H5N1

Saudi Arabia: No coronavirus death in Jeddah, says ministry, part II

Thanks to Lucie Lecomte for finding the next chapter in the ongoing saga. Via Okaz/Saudi Gazette: No coronavirus death in Jeddah, says ministry. The entire report:

Health Ministry officials in Jeddah dismissed as “false” reports that said a woman died at a local hospital after she was infected with the coronavirus. 

Social networking sites posted warnings to people against visiting Jeddah's Maternity and Children's Hospital, claiming there were coronavirus cases in the hospital. 

Jeddah Health Affairs spokesman Abdulrahman Al-Sahafi said these warnings claimed that the emergency unit of the hospital was receiving a number of patients while a woman had died and a doctor was in a coma because of the virus. 

He said all these reports were mere rumors and warned against spreading such baseless information. 

Director of Jeddah Health Affairs Dr. Sami Badawood said there were no new cases of coronavirus reported in the city. 

He said all necessary precautions have been implemented to discover new cases and deal with them in accordance with World Health Organization directives. 

He said there was one coronavirus-related death in a private hospital in Jeddah last year and another case where the patient died outside the Kingdom. 

A new case discovered in the Eastern Province on Saturday brought to 31 the total number of coronavirus infections in the Kingdom, mostly in the eastern town of Al-Ahsa, since the SARS-like virus first emerged in September 2012. 

Most patients infected with the virus are cured without any complications. In rare cases, complications may happen and infect the respiratory system and kidneys, which may cause death to elderly patients or those with heart problems, Badawood said. 

Okaz/Saudi Gazette visited the emergency unit of the hospital and patients there expressed surprise at the rumors, claiming hygiene standards were high in the hospital. 

Okaz/Saudi Gazette also visited the central sterilization center of the hospital, which is staffed by 11 employees and incorporates five sterilization systems. The staff work in two shifts to ensure the highest possible hygiene in the hospital.

Maybe Dr. Badawood knows something we don't, but according to Dr. Ian Mackay, who keeps track of the numbers, the MERS case fatality rate as of June 17 was 59%. So deaths from this virus are not exactly "rare cases."

I take this story to mean the Saudis are having communications problems in the Ministry of Health, aggravated by rumours over social media.So they're trying to squelch the rumours and calm things down...if need be, with a little excess spin about how mild MERS is.

Saudi Arabia: ‘No MERS case in Jeddah’

Arab News has picked up the report I posted here yesterday: ‘No MERS case in Jeddah’.

A Jeddah health official rejected a report that a two-year-old boy in the city has fallen prey to the deadly Middle East Respiratory Syndrome Coronavirus (MERS). 

This denial from the Director of Health Affairs in Jeddah Dr. Sami Badawood is contrary to the statement issued by the Ministry of Health on Monday on its website that a boy was undergoing treatment for the disease at a hospital in Jeddah. 

“If any person is found to have contracted the disease, he will be admitted to the isolation wards found at all hospitals in Jeddah to treat patients with contagious diseases,” a local newspaper reported Badawood as saying. 

He said that private hospitals were instructed to refer any patient with MERS to a government hospital. 

The disease has killed 32 people out of 49 infected in the Kingdom, according to the statement from the ministry. It said that three new infection cases were reported in Riyadh, Jeddah and the Eastern Province. 

Supervisor General of the Regional Laboratory and Blood Banks in Jeddah Dr. Saeed Al-Amoudi said the laboratory did not receive blood samples of any two-year-old child affected by the virus. “None of the samples of suspected cases sent to the laboratory from government and private hospitals tested positive for MERS,” he said. 

He added that the laboratory received between four to 15 blood samples sent from different parts of the Kingdom daily. “It takes eight hours to test a sample, while including routine formalities it could take up to 16 hours,” he said. 

Examining doctors refer patients for blood tests if they suspect they are infected.

I have no idea why the national ministry and the health department of a major city would disagree about something this straightforward.

Saudi Arabia: Is the 2-year-old not a MERS case?

Lucie Lecomte keeps finding remarkable resources, including a Saudi newspaper called Al-Sharq, which in today's edition has this report: «Health Jeddah» denies ministry statement: We have no infected. Excerpt from a Google translation:

The Director of Health Affairs in Jeddah Dr. Sami Badawoud no injuries virus Corona hospitals in Jeddah, contrary to the announcement by the Ministry of Health on its website for the registration of injury to a child in Jeddah reach of Alamraamin, and suffers from a chronic disease of the lungs and receiving treatment in intensive care. 

Between Badawoud to Jeddah there have been no cases of HIV infection, pointing to the absence of specific guidance in dealing with patients due to the lack of cases. 

He said in a statement to «East» that all hospitals maintain there are sections of isolating infectious diseases and Mobile and will be placed with them, if any, and the terms of the private sector will be converted infected with the virus, if any, to government hospitals for readiness rooms and sections for insulation. 

