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November 08, 2013 - SPAIN - A woman in Spain has contracted the country’s first case of the Middle East respiratory syndrome, or MERS, a deadly coronavirus that affects the respiratory system. According to Reuters, the woman had just returned from Saudi Arabia, where the disease first cropped up in September 2012. Spain’s Health Ministry announced the woman’s prognosis on Wednesday. 


Deadly MERS Virus In Spain, Patient Arrives Back From Hajj.
An electron microscope image of a coronavirus. A new form of the virus emerged in the Middle East last year,
known as MERS, has killed 64 people, the majority of whom lived in Saudi Arabia.
Reuters


The patient, who is originally from Morocco but lives in Spain, is being treated at a Madrid hospital and is stable, according to a statement from the health ministry. She was in Saudi Arabia in October. It is unclear whether she was there to attend the annual Hajj pilgrimage, during which hundreds of thousands of faithfuls assembled in Mecca. According to Medical Express, officials monitored the pilgrimage for a MERS outbreak.

MERS was first detected in September 2012. It is caused by a coronavirus, a common virus throughout the world of which five are known to infect people and cause illness. According to AFP, MERS is considered the deadlier but less-communicable cousin of the SARS virus, which infamously spawned an outbreak in Asia in 2003, infecting more than 8,200 people. Nearly one in 10 of those individuals died.

Of the 150 laboratory-confirmed cases of MERS worldwide since 2012, 64 were deadly. The greatest number of deaths from MERS was in Saudi Arabia, according to the World Health Organization, or WHO. In Europe, there have only been a handful of cases of MERS. Three of them were in the U.K., two occurred in France and one occurred in Italy, the U.S. Centers for Disease Control and Prevention reported.

The virus, for which there is no vaccine, is spread from ill people to others through close contact. Recently, WHO announced infections of MERS in Saudi Arabia and Oman. The cases occurred in two men and one woman, all between the ages of 49 and 83. At least one of the patients was known to have been in contact with a previous MERS patient.

“The Centre for Health Protection of the DH will seek more information on the cases from the WHO and the relevant health authorities,” a Hong Kong Department of Health spokesperson said. “The CHP will stay vigilant and continue to work closely with the WHO and overseas health authorities to monitor the latest developments of this disease.”

Symptoms of MERS coronavirus infection include a severe acute respiratory illness. Patients experience fever, coughing and shortness of breath. It differs from SARS in that it causes rapid kidney failure and has an extremely high death rate; nearly half of all MERS patients die.

Experts are still struggling to understand MERS, which some believe is widespread among camels in the Middle East, according to Reuters. - IBT.


Health officials in Spain have detected a case of MERS in a woman who recently returned to the country after attending last month’s Hajj pilgrimage in Saudi Arabia.
The above comments confirm that the MERS case in Spain (see map) was infected while on a Hajj pilgrimage, as suggested by statements in the Spain Ministry of Health press release, which noted that she (61F) flew to the Kingdom of Saudi Arabia (KSA) on October 1 and returned on November 1.  Shortly thereafter MERS was confirmed.

However, media reports noted that she had been hospitalized in KSA on October 15 and diagnosed as having pneumonia.  However, the etiological agent was not identified.  Disease onset on or about October 15 raises the strong possibility that she contracted MERS somewhere along the Hajj route but KSA failed to identify MERS in the above case or the source of her infection.

Moreover, travel after the KSA hospitalization increased the potential for transmission to other travelers and significant spread.

KSA has maintained that no Hajj pilgrim was diagnosed with MERS, although cases in Riyadh and the Eastern Region (Jubail) were confirmed, with disease onset dates similar to the above case.

The confirmation of a Hajj pilgrim in Spain raises serious surveillance and transparency concerns. - Recombinomics.




MERS Diagnosed In Patient In Abu Dhabi Hospital.
 A 75-year-old Omani is in hospital in Abu Dhabi suffering from the MERS coronavirus.

The victim, who was visiting the UAE, began to suffer from respiratory symptoms last month and is now in intensive care.

The diagnosis of Middle East respiratory syndrome was revealed by the Health Authority Abu Dhabi today, reported the state news agency Wam.

The health authority is coordinating with the Ministry of Health and other organisations as it treats the patient.

The authority said it had taken the necessary precautionary measures in line with international standards and recommendations set out by the World Health Organisation (WHO).

The ministry said WHO issued the first international alert about the disease in September last year.

So far, the organisation has confirmed 150 cases of infection of Mers.

WHO has said the virus was now not a public health concern, and the current situation did not require travel bans to any country, screening at points of entry, or any trade restrictions.

The ministry assured the public that it was monitoring the situation closely to ensure everyone’s health and safety. - The National.


Her symptoms began Oct 15 with cough and fever, and she was seen at a hospital emergency department of a Mecca hospital on Oct 28 and 29, where health workers diagnosed her as having pneumonia, based on chest x-ray findings.

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

The health ministry said she was in Medina from Oct 2 through Oct 10 and in Mecca from Oct 11 through Nov 1.

The above comments confirmed media reports which noted a disease onset date of October 15 for the above case (61F) as well as a Kingdom of Saudi Arabia (KSA) diagnosis of pneumonia.  The peak of Hajj activity was between Oct 13-18, corresponding with the patient’s travel to Mecca.

The disease onset date of Oct 15 suggests she was infected in Medina, where KSA reported confirmed cases at the end of Ramadan, which was also linked to a Qatari who traveled from Medina to Qatar and developed symptoms on the day of his arrival, which was subsequently linked to onward transmission in Qatar.  Although WHO noted that the Qatari did not perform Umrah or visit the Grand Mosque, his MERS infection became symptomatic after his attendance at a Medina clinic.

Thus, the presence of MERS in Medina after Ramadan raised concerns that Hajj pilgrims would be at risk and even though KSA cited the absence of any confirmed cases in Hajj or Ramadan pilgrims. MERS is widespread in KSA, including the Ramadan large cluster in Medina.

The recent MERS case was traveling and attending the Hajj in KSA while symptomatic and flew from Jeddah (see map)  to Madrid after she was diagnosed with pneumonia in Mecca.

This extensive travel strongly suggest the number of MERS infections in Hajj pilgrims is high, KSA detection / reporting failures notwithstanding. - Recombinomics.



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Thursday, November 7, 2013

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