Just a few different ways of looking at age of living and deceased MERS-CoV people, globally, since 2012.
Showing posts with label fatal. Show all posts
Showing posts with label fatal. Show all posts
Middle East respiratory syndrome coronavirus detections on the downward trend under Acting Health Minister Fakeih..[UPDATE]
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| Click on image to enlarge. |
Some brief thoughts on the very early morning (my time; AEST) case reports from the KSA.[1] There were 8 cases announced which included 2 deaths plus another 3 deaths from previously announced cases. No asymptomatic cases (h/t @HelenBranswell) or healthcare workers and few mentions of comorbid disease were included; all bucking the recent trend. There were 4 possible hospital-acquired infections listed too, including illness onset from 11-May. Clearly infection prevention and control (ICP) messaging/action is still not succeeding, at least in Riyadh and Al-Madinah.
Also announced this morning was a second imported case into the USA.
- The Patient (possibly a 44-year old male[2]) was symptomatic - including a cough, (later some diarrhoea), fever and chills (1-May) - during flights from Jeddah to London, from London to to Boston>Atlanta>Orlando, Florida.[2,3]
- Symptomatic does not necessarily mean infectious [3]
- Patient was a healthcare provider (?worker, HCW)
- Patient was admitted to hospital in Orlando 9-May and is isolated.
- Over 500 potential contacts from the US-based flights are being contacted and after 1,000 person hours by CDC staff over the weekend, no-one has been found to be reporting illness so far.[3]
- Little risk of spread from casual contact.[3]
*I'm being sarcastic
References...
- http://www.moh.gov.sa/en/CoronaNew/PressReleases/Pages/mediastatement-2014-05-12-001.aspx
- http://www.latimes.com/science/sciencenow/la-sci-sn-mers-florida-20140512-story.html
- http://www.cdc.gov/media/releases/2014/t0512-US-MERS.html
- http://www.orlandosentinel.com/health/os-mers-case-central-florida-20140512,0,5928176.story
- http://crofsblogs.typepad.com/h5n1/2014/05/us-a-little-more-on-the-florida-mers-case.html
Influenza H7N9 in the news....
Some snippets of information about H7N9 from China in recent releases include:
- The description of H7N9-induced disease has changed in 2014 from an "infectious disease" to a "communicable acute respiratory disease". For what that's worth.
Still technically infectious, just more about what sort of disease. - 7 patients have died with H7N9 infection in 2014
- The incubation period for signs and symptoms to develop after H7N9 infection is 3-4-days; if patients develop severe pneumonia, it will be 3-7-days after signs and symptoms begin
- Chinese Vice Premier Liu Yandong said
"China will strengthen monitoring on live poultry, continue vaccine research and development, tighten international communication and cooperation in epidemic prevention and control, and publicize disease information in a timely manner" - "DNA rapid tests" (PCR-based) suggest a batch of chickens being imported into Hong Kong from Foshan, Guangdong may be H7 positive. H7N9? Further testing is ongoing. [Update - looks like they were POS as Hong Kong has suspended imports and will cull 20,000 chickens already there]
- 12 cases in Zhejiang province have died from H7N9 in 2014 alone! I have 2 listed. 7 in total 2014. Looks like we've lost traceability on the numbers again.
- South China Morning Post
http://www.scmp.com/news/china/article/1414939/beijing-downgrades-h7n9-bird-flu-description-new-cases-spike - South China Morning Post
http://www.scmp.com/news/china/article/1414939/beijing-downgrades-h7n9-bird-flu-description-new-cases-spike - Xinhua
http://news.xinhuanet.com/english/china/2014-01/27/c_126066004.htm - Xinhua
http://news.xinhuanet.com/english/china/2014-01/27/c_126065993.htm - South China Morning Post
http://www.scmp.com/news/hong-kong/article/1415003/one-batch-live-chickens-may-be-infected-h7-virus-health-officials-say - Xinhua
http://news.xinhuanet.com/english/health/2014-01/27/c_133078729.htm
H7N9: males and females among total and fatal lab-confirmed cases...
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| Click on image to enlarge. |
As ever, we have no real idea of the extent to which H7N9 is circulating among those who are not ill enough to present to a hospital. Only the use of a sensitive virus detection method on less ill or healthy people could tell us that. Such testing seems to be anathema, perhaps due to cost (?), for H7N9, MERS-CoV or H5N1 for that matter. So much we don't know but settle for in the respiratory virus game. But some of us go collectively bananas when a case turns up somewhere "unexpected".
