H5N1

Robert Koch Institute on the German coronavirus case

I've belatedly dug out this November 23 news release from the Robert Koch Institute: Case of novel Corona virus in Germany 23 November 2012. The entire statement, for the record:

Through the IHR mechanism the Robert Koch Institut was informed on November 22, 2012, that a new case of novel Coronavirus disease was confirmed in a patient from Qatar. 

After disease onset in October the patient was treated at first in a hospital in Qatar, but because of his severe condition he was then transferred to a specialist lung hospital in Germany. After having received intensive care he improved markedly so that he could be discharged from hospital this week. 

Samples of the patient taken in Qatar were sent to the UK where HPA confirmed the novel Corona virus. 

In the hospital in Northrhine-Westfalia where the patient was treated for four weeks no illnesses among health care personnel were reported. An in-depth survey among contact persons is being conducted by the hospital and the local health authority. In the context of the IHR and in close co-operation with treating physicians, the state health department and the local health authority the Robert Koch-Institute has taken up the co-ordination of the investigation in Germany. 

This case constitutes the fifth known case with the novel Corona virus. To date another case was reported from Qatar and another three from Saudi-Arabia. Most patients developed ARDS in combination with acute renal failure. There is no known epidemiologic link between the cases, in addition they had their onset in rather large intervals. 

Momentarily these case are interpreted as sporadic cases in the two countries. To date there are no hints for person-to-person transmission. According to the risk assessment of the Robert Koch-Institute risk of illness in Germany is still very low. 

After the first cases came to light in September 2012 the Robert Koch Institute has informed public health services and an intensive care network, complemented by information on its website. A laboratory test in the Robert Koch Institute is capable of identifying the virus specifically. 

Further patient samples are planned to be tested at the Robert Koch Institute to characterise the illness better. Any suspicion of an illlness caused by the novel Coronavirus has to be reported to the local health authority.

Bangladesh: Ashulia RMG factory fire death toll rises to 124

Via The Daily Star, a report that reminds me of the terrible Triangle Shirtwaist fire in New York City in 1911: Ashulia RMG factory fire rises to 124.

The death toll from a fire that raged through a garment factory in Ashulia rose to 124 till Sunday morning. 

The fire that started at Tazreen Fashion near Dhaka Export Processing Zone in Ashulia on Saturday evening came under control around 5:55am Sunday, said Fire Service and Civil Defence sources. 

Sources said the death toll may rise as rescue operation was going on when this report was filed around 11:12. 

Initially nine deaths were recorded on Saturday night and more 115 charred bodies were recovered from the factory on Sunday morning. 

Police, fire-fighters and witnesses on Saturday said those killed in the incident did not suffer burns, but they died after jumping off different floors of the eight-storey Tazreen Fashion at Nischintapur in a bid to escape the blaze that started on the ground floor around 6:50pm.

Uganda: Social media fuelling HIV/AIDS prevalence

Via The New Vision: Social media fuelling Uganda’s HIV/AIDS prevalence. Excerpt:

Until World Aids Day on December 1, New Vision will publish HIV-related stories daily. Today, George Wabweyo explores how the media is fuelling reckless sex and the spread of HIV 

Scary! There is this group on Facebook. It is called No Strings Attached (NSA) Sex Uganda. A look at this group’s header sends shockwaves down your spine.   

Here is how it reads: “Hey! Live in Kampala or its surroundings? Why not meet like-minded people and arrange some NSA fun? Add your e-mail address below and get it on.”    

It has 284 members and some of its members’ explicit requests and posts arouse pity. It is not the only Ugandan Facebook group dedicated to sex.        

Several other groups have suggestive and lewd names and have several members.  There is even a mobile sex worker page. The list of these groups and pages is endless, and someone needs to report them so they are brought down.    

These pages are a stark testimony of how the booming social media use in Uganda, especially Facebook, is fuelling a dangerous sexual revolution among the youth.   

Unfortunately, the internet is an uncontrollable monster and even though Facebook and other social networks have a strict policy against lewd content, pornography and sexual content is still posted unabated. Because of social networks, more youth are so exposed to lots of sex, more so unprotected sex!   

That aside, to the individual, Facebook has broken the boundaries of traditional relationships. It is slowly becoming acceptable for people to share everything with strangers online and feel like they know them very well when they finally do get to meet.    

