unanimously decided that MERS had not yet reached the level to be considered a "Public Health Emergency of International Concern" (PHEIC). However, based on the overview of what is currently known about the MERS virus, the director-general of the committee recognizes the status of MERS as "serious and of great concern, but does not constitute a PHEIC at this time." There will be follow-up research and another review by the WHO as the next step into understanding and protecting the general public and health staff from this deadly disease.

[dothedd]

Wednesday, 21 August 2013 10:17 AM

Qatar in first case of MERS virus

Health authorities in Qatar announced the discovery of a first case of the MERS coronavirus in the country after a 59-year old man became infected.

The Qatari patient is in a stable condition, authorities said.

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which can cause coughing, fever and pneumonia, has been reported in people in the Gulf, France, Germany, Italy, Tunisia and Britain.

The World Health Organisation (WHO) says 46 people have died out of a total 94 confirmed cases, the majority in Saudi Arabia. One of the first reported cases was of a Qatari who died in London.


Recent discoveries of novel human coronaviruses[edit source | editbeta]

Following the high-profile publicity of SARS outbreaks, there has been a renewed interest in coronaviruses among virologists. For many years, scientists knew about only two human coronaviruses (HCoV-229E and HCoV-OC43). The discovery of SARS-CoV added a third human coronavirus.

By the end of 2004, three independent research labs reported the discovery of a fourth human coronavirus. It has been named NL63, NL, and the New Haven coronavirus by different research groups.[6] The three labs are still arguing over which one discovered the virus first and has the right to name it.

Early in 2005, a research team at the University of Hong Kong reported finding a fifth human coronavirus in two patients with pneumonia. They named it Human coronavirus HKU1.

In September 2012, what is believed to be a sixth new type of coronavirus, tentatively referred to as Novel Coronavirus 2012,[7] being like SARS (but still distinct from it and from the common-cold coronavirus) was discovered in Qatar and Saudi Arabia.[8] The World Health Organisation has accordingly issued a global alert[9] and an interim case definition to help countries to strengthen health protection measures against it.[10] The WHO update on 28 September 2012 said that the virus did not seem to pass easily from person to person.[11] However, on May 12, 2013, a case of contamination from human to human in France was confirmed by the French Ministry of Social Affairs and Health.[12] In addition, cases of person-to-person transmission have been reported by the Ministry of Health in Tunisia. Two confirmed cases seem to have caught the disease from their late father, who became ill after a visit to Qatar and Saudi Arabia. So far there have been twenty-two cases and ten deaths in eastern Saudi Arabia.[13] After the Dutch Erasmus Medical Centre sequenced the virus, the virus was given a new name, Human Corona Virus-Erasmus Medical Centre (HCoV-EMC). The final name for the virus is: Middle East respiratory syndrome coronavirus (MERS-CoV).

MERS cases and deaths, April 2012 – present
Country Cases Deaths Fatality (%)
France 2 1 50%
Italy 3 0 0
Jordan 2 2 100%
Qatar 2 1 50%
Saudi Arabia 76 39 51%
Tunisia 2 0 0%
UAE 6 1 17%
UK 3 2 67%
TOTAL 94 46 49%
Source: CDC

[dothedd]

Friday, 23 August 2013 KSA 08:03 - GMT 05:03
New study: Bat linked to mysterious MERS virus

AFP, Washington
A bat has been linked to the mysterious and at times fatal MERS coronavirus plaguing the Middle East, according to a new study.

Researchers said they detected a 100 percent genetic match in an insect-eating bat close to the home of the first known victim of the disease in Saudi Arabia.

Middle East Respiratory Syndrome has killed 47 people worldwide, 39 of them in Saudi Arabia.

“There have been several reports of finding MERS-like viruses in animals. None were a genetic match,” said Ian Lipkin, a co-author of the study and head of Columbia University's Center for Infection and Immunity.

“In this case we have a virus in an animal that is identical in sequence to the virus found in the first human case,” he said in a statement.
“Importantly, it’s coming from the vicinity of that first case.”

The findings of the study, which also involved researchers from the EcoHealth Alliance and Saudi Arabia’s health ministry, were published online late Wednesday in the “Emerging Infectious Diseases” journal of the U.S. Centers for Disease Control and Prevention.

