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Published Date: 2013-05-21 23:39:59
Subject: PRO/AH/EDR> MERS-CoV - Eastern Mediterranean (06): Saudi Arabia, new fatality, meeting
Archive Number: 20130521.1726656

MERS-COV - EASTERN MEDITERRANEAN (06): SAUDI ARABIA, NEW FATALITY, CALL FOR INTERNATIONAL MEETING
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A ProMED-mail post
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International Society for Infectious Diseases
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In this report:
[1]Saudi Arabia MOH media center, new fatality
[2]Tunisia ex Saudi Arabia/Qatar - BBC
[3]Call for international meeting

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[1]Saudi Arabia MOH media center, new fatality
Date: 20 May 2013
Source: Saudi Arabia Ministry of Health [edited]
http://www.moh.gov.sa/en/Ministry/MediaCenter/News/Pages/News-2013-05-20-004.aspx


20 May 2013
Within the framework of its continuous monitoring and the epidemiological surveillance of Coronavirus, the Ministry of Health (MOH) has announced the demise of one patient, who has been previously announced to be infected with this virus in the Al-Ahsa region, as he was suffering from chronic heart diseases, diabetes and high blood pressure, in addition to kidney failure. Thus, the number of deaths due to this virus, up to the date of this statement, has reached 16.

MOH has further declared that one of the cases, who has been previously announced to be infected with this virus among the Health staff, has ​recovered and been released from the hospital. It is noteworthy that no new Coronavirus cases, up to the last announcement, have been recorded.

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Communicated by:
ProMED-mail
<promed@promedmail.org>

[As of 20 May 2013 there have been a total of 22 cases including 10 deaths associated with the outbreak of MERS-CoV in the Eastern Province of Saudi Arabia. This raises the total number of laboratory confirmed cases reported by WHO to 41 including 21 deaths (case fatality rate of 51.2 percent). (See below for information on additional cases). - Mod.MPP]

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[2]Tunisia ex Saudi Arabia/Qatar - BBC
Date: 20 May 2013
Source: BBC [edited]
http://www.bbc.co.uk/news/world-europe-22610400


Tunisian man dies of new coronavirus
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A man has died of the novel coronavirus (NCoV) [now referred to as MERS-CoV] in Tunisia, in what is believed to be the 1st such case in Africa.

Tunisia's health ministry said the 66-year-old had visited Saudi Arabia, which is badly affected by the virus [according to news reports in the earlier ProMED-mail post on these cases, there was a history of travel to both Saudi Arabia and Qatar prior to onset of symptoms -- see MERS-CoV - Eastern Mediterranean (05): Tunisia ex Saudi Arabia/Qatar, fatal, RFI 20130520.1725864].

About 20 deaths and 41 cases have been reported worldwide since 2012, the World Health Organisation (WHO) says. [There are now 21 deaths reported, see above press release from the Saudi Arabian MOH - Mod.MPP]

NCoV [MERS-CoV] is from the same family of viruses as the one that caused the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003, killing about 770 people.

However, NCoV [MERS-CoV] and SARS are distinct from each other, the WHO says.

It appears likely that the virus can be passed between people in close contact, it adds.

The Tunisian man, a diabetic, had been complaining of breathing problems since he returned from Saudi Arabia and he died in hospital in the coastal city of Monastir, AFP news agency reports. 2 of his children also contracted the virus, but had responded to treatment, the health ministry said, in a statement.

"These Tunisia cases haven't changed our risk assessment, but they do show the virus is still spreading," said WHO spokesman Gregory Hartl, AP news agency reports.

Cases have been detected in Saudi Arabia, Jordan, Qatar, the United Arab Emirates (UAE), Germany, the UK and France.

"All of the European cases have had a direct or indirect connection to the Middle East, including 2 cases with recent travel history from the UAE," the WHO Update says.

22 of the 41 cases reported worldwide are in Saudi Arabia, it adds.

Out of the 20 [now 21] deaths, 9 [now 10] of them have been in the kingdom, WHO says.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The addition to these 3 cases (one fatal, 2 recovered), if confirmed by official statements (to date there have only been press reports on these cases without official statements on the Tunisian MOH website or through WHO) will bring the worldwide total of laboratory confirmed cases to 44 including 22 deaths. All cases to date can be linked to exposure in the Middle East. There has been documented limited person-to-person transmission in both the UK and France, where secondary cases occurred in individuals having close contact with cases related to exposure in the Middle East (1 secondary case in France, and 2 in the UK).