“Facebook makes one believe that they’ve known the other person for a longtime. It gives you an insight in their day-to-day lives and since you chat before actual meeting, there is a sense of trust and emotional bond you build between yourselves,” says Joy Tushabe, a third-year Makerere University student.    

Indeed, a new relationship on Facebook starts as easily as sending a friend request and enables one to communicate swiftly and with little limitations or hurdles that physical encounters may present, so by the time you meet, you have already by-passed the hard bits.   

Youth, who make the biggest population of Ugandans on social media, are increasingly using the above mentioned pages and groups to recruit sexual partners, a move that ought to be stopped, but how?   

“I know a groupie friend of mine who gets sexual partners from Facebook. She looks for hot celebrities and hooks up with them for sex,” Pam, a student and frequent Facebook user, says.   

For his part, James had this to say: “I have hooked up with six random girls on Facebook. The fact is Facebook is facilitating sex. It has made it a bit of a smooth sail,” he confesses.    

Kahuma, a recent graduate who also prefers anonymity because of the gravity of the matter, admits to recruiting a few sexual partners from social networks. “Yes, I have hooked up with someone on Facebook, but it was just for chao (Kampala slang for sex). It never was anything serious,” he says.

Branswell: Latest WHO warning about new coronavirus raises transparency concerns for health experts

I had a feeling yesterday that Helen Branswell wasn't happy about WHO's latest coronavirus statement, and her new report for The Canadian Press, in The Star, tells me I was right: Latest WHO warning about new coronavirus raises transparency concerns for health experts. Excerpt:

The World Health Organization has warned countries to heighten their surveillance for possible cases of infection with the new coronavirus, suggesting patients with unexplained pneumonias should be tested even if they don’t have links to Saudi Arabia and Qatar. 

The agency also suggested investigating clusters of severe respiratory infections, and clusters of such illnesses in health-care workers, regardless of where they occur in the world. 

Up until now the WHO has said that testing for the new coronavirus should be restricted to patients with severe respiratory infections who had recently travelled to or who were residents of a country that had recorded cases. To date the only confirmed infections have been in Qatari and Saudi nationals. 

That change in advice, the basis for which the WHO did not explain, raised eyebrows among some infectious diseases experts, who were quick to try to read between the lines. 

“That suggests that they have the idea that it’s more widespread. Where does that idea come from? What’s the evidence?” wondered Dr. Ron Fouchier. 

The Dutch virologist leads the laboratory, which in June found that a new coronavirus — from the same general family as the virus that caused SARS — was behind the infection of the first identified case, a man from Jeddah, Saudi Arabia. 

If the WHO has any evidence that the virus has spread further afield, it hasn’t revealed it. 

But its concern may stem from the fact that over three million Muslim pilgrims have recently returned to their home countries after attending this year’s Hajj, which ended in late October. 

The WHO’s new advice was contained in a statement released Friday in which it announced the global count of confirmed infections with the new virus has risen to six. Two of the confirmed cases have died. All six cases were male. 

It also revealed that Saudi Arabia has reported a cluster of cases, with two men confirmed and two others under investigation. The four men shared a household in an undisclosed part of the country. 

All four were sick around the same time, suffering similar symptoms, the WHO said. Of the two men under investigation, one died. Test results are still pending on samples taken from the man during his illness. 

The other man survived and tested negative for the virus, the WHO said. But it did not disclose the type of test used or when the testing was done. 

Until more information is known, it is not clear that the test result can be considered reliable, said Dr. Michael Osterholm, director of the Center for Infectious Diseases Research and Policy at the University of Minnesota. 

The reliability of the test could vary, depending on when the person was tested, what kind of test was used and the kind and calibre of the specimen being tested, he said. 

“If the person had an illness similar to the other illnesses, then ... I believe that you’d have to consider that this test may have been a false negative,” said Osterholm, adding testing the survivor’s blood for antibodies would shed some light on the situation. 

Both the changing WHO advice and the lack of clarity on the testing underscore a problem with this situation, both Osterholm and Fouchier suggested. 

Very little about the cases is being publicly shared. And the international teams of scientists who travelled to Saudi Arabia to look for possible sources of the virus have released no information about their investigations. 

Fouchier was front and centre in the laboratory effort during the 2003 SARS outbreak. It was his lab, at the Erasmus Medical Centre in Rotterdam, that proved what’s called Koch’s postulates — conducting the test that confirmed that the newly identified coronavirus was actually causing the disease SARS.

