Infection control

Infection control

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Middle East respiratory syndrome coronavirus (MERS-CoV) – update

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UPDATES

10th December 2015 CIDRAP – Two studies exploring potential reservoirs for MERS-CoV found evidence that the virus is widespread in camels in Nigeria but not in bats in Egypt and Lebanon.

The Nigerian study, published today inEurosurveillance, noted that RNA of MERS-CoV (Middle East respiratory syndrome coronavirus) indicated that the virus infecting camels there is distinct from strains in the Middle East, where most human cases have occurred. The virus has been previously identified in dromedary camels in the Middle East as well as in several African nations.

And in the bat study, published yesterday in Emerging Infectious Diseases, researchers identified other coronaviruses in various samples from wild bats, but not MERS-CoV.

 

8th December 2015 Korea Herald – In 2014, Koreans were just checking the day’s weather on Google. This year, they were keen for information on the Middle East respiratory syndrome. Google Korea on Tuesday announced a list of the year’s top searches, an honest, sometimes embarrassing, peek into what Koreans cared about over the past year. Searches for “MERS” soared from May 20 when the first patient was confirmed in Korea, then peaked in June. Searches for other diseases such as SARS and H1N1 also surged along with those for N95 masks, hand sanitizers and ECMO, or extra corporeal membrane oxygenation, an alternative to CPR.

 

29th September 2015 CIDRAP – As the Hajj observance in Saudi Arabia drew to a close over the weekend and throngs of pilgrims returned to their homes, the country reported just one new MERS-CoV case and two deaths from the disease.

Also, an update from the World Health Organization (WHO) yesterday on 13 recent MERS-CoV (Middle East respiratory syndrome coronavirus) cases in Saudi Arabia showed complex transmission patterns, some with recent travel to Riyadh, with the disease still causing a heavy burden on healthcare workers.

Also, Jordan’s health ministry today released a statement asking on returning Hajj travelers and hospitals to be on high alert for the disease, according to a story in Arabic from Petra, Jordan’s state news service, which was translated and posted by Avian Flu Diary, an infectious disease news blog. Jordan has reported 13 recent MERS cases, most likely linked to a hospital cluster in Amman.

So far no cases have been reported in pilgrims visiting Saudi Arabia’s holy sites, though global health officials have been skittish about this year’s Hajj amid the large outbreak in the country’s capital, along with clusters elsewhere, including Medina, the country’s second-holiest city.

Newest case and deaths

The only new lab-confirmed case reported is that of a 44-year-old foreign healthcare worker in Riyadh, according to a Sep 26 statement from the Saudi Ministry of Health (MOH). The man was exposed in a healthcare setting and is in stable condition.

His infection is likely part of a large hospital-linked outbreak under way in Riyadh. Since Jul 21 the city has reported 171 MERS-CoV infections, many of them connected to an outbreak at King Abdulaziz Medical City. However, exposure hasn’t been nailed down for some of the cases from the city.

One of the two deaths in previously announced cases involved a 26-year-old male Saudi healthcare worker in Riyadh who didn’t have an underlying medical condition, which is unusual. Most of the deaths have been reported in people with chronic health conditions. The second fatality is an 85-year-old Saudi man from Riyadh who had a pre-existing illness.

Over the 3-day period, seven more people recovered from their MERS-CoV infections, putting the number of recoveries since the disease was first detected in humans in 2012 to 685.

As of today, 30 people are still being treated for their infections. The last developments lift Saudi Arabia’s MERS total to 1,250 infections, including 535 deaths.

Multiple exposure routes

The WHO yesterday shared more details about 13 recent MERS cases reported from Saudi Arabia between Sep 12 and Sep 18. Some of the cases seem to have clear links to hospital exposure in Riyadh, Jeddah, Medina, and even to a facility in Amman, Jordan. Investigations, however, are still under way for 9 of the 13 cases.

Four of the cases involve healthcare workers, all of them from other countries, one with a recent history of travel to the Philippines. Two of the patients got sick after travel to Riyadh: a 30-year-old man from Medina and 30-year-old man from Jeddah.

One of the patients is a 72-year-old woman from Jeddah who traveled to Amman, Jordan, where she was admitted for a medical procedure to a hospital that had reported recent MERS cases. She started having symptoms about a week after arriving back in Jeddah and was cared for by a healthcare worker who got sick herself and a few days later was diagnosed with the illness.

Another is a 60-year-old man from Alqweiyha who became ill after having contact with an earlier case-patient, a woman from Riyadh who had a history of frequent contact with camels and drinks raw camel milk.

Of four healthcare workers included in the list, three had worked in hospital experiencing outbreak—two in Riyadh and one in Medina.

The only non-adult is a 14-year-old boy from Riyadh who has an asymptomatic infection and is a contact of another patient listed in the WHO statement, a 38-year-old foreign man in Riyadh. The boy has the only asymptomatic case.

Among the others, one death was reported, three patients are in critical condition, and eight are listed as stable. Illness onsets range from Aug 30 to Sep 16.

The WHO said so far it has been notified of 1,583 lab-confirmed MERS-CoV cases, including at least 566 deaths.

13th Sept 2015 ARAB NEWS – RIYADH: A well-known hospital here has been fined SR100,000 for failing to follow the rules pertaining to handling of suspected Middle East Respiratory Syndrome coronavirus (MERS-CoV) cases.
The Violation Committee of Private Health Facilities in the Riyadh Health Directorate imposed the penalty after proving laxity on the part of the hospital in handling a patient, local media has reported.
“The case was not dealt with according to the standard practice and medical requirements imposed by the Health Ministry. This forced the patient to go to another hospital and a medical analysis later confirmed he was infected with coronavirus,” a source was quoted as saying.
The Health Directorate has stressed that all health facilities must strictly follow the regulations and instructions and give the best in medical care to limit the spread of the disease.
Three men, including two expatriates, succumbed to MERS in the capital last Sunday, taking the death toll due to the contagion to 517 in the Kingdom.
Seven new cases of MERS were also reported in Riyadh, taking the total number of infections to 1,216 since the outbreak of the disease in the Kingdom in June 2012.
The health facilities in the capital have stepped up measures against the spread of the deadly virus. The MoH has launched an intensive awareness campaign to warn people of the hazards associated with the virus and to educate them about how transmission of the virus can be prevented

 

12th Sept 2015 CIDRAP – In what may be another hospital-related MERS-CoV cluster, Saudi Arabia today reported three cases from  the holy city of Medina, two of them in healthcare workers, all of whom had contact with a confirmed or suspected case.

The flare-up of cases in Medina comes as hundreds of thousands of travelers from all over the world are streaming into Saudi Arabia to make their Hajj pilgrimages, which constitute one of the five pillars of Islam.

For the first time since Aug 2, no new cases were reported in Riyadh, which is experiencing a large hospital outbreak at King Abdulaziz Medical City.

With the three new cases today, five MERS-CoV (Middle East respiratory syndrome coronavirus) illnesses have now been reported in Medina since Sep 7. The first involved an 80-year-old Saudi woman who had contact with an earlier case. The Saudi Ministry of Health (MOH) didn’t give any other details about her exposure.

23rd August 2015 Wall Street Journal – RIYADH—Saudi Arabia reported Sunday six new cases of Middle East respiratory syndrome, the latest sign of a spreading viral disease ahead of an annual religious pilgrimage that brings millions of visitors to the country. The surging number of cases—the largest since the peak of the last MERS outbreak in the summer of 2014—comes as Saudi Arabia prepares to welcome next month more than two million pilgrims to the Muslim holy city of Mecca for the annual hajj pilgrimage. In addition, the threat of the viral disease spreading could increase as more than 5 million Saudi students resume school on Sunday after summer vacation.

21st August 2015 (CIDRAP) –

The total in a MERS-CoV outbreak in Riyadh grew by six today—including a 109-year-old man—as the hospital linked to many of the cases announced new steps to curb the outbreak.

Newly announced Middle East respiratory syndrome coronavirus (MERS-CoV) confirmations from Saudi Arabia’s Ministry of Health (MOH) boost the number of cases reported since Jul 21 in Riyadh to 81.

New case details

In its daily update today, the Saudi MOH said five of the six patients had contact with a suspected or confirmed case in the community or hospital, suggesting that they could be part of an outbreak at Riyadh’s King Abdulaziz Medical City.

The 109-year-old man is hospitalized in stable condition, as are the other five patients.

One of the new confirmed cases is a 40-year-old woman who is healthcare worker from outside of Saudi Arabia.

Others include three men, ages 87, 72, and 71 years old, and a 58-year-old woman who apparently didn’t have contact with an earlier case.

In addition to the new cases, the MOH reported one death in a previously announced case-patient from Riyadh, an 86-year-old man who had underlying health conditions.

The MOH said 52 people are still being treated for their infections, and 4 more are in home isolation.

Today’s additional cases lift Saudi Arabia’s overall total from the disease, first detected in 2012, to 1,134, which includes 486 deaths. So far 592 people have recovered from their infections.

Hospital response update

King Abdulaziz Medical City said today in Twitter posts that it had postponed most outpatient appointments scheduled for Aug 23 and Aug 24 to curb spread of the virus. The only exceptions are for chemotherapy, obstetrics, and valve replacement clinics.

A specialty children’s hospital that is part of the medical city will continue with business as usual, with no cancelled clinics or admissions.

It said the Saudi MOH will continue to publish the number of positive MERS-CoV cases.

Earlier this week the hospital announced that since June, 31 illnesses had been linked to visits to its emergency department, a pattern seen in a recent MERS-CoV outbreak in South Korea. It also said several more illnesses were suspected.

Global health officials are discussing the possibility of a joint World Health Organization mission to help the country investigate the outbreak.

28th July 2015 (BBC) – UK- A suspected outbreak of Middle East Respiratory Syndrome (Mers) whichtemporarily shut a hospital’s A&E unit was a false alarm. Two patients who were thought to have the Mers condition at Manchester Royal Infirmary have tested negative. They were isolated for treatment and the hospital said there was “no significant risk to public health”. Mers is passed to people in close contact and is similar to the Sars virus. Patients who would usually travel to the Manchester Royal Infirmary were diverted to hospitals in South Manchester and Salford and the North Manchester General Hospital. The Manchester Royal said its children’s A&E department remained open throughout.

27th July 2015 ( Sky News) – UK – Two suspected cases of the respiratory virus MERS have shut the A&E department at Manchester Royal Infirmary. The patients have been isolated for continued treatment.  “We would like to reassure our patients and the general public that there is no significant risk to public health,” said a statement from the local NHS trust.

“Manchester Royal Infirmary accident and emergency department will be closed until further notice while further investigations take place.”

MERS (Middle Eastern Respiratory Virus Syndrome) symptoms typically include fever, cough, and a shortness of breath. Respiratory failure and organ failure can occur in the worst cases. Older people and those with diseases such as diabetes, cancer and lung disease are particularly vulnerable. Thirty-six percent of people who have contracted the virus have died, according to the World Health Organisation (WHO). It says MERS is contagious but “apparently only to a limited extent” and does not pass easily between people unless their is close contact. Most human to human infections have happened during medical treatment, explaining the urgency in shutting the Manchester A&E. The main source of MERS infection is thought to be through contact with camels and camel products in the Middle East. It was first identified in Saudi Arabia in 2012 and there have been at least 490 deaths related to the virus and nearly 1,400 confirmed cases.

 

27th July 2015 (Korea)  South Korean health authorities said on Monday they lifted the at-home quarantine for a suspected case of infection with the Middle East Respiratory Syndrome (Mers)  coronavirus, leaving no one subject to isolation over Mers for the first time in over two months.

The South Korean Health and Welfare Ministry said that as of Monday, 12 people remain hospitalized for Mers but only one of them has still tested positive for the coronavirus.

With no new case of the disease reported in more than three weeks, the South Korean government is planning to tell its people Tuesday that the  Mers outbreak has effectively ended, according to Yonhap News Agency.

Based on the World Health Organisation’s standards that call for a four-week waiting period after the last  Mers patient fully recovers, the formal declaration of the end of the outbreak in South Korea is expected to be made in late August.

Since the first case of  Mers infection was confirmed May 20 in the country, 186 people were found to be infected, 36 of them died and a total of about 16,000 people had been subject to quarantine

 

 

7th July 2015 (CIDRAP) – Health officials in the Philippines today announced the country’s second imported MERS-CoV case this year, in a traveler from the Middle East, as the total in South Korea’s hospital outbreak—also triggered by a traveler—grew to 186 cases.

Elsewhere, Saudi Arabia over the past 4 days reported one more MERS-CoV (Middle East respiratory syndrome coronavirus) case, as the World Health Organization (WHO) fleshed out more information on other recent cases, including some linked to a hospital outbreak in Hofuf.

Philippines case has Mideast ties

The Philippines Department of Health (DOH) today said a 36-year-old man from an unnamed Middle East country tested positive for MERS-CoV on Jul 4 and has been admitted to the country’s Research Institute for Tropical Medicine for observation, CNN Philippines reported. Quoting a DOH spokesperson, it said the man has a low viral load and was on the 14th day of incubation when he was tested.

The infection is the second imported MERS case detected in the Philippines. The first involved a female nurse whose infection was detected in February after she started having symptoms upon her return from Saudi Arabia. In the spring of 2014 the Philippines reported an asymptomatic infection in a nurse who had recently returned from the United Arab Emirates.

Media reports and a notice posted on the DOH Web site didn’t say where the man was from, but some reports said the man arrived in Manila from Dubai on Jun 19. A report from the BBC said the man had a stopover in Saudi Arabia on his way to Manila. It said he had his first symptoms on Jul 2, which is well after he arrived in the Philippines.

A DOH statement translated and posted by FluTrackers, an infectious disease news message board, said the patient is in stable condition and, due to his low viral load, is possibly already recovering. It noted that the government has activated its MERS task force and is tracing people who may have had contact with the man.