Finally, the H7N9 fatality data are severely hobbled by a lack of linkage between H7N9 case notification and which cases died. That linkage broke somewhere after April. Reporting has improved drastically of late with the WHO confirming cases and details but 12 fatal H7N9 cases are publicly lacking enough information to use in sex-related charts, age-related charts, dates-of-onset/reporting charts or dates-of-death charts.
I'm grateful to the WHO today for responding to a request and noting that 52 deaths have been reported to them, bringing the proportion of fatal H7N9 cases to 29%.
Influenza A (H10N8) virus, the new kid on the block...
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The latest, called H10N8 was detected in a human (73-year old female) for the first time Dec-6th. H10N8 has been found in the environment in the past.
The woman, who had visited a live bird market, died from respiratory failure following pneumonia, although whether that was due to H10N8 infection is not clear. The woman was treated in hospital in Nanchang, Jiangxi province from Nov-30; she also suffered a heart attack, was immunocompromised, had high blood pressure and a neuromuscular disorder.
Hong Kong's Centre for Health Protection (CHP) urged travellers to stay away from live bird markets and to avoid contact with the birds/poultry and droppings.
As CIDRAP noted, low pathogenicity avian influenza A(H10N7) virus has been reported in 2 Australian adults processing chickens during an outbreak of the virus in 2010 and reported in 2 Egyptian infants (1-year old) possibly linked to market ducks during late April 2004.
h/t to crofsblog and CIDRAP.
Happy 1st birthday Middle East respiratory syndrome coronavirus (MERS-CoV)
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| A coronavirus schematic. The spiky bits give the virus its name(corona=crown) and represent the receptor binding, antigenic Spike protein. |
How you have grown young prince and how clever of you to emerge in a Kingdom of all places (corona=crown, named for it's spikey appearance). You've certainly garnered attention worthy of a King given the relatively few cases of disease you gave been associated with in the first year we've known of you.
It was September 20th when Dr Zaki 1st alerted the world to the death of a Saudi man due to what looked to be a new coronavirus (CoV). Today we have over 135 cases 58 deaths (43%).
I've previously covered Zaki's disocvery and the problems posed for the Kingdom of Saudi Arabia (KSA) by the way in which he announced that discovery, apparently without the Ministry of Health's (MOH) foreknowledge. The way in which the sample was exported from the KSA without their prior consent was also problematic for them.
Soon after we heard of it, we had virus-detection assays with which we could seek out new cases. Were they used as they might have been in the days of the SARS-CoV? Nope. And there still seems to be only a single laboratory in KSA testing for MERS-CoV (despite reports of 3), with Dr Abdullah Al-Aeeri (a director of hospital infection control) claiming a 72-hour reporting turnaround time.
Is there an antibody detection assay that has been validated using a panel of known positive sera? Nope. There are some innovative antibody-detection methods around but why do they only include a single positive control? Is there no collaboration at all? Why is the KSA not leading the charge to develop these diagnostics and to hunt for an animal host? Why wait on advice from external organizations to screen samples? Why has the necessary testing capacity not been built well before now? Is it to do with that pesky material transfer agreement? I hope not because there is little evidence for that being a real block to anything from a public health standpoint.
At least we have some new MERS-CoV sequences to celebrate the birthday with. Although they and the 9 preceding them represent less than half of the relatively small number of cases described to date. Why can't the typing region sequences be released? That should really be part of the diagnostic process. Okay, those may not inform us about the evolution of key regions of the virus but they do confirm it is the strain we know. Why not focus on full or subgenomic Spike gene sequences? They might be a better sentinel for keeping tabs on MERS-CoV change over time.
Most of the detail about MERS-CoV and cases of MERS has come through the peer-reviewed scientific literature. That is pretty normal for respiratory viruses that are not notifiable. But it's generally a slow medium. Is MERS infection a notifiable disease? It is in some countries (e.g. the US and New Zealand), but is it at the epicenter of the outbreak, the KSA? I'm not sure. It's not obviously stated as such anywhere I looked on the KSA MOH website.