US: Connecticut woman at risk of rabies

Via CBS Connecticut: Health Authorities Try To Identify Woman Exposed To Rabies.

Health authorities are posting an urgent notice as they try to trace a woman bitten by a cat in Chaplin, Connecticut about two weeks ago.  The cat has since died, and a necropsy found it suffered from rabies, 

Director Robert Miller of the Eastern Highlands Health District says the woman was driving on South Bear Hill Road, with at least one child in her vehicle.  It was after 5 p.m. around November 8th, but because it was dark, the witness did not have more of a description than that. The car was travelling between Cross Road and Canada Lane. 

The woman had picked the cat up from the road,  and told the witness it bit her.  Rabies is a deadly disease caused by a virus present in the saliva of infected animals. It has been about two weeks since the woman was bitten, and he says typically symptoms show up three weeks to six weeks after exposure. 

Miller says it is urgent that treatment begin before symptoms appear.  After that it is almost invariably fatal. Anyone who knows who the woman could be is asked to call the health district at (860) 234 6975. 

India: Massive spurt in dengue cases in 2012

Via The Times of India: Massive spurt in dengue cases in 2012. Excerpt:

NEW DELHI: While cases of malaria and chikungunya show a dip across India, dengue cases have started to climb steadily. 

Official records of the Union health ministry reveal that there has been a massive increase of dengue infection in the country this year. 

India had recorded 15,535 cases and 96 deaths in 2009, but the corresponding figure till November, 2012, stood at over 35,000 cases and 216 fatalities. 

Tamil Nadu has recorded the highest number of deaths (60), followed by Maharashtra (59), Karnataka (21), Punjab (15), Kerala (13) and West Bengal (9). In the number of confirmed cases, too, Tamil Nadu leads the pack with 9,249 cases, only next to Bengal (6,067 cases). 

Two other states have breached the 3,000 mark - Kerala (3,674) and Karnataka (3,482). 

Maharashtra, which has recorded the second highest number of deaths, however, reported fewer dengue cases at 1,464. 

Delhi has recorded 1,584 cases and four deaths. 

The number of cases of dengue infection and deaths is higher this year than the previous two years. 

In 2010, India recorded 28,292 cases and 110 deaths, while it recorded 18,860 cases and 169 deaths last year. 

In comparison, malaria cases and deaths have decreased from 15 lakh [1.5 million] cases and 1,144 deaths in 2009 to 7.36 lakh [736,000] cases and 309 fatalities this year. 

In case of chikingunya, cases have decreased from 73,288 cases in 2009 to 14,227 cases in 2012.

Uganda: Uneb closes exams marking centre over Ebola

Via The Saturday Monitor: Uneb closes exams marking centre over Ebola. Excerpt:

The Uganda National Examinations Board (Uneb) has closed Ndejje Secondary School examination marking centre following an outbreak of Ebola in the neighbouring Luweero District. 

Mr Mathew Bukenya, the Uneb executive secretary, said examiners from Luweero are not expected to participate in this year’s marking exercise at all levels of Primary Leaving Examination (PLE), Uganda Certificate of Education (UCE), Uganda Advanced Certificate of Education (UACE) and Business Technical Vocational Education Training. 

About 600 examiners were expected to stay at the centre for about three weeks to mark PLE. The exercise is expected to start on November 27. They have been relocated to Namilyango College. 

“Because of the outbreak of Ebola, we contacted Ministry of Health and we were advised against hosting a big number of people at Ndejje SS. No examiner should travel to Ndejje SS for this year’s marking exercise,” Mr Bukenya said in a press release on Thursday. 

Uneb had earlier planned two venues: Ndejje SS and Namilyango College as centres for marking PLE English paper. 

A total of 565,663 candidates sat PLE early this month, 268,782 students for UCE, while 13,919 candidates registered for BTVET exams and 111,581 candidates are expected to sit for UACE.

Coronavirus: The view from Qatar (and Florida)

Usually I like to find stories from as close as possible to the source of an outbreak. But this report from today's Gulf Times in Qatar is disappointing: Four new cases of Sars-like virus found.

A new virus from the same family as Sars which sparked a global alert in September has now killed two people in Saudi Arabia, and total cases there and in Qatar have reached six, the World Health Organisation said. 