South Korea cases reach 186

Meanwhile, South Korea reported three additional MERS-CoV cases over the past 4 days, two of them in healthcare workers, lifting the overall total to 186 cases, according to Ministry of Health (MOH) daily updates. No new deaths have been reported, keeping the total at 33.

The two health workers include a nurse at Samsung Medical Center whose illness was announced on Jul 3 and a doctor from the same facility whose infection was announced on Jul 4. Samsung Medical Center, in Seoul, became the outbreak’s worst affected hot spot after a patient from the index hospital unknowingly spread the virus to staff, patients, and visitors when he spent nearly 3 days in the emergency department (ED) there in late May.

The latest patient, whose MERS-CoV infection was announced yesterday, is the spouse of an earlier announced case linked to Samsung’s ED.

The illness in the 50-year-old is raising more questions about the incubation period for MERS-CoV, the Korea Herald reported yesterday. It said authorities are still investigating how she was infected by the virus, and her symptoms may have started a week after 14-day incubation period. It said her symptoms began on Jul 2, about 21 days after she was isolated from her husband.

Authorities suspect that she was exposed by her husband and symptoms surfaced later, due to her compromised immune system due to cancer, according to the report. However, after her husband was hospitalized for MERS-CoV, she visited Samsung Medical Center for cancer treatment, and health officials are exploring the possibility that she was infected there.

The number of possible contacts being monitored has fallen below 1,000 in an outbreak that has slowed to a slow trickle. The ministry said as of today, 907 people are under quarantine, including 664 being monitored at home. So far 15,419 people have finished their quarantine period.

In a Jul 3 update, the WHO said so far all of South Korea’s MERS-CoV cases, except for the index one, are linked to a single transmission chain associated with healthcare facilities. It said the government is still adding new contacts each day as they are identified. The WHO added that the Korean government has said it will provide advance health insurance payments to hospitals that are having financial problems because of the MERS outbreak.

Saudi Arabia reports new case

Elsewhere, Saudi Arabia reported one new patient in the past 4 days, a 35-year-old male foreigner from Turubah, in the southwestern part of the country not far from Mecca, according to a Jul 3 statement.

The man is not a healthcare worker and is in stable condition, the Saudi MOH reported. So far the investigation has found no links to suspected or confirmed MERS cases in the community or hospital. His illness raises Saudi Arabia’s number of MERS-CoV infections to 1,045. No new deaths have been reported, so the fatality count remains at 460, according to the MOH.

The number of people who have recovered from their illnesses is at 578, and 7 people are still being treated.

WHO report covers hospital infections

On the same day that Saudi Arabia announced its most recent case the WHO provided more details on six cases the country reported between Jun 19 and Jun 30, including four from Hofuf, a town in the eastern part of the country that has been the setting for hospital and family MERS clusters over the past several weeks.

The patients in Hofuf include a 41-year-old man with an underlying medical condition who is related to an earlier announced patient who works at a hospital experiencing an ongoing MERS-CoV outbreak, a 60-year-old healthcare worker with an underlying medical condition who works at an outbreak hospital, a 61-year-old woman who had been admitted to an outbreak hospital, and a 52-year-old man who got sick with MERS-CoV while hospitalized for an unrelated condition.

The other two patients are both from Riyadh, which has reported several cases over the last few weeks. They include a 65-year-old woman and a 40-year-old man, and investigations into how they were exposed to the virus are still under way.

Illness onsets for the six patients range from May 30 to Jun 24. Ages range from 40 to 65 years old. Three are in critical condition, and three are listed as stable.

The WHO said Saudi Arabia also notified it of the death of a previously reported case-patient. The agency said that, since the disease emerged in September 2012, it has received reports of 1,363 lab-confirmed MERS cases, at least 487 of them fatal.

1st April 2015 (CIDRAP) – The stream of MERS-CoV cases in Saudi Arabia is continuing. with five more in the past 2 days, including two deaths, but the World Health Organization (WHO) says it is seeing no change in the epidemiologic pattern of the disease. The Saudi Ministry of Health (MOH) reported three cases yesterday and two more today, after listing none on Mar 28. The cases involved four Saudis and one expatriate, who is the only healthcare worker. The three MERS-CoV (Middle East respiratory syndrome coronavirus) cases reported yesterday involved Saudi men, ages 39, 54, and 80, in Hofuf, Khafji, and Tayma, respectively. The two older men, who had preexisting diseases, died, while the younger one is in critical condition, the MOH said. The ministry said none of the men had contact with other MERS patients in the community, but it provided no further exposure information, saying more information would be included in the next weekly MERS update. The two cases reported today are both in Jeddah. One patient is a 63-year-old foreign healthcare worker in stable condition; the other is 60-year-old Saudi listed in critical condition. The health worker had contact with other cases in a hospital or the community, but the other did not. No information on animal exposure was provided. The latest cases raised the MOH’s MERS count to 972, with 421 deaths, 531 patients recovered, and 20 still in treatment or home isolation.

WHO sees little change

Meanwhile, the WHO’s Regional Office for the Eastern Mediterranean published a MERS-CoV situation update that says the epidemiologic and demographic features of the disease have not changed significantly. The update consists of a set of graphs and tables with a list of highlights. The report is dated Mar 31 (tomorrow) and includes 967 Saudi Arabian cases, which was the MOH number on Mar 27. Of those, 145 cases, with 58 deaths, were reported this year, for a case-fatality rate of 40%. The disease continues to affect mainly men, with 50- to 59-year-olds hardest hit. “Nosocomial outbreaks in hospitals, though smaller in size and risk, as compared to the past, have been reported from Riyadh, Qassem [Qassim], Al-Jouf [Al Jawf], and Eastern regions,” the update says. It adds that nosocomial infections among health workers have continued to decline since the last big hospital outbreak in Jeddah in 2014.

Saudi Arabia’s MERS total for January and February of this year is 114 cases, 12% of which were in health workers, the update says. That compares with 21 cases in the same months last year, with 5% in health workers. Of the 114 cases, 13% were primary (ie, with no link to another known case), 35% were secondary (with a link to a known case), and 51% had an unknown contact history.

 

 

24th March 2015 (CIDRAP) – MERS sickens 3 more in Saudi Arabia Saudi Arabia’s Ministry of Health (MOH) reported three more MERS-CoV cases today, including the second one from Mecca this year, along with one death in a previously reported case. Two of the new MERS-CoV (Middle East respiratory syndrome coronavirus) cases are in foreigners, a 42-year-old man who got sick in Mecca and a 20-year-old man whose infection was detected in Jeddah. Neither are healthcare workers, and the younger man had contact with suspected or confirmed MERS cases in the community. Both are hospitalized in stable condition. The third patient is a 55-year-old Saudi woman from Arar, located in the northern part of the country near the border with Iraq. She is also listed in stable condition. She didn’t have contact with suspected cases in the community and is not a healthcare worker. The MOH said it would include more information on exposure history in its weekly MERS-CoV update, which usually comes out early in the week. The agency adopted a policy of including less exposure information in its daily updates last week. The patient who died is a 61-year-old man from Riyadh who had underlying medical conditions. In addition, the MOH noted three MERS-CoV recoveries, all of them involving foreign healthcare workers who got sick in Riyadh. They are a 37-year-old man and two women, 48 and 51. The new cases and death lift Saudi Arabia’s MERS-CoV totals to 964 infections, 416 of them fatal. The new cases would boost the global total from the disease to 1,109 cases, according to a list kept by FluTrackers, an infectious disease news message board.

17th March 2015 (CIDRAP) – Saudi Arabia reported five more MERS cases over the weekend, raising the total for this month to 37, but no new cases were announced today. All five patients are men who are in stable condition, the Saudi Ministry of Health (MOH) reported. None of them are healthcare workers. The two cases reported Mar 14 involve two men, a 47-year-old in Hofuf and a 60-year-old in Taimah, the ministry said. Both had preexisting conditions. The older man had a history of exposure to animals before he got sick, but neither of them had any other known exposure risks. Yesterday the MOH reported the illness in a 44-year-old expatriate in Khafji, a town on the Kuwait border, and in two Saudis, ages 56 and 27, in Riyadh. The only MERS-CoV (Middle East respiratory syndrome) risk factor among them was exposure to animals for the Khafji man. The MOH also reported three deaths over the weekend. The victims were all Saudis who lived in Riyadh and were 59, 61, and 62 years old. Officials reported the recovery of two other patients, a 46-year-old foreign woman and a 56-year-old Saudi man, both in Riyadh. The latest developments brought the MOH’s MERS count to 957 cases, including 516 deaths, 416 patients recovered, and 25 still in treatment or home isolation. In other news, the MOH today released its weekly summary of MERS cases, providing some data on 15 cases reported from Mar 8 through 14. They involved 10 men and 5 women ranging in age from 21 to 72 years. Ten cases occurred in Riyadh, the epicenter of MERS activity, with 2 in Al-Ahsa and 1 each in Jeddah, Al-Qassim, and Tabuk. By nationality, the patients included 10 Saudis, 2 Sudanese, 1 Filipino, 1 Egyptian, and 1 Yemeni. Of the Riyadh cases, 3 were community-acquired, 2 were in healthcare workers, 3 were hospital-acquired, 1 involved contact with a patient at home, and another was still being investigated. The Al-Ahsa and Jeddah cases were community-acquired, while the Al-Qassim case was under investigation. No exposure information was listed for the Tabuk one.

16th March 2015 (Kuwait News Agency) – RIYADH, March 15 (KUNA) — Saudi Arabia reported 15 confirmed new Middle East Respiratory Syndrome (MERS) coronavirus cases during last week, among them 10 in Riyadh, while two cases in Al-Ihsaa, one in each Jeddah, Al-Qassim, and Tabuk, Health ministry said on Sunday.
In its weekly report, the ministry said that 10 of those cases are male and five females, and belonged to 10 Saudi nationals, two Sudanese, one from Yemen, Philippine, and one Egyptian.
The ministry noted eight cases were discovered inside health facilities, one in National Guards ministry, one in Security Forces Medical Services, three in hospital universities, and two in the private sector. The report added three cases were from social contact in Riyadh, two cases by health workers, and three picked up the virus from hospital facilities, and one from inside a residency, among others. Since its eruption in 2012, the virus killed 416 individuals out of total 957 cases, among them 516 have already recovered and 23 are receiving treatment in the country.

15th March 2015 (Gulf Times) – Ten more people have died in Saudi Arabia from the Mers virus since last week, health ministry data showed yesterday, adding to a surge in cases over the past month. The latest deaths occurred between March 6 and 12, mostly in the capital Riyadh, bringing to 17 the number of Mers deaths so far this month, according to the ministry.

Middle East Respiratory Syndrome coronavirus (Mers-CoV) killed 30 people last month in the kingdom, which has been worst-hit by the virus.  Its symptoms can include fever, coughing and shortness of breath. Last week the health ministry started the latest phase of a public education campaign aimed at preventing the virus from spreading. The World Health Organisation has cited the preliminary results of studies indicating that people working with camels are at increased risk of infection, with young camels particularly susceptible.
Abdul Aziz bin Saeed, who heads the centre co-ordinating the health ministry’s response to Mers, warned in early February that virus cases typically surge early in the year when there are more juvenile camels circulating.  More than 20 countries have been affected by the virus, with the most cases in Saudi Arabia. A total of 950 people have been infected with Mers since it was first identified in the kingdom in 2012, and 412 of them have died. Mers is considered a deadlier but less infectious cousin of the Severe Acute Respiratory Syndrome (Sars) virus that appeared in Asia in 2003 and killed hundreds of people, mostly in China.

13th March 2015 (Infection Control Today) – Between Feb. 26, 2015 and March 2, 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified the World Health Organization (WHO) of 18 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including five deaths.

 

12th March 2015 World Health Organisation Press Release

Between 26 February and 2 March 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 18 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 5 deaths. Cases are listed by date of reporting, with the most recent case listed first.

Details of the cases are as follows:

  • A 53-year-old, non-national male from Riyadh city developed symptoms on 25 February while admitted to hospital since 16 February due to an unrelated medical condition. The patient was admitted to the same hospital and treated by the same health workers as two laboratory-confirmed MERS-CoV cases (cases n. 5, 16 – see below); however, he had no direct contact with the cases. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in critical condition in ICU.
  • A 63-year-old male from Riyadh city developed symptoms on 25 February and was admitted to hospital on 28 February. On 14 January, the patient underwent a surgical procedure for an unrelated medical condition. He has no history of exposure to any of the known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in critical condition in ICU.
  • A 61-year-old, non-national female from Riyadh city developed symptoms on 21 February and was admitted to hospital on 1 March. The patient has comorbidities. She has no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently the patient is in critical condition in ICU.
  • A 57-year-old, non-national male from Riyadh city developed symptoms on 24 February and was admitted to hospital on 28 February. The patient has no comorbidities. He has no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 51-year-old, non-national, female health worker from Riyadh city developed symptoms on 21 February. The patient has comorbidities. She works in a hospital that treated a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 23 February (case n. 2). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, she is in stable condition isolated at home.
  • A 60-year-old male from Riyadh city developed symptoms on 23 February and was admitted to hospital on 24 February. The patient had comorbidities. He had no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. The patient passed away on 2 March.
  • A 64-year-old, non-national female from Riyadh city developed symptoms on 22 February and was admitted to hospital on 28 February. The patient has comorbidities. She has no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 74-year-old male from Riyadh city developed symptoms on 20 February and was admitted to hospital on 27 February. The patient has comorbidities. He has no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in critical condition in ICU.
  • A 34-year-old, non-national male from Buridah city developed symptoms on 18 February and was admitted to hospital on 25 February. The patient has no comorbidities. He works in a hospital that treated laboratory-confirmed MERS-CoV cases. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
  • A 61-year-old male from Riyadh city developed symptoms on 21 February and was admitted to hospital on 26 February. The patient has comorbidities. He is a household contact of a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 23 February (case n. 37). He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in critical condition in ICU.
  • A 46-year-old, non-national, female health worker from Riyadh city developed symptoms on 22 February and was admitted to hospital on 27 February. The patient has no comorbidities. She has a history of providing care assistance to a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 6 March (case n. 3). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in critical condition in ICU.
  • An 80-year-old male from Riyadh city developed symptoms on 22 February and was admitted to hospital on 23 February. He visited the same hospital for an unrelated medical condition over 14 days prior to the onset of symptoms. Other laboratory-confirmed MERS-CoV cases have been treated at this hospital. He had no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. The patient passed away on 2 March.
  • A 45-year-old, non-national male from Buridah city developed symptoms on 22 February and was admitted to hospital on 26 February. The patient had comorbidities. He had no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. The patient passed away on 2 March.
  • A 40-year-old, non-national, male health worker from Riyadh city developed symptoms on 20 February and was admitted to hospital on 24 February. The patient has no comorbidities. He works in a hospital that treated laboratory-confirmed MERS-CoV cases but he has no history of contact with these cases. He has no history of exposure to any of the other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
  • A 56-year-old, non-national male from Riyadh city developed symptoms on 25 February and was admitted to hospital on the same day. The patient has comorbidities but no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
  • A 91-year-old female from Riyadh city developed symptoms on 24 February while admitted to hospital since 12 February due to unrelated medical conditions. The patient had other comorbidities. She was admitted to the same hospital as other laboratory-confirmed MERS-CoV cases; however, the patient has no epidemiological links with the cases. She had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. The patient passed away on 2 March.
  • A 40-year-old female from Aljouf city developed symptoms on 21 February and was admitted to hospital on the same day. The patient had comorbidities. On 17 February, she received care for an unrelated medical condition in a hospital that treated other laboratory-confirmed MERS-CoV cases; however, the patient had no contact with these cases. She had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. The patient passed away on 28 February.
  • A 51-year-old, non-national male from Khober city developed symptoms on 17 February and was admitted to hospital on 24 February. The patient has comorbidities. He is a household contact of a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 23 February (case n. 9). Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 6 previously reported MERS-CoV cases. The cases were reported in previous DONs on 23 February (cases n. 2, 35), on 26 February (case n. 3) and on 6 March (cases n. 2, 4, 8).