MERS is considered a cousin of the SARS virus that erupted in Asia in 2003.

Like SARS, it is thought to have jumped from animals to humans, and shares the former’s flu-like symptoms -- but differs by causing kidney failure.

Between October 2012 and April 2013, researchers collected more than a thousand samples from seven bat species in regions of Saudi Arabia where MERS cases were identified.

After a series of analyses, a fecal sample taken from an Egyptian Tom Bat collected within several kilometers of the home of the first known MERS victim “contained sequences of a virus identical to those recovered” from that person.

But “there is no evidence of direct exposure to bats in the majority of human cases of MERS,” said Ziad Memish, Saudi Arabia's deputy health minister and the study's lead author.
english.alarabiya.net/en/News/middle-east/2013/08/23/New-study-Bat-linked-to-mysterious-MERS-virus-.html

[dothedd]

Qatar announces its first MERS death

Wednesday, 4 September 2013

A woman has died in Qatar after contracting the MERS coronavirus, becoming the first recorded fatality from the SARS-like virus in the Gulf state, local press reported on Wednesday.

The 56-year-old Qatari victim, who already had chronic illnesses, died on Aug. 31, a week after she was admitted into intensive care at a Doha hospital, newspapers quoted the emirate’s Supreme Council of Health as saying.

Two other cases of infection have been registered in the Gulf state, including two men, aged 59 and 29, who were hospitalized last month.

Another Qatari died of the virus in a hospital in Britain on June 28.

The virus has killed 50 people out of 108 confirmed cases of infections, the World Health Organization said on its website on Aug. 30. Saudi Arabia is the country worst hit by MERS.

MERS - Middle East Respiratory Syndrome - is considered a cousin of the SARS virus that erupted in Asia in 2003 and infected 8,273 people, nine percent of whom died.

Like SARS, it is thought to have jumped from animals to humans, and shares the former’s flu-like symptoms -- but differs by causing kidney failure.

According to research published last month in the American health journal Emerging Infectious Diseases, MERS was transmitted to humans from bats, but a study in the Lancet found the virus could have come from camels.

[dothedd]

MERS virus claims two more lives in Saudi Arabia
Friday, 6 September 2013

AFP, Riyadh
Two women have died of the coronavirus MERS in Saudi Arabia, the health ministry said on Friday, bringing the total number of fatalities in the kingdom to 44.

The victims were identified as a 41-year-old expat who was working in the health sector in Riyadh and a 79-year-old Saudi who suffered from chronic illnesses and who came into contact with a patient stricken by the virus in the northeastern city of Hafr al-Baten.

Saudi Arabia is the country worst hit by MERS, which has killed 50 people globally, according to a statement published by the World Health Organization on August 30.

Experts are struggling to understand MERS -- Middle East Respiratory Syndrome -- for which there is still no vaccine and which has an extremely high fatality rate of more than 51 percent.

It is considered a cousin of the SARS virus that erupted in Asia in 2003 and infected 8,273 people, nine percent of whom died.

Like SARS, MERS is thought to have jumped from animals to humans, and it shares the former's flu-like symptoms -- but differs by also causing kidney failure.

According to research published this month in the American health journal Emerging Infectious Diseases, MERS was transmitted to humans from bats. But a study in the Lancet found the virus could have come from camels.
news.yahoo.com/mers-virus-claims-two-more-lives-saudi-arabia-145941501.html

[dothedd]

World - travel advice on MERS-CoV for pilgrimages

World Health Organization interim travel advice on MERS-CoV for pilgrimages to the Kingdom of Saudi Arabia
I. Introduction

An outbreak of the Middle East respiratory syndrome coronavirus (MERS-CoV), first reported in 2012, has affected nine countries to date. WHO is coordinating the global response to this emerging virus according to the International Health Regulations (IHR 2005). This paper provides guidance to national authorities of countries from which pilgrims will be travelling in the coming months for Umra and Hajj for the prevention, detection and management of imported cases of MERS-CoV. At this time, the risk to an individual pilgrim of contracting MERS-CoV is considered very low.

II. Effective communication of risk information
It is important for countries to use all practical and effective means possible to communicate information on a range of issues before, during and after Umra and Hajj to all key groups, including the following:
• travellers to Umra and Hajj, particularly vulnerable groups within this population;
• public health officials;
• health care staff responsible for the care of ill pilgrims;
• public transportation and tourism industries; and
• the general public.