The general supervisor of the lab regional and managing director of laboratories and blood banks in the health of Jeddah consultant Hematology Dr. Saeed Al-Amoudi told «Middle» non-receipt of laboratory regional sample of a child at the age of two years, confirming the arrival of a number of samples of suspect transferred from hospitals Jeddah governmental and private, all of which have undergone screening positive were recorded by the virus permanently.

The report goes on with an obscure explanation of testing times, even harder to follow than what I've posted here. But if I understand the story, Jeddah says the 2-year-old, while ill, isn't ill with MERS. Jeddah's hospitals have the isolation and intensive-care units to deal with such cases, but they have no cases; while the regional lab has had samples from suspected cases in both public and private hospitals, nothing was received from the child. And while "screening positive" sounds as if those tests reflect a serious outbreak, the sense of the story is that no MERS cases been found.

The story's chief interest lies in the disagreement between the Saudi Ministry of Health and the head of public health in one of the kingdom's major cities: message control is evidently an issue in this outbreak.

CIDRAP: News scan for June 17

Via CIDRAP: NEWS SCAN: Angola dengue threat, polio worker deaths, Cambodia malaria drop. Excerpt:

The United States and other countries are seeing a rise in lab-confirmed dengue cases in people who have traveled to Luanda, Angola's capital, and health providers should be aware that the disease in Africa is endemic, the US Centers for Disease Control and Prevention (CDC) said today. 

So far at least 91 cases have been reported from Canada, France, Germany, Israel, Portugal, South Africa, and the United States, according to a report in Morbidity and Mortality Weekly Report (MMWR). Luanda is an international travel destination because of its connection to the oil industry. 

The CDC said Angola's disease surveillance system has gaps, but so far the country's health ministry has reported 517 suspected cases, all from Luanda province. One death has been reported, but the CDC said that figure could be subject to underreporting. 

CDC testing of 49 specimens revealed dengue type 1, and phylogenetic evidence suggests the disease has been circulating since 1968 and is endemic in Angola, as in most other parts of Africa, according to the report. 

The agency said three other African countries have reported dengue outbreaks so far this year: Seychelles, Kenya, and Tanzania. Public health messaging in Angola has focused on recognizing dengue symptoms, especially severe ones, and minimizing mosquito breeding sites.

Saudi Arabia: Still very quiet about new MERS cases

I've just spent some time trying to find more news about last night's announced 3 new cases and 4 deaths from MERS. About the best I can find is this Reuters piece: Saudi Arabia says MERS coronavirus kills four more. Excerpt:

Four more people have died and three more have fallen ill in Saudi Arabia from the new SARS-like coronavirus MERS-CoV, the Saudi Health Ministry said on Monday. 

The ministry said the four deaths were among previously registered cases. The new infections were in Eastern Province, in the capital Riyadh and in Red Sea port city of Jeddah. 

Saudi Arabia has been the country most affected by the respiratory-system virus, with 49 confirmed cases, of whom 32 have died, according to data from the ministry.

Meanwhile, the Saudi media—both English and Arabic—have nothing to say about the Ministry of Health's announcement, and the MOH itself has no further details. Maybe WHO's next update will have something. 

ProMED-mail has the MOH report and a moderator's comment that hints at the kind of exasperation I'm feeling.

The best report we've got so far is Mike Coston's comment on a new Lancet article about an earlier case in Germany.

Saudi Arabia: Thinking about Sunday's MERS report

I've been trying to absorb the latest "meda statement" from the Saudi Ministry of Health: "Three New Confirmed Cases of Coronavirus Recorded and Four Cases Passed Away". Earlier today I posted it without really thinking about it—it was obviously big news.

A few hours later, when it's 9:00 p.m. Sunday in Vancouver and 7:00 a.m. Monday in Riyadh, the Saudi media still have nothing to say about—neither in English nor in Arabic. Even the MOH's own Twitter feed has nothing to say about it to its 210,0093 followers (of which I am now one). Maybe the Saudis are trying to absorb the news also.

Apart from the four deaths, the three new cases offer food for thought: a 63-year-old woman in the Riyadh region, a 42-year-old (male?) in the Eastern region, and a 2-year-old (boy? girl?) in Jeddah.

The cases affect people of different ages, in different areas. This is not like the early cases, when you could imagine one unfortunate person picking it up somehow and then transmitting it to hospital workers or other patients. Now MERS seems to have spread right across Saudi Arabia, from the Persian Gulf in the east to Taif in the west and Jeddah on the Red Sea. Those two cities actually flank Mecca, which does not bode well for this year's Hajj.

I would like to think that the Saudi political and health authorities are working very hard to track down the origin and vector of this disease. But public health, like justice, must not only be done; it must be seen to be done. So far, the Saudis have missed several opportunities to show the world they're on the case.