Contact tracing of household contacts and healthcare contacts is ongoing for these cases.

Globally, WHO has been notified of 1059 laboratory-confirmed cases of infection with MERS-CoV, including at least 394 related deaths.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

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.

 

 

11th March 2015 (By Mohammed Dawood  Okaz/Saudi Gazette, Jeddah) –  Three people who were being treated for Middle East Respiratory Syndrome Coronavirus at a government hospital in Riyadh have died and four others have contracted the deadly virus within the space of 24 hours on Monday. According to the Health Ministry, the victim included a 41-year-old Saudi man, a 75-year-old expatriate man and a 61-year-old Saudi man. It said all victims were suffering from other underlying health conditions and had been confined to hospital for some tim10th March 2015 (CIDRAP) – The late-winter stream of MERS cases in Saudi Arabia continued with seven more reported over the past 3 days, while Germany reported a case imported from the United Arab Emirates (UAE) and Qatar cited its second case of the year. The latest cases in Saudi Arabia included one reported by the Saudi Ministry of Health (MOH) Mar 7, two reported Mar 8, and four more noted today. Six patients are from Riyadh and one is from Hofuf in the eastern province; all but two of them are men. Four are in critical condition and three are stable. Their ages range from 37 to 61. Just one healthcare worker, a 37-year-old foreigner in Riyadh, is among the seven patients. None of them were exposed to animals or to other MERS-CoV (Middle East respiratory syndrome coronavirus) patients in community settings before their illnesses, but possible exposure in healthcare settings is under investigation in four cases. The MOH also reported four recoveries and five deaths among previously reported case-patients in the past 3 days. Four of the deaths were in Riyadh and one was in Unayzah. The agency’s MERS count has reached 945 cases, with 408 deaths, 512 recoveries, and 25 patients still in treatment or under observation. In addition, yesterday the MOH gave its second weekly summary of MERS cases, a practice it inaugurated a week earlier. It said the preceding week brought 19 cases involving 11 men and 8 women, with 16 in Riyadh, 2 in Al-Qassim, and 1 in Jeddah. Among the patients were 11 Saudis, 2 Filipinos, 2 Bangladeshis, a Yemini, an Indian, a Sudanese, and a Pakistani. Of the 16 cases in Riyadh, 8 were acquired in the community, 3 were hospital-acquired, 3 involved healthcare workers, and 3 resulted from exposures to MERS patients in homes, the MOH said. Of the other three cases, two were community-acquired and one (in Al-Qassim) involved a health worker. The agency also said rapid response teams working to prevent transmission in healthcare facilities made 18 field visits, while other teams visited 15 houses to monitor contacts of case-patients.

11th March 20115 (Infection Control Today) – On March 7, 2015, the National IHR Focal Point for Germany notified the World Health Organization (WHO) of one case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The case is a 65-year-old, male, German citizen who returned on Feb. 8 to Germany from Abu Dhabi, United Arab Emirates. He developed symptoms on Feb. 10 and was hospitalized in an intensive care unit one week later. The MERS-CoV infection was laboratory confirmed on two samples; the latest sample was taken on March 5. Currently, the patient is in a severe but stable condition. All necessary, recommended, preventive and control measures have been applied since Feb. 23 at the hospital where the patient is being treated. Contact tracing of all possible contacts is ongoing for this case. So far, no additional cases have been identified. Globally, WHO has been notified of 1041 laboratory-confirmed cases of infection with MERS-CoV, including at least 383 related deaths.

10th March 1015 (CIDRAP) – The late-winter stream of MERS cases in Saudi Arabia continued with seven more reported over the past 3 days, while Germany reported a case imported from the United Arab Emirates (UAE) and Qatar cited its second case of the year. The latest cases in Saudi Arabia included one reported by the Saudi Ministry of Health (MOH) Mar 7, two reported Mar 8, and four more noted today. Six patients are from Riyadh and one is from Hofuf in the eastern province; all but two of them are men. Four are in critical condition and three are stable. Their ages range from 37 to 61. Just one healthcare worker, a 37-year-old foreigner in Riyadh, is among the seven patients. None of them were exposed to animals or to other MERS-CoV (Middle East respiratory syndrome coronavirus) patients in community settings before their illnesses, but possible exposure in healthcare settings is under investigation in four cases. The MOH also reported four recoveries and five deaths among previously reported case-patients in the past 3 days. Four of the deaths were in Riyadh and one was in Unayzah. The agency’s MERS count has reached 945 cases, with 408 deaths, 512 recoveries, and 25 patients still in treatment or under observation. In addition, yesterday the MOH gave its second weekly summary of MERS cases, a practice it inaugurated a week earlier. It said the preceding week brought 19 cases involving 11 men and 8 women, with 16 in Riyadh, 2 in Al-Qassim, and 1 in Jeddah. Among the patients were 11 Saudis, 2 Filipinos, 2 Bangladeshis, a Yemini, an Indian, a Sudanese, and a Pakistani. Of the 16 cases in Riyadh, 8 were acquired in the community, 3 were hospital-acquired, 3 involved healthcare workers, and 3 resulted from exposures to MERS patients in homes, the MOH said. Of the other three cases, two were community-acquired and one (in Al-Qassim) involved a health worker.The agency also said rapid response teams working to prevent transmission in healthcare facilities made 18 field visits, while other teams visited 15 houses to monitor contacts of case-patients.

9th March 2015 (The Peninsular) – DOHA: The Supreme Council of Health (SCH) has announced that a new “Middle East Respiratory Syndrome Corona Virus (MERS-CoV) case has been reported for a Qatari patient aged 69 years old who also had a history of chronic illnesses. The patient has had fever for a few days then he developed sore throat and cough where he has been referred to Hamad General Hospital. Upon assessment and laboratory investigations, the patient was diagnosed with pneumonia and subsequently confirmed as a MERS-CoV case in the national reference laboratory . He is currently admitted in ICU in critical condition. The Rapid Response Team of the SCH conducted an epidemiological investigation including line listing of all close contacts to the case and initiate screening . Health education about appropriate preventive measures was given to the contacts along with close follow-up for any symptoms.  The SCH urges all community members to implement all the recommended infection prevention and control measures. As a general precaution, anyone visiting farms, markets, barns, or other places where animals are present should practice general hygiene measures, including regular hand washing before and after touching animals, and avoid contact with sick animals. People with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection.  Therefore, these people should avoid contact with camels, drinking raw camel milk or eating meat that has not been properly cooked.

9th March 2015 (Outbreak News Today) – Germany’s Robert Koch Institute has reported (computer translated) their third imported Middle East Respiratory Syndrome Coronavirus (MERS-CoV) since 2012 in a German resident who traveled to Abu Dhabi, United Arab Emirates (UAE).

8th March 2015 (MANILA, Philippines) – Three Filipinos have contracted Middle East respiratory syndrome while working at separate hospitals in Saudi Arabia, the Philippine government said Friday. Two are nurses and the third is a medical technician, said Department of Foreign Affairs spokesman Charles Jose. They are in the early stage of the infection after being exposed to MERS patients, Jose said. He said an emergency room nurse is isolated in staff housing and the other two in their respective hospitals.

27th Feb 2015 (Arab News) – Health authorities confirmed that so far, the only way to verify if a patient is infected with Middle East Respiratory Syndrome coronavirus (MERS-CoV) is through a laboratory test. “This is because MERS symptoms very much resemble those of the influenza. Therefore it is essential to make a lab test to verify whether there is a MERS-CoV infection or not, ” Dr. Nesreen Sherbini, consultant of communicable diseases and epidemiologist, told local media. Sherbini also works at the National Center for Health Communication and Awareness at the Ministry of Health, where authorities have set up a call center to answer questions regarding the MERS virus. Echoing health officials’ recommendations, Sherbini reiterated that the MERS infection is caused by exposure to cough, sneeze, by touching the eyes or the mouth of the infected person or camel. “If there has been exposure, it is important to wash carefully that part of the body with water and detergents or antiseptics. Also, it is crucial that the person should get an urgent medical checkup, especially if the person starts to have high temperature and symptoms of influenza, coupled with shortness of breath,” she warned. Sherbini mentioned that major studies show that camels are the main carriers of the virus, so it is strongly advised to avoid touching their sprinkles and nasal or eye mucosa. “However, there is no harm in drinking their milk as it has not been proved that the infection can be caused by drinking camel milk, but as a strong precautionary measure, it should be properly boiled or pasteurized,” the physician said.

26th Feb 2015 (CIDRAP) – Saudi Arabia reported five more MERS cases today, four of them in Riyadh, while a media report said the government is warning it will close clinics and hospitals that hide MERS cases or violate prevention guidelines. In addition, the European Centre for Disease Prevention and Control said in an updated MERS-CoV (Middle East respiratory syndrome coronavirus) risk assessment that about a third of the recent cases in Saudi Arabia may be healthcare-related. The agency also likened the recent surge of cases to what happened in the country early in 2014. Of the five new cases, all the patients are Saudis and have preexisting conditions, and none are healthcare workers, the Saudi Ministry of Health (MOH) said. The four patients in Riyadh are all in critical condition. They are three men, ages 75, 83, and 80, and a 24-year-old woman. None of them have a history of exposure to animal or to MERS patients in the community, but possible exposure to other patients in healthcare settings is under investigation for three of them. The fifth patient is a 35-year-old man in Hofuf who is in stable condition. He was exposed to MERS patients in a healthcare setting, the MOH said. The five cases raise the total reported by the MOH in February to 67. The agency has also reported 24 MERS deaths this month. The MOH’s cumulative MERS count has reached 912 cases, including 388 deaths and 26 active cases. Reported threat of sanctions for hospitals. Meanwhile, a Saudi health official has warned that clinics and other health facilities that fail to report MERS-CoV cases will be shut down, according to a story today from Gulf News, based in Dubai, United Arab Emirates. The story cited a local daily newspaper named Al Eqtisadiya as its source. Fines of up to 100,000 Saudi riyals will be imposed on facilities and health practitioners that conceal cases or do not take steps to prevent the spread of the disease, Abdul Aziz Bin Saeed, PhD, MBBS, the deputy minister of public health, was quoted as saying. The story said the warning came after the government closed a large private hospital in Riyadh for failing to respond properly to the threat of MERS. The health ministry said the hospital, which was not named, failed to comply with infection control guidelines issued by the ministry’s Command and Control Center. A Riyadh health official said the violations had to do with sterilization and other precautions in the hospital’s emergency department, intensive care units, and operating rooms, according to the story.

ECDC counts 1,042 cases

The ECDC, in its 14th and latest MERS-CoV risk assessment today, said 1,042 cases and 419 deaths had been reported in 23 countries as of Feb 20. The World Health Organization’s official count of confirmed cases as of yesterday was slightly lower at 1,026, with at least 376 deaths.

 

23rd Feb 2015 (Ottawa Sun)   –   LONDON – Saudi Arabia has not done enough to investigate and control a deadly new MERS virus that has killed hundreds of people there and remains in many ways a mystery, United Nations health experts said on Monday. Cases of Middle East Respiratory Syndrome (MERS) are surging again, but Saudi health officials and scientists appear unable to explain where the infections start and how they spread, the UN experts said. The UN group – a international delegation of scientists and public health experts from World Health Organization (WHO), the United Nations Food and Agriculture Organization (FAO) and World Organization for Animal Health – visited Saudi Arabia last week to investigate a sharp rise in MERS cases. MERS causes coughing, fever and breathing problems, and can lead to pneumonia and kidney failure. “Critical gaps in knowledge remain, and several challenges … will require further work,” it said in a joint statement. “How and why infections occur in the community is yet to be understood, and this is critical for stopping the outbreak.”