2.1. Actions to take before Umra or Hajj
• Countries should advise pilgrims that pre-existing major medical conditions (e.g. chronic diseases such as diabetes, chronic lung disease, immunodeficiency) can increase the likelihood of illness, including MERS-CoV infection, during travel; thus, pilgrims should consult a health care provider before travelling to review the risk and assess whether making the pilgrimage is advisable.
• Countries should make information known to departing pilgrims and travel organizations on general travel health precautions,1 which will lower the risk of infection in general, including illnesses such as influenza and traveller’s diarrhoea. Specific emphasis should be placed on:
o washing hands often with soap and water. When hands are not visibly dirty, a hand rub can be used;
o adhering to good food-safety practices, such as avoiding undercooked meat or food prepared under unsanitary conditions, and properly washing fruits and vegetables before eating them;
o maintaining good personal hygiene;
o avoiding unnecessary contact with farm, domestic, and wild animals.
• Health advisories should be made available to all departing travellers to Umra or Hajj by working with the travel and tourism sectors and placing such materials at strategic locations (eg. travel agent offices or points of departure in airports).
o different kinds of communication, such as health alerts on board planes and ships, and banners, pamphlets and radio announcements at international points of entry, can also be used to reach travellers.
o travel advisories should include current information on MERS-CoV and guidance on how to avoid illness while travelling.
• Current WHO guidelines, or their national equivalents, on surveillance,2 infection prevention and control measures3 and clinical management4of MERS-CoV should be distributed to health care practitioners and health care facilities.
• Countries should ensure that there are adequate laboratory services for testing for MERS-CoV and that information on laboratory services and clinical referral mechanisms is known to health care providers and facilities.
• Medical staff accompanying pilgrims should be up to date on MERS-CoV information and guidance, including how to recognize early signs and symptoms of infection, who is considered to be in a high-risk group, and what to do when a suspected case is identified, as well as on simple health measures to reduce transmission.
2.2. Actions to take during Umra or Hajj
• Travellers who develop a significant acute respiratory illness with fever and cough (severe enough to interfere with usual daily activities) should be advised to:
o minimize their contact with others to keep from infecting them;
o cover their mouth and nose with a tissue when coughing or sneezing and discard the tissue in the trash after use and wash hands afterwards, or, if this is not possible, to cough or sneeze into upper sleeves of their clothing, but not their hands;
o report to the medical staff accompanying the group or to the local health services.
2.3. Actions to take after Umra or Hajj
• Returning pilgrims should be advised that if they develop a significant acute respiratory illness with fever and cough (severe enough to interfere with usual daily activities) during the two weeks after their return, they should seek medical attention and immediately notify their local health authority.
• Persons who have had close contact with a pilgrim or traveller with a significant acute respiratory illness with fever and cough (severe enough to interfere with usual daily activities) and who themselves develop such an illness should be advised to report to local health authorities to be monitored for MERS-CoV.
• Practitioners and facilities should be alerted to the possibility of MERS-CoV infection in returning pilgrims with acute respiratory illness, especially those with fever and cough and pulmonary parenchymal disease (e.g. pneumonia or the acute respiratory distress syndrome). If clinical presentation suggests the diagnosis of MERS-CoV, laboratory testing,5,6 in accordance with WHO’s case definition7 should be done and infection prevention and control measures implemented. Clinicians should also be alerted to the possibility of atypical presentations in patients who are immunocompromised.
III. Measures at borders and for conveyances

WHO does not recommend the application of any travel or trade restrictions or entry screening.

WHO encourages countries to raise awareness of this travel advice to reduce the risk of MERS-CoV infection among pilgrims and those associated with their travel, including transport operators and ground staff, and about self-reporting of illness by travellers.

As required by the IHR, countries should ensure that routine measures are in place for assessing ill travellers detected on board conveyances (such as planes and ships) and at points of entry, as well as measures for safe transportation of symptomatic travellers to hospitals or designated facilities for clinical assessment and treatment.
If a sick traveller is on board a plane, a passenger locator form8 can be used. This form is useful for collecting contact information for passengers, which can be used for follow-up if necessary.