For a map showing the location of Monastir, Tunisia, see http://www.mappi.net/img/tunisie/carte_tunisie_route_riviere_aeroport.gif. It is a coastal city located to the south east of the capital Tunis.

For the map showing the Middle East Region, see http://healthmap.org/r/1HAJ. - Mod.MPP]

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[3]Call for international meeting
Date: 21 May 2013
From: Daniel Lucey <DRL23@Georgetown.edu>


During the past 5 weeks I have been kindly welcomed by medical and public health colleagues while traveling in Jordan, Qatar, UAE, and Egypt to discuss the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) of 2012-2013, and lessons from the SARS Coronavirus (SARS-CoV) epidemic of 2002-2003.

Based on these experiences, and those working as a physician during times when novel infectious diseases caused crises in hospitals e.g., AIDS in San Francisco in 1982, anthrax in Washington in 2001, and SARS in Toronto in 2003, I am writing to recommend 2 measures be coordinated by international public health and medical authorities to strengthen preparedness against MERS-CoV:

1- Convene in the Middle East an open "One Health" MERS-CoV conference within the next 3 weeks, to discuss all key issues necessary to prevent and control this novel coronavirus.
A. Such key issues would include e.g., clinical, epidemiologic, virologic, immunologic, risk communication, animal reservoir(s), global public health, animal model(s), antiviral treatment protocols, and additional international collaborative protocols (e.g., by the International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC)).
B. The most recent information would be shared by the 8 (or more) nations linked to laboratory-confirmed infections: Jordan, Saudi Arabia, Qatar, UAE, UK, Germany, France, and Tunisia.
C. The conference should be held in the next 3 weeks due to the accelerating pace of the "emergence" of the virus, and also due to increased travel and other traditional activities prior to and during the month of Ramadan [9 Jul 2013-7 Aug 2013].

2 - Create a detailed medical and public health operational plan for both hospital and outpatient settings where patients are evaluated for MERS-CoV.
A. A major goal of this effort is to decrease the risk of health care facility-associated transmission of this virus, as has now been proven to occur in several countries.
B. Another major goal of this effort is to decrease virus transmission in the community partly by optimizing contact tracing via close collaboration between medical and public health professionals.
C. Such a detailed plan can be based on experiences with MERS-CoV in the Middle East, Europe, and North Africa, as well as the highly detailed plans developed in the midst of the SARS crises in parts of Asia and Canada in 2003. Such detail would be in addition to existing guidance on MERS-CoV.

In the spirit of person-to-person cooperation,

--
Daniel R. Lucey MD, MPH
Adjunct Professor of Microbiology and Immunology
Georgetown University Medical Center, Washington DC <DRL23@Georgetown.edu>

[ProMED-mail supports Dr. Lucey's call for an international meeting to address concerns re: the MERS-CoV. As a reminder, there was an international meeting to discuss the SARS outbreak held in Kuala Lumpur, approximately this time of year 10 years ago, at which time similar issues were discussed related to the SARS outbreak. - Mod.MPP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/r/1HAJ.]