22nd Feb 2015 (Reuters) – Saudi Arabia has not done enough to investigate and control a deadly new MERS virus that has killed hundreds of people there and remains in many ways a mystery,United Nations health experts said on Monday. Cases of Middle East Respiratory Syndrome (MERS) are surging again, but Saudi health officials and scientists appear unable to explain where the infections start and how they spread, the UN experts said. The UN group – a international delegation of scientists and public health experts from World Health Organization (WHO), the United Nations Food and Agriculture Organization (FAO) and World Organization for Animal Health – visited Saudi Arabia last week to investigate a sharp rise in MERS cases.

22nd Feb 2015 (RT) – As the deadly MERS virus with no vaccine caused two more fatalities in Saudi Arabia, bringing the death toll in the country to 385, an international team of health experts was dispatched to look into the cases. The news of two more deaths was issues by Saudi Arabia’s Health Ministry on Saturday. Middle East Respiratory Syndrome, or MERS, has infected 902 people in the country since it was first identified in 2012, though 490 people who contracted the disease have recovered. Some 57 people have contracted MERS in the kingdom since the start of February. An international team of UN human and animal health experts flew into Saudi Arabia on Friday to investigate the recent surge. A spokeswoman for the World Health Organization team said February has seen what appears to be one of the highest numbers of cases since the virus first emerged in humans. “We are all very aware of this surge in cases,” one of an 11-strong international MERS expert team, the WHO’s Fadela Chaib, said in Ryad. “Although this is still a small outbreak compared to last year, we still need to understand more about what is happening,” she told Reuters.

21st Feb 2015 (Reuters) – An international team of United Nations human and animal health experts has flown to Saudi Arabia to investigate a recent surge in cases of a deadly virus known as Middle East Respiratory Syndrome, or MERS. Speaking from Riyadh on Friday, a spokeswoman for the World Health Organization-led team said it was worried by a steep rise in cases of MERS, which has infected some 50 people in the Kingdom in February alone — one of the highest monthly rates since it first emerged in humans in 2102. “We are all very aware of this surge in cases,” said the WHO’s Fadela Chaib, one of an 11-strong international MERS expert team due to end a three-day mission by Saturday. “Although this is still a small outbreak compared to last year, we still need to understand more about what is happening.”

20th Feb 2015 (Arab News) – Two more Saudis and an expatriate have died of the Middle East Respiratory Syndrome coronavirus, raising the total number of deaths from Mers CoV i the Kingdom to 377, the Ministry of Health said late Wednesday. The victims, all male, included a 54-year-old in Buraidah, a 65-year-old in Tabuk, and a 60-year-old expat worker in Riyadh, said an update on the MOH website. All the victims had pre-existing diseases, said the report prepared by the MOH Command and Control Center. The MOH said two previous reported MERS cases, both males in Dhahran, have recovered. One new case, a 58-year-old Saudi who is in critical condition, was also found in the eastern city of Alkhobar, the report said. The latest case brings to 897 the total number of confirmed MERS infections in Saudi Arabia since the coronavirus was first detected in June 2012. Of the total infected patients, 486 have fully recovered. The World Health Organization (WHO) placed the total number of laboratory-confirmed cases of MERS-CoV infection at 983 as of Feb. 16, 2015, including at least 360 related deaths, lower than the total deaths in Saudi Arabia alone. side from Saudi Arabia, MERS cases have also been confirmed in the United Arab Emirates, Kuwait, Malaysia, Jordan, Qatar, Egypt, Turkey, Oman, Algeria, Bangladesh, the Philippines, Austria, France, Italy, the United Kingdom, and the United States. Many of the cases were somehow linked to Saudi Arabia.

19th Feb 2015 (Arab News) – The representative of the World Health Organization in the Kingdom, Dr. Hasan Al-Bushra, has announced that the origin of Middel east Respiratory Syndrom (MERS-CoV) is still a mystery and that no vaccine has yet been developed against it. ‘Though camels are most likely the origin of the virus, there is no confirmation of this as studies are still at the stage of analyzing data,” he said while speaking at an awareness program organized by the Ministry of Health.
The senior international official stressed that the recent infection cases in the Kingdom have not caused a global alarm because “the situation is under control and the virus has not been transmitted from human to human.” Al-Bushra expects a rise in infection rates in the Kingdom during the coming two months, March and April, because of factors related mainly to weather changes. “The current efforts in the country aim at spreading awareness to eliminate the proliferation of the virus, thus decreasing the infections while, at the same time, treating confirmed cases so they do not result in deaths,” he said.

17th Feb 2015 (Philippines Star) – MANILA, Philippines (Xinhua) – The Philippines confirmed today one case of Middle East Respiratory Syndrome-Corona Virus (MERS-CoV), involving a pregnant nurse coming back from Saudi Arabia days ago. All known contacts with nurse are clear of infection, Dr. Lyndon Lee Suy of the country’s Department of Health said at a press briefing, referring to report that three other persons were earlier considered as “patients under investigation.”  “So as of this moment, we only have one case, which is closely monitored, our index case – the Filipina nurse who tested positive with Mers-CoV,” he said.  The nurse had earlier passed through the thermal scanner at the Ninoy Aquino International Airport undetected on arrival from Saudi Arabia. However, according to the spokesman, such measures are not entirely foolproof as the virus has an incubation period of 14 days. Dr. Lee Suy also advised that travelers coming home from a MERS- CoV affected country should immediately go to a health facility if they develop any flu-like symptoms.

24th July 20114 (Daily Mail) – The deadly MERS virus which has killed more than 300 people may be airborne, it has been claimed.
Saudi scientists drew the conclusion after finding gene fragments of the deadly Middle East Respiratory Syndrome in air from a barn housing an infected camel.
They say this suggests the disease may be transmitted through the air.
This is concerning because viruses that spread through air – such as flu viruses – are far more likely to spread swiftly and widely in human populations than those that can only move from an animal to a person, or from person to person, via direct contact.
MERS, a serious respiratory illness caused by a virus known as a coronavirus (CoV), has infected at least 850 people since it first emerged two years ago.
Of these people, it has killed 32, according to latest figures from the European Centre for Disease Prevention and Control.
The vast majority of human cases have been in Saudi Arabia, but isolated MERS cases have been reported across Europe, Asia and the U.S. in people linked who have recently travelled in the Middle East.
Scientists are not sure of the origin of the virus, but several studies have linked it to camels.
Some experts believe it is being passed to humans through close physical contact or through the consumption of camel meat or camel milk.
However, the latest research suggests the detection of the virus in air samples was concerning and needed to be followed up, Reuters Health reports.
The study was published in the online journal of the American Society for Microbiology, mBio.

Read more: http://www.dailymail.co.uk/health/article-2702700/MERS-virus-airborne-scientists-warn.html#ixzz38N1VTqqd

8th May 2014 (Arabian Business) – Eighteen more people in Saudi Arabia have contracted the potentially deadly Middle East Respiratory Syndrome (MERS), bringing the number of cases in the kingdom to 414, its health ministry said on Monday, more than a quarter of whom have died.
The new cases, reported in the past 48 hours, were in the capital Riyadh, the coastal city of Jeddah, and the holy cities of Makkah and Medina, the ministry said on its website. The spread of the disease is a concern for Saudi Arabia which will host millions of foreign pilgrims in July in Mecca and Medina during Islam’s fasting month of Ramadan. Millions more are expected in October for the annual Haj pilgrimage. So far 115 of the people in Saudi Arabia who contracted the virus have died, the ministry said. Many of those affected have been foreign health workers.
7th May 2014 A new virus that has killed more than 100 people in the Middle East has been found in the United States for the first time, in an Indiana health care worker who recently returned from Saudi Arabia, federal health officials said Friday.

7th May 2014 (the Tech Online) – USA – MERS virus found in United States for first time. A new virus that has killed more than 100 people in the Middle East has been found in the United States for the first time, in an Indiana health care worker who recently returned from Saudi Arabia, federal health officials said Friday. The man, whose name, age and exact occupation have not been released, is in stable condition in an Indiana hospital, said Dr. Anne Schuchat, director of respiratory diseases at the Centers for Disease Control and Prevention. He is in isolation and receiving oxygen.

1st May 2014 (Channel NewsASIA) RIYADH: Saudi health authorities announced on Wednesday two new deaths from the MERS coronavirus in the kingdom, where 16 more infections were also detected. A 41-year-old man in the northwestern city of Tabuk and an 88-year-old in Riyadh died of Middle East Respiratory Syndrome, bringing to 107 the total deaths since the disease appeared in the kingdom in September 2012, the health ministry said. At the same time, the ministry said 16 new infections nationwide have raised the total number of cases diagnosed to 361, representing the bulk of infections registered globally. Public concern over the spread of MERS mounted earlier this month after the resignation of at least four doctors at Jeddah’s King Fahd Hospital who refused to treat patients for fear of infection. Acting health minister Adel Fakieh said on Tuesday that measures to contain the spread of MERS “will be announced in the coming days” as Western experts and representatives of the World Health Organisation met in Riyadh this week.

28th April 2014 (BBC) – Saudi Arabia says more than 100 patients infected with the Mers coronavirus have now died since the outbreak began in 2012. The health ministry said another eight deaths occurred on Sunday, taking the toll to 102. The acting health minister says three hospitals in Riyadh, Jeddah and Dammam have been designated specialist centres for treating Mers. Mers causes symptoms including fever, pneumonia and kidney failure. The rate of infections is increasing and the World Health Organization (WHO) has offered to help Saudi Arabia investigate infection patterns. The Saudi health ministry reported the latest deaths in a statement late on Sunday. Among the victims were a child in the capital, Riyadh, and three people in the western city of Jeddah. The ministry said it had detected a total of 16 new cases of Mers (Middle East Respiratory Syndrome) over the past 24 hours. Acting health minister Adel Fakieh said the three hospitals designated as specialist centres for Mers treatment can accommodate 146 patients in intensive care. On Saturday, Egypt recorded its first case – a 27-year-old man who had recently returned from Saudi Arabia. Correspondents say many Saudis have voiced concerns on social media about government handling of the outbreak. Last Monday, Saudi health minister Abdullah al-Rabiah was sacked without explanation as the Mers death toll climbed.

17th April 2014 (The National) ABU DHABI A paramedic who died last week after contracting the Mers coronavirus infected 10 colleagues, the World Health Organisation said on Tuesday. Abundio Verzosa Esporlas, 45, an Al Ain Rescue and Ambulance Section worker from the Philippines, died on Thursday after developing flu-like symptoms. It was not known whether the WHO figure included five Al Ain Rescue workers who had direct contact with Esporlas before his death and are in precautionary quarantine. WHO said it had been informed of the 10 new cases by UAE health authorities. However, in a statement released through the state news agency Wam, the Health Authority Abu Dhabi (Haad) said it had identified an additional three cases after screening healthcare workers in Al Ain. Officials at Haad refused to comment on the discrepancy in the figures. In its statement to Wam, Haad said the three new cases displayed no symptoms, but preventive measures had been taken to keep them in quarantine. “From previous asymptomatic cases in the UAE, individuals tend to clear the virus themselves within 10-14 days, but are kept in isolation in hospital during this time,” the authority said. Haad said there was no public-health concern and it was coordinating with the Ministry of Health and other authorities, taking measures recommended by WHO to screen anyone who had come in contact with a confirmed case. WHO said it had been informed of the 10 new cases on Sunday and Monday but was not issuing any special recommendations. “We would need more information to understand the background to the new cases,” said spokesman Gregory Hartl. The new cases bring the global Mers total to 238 infected, with 92 deaths

15th April 2014 (Infection Control Today reporting from the WHO on April 9, 2014) – The Ministries of Health of Jordan notified WHO of an additional laboratory-confirmed case of infection with Middle East respiratory syndrome coronavirus (MERS-CoV). The patient is a 52-year-old man with underlying medical conditions. He visited Saudi Arabia from March 20 to March 29, 2014. He became ill on March 25 and visited a hospital in Jeddah. He returned to Jordan on March 29 and visited a hospital in Amman on the same day and on April 2. He is currently in stable condition. The authorities in Jordan are in contact with the authorities in Saudi Arabia to follow up on all close contacts of the case.

Globally, from September 2012 to date, WHO has been informed of a total of 212 laboratory-confirmed cases of infection with MERS-CoV, including 88 deaths.

14th April 2014 (Gulf News) Jeddah: A foreigner has died from Mers while eight people including five health workers have been infected in the Saudi city of Jeddah, where the spread of the coronavirus among medics has sparked panic. The death of the 45-year-old man, whose nationality has not been disclosed, brings the nationwide toll in the world’s most-affected country to 68. The health ministry late on Saturday announced the death of the man and said five

health workers — two women and three men — and three other people had been infected by the virus in Jeddah. The announcement came days after panic over the spread of the virus among medical staff led to the closure of the emergency room at the city’s main public hospital.

13th April 2014 (Reuters) – Yemen reported its first case of the deadly MERS coronavirus on Sunday in a further spread of the deadly strain in the Middle East two years after its outbreak in neighboring Saudi Arabia. “Medical personnel have recorded one case of the coronavirus in Sanaa and the victim is a Yemeni man who works as an aeronautics engineer,” the semi-official al-Thawra newspaper quoted Public Health Minister Ahmed al-Ansi as saying. “The ministry is working in effective cooperation with the World Health Organisation to confront this virus and is in direct and constant communication with all hospitals to receive information on any other suspected cases,” Ansi said.

9th April 2014 (Straights Times) – JEDDAH, Saudi Arabia(AFP) – The main public hospital in the Saudi city of Jeddah has closed its emergency room after a rise in cases of the MERS virus among medical staff, medics said on Tuesday. A Jeddah paramedic was among two more people Saudi health authorities reported on Sunday had died from the SARS-like disease, bringing the nationwide death toll to 66. On Monday, the health ministry reported four more MERS cases in Jeddah, two of them among health workers, prompting authorities to close the emergency department at the city’s King Fahd Hospital.
A medical source told AFP it was a “precautionary measure” and the Sabq.org news website reported that patients were being transferred to other hospitals in the city.