[dothedd]

Sunday, 8 September 2013 KSA 15:18 - GMT 12:18

Another three die of Mers virus in Saudi Arabia

FP, Riyadh

Another three people have died in Saudi Arabia after contracting the MERS coronavirus, the health ministry said Sunday, bringing the kingdom's total fatalities of the SARS-like virus to 47.

A Saudi man, aged 74, died in the western city of Medina after being in contact with an infected person, the ministry said on its website.

A 56-year-old foreigner, who worked in the health sector, also died in Medina, while another Saudi, aged 53, who suffered chronic diseases, died in Riyadh, the ministry added.

The health authority also announced five new cases of infection of the coronavirus, including an 18-year-old Saudi man, and a three-year-old girl in Hafr al-Baten, in the northeast, who contracted the virus after being in contact with an infected person.

The three others are all Saudi nationals.

Saudi Arabia is the country worst hit by MERS, which has killed 47 in the kingdom. On Friday the World Health Organisation said the virus had killed 52 people worldwide. Saudi authorities said 96 people have been infected in the kingdom, out of a global figure of 110.

Experts are struggling to understand MERS (Middle East Respiratory Syndrome) for which there is still no vaccine and which has an extremely high fatality rate of more than 51 percent.

It is considered a cousin of the SARS virus that erupted in Asia in 2003 and infected 8,273 people, nine percent of whom died.

Like SARS, MERS is thought to have jumped from animals to humans, and it shares the former's flu-like symptoms -- but differs by also causing kidney failure.

The MERS problem persists in Saudi Arabia as the kingdom gears up to host around two million Muslims in October for the annual hajj pilgrimage to Mecca.

Authorities have urged the elderly and chronically ill Muslims to avoid the hajj this year and have cut back on the numbers of people they will allow to perform the pilgrimage.

[dothedd]

Deaths and 10 injuries uncertain 'Corona' in a hospital in Riyadh

Wednesday, September 11, 2013

Confirmed for "economic" informed sources record the number of HIV infections in the city of Corona military medical Prince Sultan in the capital Riyadh, an estimated ten cases. The sources said that among the injured doctor esoteric Saudis, a recent graduate, enter the intensive care unit at the hospital, although there are a number of cases still is among the suspected cases, in addition to recording the event of the death of a nurse from the Philippine citizenship.

This comes amid silence by officials of the hospital, where he contacted the "economic" a number of them to clarify the matter, but attempts met with no reply or an apology and promise to issue a statement demonstration during the coming period, without setting a specific date.

The sources pointed out that there are a number of actions taken by the management of the hospital to prevent the transmission of infection among inpatients and employees of the hospital and dismissal, noting that there are medically استنفارا and meetings between the leaders until the preparation of the news.

She explained that the spread of the news of the existence of injuries among the employees of the hospital sparked panic many of the reviewers, which led to their absence from attending appointments during the past two days.

This comes amid Declaration and the Ministry of Health in a number of deaths virus Corona, within the work of continuous monitoring and investigation carried out by the ministry for the virus Corona new virus that causes AIDS Middle East respiratory MERS-COV, as announced in a statement yesterday, for the registration of four new cases of the virus, the first a citizen in Medina at the age of 22 years, Mkhalta to certain infected with the virus, and did not showing Oaradalmred.

The second is a citizen at the age of 24 years, working in the health sector in Medina, too, as well as not showing any symptoms, and the third case of a citizen at the age of 60 years in Riyadh, Mkhalta case-infected uncertain, did not show symptoms of the disease as well, and was The fourth case of a 70-year-old citizen also in Riyadh, mixer case of infected uncertain, and his condition is stable.

It was a few days ago announced record two deaths virus, the first of a resident in the area of ​​Medina at the age of 56 years, and works in the health sector, and the second of a citizen in the area of ​​Riyadh at the age of 53 years suffering from chronic diseases, multiple, also announced record two cases the first citizen of the 18-year-old, and the other for three-year-old girl, and attributed the to مخالطتهما the cause of confirmed cases in the Batin area, pointing out that he did not show them any symptoms and in good health condition.

Thus an infected cases at the level of Saudi Arabia since the emergence of the disease hundred cases, of whom 47 died, according to the website of the Ministry of Health.

