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Published Date: 2012-09-23 15:18:12
Subject: PRO/AH/EDR> Novel coronavirus - Saudi Arabia (02): additional cases, RFI
Archive Number: 20120923.1305931

NOVEL CORONAVIRUS - SAUDI ARABIA (02): ADDITIONAL CASES, REQUEST FOR INFORMATION
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[1]
Date: 23 Sep 2012
Source: Bahrain News Agency
http://www.bna.bh/portal/en/news/525747

Saudi Health Ministry Announces Diagnosis of New Form of Coronavirus
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Saudi Ministry of Health announced Sunday that a new form of the coronavirus was diagnosed in 3 people causing the death of 2 of them; the 3rd is still undergoing treatment. The Ministry explained that, with the rapidly changing weather at this time of the year and with the start of the Hajj season a new strain of coronavirus has been recovered from 3 patients.

Coronaviruses are considered to be one of the common etiological agents of the common cold. The 1rst case was a Saudi patient diagnosed in one of the hospitals in Jeddah; the 2nd was a Saudi patient and the 3rd a Gulf State patient both diagnosed in London, England. Two of the patients passed away and the 3rd patient is still under treatment. The Ministry said that the coronaviruses are well known and most of those who are diagnosed with it recover completely with no complications after receiving the needed supportive therapy.

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[2]
Date: 23 Sep 2012
Source: Arab News / Saudi Arabia Ministry of Health Press Release [edited]
http://www.arabnews.com/saudi-ministry-health-announcement-coronavirus

Saudi Ministry of Health announcement on Coronavirus
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Saudi Ministry of Health announced Sunday [23 Sep 2012] that a new form of the coronavirus was diagnosed in 3 people causing the death of 2 of them; the 3rd is still undergoing treatment.

The Ministry explained that, with the rapidly changing weather at this time of the year and with the start of the Hajj season a new strain of coronavirus has been recovered from 3 patients. Coronaviruses are considered to be one of the common etiological agents of the common cold. The 1st case was a Saudi patient diagnosed in one of the hospitals in Jeddah; the 2nd was a Saudi patient and the 3rd a Gulf State patient both diagnosed in London, England. Two of the patients passed away and the 3rd patient is still under treatment.

The Ministry said that the coronaviruses are well known and most of those who are diagnosed with it recover completely with no complications after receiving the needed supportive therapy. In minority of the patients who are infected with this novel strain; complications can develop affecting the respiratory system and the kidneys and can cause death especially among the elderly and in patients with chronic respiratory & cardiac conditions and among immunocompromised patients.

The ministry assured the public that such occurrences are rare and the overall health conditions are stable and there are no reasons for concern. And encourages those who would like to perform Hajj and Umra from within the kingdom or from abroad to take the necessary precautions and recommended vaccines recommended by the government of Saudi Arabia and pay special attention to personal hygiene, and hand cleansing, to wear masks in crowded places and change them frequently.

The Ministry would like to affirm that it will continue to monitor the situation locally, regionally and globally in close coordination with concerned departments and the international health authorities.

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[As mentioned by Mod.CP, in the 1st post on this novel coronavirus in Saudi Arabia "The family _Coronaviridae_ is comprised of a group of RNA-containing viruses that are associated with respiratory infections in humans and animals, including pigs, cats, dogs, mice and chickens." (see prior ProMED-mail post Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733).

The coronavirus family has been identified as the etiology of many of the varieties of upper respiratory illnesses in humans referred to as the common cold. Oftentimes 1st reports of novel diseases are associated with severe clinical presentations including fatalities. Upon further community based studies, new diseases with severe early presentations are found to be less severe as studies reveal the overwhelming majority of infected individuals have had either subclinical infections (no disease) or very mild clinical presentations (i.e. "the common cold"). Concern is raised when there are reports of severe illness in otherwise healthy individuals when infected by a novel organism.

One question that arises here is whether these 3 individuals had predisposing illnesses which would lead to more severe disease with organisms usually associated with mild disease. Another question is whether community based studies are underway to determine how widespread transmission of this organism is, and what might be the "true" case fatality rate (CFR) -- right now the information available suggests the CFR is 67 percent (2 out of 3 known cases), but if there are many infected individuals with mild disease, that would significantly lower the CFR. Another observation/clarification that Mod.CP raised is that it is not entirely certain that this virus is the same one described in the 1st report. That virus (from the 1st report) was sent to the Netherlands, whereas diagnosis and the identification of some of these 3 isolates seems to have been done in London.

Given the rapid identification of new cases shortly following the identification of the 1st case, it strongly supports an observation that the Saudi MoH is monitoring the situation closely and appropriately with a focus on the upcoming mass gathering of the Hajj in Saudi Arabia.

For the HealthMap/ProMED-mail interactive map of Saudi Arabia and the Gulf States, see http://healthmap.org/r/1HAJ. - Mod.MPP]

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