H7N9: Current status and future prospects

H7N9 has almost entirely dropped out of the media, even in China. This is unsurprising; if you do not catch an avian influenza, one of its well-known sequelae is amnesia. But researchers are still studying it. Via Biomedical Journal, an article published on the web on June 10: The Outbreak of Avian Influenza A (H7N9) in China: Current Status and Future Prospects. After discussing the likelihood of H7N9 moving from wild ducks to domestic ducks near Shanghai, the authors conclude:

A (H5N1) and other AIVs[avian influenza viruses] have shown a seasonal pattern whereby human cases in summer months are much lesser than those in winter months. We expect that A (H7N9) will follow the same seasonal pattern. 

However, since migratory birds were first implicated in H7N9 transmission, we cannot exclude the possibility that the virus may spread into other regions or countries with colder weather, given the widespread migratory patterns, thus causing a new outbreak there. 

We now ask whether we should expect its re-emergence during the winter months and, if so, what precautionary steps should be taken. A global surveillance system should be established to monitor the spread of AIVs, particularly A (H7N9) and A (H5N1). Close collaboration between the epidemiologists responsible for monitoring AIVs in humans and those monitoring AIVs in migratory birds, poultry, and the environment is urgently needed. 

It is also important for researchers to identify the viral mutations or reassortments that may alter risks for animals or humans, in order to gain insight into critical viral characteristics, including antiviral resistance, transmissibility, and pathogenicity, followed by developing strategies to control the future spread of A (H7N9).

The question, of course, is what amnesic governments are prepared to do to deal with a threat that seems over—especially in countries that have yet to experience their first case. If generals always want to fight the last war, politicians always want to go back to the peacetime conditions that led to the damn war in the first place.

Dominican Republic: Government works to end Haitian poultry ban

Via HaitiLibre.com: Health : Haitian Ministers will meet with President Danilo Medina. Excerpt:

Saturday, Luis Ramon Rodriguez, the Dominican Minister of Agriculture and José del Castillo Saviñón, Minister of Industry and Commerce, met with President Danilo Medina, to find a solution to the export ban on poultry, eggs and live animals imposed by Haiti since Friday, June 7, 2013. 

That same day, Ramon Luis Rodriguez, reported that Thomas Jacques, the Haitian Minister of Agriculture and Dr. Florence Guillaume Duperval, Health Minister accompanied by a commission of several Haitian officials will travel to the Dominican Republic Monday for a working session on this matter with the President Medina.

It's an absurd dispute, with the Haitians claiming that the DR's H1N1 cases are "bird flu." I expect the negotiations will deal largely with finding a way for the Haitian government to retract the ban without losing face.

Over 1.4 million children administered polio drops in Haryana

In contrast to Pakistan, India's vaccination campaign seems to be going well. Via Zeenews.com: Over 14 lakh children administered polio drops in Haryana.

Chandigarh: The sub-national immunisation round of 'Pulse Polio 2013-14' was launched in 13 districts of Haryana and about 14.30 lakh [1,430,000] children below the age of five years were administered polio drops on the first day of the 3-day campaign today at special booths. 

These districts included Ambala, Faridabad, Gurgaon, Jhajjar, Karnal, Kurukshetra, Mewat, Palwal, Panchkula, Panipat, Rohtak, Sonipat and Yamunanagar, a spokesman of the state's Health Department said on Sunday. 

He said that about 55 per cent of the targeted children have been covered on the first day of the campaign. The campaign was launched by state Health Minister Rao Narender Singh at Bhora Kalan village in Gurgaon. 

The spokesman said that this campaign will continue for another two days as teams would go from house to house to administer polio drops to those children who were not uncovered today. In order to smoothly carry out this campaign, a total of 10,573 booths were setup in the state and these were manned by about 42,000 health officials, volunteers, Anganwari workers and Accredited Social Health Activists. 

About 2,100 officials supervised the activity apart from independent monitors of PGIMS, Rohtak and the WHO. Approximately 26 lakh [2,600,000] children are to be covered during this campaign in the state, he said, adding during this round, special attention has been paid to high risk areas like slums, isolated hutments, brick kilns, floating or migrating population and construction sites so that no child is left uncovered in these areas. 

About 1,000 mobile teams are also working to cover all children in underserved and poorly approachable areas, he added.

Pakistan: Two polio workers in Swabi killed in attack

Via Dawn.com: Two polio workers in Swabi killed in attack.

PESHAWAR: Two polio workers were killed in an attack on the polio team in Swabi on Sunday, June 16. 

According to sources, two polio workers were on duty in the area of Kandaro when they were attacked and killed. District police officer (DPO) Dr. Mian Muahmmad Saeed confirmed the deaths. 

Sources said that school teacher Muhammad Shiraz and health department official Aziz Muhammad were in Pabaini village when they were attacked. 

According to the DPO, both workers were on duty without any security. "Four suspects have also been arrested in connection with the attack," said the DPO.