According to the outcome of the recent World Health Organization issued on 30 August, the death of 50 people out of 108 confirmed cases in the world, from HIV Corona, which leads to respiratory problems and renal insufficiency fast, and Saudi Arabia is the country most affected by it - according to the "French" .

The new virus, which belongs defined by the World Health Organization as "the Middle East respiratory syndrome," "Mirs" to the viruses that faction led to the severe acute respiratory syndrome "SARS", which led to the deaths of about 800 people around the world in 2003.

[dothedd]

Monday October 28, 2013

Virus Scare: Hajj Pilgrims undergo rigorous screening

Medical researchers from Korle Bu, Noguchi and Port Health (Ghana) are keeping a 10-day watch on the mouth and nose swabs taken from the first returning batch of this year’s Ghanaian pilgrims to Mecca.

This year’s Hajj took place amidst heightened fear around the world over the Middle East Virus, a deadly virus that had infected a number of people and visitors to Saudi Arabia.

To ensure that any case of infection would be dealt with quickly, the first 319 pilgrims who arrived at dawn yesterday around 4am were taken through a medical screening by a medical team constituted to deal with the threat.

Although coughing is one of the symptoms of the Middle East Respiratory Syndrome (MERS) Corona virus, and there was a lot of coughing among the pilgrims during the screening exercise, it is only after 10 days that the pilgrims will know whether they have contracted the Middle East Respiratory Syndrome (MERS) Corona virus, as the virus has a 10-day incubation period.

The medical team, which is composed of bio-chemists from the Korle Bu Teaching Hospital, Port Health, a unit within Ghana Health Service, and researchers from the Noguchi Memorial Institute for Medical Research, was still screening the first batch of pilgrims at the Hajj Villages as at the time of going to press yesterday.

The second batch of pilgrims was expected to arrive at 5pm yesterday.

Swabs from the mouth and nose of pilgrims collected by the medical team were sent to the Noguchi Memorial Institute for Medical Research, University of Ghana, for assessment.

“When anything comes up during the assessment period we will call the individual pilgrim and see to the issue,” a member of the medical team who spoke on condition of anonymity disclosed to The Finder.

Hats off to Ghana for being proactive... Too bad they are the exception, not the rule. It's now been about 10 days since Hajj...the incubation period is about 10 days for MERS.

[dothedd]

October 28, 2013

Egypt: Suspected MERS in 28-year-old woman returned from Saudi Arabia

Thanks to MERScoV for tweeting the link to this report in Al Masry Al Youm, an Egyptian paper: Suspicion of injury lady returning from Saudi Arabia virus 'Corona' in Mansoura. Excerpt from a Google translation:
The Ministry of Health and Population, obtaining a sample of the lady suspect bird flu Pfirs, the 'Corona', for analysis central labs in the ministry, is expected to be completed by the analysis results and announced, on Tuesday evening.

A medical source said the ministry, Monday, said that «the Ministry of Health held a woman from the city of Mansoura Dakahlia Governorate, on suspicion of being infected with HIV Corona, a housewife (28 years), and was present in Riyadh, Saudi Arabia, to accompany her husband since 4 months and returned to Cairo since the days».

He added that «Ms. developed symptoms of infection immediately after returning to Cairo, and was suspected of being infected with the virus, the ministry detaining hospital issued and viruses Mansoura and get a sample to be analyzed central labs, to make sure her or not, it exists now in intensive care in hospital as a result of her pneumonia».
October 28, 2013 at 09:13 AM

[dothedd]

Saudi Arabia: The second MERS death in a week in Jubail?

Via Al-Asharq, a slightly confusing report: Jubail: second death 'Corona' within a week.

The Google translation, somewhat worse than average, of the full report:
The funeral of the people of Jubail yesterday deceased's body Coruna second in the province, which is lady Tmaninih and she died yesterday morning after being infected with the virus. He was buried mourners dead in a cemetery in Jubail, bringing the total number of deaths to 53 cases, while Al «East» from sources that citizenship was lying in intensive care at a hospital in Jubail almost a month ago, and suffer from chronic diseases, and moved as a result of مخالطتها confirmed cases from within hospital.