The UN agency issued an international alert in late September saying a virus previously unknown in humans had infected a Qatari man who had recently been in Saudi Arabia, where another man with the same virus had died. 

Yesterday, it said in an update that it had registered four more cases and one of the new patients had died. “The additional cases have been identified as part of the enhanced surveillance in Saudi Arabia (3 cases, including 1 death) and Qatar (1 case),” the WHO said. 

The new virus is known as a coronavirus and shares some of the symptoms of Sars, or Severe Acute Respiratory Syndrome, which emerged in China in 2002.

Another Gulf Times story is longer, but it's just a Reuters report from London. An Al Jazeera, which after all is based in Qatar, has absolutely nothing about the novel coronavirus.

Meanwhile, Mike Coston in Florida has an excellent overview of the situation this morning.

Novel coronavirus: Hong Kong takes note

A news release from the Hong Kong Department of Health: DH closely monitors additional overseas cases of Severe Respiratory Disease associated with Novel Coronavirus. Excerpt:

The Department of Health is closely monitoring four additional cases due to infection with the novel coronavirus reported to the World Health Organization (WHO) yesterday (November 23). These additional cases comprised three from Saudi Arabia (of which one was fatal) and one from Qatar. 

Of the six laboratory confirmed cases reported by WHO so far, four cases (including two deaths) were from Saudi Arabia and two cases were from Qatar.      

According to the WHO, two of the three most recently confirmed cases in Saudi Arabia are from the same family, living in the same household. Preliminary investigations indicate that these two cases presented with similar symptoms of illness. One died and the other recovered.      

Additionally, two other members of this family also presented with similar symptoms of illness, where one died and the other is recovering. Laboratory results of the fatal case is pending, while the case that is recovering tested negative for the novel coronavirus.      

Investigations are ongoing in areas of epidemiology, clinical management, and virology, to look into the likely source of infection, the route of exposure, and the possibility of human-to-human transmission of the virus. Close contacts of the recently confirmed cases are being identified and followed-up.

That's what I like about the Hong Kong health authorities: They never shrug anything off, least of all reports that evoke memories of H5N1 or SARS.

Branswell: Cluster of coronavirus cases raises spectre of person to person spread: WHO

I linked to Helen Branswell's report for The Canadian Press in my post on Maryn McKenna, but Branswell's outline of the situation deserves a post of its own.From the Winnipeg Free Press: Cluster of coronavirus cases raises spectre of person to person spread: WHO. Excerpt:

Up till now there has been no suggestion of person-to-person spread of the virus, prompting authorities to say the virus didn't pose a global threat. But this cluster in Saudi Arabia may change thinking on that. 

Two men in a single household fell ill and tested positive for the virus. One of the two died. 

Two other members of the same household were sick at the same time with similar symptoms; one of those men died as well. The survivor tested negative for the virus, but results are still pending on the testing of samples taken from the man who died, the WHO said Friday. 

Chaib said if there was human-to-human spread in this case it looks like it petered out. She said work is underway to try to tease out whether the people were all infected from a single non-human source, or if one member of the household picked up the infection and passed it along. 

"The timing of the cases in the Saudi cluster does raise that concern but when a cluster occurs in a setting such as a household where everyone has similar environmental exposures it can be very difficult to separate out exposure to the same environmental source versus spread from one person to another," she said. 

"Investigations are on-going to try and answer this question, however if H2H (human-to-human spread) has occurred, it does not appear to be sustained." 

Osterholm said too little information is known at present to be reassured that the negative test was a true negative. The reliability of the test could vary, depending on when the person was tested, what kind of test was used and the kind and calibre of the specimen being tested, he said. 

"If the person had an illness similar to the other illnesses, then ... I believe that you'd have to consider that this test may have been a false negative," said Osterholm, adding testing the survivor's blood for antibodies would shed some light on the situation. 

It's not clear what kind of testing has been done. In fact, very little information about the cases has been revealed. 

The new statement does not mention the ages of the cases or when they became sick. 

It also does not say what symptoms the men suffered from, how they were treated or how sick the survivors were. It does not reveal where the cases lived — in a city or in a rural setting, where they might be in closer proximity to animals that could be the source of the virus. 

Last month teams of researchers from Columbia University in New York, the WHO and the U.S. Centers for Disease Control travelled to Saudi Arabia to investigate possible sources of the new virus. To date they have not publicly revealed whether they found any clues where the virus comes from or how people become infected with it.