See Also

MERS-CoV - Eastern Mediterranean (05): Tunisia ex Saudi Arabia/Qatar, fatal, RFI 20130520.1725864
MERS-CoV - Eastern Mediterranean (04): Saudi Arabia, WHO 20130520.1723626
MERS-CoV - Eastern Mediterranean (03): animal reservoir, RFI 20130519.1723544
MERS-CoV - Eastern Mediterranean (02): WHO summary, ECDC risk assessments 20130518.1721873
MERS-CoV - Eastern Mediterranean: Saudi Arabia, new case, RFI 20130518.1721601
Novel coronavirus - Eastern Mediterranean (29): MERS-CoV, ICTV nomenclature 20130516.1717833
Novel coronavirus - Eastern Mediterranean (28): Saudi Arabia, WHO 20130516.1716274
Novel coronavirus - Eastern Mediterranean (27): Saudi Arabia, WHO, RFI 20130515.1715334
Novel coronavirus - Eastern Mediterranean (26): Saudi Arabia new cases, RFI 20130514.1712370
Novel coronavirus - Eastern Mediterranean (25): Saudi Arabia deaths, WHO 20130512.1708475
Novel coronavirus - Eastern Mediterranean (24): France, 2nd case 20130512.1707305
Novel coronavirus - Eastern Mediterranean (23): France, RFI 20130511.1705803
Novel coronavirus - Eastern Mediterranean (22): France, susp. RFI 20130509.1702445
Novel coronavirus - Eastern Mediterranean (21): Saudi Arabia 20130509.1701527
Novel coronavirus - Eastern Mediterranean (20): France ex UAE, WHO, Saudi Arabia 20130508.1700034
Novel coronavirus - Eastern Mediterranean (19): France ex UAE, RFI 20130508.1699168
Novel coronavirus - Eastern Mediterranean (18): Saudi Arabia 20130505.1693290
Novel coronavirus - Eastern Mediterranean (17): Saudi Arabia 20130503.1688355
Novel coronavirus - Eastern Mediterranean (16): Saudi Arabia, RFI 20130502.1686948
Novel coronavirus - Eastern Mediterranean (15): camel exposure 20130405.1623188
Novel coronavirus - Eastern Mediterranean (14): Germany ex UAE, WHO, fatal 20130326.1604564
Novel coronavirus - Eastern Mediterranean (13): Germany ex UAE 20130326.1603038
Novel coronavirus - Eastern Mediterranean (12): KSA, UK fatality, RFI 20130323.1600113
Novel coronavirus - Eastern Mediterranean (11): UK, pers to pers transm 20130316.1588808
Novel coronavirus - Eastern Mediterranean (10): Saudi Arabia, WHO 20130313.1584076
Novel coronavirus - Eastern Mediterranean (09): Saudi Arabia, WHO 20130306.1574423
Novel coronavirus - East. Med. (07): Saudi Arabia, UK, Germany 20130221.155410
Novel coronavirus - Eastern Mediterranean (06): UK, fatality 20130220.1552014
Novel coronavirus - Eastern Mediterranean (05): UK, 3rd case, 20130215.1544940
Novel coronavirus - Eastern Med. (04): UK, pers to pers trans susp 20130213.1541531
Novel coronavirus - Eastern Med. (03): Saudi comment 20130212.1540011
Novel coronavirus - Eastern Med. (02): UK ex Saudi Arabia, Pakistan 20130212.1539086
Novel coronavirus - Eastern Mediterranean: bat reservoir 20130122.1508656
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Novel coronavirus - Eastern Mediterranean (06): comments 20121225.1468821
Novel coronavirus - Eastern Mediterranean (05): WHO, transmission route 20121223.1465597
Novel coronavirus - Eastern Mediterranean (04): receptor charact. 20121211.1446670
Novel coronavirus - Eastern Mediterranean (03): research, ISARIC (UK) 20121208.1443486
Novel coronavirus - Eastern Mediterranean (02): diagnostics 20121207.1442473
Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI 20121130.1432498
Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664
Novel coronavirus - Saudi Arabia (17): 4th case, RFI 20121121.1418018
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Novel coronavirus - Saudi Arabia (15): new case 20121104.1391285
Novel coronavirus - Saudi Arabia (14): KSA MOH 20121022.1358297
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Novel coronavirus - Saudi Arabia (11): clin. lab. & epi. investigations 20121004.1324712
Novel coronavirus - Saudi Arabia (10): WHO, revised case def. 20120930.1315960
Novel coronavirus - Saudi Arabia (09): real-time RT-PCR, addition 20120929.1315725
Novel coronavirus - Saudi Arabia (08): real-time RT-PCR assay 20120928.1314254
Novel coronavirus - Saudi Arabia (07): Eurosurveillance reports 20120928.1313337
Novel coronavirus - Saudi Arabia (06) 20120927.1311743
Novel coronavirus - Saudi Arabia (05): WHO, case def., nomenclature 20120926.1309747
Novel coronavirus - Saudi Arabia (04): RFI, Jordan, April 2012 20120925.1308001
Novel coronavirus - Saudi Arabia (03): UK HPA, WHO, Qatar 20120923.1305982
Novel coronavirus - Saudi Arabia (02): additional cases, RFI 20120923.1305931
Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733
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