For his part, the spokesman stressed media to the Ministry of Health, Dr. Khaled Marghalani health and death citizenship because of the virus, at a time in which it proclaimed the ministry said in a statement yesterday for the registration of three cases, the first citizen at the age of 83 years, mixing with the confirmed case and has several chronic diseases and receive treatment in intensive care and in stable condition, and the second to a resident working in the health sector at the age of 54 years old, and has a chronic illness, and receiving treatment in intensive care and his condition is stable, while the third is a citizen at the age of 49 years, and receiving treatment in intensive care and his condition is stable.

The deceased Corona Jubail is the second case in a week in the province of Al Jubail, according to sources Asharq the second case announced by the Ministry of Health to a resident working in the health sector at the age of 54 years is coming from outside the province.

I reported the death of the 54-year-old on October 24; the case is #163 on Andrew Rambaut's running tally. The new death seems to be that of a woman who was in intensive care in a Jubail hospital (in Eastern Province) almost a month ago. She was moved because of something (MERS?) within her hospital. The Arabic term in the report is beyond Google's capacity.

If the story hadn't said the new death brings the total to 53, I would have dismissed it as a belated and garbled report on the most recent cases and death #52. So I offer it in the hopes that some Arabic speaker will explain what the story is really about.

[dothedd]

MERS Coronavirus Confirmed in Spain after woman returns from Saudi Arabia
November 6, 2013

Spain's Health Ministry reported the country's first case of Middle East respiratory syndrome (MERS) coronavirus on Wednesday in a woman recently arrived from a trip to Saudi Arabia.

The virus has already been reported in four other European countries, the ministry said.

The latest patient, resident in Spain and born in Morocco, was checked in to a Madrid hospital on November 1 and is in a stable condition, posing no risk to public health, the ministry's statement said.

There have been 150 confirmed cases of the MERS virus worldwide, with 125 in Saudi Arabia. In Europe, two cases have been reported in Britain, two in Germany, one in France and another in Italy, the ministry said.

Guess who has the only MERS vaccine?

NVAX!!!

Novavax Produces MERS-CoV Vaccine Candidate

Rockville, MD (June 6, 2013)–/GlobeNewswire, Inc. /-Novavax, Inc. (NASDAQ: NVAX) announced today that it had successfully produced a vaccine candidate designed to provide protection against the recently emerging Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The vaccine candidate, which was made using Novavax’ recombinant nanoparticle vaccine
technology, is based on the major surface spike (S) protein. The Company believes that its MERS-CoV vaccine candidate may provide a path forward for a vaccine for this emerging threat.
MERS-CoV is a novel coronavirus first identified in September 2012 by an Egyptian virologist, who isolated the previously unknown coronavirus from the lungs of a 60-year-old patient with pneumonia and renal failure. To date, the World Health Organization (WHO) has reported a total of 53 laboratory-confirmed cases of infection with MERS-CoV, including 30 deaths. The newly emergent virus is a part of the coronavirus family that includes the severe acute respiratory syndrome coronavirus (SARS-CoV), first recognized as a global threat in March 2003 and by July 2003, had resulted in 8,098 SARS cases in 26 countries, with 774 deaths.

Novavax had previously produced a recombinant nanoparticle vaccine candidate for the SARS-CoV virus which was similarly based on its major surface S protein. Novavax’ SARS-CoV vaccine candidate study demonstrated immunogenicity and complete protection of animals in a live viral challenge; the study was published in the journal Vaccine (online 14 July, 2011)
MERS-CoV was first reported in Saudi Arabia and has spread to Europe, including England, France, Germany and most recently Italy. Health officials do not know how the newly discovered MERS-CoV spreads, making the development of an effective vaccine an important public health priority.

About Novavax
Novavax, Inc. (Nasdaq: NVAX) is a clinical-stage biopharmaceutical company creating vaccines to address a broad range of infectious diseases worldwide. Using innovative recombinant nanoparticle technology, as well as new and efficient manufacturing approaches, the company produces vaccine candidates to combat diseases, with the goal of allowing countries to better prepare for and more effectively respond to rapidly spreading infections. Novavax is committed to using its technology platform to create geographic-specific vaccine solutions and is therefore involved in several international partnerships, including collaborations with Cadila Pharmaceuticals of India, LG Life Sciences of Korea and PATH. Together, these organizations
support Novavax’ worldwide commercialization strategy and have the global reach to create real and lasting change in the biopharmaceutical field. Additional information about Novavax is available on the company’s website, www.novavax.com.