The World Health Organization politely notes:
WHO encourages all Member States to enhance their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns of SARI or pneumonia cases. WHO urges Member States to notify or verify to WHO any probable or confirmed case of infection with MERS-CoV.
How's that been working out? In a nice summary of the lack of communication, Helen Branswell and Declan Butler highlight that, as usual, everyone who was asked agreed that it's not working out well at all. In fact it's pretty woeful. And to add to matters, the latest WHO Disease Outbreak News (DON) takes the form of a summary of 18 "new" cases; no extra or confirmatory detail to be had from it. SO the KSA MOH is now the source for detail.
If we were talking about wanting more data on the monthly proportion of rhinovirus infections, the KSA would be justified in saying that the world doesn't need to know (I'd like to but that's my thing).
If we were talking about influenza, then there are plenty of international public health sites publishing these notifiable data on the internet; here's Queensland, Australia's for example.
But we're talking about an emerging disease which kills half of the people it infects, is caused by a novel virus for which no host is known, which transmits between people in a way we don't yet understand, which is shed from ill (or well) people for an undefined period of time (if at all), which remains infectious in the environment for who knows how long, which jumps to other countries, which may only cause severe disease in those who are already ill with another disease, which may be endemically spreading within the community as mild or asymptomatic infections, for which there is no vaccine or proven antiviral therapy available..I'd say it's a no-brainer that at the very least the WHO deserves regular and detailed updates of what's going on. Reading between the lines, that does not seem to be happening even behind closed doors.
The mass gathering of pilgrims known as the Hajj is fast approaching. This may trigger a large increase in MERS cases or, in the worst case, a pandemic. I personally believe it won't go that far. We shouldn't forget is the 2nd Hajj for MERS. But perhaps the virus is much more widespread than it was in October 2012. But without testing data, we can only guess.
So, it's your 1st birthday MERS-CoV. But instead of wishing you a happy birthday you opportunistic, spiky little killer, I'm wishing Dr Zaki well and congratulating him on co-parenting the birth of this novel coronavirus. Going by what we've seen to date, his actions may have been the only way we would have ever heard of this virus otherwise.
And, as noted previously, but not given much air to in the above rant (thanks to @MicorbeLover for straightening me out)...
It's very sad that there are real people in these numbers who have died from MERS. You may have noticed that I try and stick with the cold number-crunching aspect of these outbreaks. It's not because I'm a heartless b&^$# but because that is not what this blog is about. That and my editorialisation and expositionary writing consume what little time I have spare. But I don't feel that I have enough information to make any other comments about these or any other lives lost to infectious disease. I personally feel that any unexpected and acute loss of life (if I had to scale loss of life) is the worst kind of loss; it's a waste of potential, a source of great sorrow for all involved and it's something we should all strive to prevent, if we can. I know that's not much to convey, but it's all I can offer from my kinda comfy chair in Brisbane.
The mass gathering of pilgrims known as the Hajj is fast approaching. This may trigger a large increase in MERS cases or, in the worst case, a pandemic. I personally believe it won't go that far. We shouldn't forget is the 2nd Hajj for MERS. But perhaps the virus is much more widespread than it was in October 2012. But without testing data, we can only guess.
So, it's your 1st birthday MERS-CoV. But instead of wishing you a happy birthday you opportunistic, spiky little killer, I'm wishing Dr Zaki well and congratulating him on co-parenting the birth of this novel coronavirus. Going by what we've seen to date, his actions may have been the only way we would have ever heard of this virus otherwise.
And, as noted previously, but not given much air to in the above rant (thanks to @MicorbeLover for straightening me out)...
It's very sad that there are real people in these numbers who have died from MERS. You may have noticed that I try and stick with the cold number-crunching aspect of these outbreaks. It's not because I'm a heartless b&^$# but because that is not what this blog is about. That and my editorialisation and expositionary writing consume what little time I have spare. But I don't feel that I have enough information to make any other comments about these or any other lives lost to infectious disease. I personally feel that any unexpected and acute loss of life (if I had to scale loss of life) is the worst kind of loss; it's a waste of potential, a source of great sorrow for all involved and it's something we should all strive to prevent, if we can. I know that's not much to convey, but it's all I can offer from my kinda comfy chair in Brisbane.
The MOH says it better in anyway; May Allah have mercy upon the deceased.
