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Showing posts with label Malaysia. Show all posts
Showing posts with label Malaysia. Show all posts

2 Middle East respiratory syndrome coronavirus (MERS-CoV) cases emerge in the Philippines and Malaysia [UPDATED]

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In a surprising pair of temporally related announcements, there has been an imported and fatal case of MERS occurring in a 54-year old man (54M) originally from Johor, Malaysia [1] and a distinct case in a  recently returned 45-year old [5] Filipino male nurse working in the United Arab Emirates (UAE).[2,3,4]
  • 54M had returned from performing an Umrah pilgrimage ("mini-Hajj")  at Mecca (Makkah), Saudi Arabia on 29-March , becoming ill 8-9-Apr, dying of pneumonia secondary to his MERS-CoV infection, 13-Apr.[8]
    • Passengers on board the same flights are urged to contact the Health Ministry for testing but he was not symptomatic while in transit [8]
    • Diabetic (a comorbidity) [6]
    • Had visited a camel farm but source of infection remains unknown [6]
  • 45M, currently in quarantine with his family, was a friend of the recent fatal MERS case in a Filipino paramedic
    • The nurse was asymptomatic
    • Returning from vacation in the Philippines when retrospective testing results were released to Philippines embassy by UAE authorities  [5]
    • Testing was conducted in the UAE, referred to as a "blood test" ?serology not PCR-based?
    • Source of infection remains unknown
    In 2013, Kingdom of Saudi Arabia's (KSA) Health Minister Abdullah Al-Rabeeah, said that 4,800,000 pilgrims visited to perform Umrah and not one left having had MERS-CoV infection. That will not be the case in 2014.

    References...


    1. FluTrackers thread on fatal MERS-CoV case in 54M, Malaysia
      http://www.flutrackers.com/forum/showthread.php?t=221664
    2. FluTrackers on Filipino nurse positive for MERS-CoV
      http://www.flutrackers.com/forum/showthread.php?p=531474#post531474
    3. http://www.gmanetwork.com/news/story/357189/news/nation/pinoy-nurse-tests-positive-for-mers-virus-first-case-in-phl
    4. OFW who returned home from UAE tests positive for MERS-CoV � DOH chief|Inquirer.net article http://newsinfo.inquirer.net/594740/ofw-who-returned-home-from-uae-tests-positive-for-mers-cov-doh-chief#ixzz2z2x7xUEr
    5. OFW with MERS arrives in Manila
      http://www.philstar.com/headlines/2014/04/17/1313580/ofw-mers-arrives-manila
    6. Health Ministry Confirms Umrah Pilgrim Died Of MERS-CoV
      http://www.bernama.com/bernama/v7/bu/newsmarkets.php?id=1031217
    7. MERS Coronavirus Makes First Appearance In Asia: Malaysia, Philippines Report MERS-CoV Cases
      http://www.theglobaldispatch.com/mers-coronavirus-makes-first-appearance-in-asia-malaysia-philippines-report-mers-cov-cases-43672/
    8. First Mers death recorded in Asia
      http://www.thenational.ae/world/first-mers-death-recorded-in-asia
    9. Mike Coston on Malaysia imported case
      http://afludiary.blogspot.com.au/2014/04/malaysian-moh-statement-on-imported.html
    10. Mike Coston on Philippines imported case
      http://afludiary.blogspot.com.au/2014/04/philippines-quarantines-imported.html
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    First Taiwan, then Hong Kong, now Malaysia becomes a holiday destination for an H7N9 case...[UPDATED x2]

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    Mike Coston has just made us aware via a Tweet that avian influenza A(H7N9) virus has escaped its usual roosting ground in southern eastern China by hitching a lift in a tourist to Malaysia. 

    A more detailed post on his Avian Flu Diary wrangles the issue of language very nicely and tells us that the infected Chinese tourist has been hospitalized and is currently in a stable condition. 

    Brief details..
    • 66-year old female
    • Fever, 01-Feb prior to leaving China
    • Travelled from Guangzhou City in Guangdong province to Peninsular Malaysia 04-Feb then to Sabah, Malaysian Borneo 06-Feb then to Kota Kinabalu
    • Hospitalised 07-Feb in Kota Kinabalu, Sabah, Malaysia 
    • Laboratory confirmed 11-Feb and remained positive 13-Feb and 22-Feb
    • No sign of R294K (N9 numbering) mutation associated with oseltamivir resistance despite virus "persistence" wihc may have been related to treatment with steroids
    • 191 contacts; 6 were symptomatic but tested negative for H7N9
    It is worth highlighting here that this sort of export is not unexpected and not even surprising. We live in a hyper-connected world. It's nigh on impossible to stop respiratory viruses from spreading. This case highlights that even when we're ill, we still feel the pressure to continue on with our jobs, our daily routine or our holiday. After all, we've all been a bit crook before and it has mostly been nothing much to speak of. Why should this time be any different? 

    To date, H7N9 does not jump easily between humans as far as we know. The 20 negative contacts stand in testimony to that. But if you see some articles or posts or Tweets in the coming hours and days which suggest that the sky is falling...I think you can rest assured that this is not it falling. 

    Not yet anyway!  

    Now, go follow Mike via @Fla_Medic if you are not already.

    Sources...
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