[dothedd]

TROUBLING DETAILS EMERGING FROM SPANISH MERS CASE....

Nov 7, 2013

European and Spanish health officials released new details today about a Spanish woman who is hospitalized with a Middle East respiratory syndrome coronavirus (MERS) infection after visiting Hajj holy sites in Saudi Arabia, plus efforts under way to identify those who flew with her from Jeddah to Madrid.
The European Centre for Disease Prevention and Control (ECDC) said today in an updated risk assessment that the 61-year-old woman with no known underlying health conditions was in Saudi Arabia from Oct 2 to Nov 1. She visited Medina, then Mecca and had no known contact with animals.
Her symptoms began Oct 15 with cough and fever, and she was seen at a hospital emergency department of a Mecca hospital on Oct 28 and 29, where health workers diagnosed her as having pneumonia, based on chest x-ray findings.

Spain's health ministry told CIDRAP News that it has relayed more details about the case to European health authorities, including that the woman refused to be hospitalized in Saudi Arabia and was hospitalized in Madrid on Nov 1 when she arrived back in Spain.

According to the ECDC, the patient was sick during the flight and needed oxygen treatment while she was aboard.

Bottom Line: This woman was in a hospital in Mecca... and as sick as she was, and with MERS looming...
they diagnosed her as having pneumonia and allowed her to board a passenger airplane and fly back to Spain!
Think about how many people may have been infected? How many more MERS patients that visited Mecca were misdiagnosed and sent back to their home countries?

[dothedd]

November 15 2013


A new virus similar to SARS is spreading through the Middle East and parts of Europe. The virus, dubbed MERS-CoV for Middle East respiratory syndrome coronavirus, has killed more than half of its victims as experts scramble to identify the source. The ABC News medical team reports on the outbreak as it unfolds.

A MUST SEE LINK CONTENT:

abcnews.go.com/Health/fullpage/mers-coronavirus-infographic-abcnews-19315579

[dothedd]

4 new MERS cases "the virus is continuing to spread"

www.redorbit.com/news/health/1113005939/mers-coronavirus-slowly-growing-epidemic-111813/

Four New Coronavirus Cases May Indicate The Potential For An Epidemic
November 18, 2013


Over the past weekend, the World Health Organization (WHO) has been informed of four additional laboratory-confirmed cases of infection with Middle Eastern respiratory syndrome coronavirus (MERS-CoV). The new cases may actually come as no surprise to an international group of experts who reported last week that the disease may become a “slowly growing epidemic.”

Publishing a paper in The Lancet Infectious Diseases, the researchers have estimated that at least 62 percent of MERS cases have gone undetected, likely due to many cases being mild and not requiring hospitalization. Furthermore, surveillance efforts are geared toward the most severe cases. The research team also said it is unclear whether the disease can sustain human-to-human transmission without a recurrence of animal infections.

The scientists, hailing from Imperial College London, the University of Edinburgh, and the Institut Pasteur in Paris, have gathered data on 111 of the confirmed and probable cases that have been identified through August 8 of this year.

According to CIDRAP’s Robert Roos, the team followed four cases that occurred in visitors to Jordan, Qatar, Saudi Arabia, and the United Arab Emirates to work out an estimate for the number of undetected cases of MERS. Using these cases, they then calculated the average length of their visits and then noted that that each of the visitors had passed the virus to one or two other people after returning home from their visit.

Assuming that the per-day risk of infection for the visitors was the same for residents in the countries visited and taking into consideration the number of reported cases in the Middle East, the researchers estimated that the number of symptomatic cases of MERS up to August 8 was about 940. The researchers said based on this calculation, at least 62 percent of cases have been missed.

The research team also used MERS-CoV genetic data to estimate the total number of infections in both animals and humans.

Utilizing a method that involves taking estimates of the growth rate of the viral population derived from charting the diversity of genetic sequences, the team estimated that 17,940 infections occurred in both humans and animals between March 2012 and August 8, 2013. Based on their calculations, the team said the virus is continuing to spread, but it is unclear how much of the transmission is in animals and how much is in humans.

“Both the analysis of the genetic sequences and of the epidemic curves suggested that an epidemic is underway either in an animal reservoir or in man. These analyses do not allow us to distinguish between these scenarios and to determine whether MERS-CoV is currently self-sustaining in man,” the researchers said.