9th April 2014 (The National) ABU DHABI A 59-year-old resident of Abu Dhabi, who suffers from diabetes and final-stage renal failure, was diagnosed with Mers coronavirus, the Health Authority – Abu Dhabi confirmed. The man, currently on dialysis, complained of respiratory symptoms and was admitted to hospital, where he was diagnosed with the illness, the state news agency, Wam, reported

7th April 2014 (Arab News) – Two more Saudis — a nurse and an elderly man — died in Jeddah of the MERS coronavirus on Sunday, the Health Ministry has announced. It also said that a doctor in Jeddah who was inflicted by the virus was in recovery mode. “We have found 356 suspected cases during the past week,” sabq.org quoted the ministry as saying. The electronic newspaper said medical tests have proved that three health workers in the city have contracted the disease, adding that they are stable. “An 70-year-old man who was suffering from MERS, along with other chronic diseases, died today,” the ministry said.

2nd April 2014 Global Dispatch – Abu Dhabi Man Becomes The 87th MERS Fatality. The National IHR Focal Point of the United Arab Emirates (UAE) has confirmed an additional laboratory-confirmed case of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) and notified the World Health Organization this past Sunday. A 64 year-old man from Abu Dhabi with underlying medical conditions. He became ill on 21 March, and was admitted to hospital on 25 March. His condition deteriorated and he was placed in intensive care. He passed away on 30 March. The patient had no reported contact with laboratory-confirmed cases, however did report having contact with animals, including camels. The patient also had a recent history of travel to Oman and to Saudi Arabia. Further epidemiological investigation in ongoing.

This case brings the global total to 207 laboratory-confirmed cases of infection with MERS-CoV, including 87 deaths.

26 March 2014 Arab Business – Another person has died in Saudi Arabia after contracting Middle East Respiratory Syndrome (MERS), bringing to 64 the total number of fatalities related to the virus in the Gulf kingdom. The Saudi Ministry of Health said the latest victim was a chronically ill 86-year old Saudi man who died in Riyadh on Sunday, Associated Press reported. The ministry said five new cases of the virus also had been confirmed recently, increasing the number of people infected in the kingdom since September 2012 to 162.

26th Febraury 2014 (HealthCanal) – Saudi Arabia – Countrywide Survey Finds Virus in Humans and Camels Match, Establishes That Direct Camel-to-Human Transmission Is Possible and Likely
An estimated three-quarters of camels recently surveyed in Saudi Arabia have evidence of infection with the Middle East Respiratory Syndrome coronavirus (MERS-CoV), the virus responsible for human cases of MERS. Results of the new study establish for the first time that direct camel-to-human transmission is possible and provide a pathway to control the spread of the disease. Results in the journal mBio are reported by scientists at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health; Mammals Research Chair, King Saud University, Riyadh, Saudi Arabia; the National Institute of Allergy and Infectious Diseases at the National Institutes of Health; and EcoHealth Alliance

24th February 2014 (AFP) Riyadh — Saudi health authorities announced on Sunday the death of an elderly woman from the MERS coronavirus, bringing the death toll from the respiratory disease in the kingdom to 61. The 81-year-old, who died from the Middle East Respiratory Syndrome in Riyadh, was suffering from several chronic illnesses, the health ministry website said. Saudi Arabia, the country worst hit by MERS, has recorded 147 cases, of which 61 have now proven fatal, since the virus first appeared in September 2012.
17th February 2014 (AFP) 60th death reported – Riyadh — Saudi health authorities have announced the death of a young man from the MERS coronavirus, bringing the death toll from the respiratory disease in the kingdom to 60. The health ministry website said the latest victim of Middle East Respiratory Syndrome in the country is a 22-year-old who was also suffering from cancer. Saudi Arabia, the country worst hit by MERS, has recorded 145 cases, of which 60 have now proved fatal, since the virus first appeared in September 2012.

9th February 2014 (Infection Control Today) – United Arab Emirates (UAE) notified the World Health Organization (WHO) of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection. The case is a 66-year-old male UAE national, residing in Abu Dhabi. He had onset of symptoms on Jan. 20, 2014 with an upper respiratory tract illness and was admitted to the hospital on Jan. 24, 2014 with pneumonia and renal failure. He had underlying medical conditions. MERS-CoV was laboratory-confirmed at the national laboratory in Abu Dhabi on Jan. 30, 2014 by two positive PCR targets. The patient is currently in the Intensive Care Unit (ICU) in stable condition. Public health authorities are carrying out contact tracing and an epidemiological investigation. The patient owns camels in UAE and has recent travel history to Oman where he had contact with camels.
Globally, from September 2012 to date, WHO has been informed of a total of 182 laboratory-confirmed cases of infection with MERS-CoV, including 79 deaths. Based on the current situation and available information, WHO encourages all of its member states to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns

20th January 2014 The WHO have published an update paper. See their website for a full copy.
Some key facts include:
To date there have been 178 laboratory-confirmed of human infection reported to WHO. Of this total. 76 patients have died (42.6 percent Case-Fatality Rate CFR) since April 2012.
Mean age of the MERS cases was 52 years
62 percent of MERS patients were male.
More than half of all laboratory-confirmed secondary cases have been associated with health care settings. These include health care workers treating MERS-CoV patients, other patients receiving treatment for conditions unrelated to MERS-CoV, and people visiting MERS-CoV patients

3rd January 2014 (the National) DUBAI // A healthcare worker in Dubai has contracted the Mers coronavirus after being in contact with a 68-year-old man who died from the disease
The World Health Organisation said on Friday it had been informed on New Year’s Eve of the latest laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus, or Mers-cov, in the UAE. The 33-year-old male healthcare worker had been in contact with the 68-year-old Emirati man, who suffered from diabetes and chronic kidney failure and who died on December 22. The Emirati was the first confirmed case in Dubai after several in Abu Dhabi. Four days after his death his wife, 59, from Sharjah, was confirmed as having been infected. The healthcare worker developed symptoms on December 27 and had pneumonia in both lungs, acute renal failure and thrombocytopenia diagnosed the following day. He has an underlying history of bronchial asthma and chronic kidney disease and he is currently in a critical but stable condition. The UAE is now the second most prevalent country for Mers after Saudi Arabia.

31st December 2013 (CIDRAP) – The wife of a United Arab Emirates (UAE) man who contracted Middle East respiratory syndrome coronavirus (MERS-CoV) is now infected but has no symptoms, the World Health Organization (WHO) said today as it confirmed the latest five cases reported in Saudi Arabia. The six cases raise the WHO’s MERS-CoV tally to 176 cases, including 74 deaths. The new UAE case is in a 59-year-old woman from Sharjah who is married to a 68-year-old man whose case was reported earlier, the WHO noted. Despite having no symptoms, the woman is in isolation in a hospital. She is reported to have no history of contact with animals or recent travel, the agency said. It also said other contacts of the couple have tested negative for the virus. The woman’s husband, who had been treated in an intensive care unit (ICU), has died, the WHO said. His illness was reported by the media on Dec 20 and noted by the WHO on Dec 22. He had diabetes and chronic kidney failure. In confirming the five latest cases reported by Saudi Arabian authorities, the WHO added a little additional information. The Saudi Ministry of Health (MOH) said all five people are from Riyadh. The cases involve a 73-year-old Saudi man, a 57-year-old Saudi man, and three healthcare workers—two women and a man—who are asymptomatic, the WHO said. The 73-year-old was hospitalized in an ICU on Nov 25 and died Dec 17, the agency said. His MERS-CoV infection was confirmed posthumously on Dec 19. He had no known exposures to animals or other MERS patients and no history of travel outside Riyadh. The 57-year-old was hospitalized on Dec 17 and remains in an ICU, the WHO said. Like the 73-year-old, he has no history of recent travel or exposure to animals or other case-patients. The WHO gave no new information about the three healthcare workers. The Saudi MOH earlier said they were a 27-year-old Saudi, a 43-year-old resident, and a 35-year-old resident (implying that the last two are foreign nationals), all of whom were exposed to MERS patients.

31st December 2013 (Reuters) – Another five people in Saudi Arabia and one in the United Arab Emirates have become infected with the potentially deadly Middle East Respiratory Syndrome (MERS) virus, the World Health Organisation said on Tuesday. The new infections, including one fatal case in a 73-year-old Saudi man and three in Saudi health workers who showed no adverse symptoms, bring the total confirmed cases of the respiratory disease to 176, of which 74 have died, the United Nations health agency said.

27 December 2013 (Medical Daily) A 73-year-old man from Riyadh, Saudi Arabia, has died after becoming one of the Arabic state’s four laboratory-confirmed Middle East Respiratory Syndrome coronavirus (MERS-CoV) cases announced by the World Health Organization (WHO) on Friday. The three other cases, all reported in Saudi Arabia’s capital and largest city, included two female health workers and a 53-year-old man who is currently being treated at an intensive care unit (ICU). According to the WHO, 170 laboratory-confirmed cases of MERS-CoV infections have been reported since September 2012, resulting in 72 deaths. People diagnosed with this chronic respiratory infection have reported minor symptoms such as fever, cough, shortness of breath, and diarrhea as well as severe complications, including renal failure and acute respiratory distress syndrome (ARDS). The elderly man who passed away in Riyadh had no travel history. However, it was reported he had been exposed to animals. Earlier this month, a research team from the Netherlands and Qatari discovered the MERS virus can infect camels the same way it does in humans, Reuters reported. Seeing as camels provide the region with milk, transportation, and meat, the animals can lead to a possible outbreak. The man also had underlying chronic illnesses when he was hospitalized three days before passing away on Dec. 18.

24 December 2013 (Infection Control) On Dec. 20, 2013, the World Health Organization (WHO) was informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in United Arab Emirates (UAE).A 68-year-old male with onset of illness on Dec. 13 was admitted to the hospital on Dec. 14, 2013 for joint replacement; he was also complaining of cough and transferred to the intensive care unit on Dec. 16 due to rapid deterioration. On Dec. 19, the diagnosis was laboratory confirmed for MERS-CoV. The patient has underlying medical conditions. Preliminary investigations reveal that he had no recent travel history and no contact with animals, and no contact with laboratory confirmed case. Investigation among family and healthcare contacts is ongoing. On Dec. 17, WHO was informed of an additional two laboratory-confirmed cases of infection with MERS-CoV in Saudi Arabia. The first case is a 51-year-old female from Saudi Arabia, living in Jawf province with onset of symptoms on Nov. 20, 2013. She has underlying chronic disease and was transferred to Riyadh for treatment in an intensive care unit. She had no reported contact with animals. The epidemiological investigation is ongoing. The second case is a 26-year-old female who is a non-Saudi healthcare worker in Riyadh. She is asymptomatic. She had reported contact with a 37-year-old male laboratory confirmed case that was reported to WHO on Nov. 21, 2013. Globally, from September 2012 to date, WHO has been informed of a total of 166 laboratory-confirmed cases of infection with MERS-CoV, including 71 deaths. Healthcare facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Healthcare 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, healthcare workers and visitors. People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular handwashing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.

23 December 2013 (Saudi Gazette) RIYADH – The Health Ministry announced on Saturday a new MERS death, raising to 56 the number of people killed by the coronavirus in the country with the most fatalities. The victim was a 73-year-old Saudi man, who suffered from chronic illnesses, the ministry said on its website.
It also reported three new cases of the virus. They are two foreigners working in health care who had been exposed to patients suffering from the virus and a 53-year-old Saudi man who is also chronically ill and in intensive care. The ministry said 136 cases have been reported in the country since the virus appeared more than a year ago

20 December 2013 (Vaccine News and WHO) The World Health Organization released an update on Tuesday announcing two novel laboratory-confirmed cases of Middle East respiratory syndrome coronavirus infections in Saudi Arabia. The first confirmed case involved a 51-year-old woman from the Jawf province in Saudi Arabia. Her symptoms onset on November 20 and she was treated in the intensive care unit at a hospital in Riyadh. She had no reported contact with animals and the investigation concerning her case is still being conducted. The second confirmed case involved a 26-year-old female healthcare worker in Riyadh. She is asymptomatic but had contact with a 37-year-old male patient who had a confirmed MERS-CoV infection in November.

The new cases bring the total count for MERS-CoV infections to 165, including 71 deaths

20 December 2013 (Global Dispatch) – Hong Kong health officials announced today that they received notification of a suspected case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) from Princess Margaret Hospital (PMH). The patient is a 67-year-old tourist who arrived in Hong Kong from Qatar alone on December 17. It is noted that the patient, who has underlying medical conditions, presented with cough and runny nose since December 14. He consulted a private doctor today and was subsequently transferred to PMH for further management under isolation.

18 December 2013 (Reuters) – Scientists have proved for the first time that the Middle East respiratory syndrome (MERS) virus that has killed 71 people can also infect camels, strengthening suspicions the animals may be a source of the human outbreak. Researchers from the Netherlands and Qatar used gene-sequencing techniques to show that three dromedary, or one-humped camels, on a farm in Qatar where two people had contracted the MERS coronavirus (CoV) were also infected. The study, published in the Lancet Infectious Diseases journal on Tuesday, confirms preliminary findings released by Qatari health officials last month. Camels are used in the region for meat, milk, transport and racing.

6 December 2013 (Oman Tribune) – LONDON Another three people in the UAE are sick with the Middle East Respiratory Syndrome (Mers) virus and two people infected with it in Qatar have died, the World Health Organisation (WHO) said on Monday. The new cases in UAE were in a family in Abu Dhabi – a mother, father and an 8-year-old boy – the United Nations health agency said in a disease outbreak update. The parents are both in a critical condition in hospital, the boy has mild respiratory symptoms. The WHO said the mother gave birth while in hospital, adding the baby, other close family contacts and healthcare staff were being monitored and tested for signs of the virus.

4th December 2013 WHO Statement

The fourth meeting of the Emergency Committee convened by the Director-General under the International Health Regulations (2005) [IHR (2005)] concerning MERS-CoV was held by teleconference on Wednesday, 4 December 2013, from 12:00 to 15:50 Geneva time (CET).

In addition to Members of the Emergency Committee, two expert advisors also participated1. A number of affected States Parties reporting recent cases of MERS-CoV – Kingdom of Saudi Arabia, Kuwait, Oman, Qatar and Spain – were also on the teleconference.

During the informational session of the meeting, the WHO Secretariat provided an update on and assessment of epidemiological and scientific developments, including a description of cases over time, notable recent clusters, detection by polymerase chain reaction testing of MERS-CoV in camels, and the public health preparation and experience of the Hajj pilgrimage.

The above affected States Parties presented on recent developments in their countries.

After discussion and deliberation on the information provided, the Committee concluded that it saw no reason to change its previous

advice to the Director-General. Based on a risk assessment of current information, it was the unanimous decision of the Committee that the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

The situation continues to be of concern, in view of ongoing cases and of new information about the presence of the virus in camels. Although it still does not consider the events to constitute a PHEIC, the Committee reinforced its previous advice for consideration by WHO and Member States, as follows:

strengthening surveillance, including in countries with pilgrims;
continuing to increase awareness and effective risk communication concerning MERS-CoV;
supporting countries that are particularly vulnerable, especially in sub-Saharan Africa, taking into account the regional challenges;
increasing relevant diagnostic testing capacities;
continuing with investigative work, including identifying the source of the virus and relevant exposures through case-control studies and other research;
timely sharing of information in accordance with the International Health Regulations (2005) and ongoing active coordination with WHO.
Based on events since its last meeting, the Committee emphasized the need for:

investigative studies, including international case-control, serological, environmental, and animal-human interface studies, to better understand risk factors and the epidemiology;
further review and strengthening of such tools as standardized case definitions and surveillance and further emphasis on infection control and prevention.
The Committee commended the extensive public health preparation for, surveillance and management of the Hajj pilgrimage by the Kingdom of Saudi Arabia.

As it has since the initial meeting, the WHO Secretariat continues to provide regular updates to the Committee Members and Advisors. With regard to reconvening the Committee, it was suggested that March 2014 might be an appropriate time (i.e. after the Northern Hemisphere winter). It was noted that any serious developments may require re-convening the Committee before then.

Based on this advice and the currently available information, the Director-General accepted the Committee’s assessment. The Director-General thanked the Committee Members and Advisors for their advice

4th December 2013 (IBTimes) – A woman in Abu Dhabi has died after giving birth to a baby by cesarean section after being diagnosed with Middle East respiratory syndrome coronavirus (Mers-CoV). The World Health Organisation confirmed three additional cases of the virus in the United Arab Emirates – the woman’s husband and eight-year-old son were also diagnosed with the disease. The woman, 32, became the first person to die from Mers-CoV in the UAE. Their eight-year-old son had mild symptoms and is being kept in isolation in hospital, while the baby is being cared for and is believed to be doing well. None of the family members have travel history, contact with a known confirmed case or any contact with animals. Further investigations into close contacts of the family are ongoing. WHO also confirmed two more deaths from the disease, making the official total death toll 70. The Abu Dhabi woman’s death will bring the total to 71.

3rd December 2013 As at today the WHO has been informed of a total of 163 laboratory-confirmed cases of infection with MERS-CoV, including 70 deaths.

24th November 2103 (CIDRAP) – The World Health Organization (WHO) said in a report today that the continuing outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) cases is probably being sustained, as some researchers have suggested, by a combination of human-to-human transmission and spillover from animals or other non-human sources—not one or the other. In its latest summary and literature update, the WHO also agreed that many MERS-CoV cases are probably going undetected and warned that this poses a risk of further outbreaks in hospitals. The agency’s current MERS-CoV count is 157 confirmed and 19 probable cases, for a total of 176. With 69 deaths, the case-fatality ratio is 39.2%. Two cases recently reported in Spain remain in the “probable” category, pending completion of testing.
Most recent cases sporadic –
Since the WHO’s last summary on Sep 20, 27 new MERS-CoV cases have been reported, and three countries have had their first cases: Kuwait, Oman, and Spain. Eighteen of the 27 cases were sporadic, meaning the patients had no contact with other known cases, the WHO said. Another 7 case-patients reported contact with others, and information was lacking for the other 2 cases. “This appearance of the virus in new countries and the steady increase in sporadic cases continues to raise concerns about possible expansion of virus in the as yet unknown reservoir,” the WHO said. “It is clear that human-to-human transmission is occurring. However, the continuing of reports of sporadic cases from Middle Eastern countries suggests that cases continue to be infected from non-human source(s) as well.” The statement added that the two probable cases in Spain are the only ones reported in people who participated in this year’s Hajj in Saudi Arabia. The cases involved two women who traveled together and have since recovered. In a statement today, Spain’s health ministry said the follow-up period for monitoring the two women’s contacts expired yesterday without detection of any more cases. “The public health alert is now considered closed,” the ministry statement said. In other observations, the WHO said, “MERS-CoV surveillance is focused on severe disease in much of the Middle East and it is likely that many milder cases are undetected.” This echoes the conclusion of a recent study in which researchers estimated, on the basis of cases related to travel to the Middle East, that at least 62% of symptomatic MERS cases have gone unnoticed.
Risk of hospital outbreaks – Undetected cases can spawn hospital outbreaks, the WHO warned. “The large number of transmissions that occur in hospitals raises concerns about transmission occurring in this setting when infection with MERS-CoV is not recognized either because cases are not tested or the tests are falsely negative,” the agency said. It noted that upper respiratory samples can yield false-negative results and that lower respiratory specimens are more reliable. The agency made several recommendations to help prevent hospital outbreaks of MERS-CoV. Among them is that countries in the affected region should consider testing community-acquired pneumonia patients even if they are not severely ill.
Possible animal sources – In developments related to the mystery of the virus’s source, the agency said all four recent case-patients in Qatar had contact with farm animals. The first case involved a 61-year-old Qatari who owns a farm, and the second case was in a 23-year-old resident who worked on the farm. The third and fourth cases involved a 48-year-old man and a 61-year-old man who had had no contact with other cases but had “frequent interactions with farm animals,” the WHO said. It added that Qatar’s Supreme Council of Health is investigating the animal exposures of all four patients. Meanwhile, a Kuwait News Agency (KUNA) report today, citing Qatari health officials, said the 48-year-old MERS patient in Qatar died of his illness yesterday. This appears to contradict a machine-translated Nov 19 KUNA report, which said a 48-year-old patient in Qatar had recovered. The same Nov 19 KUNA story said a 61-year-old who was a foreign visitor in Qatar had died. As for the possibility that camels are the source of the virus, the WHO today repeated the cautious view it expressed in a set of frequently asked questions earlier this week. It said the recent finding of the virus in a camel owned by a Saudi Arabian MERS patient is consistent with earlier findings of MERS-CoV–reactive antibodies in camels and is important information. “However, this finding does not necessarily implicate camels directly in the chain of transmission to humans,” the agency said. “The critical remaining question about this virus is the route by which humans are infected.” It also noted that most of the patients in sporadic cases were not exposed to camels.

20th November 2013 (Arab News) – RIYADH: Health authorities on Wednesday announced a new MERS death, raising to 54 the number of people killed by the coronavirus in the country with the most fatalities. A 73-year-old Saudi woman, infected by the virus and who had suffered chronic illnesses, died in Riyadh, the health ministry said in a statement on its website.
It also reported a new infection of a 65-year-old Saudi man in the northern Al-Jawf province, currently receiving treatment at a Riyadh hospital.

18 November 2013 (CIDRAP) – The World Health Organization (WHO) today confirmed the first two Middle East respiratory syndrome coronavirus (MERS-CoV) cases in Kuwait, while a media report said Spain now has its second probable case in a woman who participated in the recent Hajj in Saudi Arabia. Kuwait’s cases were reported by the media last week. The first patient is a 47-year-old man who became ill Oct 30, was hospitalized Nov 7, and is in critical condition, the WHO said. News reports had said the man has diabetes and high blood pressure, but the WHO did not mention those details. The agency said the second patient, also in critical condition, is a 52-year-old man who got sick on Nov 7 and was hospitalized Nov 10. A media report last week said the man had performed the Hajj. The WHO statement was silent on that point, but WHO spokesman Gregory Hartl indicated via Twitter today that one of the men has a history of travel to Saudi Arabia. The country, site of the majority of MERS cases, attracted more than 1.3 million foreign visitors in mid-October for the Hajj pilgrimage. With the two Kuwait cases, the WHO’s MERS-CoV tally has reached 157 cases with 66 deaths. Kuwait is the sixth country on or near the Arabian Peninsula with confirmed cases, joining Saudi Arabia, Jordan, Qatar, the United Arab Emirates, and Oman. Cases in several European countries and Tunisia have all been linked directly or indirectly to one of those six nations.

16 November 2013 (CIDRAP) – The World Health Organization (WHO) today confirmed two previously reported cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, in the United Arab Emirates and Qatar, and announced two deaths. The case in the UAE involves a 75-year-old Omani man who became ill on Oct 1, was hospitalized Oct 12, and died Nov 10, the WHO said in an e-mailed press release. His case was reported by the media Nov 7. WHO spokesman Gregory Hartl reported via Twitter that the Omani patient had a history of diabetes and was a heavy smoker. He was the second Omani confirmed to have the infection, and his illness marked the sixth case reported in the UAE. The patient in Qatar is a 61-year-old with underlying medical conditions, the WHO said. Media reports had said the man was a foreign visitor who came to the country looking for work, but the WHO agency said he was from Qatar. The man was hospitalized Nov 7, 3 days after he got sick, and is in critical condition, the agency reported. A preliminary investigation indicates that he was exposed to farms where livestock are kept. The WHO also said a previously confirmed case-patient from Oman has died. It gave no details, but the only other case reported in Oman so far involved a 68-year-old with diabetes who was hospitalized in Nazwa, 150 kilometers west of Muscat, the capital. His case was reported by the media on Oct 30. The WHO’s MERS-CoV count has reached 155 cases, including 66 deaths. The agency has not yet acknowledged two cases in Kuwait that were first reported by the media 2 days ago.

12 November 2013 (CIDRAP) – Media reports today said the Middle East respiratory syndrome coronavirus (MERS-CoV) has been detected in a camel linked to a human case in Saudi Arabia. If confirmed, the finding will mark the first time the virus has clearly been found in an animal and will strengthen the suspicion that camels are a source of human infections. The camel was tested in the investigation of a MERS case in a 43-year-old man from Jeddah, whose illness was reported last week, according to a Canadian Press report that quoted Ziad Memish, MD, the Saudi deputy minister for public health. Testing was by polymerase chain reaction. Memish said the man had a history of contact with sick animals that he owned and added that testing of other animals belonging to him was still under way. The Saudi Ministry of Health (MOH) said it was working to isolate the virus and compare its genome with that of a sample from the 43-year-old man, according to an Agence France-Presse (AFP) report. If the two isolates are identical, “this would be a first scientific discovery worldwide, and a door to identify the source of the virus,” the ministry was quoted as saying. Recent studies showed that camels in Oman, Egypt, and the Canary Islands carried antibodies to MERS-CoV or a closely related virus, but the virus itself had not been found in a camel or any other animal until now. In August a team of US and Saudi scientists, including Memish, reported finding a viral fragment in bat feces in Saudi Arabia that matched up with MERS-CoV, but other scientists said the fragment was so small that it might have represented only a related virus. Just which animals serve as the natural reservoir or hiding place of MERS-CoV, and which animals pass it to humans, have been two of the biggest mysteries about the virus. Scientists have speculated that bats, which harbor other coronaviruses, may be the reservoir and that camels may provide a pathway for the virus to reach humans.

11th November 2013 (Gulf News) Abu Dhabi: An Omani man diagnosed with the Middle East Respiratory Syndrome (Mers) coronavirus died in Abu Dhabi on Friday, an Abu Dhabi Government official said on Sunday. The victim, 75, had been visiting Abu Dhabi in October when he was diagnosed with the virus. He was admitted to a public hospital for treatment but succumbed to the disease, the source told Gulf News. Following his death, the patient’s body was repatriated to Oman. The patient’s diagnosis with Mers was earlier confirmed to the World Health Organisation (WHO) by the Health Authority Abu Dhabi, the source added.

8th November 2013 (Press TV) Spain’s Health Ministry says a woman has been infected with a new deadly respiratory virus related to the Severe Acute Respiratory Syndrome (SARS). According to a statement released by the ministry on Wednesday, the woman, who had been diagnosed with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), is currently under treatment in a hospital in Madrid. The statement added that this was the first case of the MERS coronavirus infection to have been reported in the European country. The woman was infected with the deadly coronavirus after returning from a visit to Saudi Arabia, it said.

4 November 2013 (WHO) – The United Nations World Health Organization (WHO) has been informed of an additional laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia. The patient was a 56-year-old woman from Saudi Arabia’s Eastern Region, who became ill on October 26 and died on October 30. She had no contact with animals, but had contact with a previously laboratory confirmed case. WHO have been informed of 150 laboratory-confirmed cases of MERS-CoV infections globally since September 2012, including 58 deaths.

31 October 2013 (Middle East Online) – Oman has discovered the first case of the MERS coronavirus in the Gulf sultanate, Health Minister Ahmed al-Saeedi said on Wednesday. The patient, a 68-year-old Omani man, was receiving treatment at a hospital in Nazwa, 150 kilometres (93 miles) west of Muscat, and was “stable,” Saeedi said. He said the case, the first in Oman, had been discovered on Tuesday, and that the patient had diabetes.

31 October 2013 (AFP) – The suspected patient who reportedly returned from Saudi Arabia tested negative to the respiratory disease. A patient suspected of having contracted the Mers coronavirus has tested negative for the lethal respiratory disease, France’s health ministry has announced. The ministry had initially said on Tuesday that a person who had just returned from Saudi Arabia, where the Middle East Respiratory Syndrome Coronavirus (Mers-CoV) first appeared in September 2012, was likely infected by the virus. But in-depth tests on the 43-year-old patient revealed that they had not been infected. “The two cases identified in May 2013 are therefore the only two confirmed cases in France so far,” it said in a statement. Of these two cases, one patient fell ill when he came back from a trip to Dubai and later died on May 28.