If there is an epidemic currently going on in humans, the team note that, given the current low estimated reproduction rate, it is likely that public health measures are sufficient to contain the spread of the disease and reduce morbidity and mortality.

Based on the team’s estimate of missed cases, the current mortality rate is likely at the high end of the clinical spectrum, meaning that far fewer people are dying from the disease than is reported. Currently, the mortality rate for confirmed cases stands at about 42 percent. If the scientists’ estimates of 940 cases through August 8 is accurate, then mortality rates would drop exponentially.

In the latest WHO reports, Saudi Arabia’s Ministry of Health has stated that a previously laboratory-confirmed MERS-CoV patient has died along with an additional new death, bringing the total number of deaths related to the disease to 66.

Additionally, the MOH has confirmed four new cases of MERS, bringing the total number of cases to 157.

The new cases include a 75-year-old man from Oman with underlying medical conditions who became ill on Oct 1 and died on Nov 10; a 61-year-old man from Qatar with underlying medical conditions who became ill on Nov 4 and was hospitalized on Nov 7, currently in critical condition; a 47-year-old man from Kuwait who became ill on Oct 30 and was hospitalized on Nov 7, currently in critical condition; and a 52-year-old man from Kuwait with underlying medical conditions who became ill on Nov 7 and was hospitalized on Nov 10, also currently in critical condition.

[dothedd]

Saudi Arabia Reports Three New Confirmed Cases Of MERS Infection
11/26/2013
The United Nations World Health Organization (WHO) announced Tuesday that it has been informed of three additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia.

According to a WHO statement, the first patient is a 73-year-old woman from Riyadh who became ill on November 12. She was hospitalized on November 14, but died four days later. The second patient is a 65 year-old man with an underlying medical condition from Jawf region who became ill on November 4 and was hospitalized on November 14.

The third patient is a 37-year-old man from Riyadh who became ill on November 9. Although he was hospitalized on November 13, he died five days later. Notably, none of the three patients had exposure to animals or contact to a previously laboratory-confirmed case with MERS-CoV.

From September 2012 to date, WHO has been informed of a total of 160 laboratory-confirmed cases of infection with MERS-CoV globally, including 68 deaths.

Based on the current situation and available information, WHO has urged all Member-States to continue their surveillance for Severe Acute Respiratory Infections (SARI) and carefully review any unusual patterns.

The agency reminded healthcare facilities of the importance of systematic implementation of infection prevention and control, and urged them to decrease the risk of transmission of MERS-CoV virus to other patients, health care workers and visitors.

WHO said it had "convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation."

[Deleted]

Nov 8, 2013 10:29:02 GMT -5 dothedd said:

TROUBLING DETAILS EMERGING FROM SPANISH MERS CASE....

Nov 7, 2013

European and Spanish health officials released new details today about a Spanish woman who is hospitalized with a Middle East respiratory syndrome coronavirus (MERS) infection after visiting Hajj holy sites in Saudi Arabia, plus efforts under way to identify those who flew with her from Jeddah to Madrid.
The European Centre for Disease Prevention and Control (ECDC) said today in an updated risk assessment that the 61-year-old woman with no known underlying health conditions was in Saudi Arabia from Oct 2 to Nov 1. She visited Medina, then Mecca and had no known contact with animals.
Her symptoms began Oct 15 with cough and fever, and she was seen at a hospital emergency department of a Mecca hospital on Oct 28 and 29, where health workers diagnosed her as having pneumonia, based on chest x-ray findings.

Spain's health ministry told CIDRAP News that it has relayed more details about the case to European health authorities, including that the woman refused to be hospitalized in Saudi Arabia and was hospitalized in Madrid on Nov 1 when she arrived back in Spain.

According to the ECDC, the patient was sick during the flight and needed oxygen treatment while she was aboard.

Bottom Line: This woman was in a hospital in Mecca... and as sick as she was, and with MERS looming...
they diagnosed her as having pneumonia and allowed her to board a passenger airplane and fly back to Spain!
Think about how many people may have been infected? How many more MERS patients that visited Mecca were misdiagnosed and sent back to their home countries?

 For God's sake... why isn't everyone PANICKING!!!!!!!!