30 October 2013 (CIDRAP) – France today reported a probable Middle East respiratory syndrome coronavirus (MERS-CoV) case in a person who recently traveled to Saudi Arabia, while the World Health Organization (WHO) offered new details on a MERS case reported in Qatar yesterday. The patient in France is a 43-year-old who recently returned from Saudi Arabia, the French health ministry said in a statement, but it did not specify whether the patient attended the Hajj pilgrimage in mid-October. The patient was hospitalized in northern France yesterday and is in stable condition, the statement said.

29 October 2013 (Infection Control and WHO) – The World Health Organization (WHO) has been informed of an additional laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Qatar. The patient is a 23-year-old man who was identified as a close contact of a previously laboratory-confirmed case as part of the epidemiological investigation. He is a worker in the animal barn owned by the previously laboratory-confirmed case. The man developed mild symptoms of illness and is in good condition. Preliminary investigations revealed that he did not recently travel outside the country. Globally, from September 2012 to date, WHO has been informed of a total of 145 laboratory-confirmed cases of infection with MERS-CoV, including 62 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

21 October 2013 (CIDRAP) – Saudi Arabia has reported two more Middle East respiratory syndrome coronavirus (MERS-CoV) cases in the past few days, both in men living in the Riyadh region, according to a press account and a translated government statement. One case is in a 73-year-old man who has chronic diseases and is being treated in an intensive care unit (ICU), said an Arab News report yesterday. The man had not traveled outside the Riyadh area recently, but the story gave no other details. The other case involves a 54-year-old man who likewise has chronic diseases and is in an ICU, according to a machine-translated statement yesterday from the Saudi Ministry of Health (MOH). It gave no other details. An MOH coronavirus Web site shows that 121 MERS-CoV cases, with 51 deaths, have been confirmed in Saudi Arabia. The World Health Organization (WHO), which has not yet confirmed the two cases, lists an official MERS-CoV count of 139 cases and 60 deaths, but some other groups list slightly higher counts. In the wake of the Hajj pilgrimage, which ended Oct 18, Saudi officials said there has been no evidence of any MERS cases or other life-threatening infectious diseases among pilgrims, according to the Arab News report. But, as many observers have noted, the MERS-CoV incubation period is long enough so that cases could still surface in pilgrims who have returned home.

4 October 2013 (WHO) – WHO has been informed of an additional six laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia. The six new patients are from Riyadh region with ages from 14 to 79 years old, of which three are women and three men. The dates of onset of the patients range from 15 to 26 September 2013. One patient has mild symptoms while the others are hospitalized. Three patients are contacts of previously confirmed cases with MERS-CoV, two are reported to have had no exposure to animals or a confirmed case, and there is no information on exposure of one patient. Globally, from September 2012 to date, WHO has been informed of a total of 136 laboratory-confirmed cases of infection with MERS-CoV, including 58 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 travellers 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 diarrhoea, 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

11th September 2013 (CIDRAP) – Saudi Arabia’s health ministry today and yesterday announced eight new Middle East respiratory syndrome (MERS) cases, all of which involved contact with previously confirmed cases, including four possible healthcare exposures. The patients are all younger or middle-aged adults from Riyadh and Medina, and most have mild infections or are asymptomatic, the Saudi Ministry of Health (MOH) said. The new detections lift the unofficial global total to 130 cases, of which 57 have been fatal. Three of the four cases reported yesterday were asymptomatic: a 22-year-old man from Medina, a 24-year-old man who works in a health setting in Medina, and a 60-year-old man from Riyadh. The other patient is a 47-year-old man from Riyadh who is in stable condition, according to the MOH. Of the four MERS cases reported today, all were reported from Riyadh, and three involve healthcare workers: a 47-year-old woman who had mild symptoms, a 39-year-old woman who had mild symptoms, and a 38-year-old man whose health status is stable, the MOH said. The fourth patient is a 51-year-old woman who is also in stable condition. The newly announced cases follow closely on the heels of eight other cases that the health ministry announced on Sep 7 and Sep 8. Three of those infections were fatal. The World Health Organization, which has not issued a MERS update since Sep 7, lists 114 global cases, 54 of which were fatal. That total does not include the 16 most recent Saudi cases.

8th September 2013 (Medical Daily) – Two well-known antiviral drugs have improved clinical outcomes in a small experiment on monkeys infected with the Middle East respiratory syndrome coronavirus (MERS-CoV). The finding, published in the Sept. 8 issue of Nature Medicine, gives clinicians some hope in treating the mysterious and very fatal disease, which currently has no cure. Ribavirin and interferon-alpha 2b, two antiviral drugs used to treat chronic hepatitis C in humans, were administered to four rhesus monkeys eight hours after they were infected with MERS-CoV. Compared to four infected monkeys who did not receive treatment, the monkeys receiving the antiviral cocktail showed less blood and lung inflammation, less severe tissue damage in the lungs, and fewer copies of the virus. Monkeys treated with the antivirals exhibited no difficulty breathing and had minimal signs of pneumonia in their chest X-rays. Since the first reports of MERS-CoV surfaced in mid-2012, there have been 111 confirmed cases and 52 deaths, the majority of which occurred in Saudi Arabia, according to the World Health Organization and recent reports. Currently, treatment of the respiratory virus in humans is limited to supportive care, such as corticosteroids to reduce lung inflammation and ventilator support to assist with breathing. But considering the high fatality rate, supportive care is not very effective. The researchers’ experiment on rhesus macaque monkeys is a follow-up to an April finding showing that the antivirals stopped virus replication in cell cultures. Researchers recommend that the antiviral combination should be considered as an early intervention, but MERS-CoV is far from solved.

29 August 2013 – (CNN) – Ten new cases of the MERS coronavirus in Saudi Arabia have brought the global total to 104, including 49 deaths.
According to a release sent by the World Health Organization (WHO), the cases include two men from Riyadh who died.
One was 54 and the other 51, the agency said Wednesday

20 August 2013 (Aljazeera) – Health authorities in Qatar have announced the first case of MERS coronavirus in the Gulf state, with a 59-year-old man infected. The patient, a Qatari, was in stable condition, they said on Tuesday. Another Qatari with the infection died in a London hospital on June 28.

13 August 2013 (CIDRAP) – The US Centers for Disease Control and Prevention (CDC) yesterday issued updated its guidance to clinicians on evaluating patients for Middle East respiratory syndrome coronavirus (MERS-CoV). In a Health Alert Notice (HAN), the CDC said it has changed its criteria on which patients should be evaluated for the disease. In earlier guidance the agency did not advise testing for those whose illnesses could be explained by another cause. But in new recommendations issued Aug 9, the CDC said patients who meet certain clinical and epidemiologic criteria can be tested for MERS-CoV and other pathogens at the same time. It also added that diagnosis with another respiratory pathogen doesn’t necessarily rule out testing for MERS-CoV. The CDC’s revised guidance also contains a clarification about investigating clusters of severe acute respiratory illnesses that don’t have an apparent link to a MERS case. It said clusters should be evaluated for common pathogens and reported to local and state health departments, with MERS-CoV testing considered if the infections are still unexplained.
In related developments, two global health groups have updated their information about the disease. The World Health Organization (WHO), in an update today, reviewed the most recent published MERS studies, along with recent outbreak developments. It said though new cases continue to be reported from the Arabian Peninsula, no exported infections have occurred since June, despite a surge of pilgrims traveling to Saudi Arabia during Ramadan. The agency also added that Saudi Arabia’s health ministry enhanced its surveillance during that time and found no MERS-CoV infections among pilgrims. The WHO noted, however, that Ramadan ended on Aug 8, and the disease’s incubation can be 10 days or more, and it urged countries to remain vigilant. “It is notable that only one previously reported case became ill after a pilgrimage,” the WHO said. The European Centre for Disease Prevention and Control (ECDC) yesterday issued a statement on a recent study that identified antibodies to MERS-CoV or a closely related virus in camels from Oman and Spain. It said the finding are intriguing but aren’t definitive proof that camels are the source of the virus. Though earlier studies have shown that coronaviruses can infect a variety of animals and can cause severe symptoms in newborn camels, the study doesn’t exclude the possibility of cross reactions with viruses similar to MERS-CoV, the ECDC said. It noted that investigations have ruled out direct animal contact for most patients and that few had contact with

camels. The ECDC said more studies are needed to pin down the reservoir or potential intermediate animal hosts.

9 August 2013 (BBC) – Dromedary camels could be responsible for passing to humans the deadly Mers coronavirus that emerged last year, research suggests.
Tests have shown the Mers (Middle East Respiratory Syndrome) virus, or one that is very closely related, has been circulating in the animals, offering a potential route for the spread. The study is published in the journal Lancet Infectious Diseases. But the scientists say more research is needed to confirm the findings. The Mers coronavirus first emerged in the Middle East last year. So far, there have been 94 confirmed cases and 46 deaths. While there has been evidence of the virus spreading between humans, most case are thought to have been caused by contact with an animal. But until now, scientists have struggled to work out which one. To investigate, an international team looked at blood samples taken from livestock animals, including camels, sheep, goats and cows, from a number of different countries. Professor Marion Koopmans, from the National Institute of Public Health and the Environment and Erasmus University in The Netherlands, said: “We did find antibodies that we think are specific for the Mers coronavirus or a virus that looks very similar to the Mers coronavirus in dromedary camels.” The team found low levels of antibodies in 15 out of 105 camels from the Canary Islands and high levels in each of the 50 camels tested in Oman, suggesting the virus was circulating more recently. “Antibodies point to exposure at some time in the life of those animals,” Prof Koopmans explained. No human cases of the Mers virus have been reported in Oman or the Canary Islands, and the researchers say they now need to test more widely to see if the infection is present elsewhere. This would include taking samples from camels in Saudi Arabia, the country where the virus is the most prevalent. Prof Koopmans said: “It is a smoking gun, but it is not definitive proof.” Commenting on the research, Professor Paul Kellam from the Wellcome Trust Sanger Institute in Cambridge and University College London, said the research was helping to narrow down the hunt for the source of the virus. But he told BBC News: “The definitive proof would be to isolate the virus from an infected animal or to be able to sequence and characterise the genome from an infected animal.” Health officials say confirming where the virus comes from is important, but then understanding how humans get infected is a priority. Gregory Hartl, from the World Health Organization, said: “Only if we know what actions and interactions by humans lead to infection, can we work to prevent these infections.” Data suggests that it is not yet infectious enough to pose a global threat and is still at a stage were its spread could be halted.

8 August 2013 (CIDRAP) – A letter appearing today in the New England Journal of Medicine describes mild and asymptomatic cases of MERS-CoV (Middle East respiratory syndrome coronavirus) in seven female Saudi Arabian nurses, further solidifying the evidence that the illness can be other than severe. The letter, by two Saudi health officials and a British expert, says two of the nurses had no symptoms and the others had only mild ones, and all recovered without treatment. Further, the nurses apparently did not pass the virus to anyone else. Until recently, most confirmed MERS cases have been severe; 46 of the 94 cases recognized by the World Health Organization have been fatal. But at least 16 asymptomatic cases have been reported since mid June, along with several mild cases. Health officials are anxious to define the full range of clinical disease associated with MERS-CoV. One of the reasons is the concern that asymptomatic carriers of the virus may unwittingly pass the virus to others. The letter says the nurses’ cases were identified through screening of close contacts of confirmed MERS-CoV patients by means of polymerase chain reaction testing of nasopharyngeal swabs. The nurses, who all worked at different hospitals, ranged in age from 28 to 56, with a mean of 42.7. All were previously healthy except one, who had diabetes. All seven had some level of exposure to MERS-CoV patients, and six of them were present during aerosol-generating procedures. Their compliance with infection control precautions was spotty, and some had “maximal exposure.” They had no history of exposure to animals or to MERS-CoV cases in the community. Of the five nurses who had mild symptoms, one had only a runny nose. “They did not require treatment, recovered fully within a week, and remained healthy on follow-up,” the letter states. The authors say no subsequent MERS cases were associated with the nurses. However, earlier this week, Saudi health officials reported in another journal that a Saudi man contracted MERS-CoV from an unknown source in a hospital while being treated for an unrelated condition. That report suggested that unrecognized mild or asymptomatic cases may be a more important contributor to transmission than previously thought. The NEJM letter states, “The identification of asymptomatic and subclinical cases of MERS-CoV infection in health care workers brings to light the urgent need to develop a rapid, sensitive, and specific diagnostic test and to conduct studies to accurately define the clinical spectrum of MERS-CoV infection.” The authors add that vigilance for the possibility of MERS cases and rapid implementation of infection prevention measures are important for controlling nosocomial transmission. Memish ZA, Zumla AI, Assiri A. Middle East respiratory syndrome coronavirus infections in health care workers. (Letter) N Engl J Med 2013 (early online publication Aug 7)

4 August 2013 RIYADH, (KUNA Kuwait News Agency) — No cases of the new Coronavirus, MERS/Cov, have been reported among Muslim pilgrims or visitors to Saudi Arabia, the health ministry said Sunday. Field follow-up reports and surveillance teams found no epidemic between over five million pilgrims and visitors, it said in a statement. Most of the patients suffered from heat waves, it noted. (end)

2 August 2013 (Arab News) – JEDDAH: Three more confirmed cases of Middle East Respiratory Syndrome (MERS) coronavirus infections in the Kingdom have been recorded, the Ministry of Health said on Thursday. A statement posted on the ministry’s website said one of the patients is a 67-year-old woman in Riyadh, who had been suffering from various chronic diseases. She is now under intensive care, receiving the health care and proper treatment.
The two other cases are both women health workers, one of them living in Asir region and the other in Riyadh. “They have mild symptoms but their health status are stable,” said the MOH. The new cases bring to 92 the total number of people who have contracted the virus worldwide, including 71 in Saudi Arabia. Of the 92 cases registered with the World Health Organization since last year, 46 have died, including 39 in Saudi Arabia. The latest MERS death in the Kingdom, announced by the Ministry of Health on July 25, was an 83-year-old man in Asir.

1 August 2013 (Reuters) – Two Saudi health workers who had been in contact for patients with Middle East respiratory syndrome (MERS) coronavirus infections are among three new cases reported to the World Health Organization, the U.N. agency said on Thursday. The WHO said the female health staff, from the Saudi regions of Assir and Riyadh, both had mild symptoms of MERS, while a third new case in a 67-year-old woman from Riyadh was more severe, with that patient being treated in hospital. A study by international team of infectious diseases experts who went to Saudi Arabia in May to analyze an outbreak concluded that MERS infection is a “serious risk” in hospitals because it is easily transmitted in healthcare settings.

31 July 2013 (World Health Organization) – The World Health Organization (WHO) has been informed of an additional laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia. The patient is an 83-year-old man from Assir region who became ill on 17 July 2013 and is currently hospitalized. Additionally, a previously laboratory-confirmed case, also from Assir region, has died. Globally, from September 2012 to date, WHO has been informed of a total of 91 laboratory-confirmed cases of infection with MERS-CoV, including 46 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. Healthcare 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.

26 July 2013 (BBC) The new Mers virus, which has killed half of those infected, is “unlikely” to reach the same scale as Sars, ministers in Saudi Arabia say. Most of the 90 Mers cases reported so far have been in Saudi Arabia. Mers is from the same group of viruses as the common cold and Sars, which killed 774 people. However, a detailed analysis of the Saudi cases, published in Lancet Infectious Diseases, did warn of “major gaps” in understanding of the virus. The Middle East respiratory-syndrome coronavirus (Mers) emerged in 2012 and has infected 90 people worldwide, 45 of them have died.
The global concern is that cases could spread much further, echoing the Sars outbreak. Cases have been centred on the Middle East – with patients in Jordan, Qatar, Saudi Arabia and the United Arab Emirates. Additional cases in France, Germany, Italy, Tunisia and the UK have all been linked to travel to the Middle East. Researchers in Saudi Arabia have published details of the 47 cases reported in the country. They suggest a pattern of mostly older men being infected. Most cases were also in people with other medical problems, more than two-thirds of the reported cases also had diabetes.
The lead researcher and Deputy Minister for Public Health, Prof Ziad Memish, said: “Despite sharing some clinical similarities with Sars, there are also some important differences. “In contrast to Sars, which was much more infectious especially in healthcare settings and affected the healthier and the younger age group, Mers appears to be more deadly, with 60% of patients with co-existing chronic illnesses dying, compared with the 1% toll of Sars.
“Although this high mortality rate with Mers is probably spurious due to the fact that we are only picking up severe cases and missing a significant number of milder or asymptomatic cases. “So far there is little to indicate that Mers will follow a similar path to Sars.” A report earlier this month showed that the virus struggled to spread in people. However, it and the latest Saudi investigation both highlighted the need to find where the virus was coming from. Prof Memish’s report said: “Reducing the rate of introduction of Mers coronavirus into human beings is unpredictable because the source of the virus is not yet known. “We are searching vigorously for the source.”

26 July 2013 (CIDRAP) – The World Health Organization (WHO) advised today that people who have chronic medical conditions and want to go on a pilgrimage to Saudi Arabia, epicenter of MERS-CoV (Middle East respiratory syndrome coronavirus), should talk with their healthcare provider about the risks. Saying the risk to travelers is “very low,” the WHO recommended no travel restrictions or border screening during the Muslim Umrah and Hajj pilgrimages, which are expected to draw millions of people to Saudi Arabia. The recommendations focus on awareness and routine precautions to prevent travel-related infections. Meanwhile, Saudi Arabia today reported another MERS case and the death of a previously reported case-patient, according to a translated government statement posted on FluTrackers, an infectious disease message board. The new case is in an 83-year-old man in the southwestern region of Asir, the report said. It gave no other details about the man or about the deceased patient. If confirmed, the additional case and death will raise Saudi Arabia’s MERS count to 71 cases and 39 deaths.

26 July 2013 (Times UK) – 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.

26 July 2013 (FOX News) – The new respiratory virus that emerged in the Middle East last year appears to make people sicker faster than SARS, but doesn’t seem to spread as easily, according to the latest detailed look at about four dozen cases in Saudi Arabia.
Since last September, the World Health Organization has confirmed 90 cases of MERS, the Middle East respiratory syndrome, including 45 deaths. Most cases have been in Saudi Arabia, but the mysterious virus has also been identified in countries including Jordan, Qatar, Britain, France, Germany, Italy and Tunisia. MERS is related to SARS and the two diseases have similar symptoms including a fever, cough and muscle pain.
“At the moment, the virus is still confined (to the Middle East),” said Dr. Christian Drosten of the University of Bonn Medical Centre in Germany, who wrote an accompanying commentary. “But this is a coronavirus and we know coronaviruses are able to cause pandemics.” Coronaviruses are a family of viruses that mostly cause respiratory infections like the common cold, but it also includes SARS, the virus that killed about 800 people in a 2003 global outbreak. MERS is distantly related to SARS but there are major differences between the two. Unlike SARS, MERS can cause rapid kidney failure and doesn’t seem as infectious. Drosten said the upcoming hajj in October — where millions of Muslim pilgrims will visit Saudi Arabia, where the virus is still spreading — is worrisome. On Thursday, WHO said in a statement that the risk of an individual traveler to Mecca catching MERS was considered “very low.” The agency does not recommend any travel or trade restrictions or entry screening for the hajj.
In the latest study, researchers found 42 of the 47 cases in Saudi Arabia needed intensive care. Of those, 34 patients deteriorated so badly within a week they needed a breathing machine. That was up to five days earlier than was the case with SARS. Most of the MERS cases were in older men with underlying health problems, as one of the biggest outbreaks was among dialysis patients at several hospitals. The research was published Friday in the journal, Lancet Infectious Diseases. Ali Zumla, one of the paper’s co-authors and a professor of infectious diseases at University College London, said in an email that the rapid deterioration of patients was “not worrying at all since the numbers are small” and most of the patients had other health problems. Drosten, however, said that could be bad news. “That could mean the virus is more virulent and that (doctors) have a smaller window of opportunity to intervene and treat patients,” he said. Detecting MERS fast could be a problem since quick diagnostic tests aren’t available.
Read more: http://www.foxnews.com/health/2013/07/26/mers-virus-may-be-deadlier-than-sars-study-finds/#ixzz2a8SsQ0lL

25 July 2013 (Dubai7days) – A doctor from the Arab Hygiene Council has revealed that four patients with the potentially deadly MERS coronavirus in the UAE are all health workers. Dr Muhammad Halwani, who is based in Saudi Arabia, said that four people diagnosed in Abu Dhabi a week ago and two new cases in Saudi Arabia were all people who had close contact with other victims of the respiratory disease. One of the new victims caught it from a family member. Halwani told 7DAYS: “Since it was first diagnosed in March 2012, 90 people have contracted it worldwide, six of them in the UAE. There were two at the beginning and now another four.”

25th July 2013 (Reuters) – Little is known about a SARS-like virus that has infected people in the Middle East, North Africa and Europe, but there is strong support around the globe for screening travelers to prevent the spread of the disease, according to a new poll. 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.

24 July 2013 (Infection Control Today) – Middle East respiratory syndrome coronavirus (MERS-CoV) 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 in Germany and South Africa have now detected a virus in the feces 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.

19th July 2013 (FOX News) GENEVA (AFP) – Six more people, most of them health care workers, have contracted the deadly MERS virus in Saudi Arabia and the United Arab Emirates, the World Health Organization said Thursday. The UN’s health body said that four health care workers from two hospitals in Abu Dhabi had contracted MERS, short for Middle East Respiratory Syndrome coronavirus, after caring for a patient who had fallen ill with the disease.
In two of the cases, a 28-year-old man and a 30-year-old woman had not developed symptoms of the illness, while two other women, aged 30 and 40, were in stable condition. In Saudi Arabia, one 42-year-old female health care worker and a 26-year-old man who were in close contact with a MERS patient are both suffering from mild symptoms and have not been hospitalised, WHO said. The announcement came amid growing concern about the spread of the virus that so far has killed 45 of the total 88 people confirmed to have contracted it, especially as worst-hit Saudi Arabia braces for the Muslim hajj pilgrimage. On Saturday, Saudi Arabia, which counts 67 cases and 38 deaths to date, urged the elderly and chronically ill, as well as children and pregnant women, not to perform the hajj.

18th July 2013 (CIDRAP) – The MERS-CoV (Middle East respiratory syndrome coronavirus) situation is “serious and of great concern” but doesn’t rise to the level of a global public health emergency, an international committee of experts organized by the World Health Organization (WHO) decided today (17th July). The committee felt that the “dramatic action” of declaring an emergency would be disproportionate and might do more harm than good, said Keiji Fukuda, MD, the WHO’s assistant director-general for health security and environment. The panel’s recommendation was unanimous. At a press conference, Fukuda also said the WHO does not plan to recommend any travel restrictions over MERS-CoV, but it will issue some travel-related advice within a few days. The WHO announcement came hours after Saudi Arabia reported two more confirmed MERS-CoV cases, both of them mild. They involve a 26-year-old Saudi man and a 42-year-old female “resident,” both of them living in the southwestern province of Asir. The man had contact with a previous case-patient, and the woman works in the health sector, the Saudi Ministry of Health (MOH) said in a statement. Neither patient was hospitalized. A previous MERS case in Asir involved a 66-year-old man and was reported by the MOH on Jul 8. The MOH said it has tested 1,460 people for the virus in the past few weeks. The two newest cases raise the global count to 84 cases, with 45 deaths, according to the US Centers for Disease Control and Prevention (CDC). (The WHO has not yet acknowledged the two cases.) Of the total, 68 cases and 38 deaths have occurred in Saudi Arabia.

17th July 2013 (independent Online) News from Paris reporting that Saudi Arabia will not issue visas to the elderly, pregnant women or children for the hajj and umrah pilgrimages to help combat the spread of MERS coronavirus, the French health ministry said on Tuesday. In an urgent circular to doctors, it said the Saudi health ministry “has taken the decision to restrict the issuing of visas” for the annual hajj and for the umrah, a pilgrimage which can be undertaken at any time. “Elderly persons (for whom no precise age threshold has been specified), pregnant women, children and people affected by chronic diseases, notably people with cardiac, diabetic or respiratory disease, kidney or immune-system deficiencies, will be unable to obtain a visa this year,” the circular said. The circular was issued by the General Health Directorate (DGS), which administers the health ministry. In a statement posted on its website on Saturday, the Saudi health ministry urged people in these categories not to perform the hajj.

16th July 2013 (Reuters) – The US Food and Drug Administration issued an emergency authorization on Tuesday for a diagnostic test to detect the presence of the Middle East coronavirus at the request of the Centers for Disease Control and Prevention. The emergency approval follows the Health and Human Services secretary’s determination that the virus called Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which has killed at least 40 people, poses a potential public health threat. On July 5, the World Health Organization said MERS, which can cause fever, coughing and pneumonia, had not yet reached pandemic potential and may simply die out. WHO experts last month said countries at risk from MERS should put in place plans for handling mass gatherings but has stopped short of recommending restrictions on travel.

13th July 2013 (Telegraph) Saudi Arabia has issued a series of rules to pilgrims travelling to Mecca for the Hajj that will ban the elderly and force others to wear respiratory masks to prevent the Mers coronavirus turning into an epidemic.

9th July 2013 (WHO) WHO has issued the following statement after its Emergency Committee met on 9 July 2013 to discuss the MERS-CoV situation: Cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) have been reported regularly to WHO since 2012. In order to take an independent expert view of the situation and to be prepared for any further action, should it be required, the Director-General convened a meeting of the International Health Regulations Emergency Committee. The Emergency Committee is composed of international experts from a variety of relevant disciplines and all Regions of WHO, their task is to provide expert technical advice to the Director-General in accordance with the IHR (2005).1 The first meeting of the Committee was held on Tuesday, 9 July 2013, from 12:00 to1 5:00 Geneva time (CET). After reviewing data on the current situation provided by the Secretariat, and information presented to the Committee by officials of several States Parties which have, or have had, cases of MERS-CoV, and after further deliberation, the Committee considered that additional information was needed in a number of areas. The Committee also considered it needed time for further discussion and consideration. In this regard, it noted that a second Committee meeting is set to be held Wednesday, 17 July 2013, at 12:00 Geneva time (CET).

8th July 2013 (WHO press release) WHO to convene emergency committee on MERS-CoV The emergence of Middle East respiratory syndrome coronavirus (MERS-CoV) is an important challenge for all countries in the world. On 5 July 2013, reflecting the need for a global response to the continuing outbreak, WHO Director-General Margaret Chan called for the establishment of an emergency committee on MERS-CoV under the International Health Regulations (IHR).

7 July 2013 (Reuters) – Two more people have died of the SARS-like coronavirus MERS, Saudi Arabia’s Health Ministry said, bringing to 38 the number of deaths from the disease inside the country shortly before Islam’s Ramadan fast when many pilgrims visit. A two-year-old child died in Jeddah and a 53-year-old man died in Eastern Province, where the outbreak has been concentrated, the ministry said late on Saturday in a statement on its website. Four people have died outside the kingdom. The ministry said another three people had been confirmed as being infected with Middle East respiratory syndrome (MERS), bringing the total number of confirmed cases inside the kingdom to 65 since it was identified a year ago.

3 July 2013 (Fox News Networks) report: A Saudi man and a woman have died from the MERS virus, raising the death toll from the SARS-like infection in the kingdom to 36, the health ministry said on Wednesday. Three others infected with the same virus, two in Eastern Province and one in Riyadh, have been treated, the ministry said on its website. It said 62 people have been infected with the virus in the kingdom so far, down from a previous figure of 66. The ministry did not clarify why it had lowered the number of rep