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PostPosted: Mon Jun 16, 2014 5:51 pm 
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WHO is planning on releasing its 6th PHEIC (Public Health Emergency of Internal Concern). This is going to be yet another fake report, which will not address the sequences from the 2014 cases in KSA.

Failure to discuss the emergence of two novel sub-clades linked to record MERS cases in Jeddah/Mecca and Median/Riyadh will render the report as fake, at best.

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PostPosted: Mon Jun 16, 2014 5:51 pm 
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Gregory Härtl @HaertlG · 11h
.@WHO Emergency Cttee on #MERS meeting now. Results to be announced tomorrow.

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PostPosted: Mon Jun 16, 2014 6:06 pm 
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11 full or partial sequences from MERS cases with collections since April, 2014 have been released. Moreover 25 partial S sequences have been cited as matching the full or nearly full Jeddah/Mecca sequences. Thus, there are 30 sequences from Jeddah and 1 from Mecca and all are the same sub-clade, which has not been reported in any camel sequence. In addition Jeddah exports to Athens, Greece and Orlando, Florida also match the Jeddah/Mecca sub-clade.

In addition to the 33 sequences from the Jeddah/Mecca sub-clade, there have been sequence from 3 exported cases. The full sequence from the Riyadh export to Munster, Indiana is novel and distinct from prior human and camel MERS sequences. Two sequences from Medina exports to the Netherlands match each other and the Munster sequences.

Thus, the 3 sequences from Riyadh/Medina form another sub-clade with no camel sequences. In spite of record numbers of MERS cases from Riyadh and Medina and the start of Ramadan days away, all MERS KSA sequences from these two cities have been withheld.

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PostPosted: Mon Jun 16, 2014 6:13 pm 
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Details of the cases reported by Saudi Arabia are as follows:

Between 11 April and 9 June 2014, 515 cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported from Saudi Arabia to WHO. This includes 402 laboratory-confirmed cases reported on various dates, and 113 cases that have been identified through retrospective review of hospital records, and which was reported by Saudi Arabia on 3 June. Further information on these cases will be provided as information becomes available as part of the collaboration between the Saudi authorities and WHO on the MERS-CoV response.

This update covers 402 laboratory-confirmed cases, including 114 deaths.

Thirty-five cases were reported from Madina, 132 from Riyadh, 208 from Mecca Province (including 154 from Jeddah, 39 from Mecca, 8 from Qunfudhah and 7 from Al Taif), 10 from Tabuk, 6 from Al Jawf, 3 from Najran, and 3 from Ash Sharqiyah. The location from where 5 cases were reported was not specified.

The median age of the 402 cases is 46 years old (ranging from 9 months to 94 years old) and 58.3% of those with information on sex (n=388) are men. Almost half (44.5%) of the cases with reported information (n=398) experienced severe disease including 114 cases who died; and 114 cases (28.6%) were reported to be asymptomatic or have mild disease. Underlying medical conditions were only reported for 149 of the 402 cases, of which 140 cases were reported to have at least one underlying medical condition.

More than 25% (109)of the 402 reported cases are health care workers. Among the 109 health care workers, 63 were reported as asymptomatic or developing mild symptoms, 35 were reported with moderate symptoms (requiring hospitalization but not admission to an intensive care unit), 7 were reported as having severe disease and 4 died.

http://www.who.int/csr/don/2014_06_13_mers/en/

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PostPosted: Mon Jun 16, 2014 6:16 pm 
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niman wrote:
Details of the cases reported by Saudi Arabia are as follows:

Between 11 April and 9 June 2014, 515 cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported from Saudi Arabia to WHO. This includes 402 laboratory-confirmed cases reported on various dates, and 113 cases that have been identified through retrospective review of hospital records, and which was reported by Saudi Arabia on 3 June. Further information on these cases will be provided as information becomes available as part of the collaboration between the Saudi authorities and WHO on the MERS-CoV response.

This update covers 402 laboratory-confirmed cases, including 114 deaths.

Thirty-five cases were reported from Madina, 132 from Riyadh, 208 from Mecca Province (including 154 from Jeddah, 39 from Mecca, 8 from Qunfudhah and 7 from Al Taif), 10 from Tabuk, 6 from Al Jawf, 3 from Najran, and 3 from Ash Sharqiyah. The location from where 5 cases were reported was not specified.

The median age of the 402 cases is 46 years old (ranging from 9 months to 94 years old) and 58.3% of those with information on sex (n=388) are men. Almost half (44.5%) of the cases with reported information (n=398) experienced severe disease including 114 cases who died; and 114 cases (28.6%) were reported to be asymptomatic or have mild disease. Underlying medical conditions were only reported for 149 of the 402 cases, of which 140 cases were reported to have at least one underlying medical condition.

More than 25% (109)of the 402 reported cases are health care workers. Among the 109 health care workers, 63 were reported as asymptomatic or developing mild symptoms, 35 were reported with moderate symptoms (requiring hospitalization but not admission to an intensive care unit), 7 were reported as having severe disease and 4 died.

http://www.who.int/csr/don/2014_06_13_mers/en/

WHO's first KSA MERS update since April is WELL beyond ABSURD and requires no further comment.

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PostPosted: Tue Jun 17, 2014 7:19 am 
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WHO statement
17 June 2014

The sixth meeting of the Emergency Committee convened by the Director-General under the International Health Regulations (2005) concerning Middle East respiratory syndrome coronavirus (MERS-CoV) was held by teleconference on Monday, 16 June 2014, from 12:15 to 16:19 Geneva time (CEST).
List of members and advisers of the Committee

In addition to Members of the Emergency Committee, three expert advisors participated in the informational session only. These advisors did not participate in the formulation of advice to the Director-General.

Seven affected States Parties reporting cases of MERS-CoV or evidence of infection since the fifth meeting of the Committee were also on the first part of the teleconference: Algeria, Iran, Jordan, Netherlands, Saudi Arabia, United Arab Emirates (UAE), and United States of America.

The WHO Secretariat provided an update on and assessment of epidemiological and scientific developments, including a description of recently reported cases, transmission patterns, and the main observations of a recent WHO mission to UAE.

Affected countries gave information about recent events in their countries, including description of cases, measures taken and their concerns about the current situation.

The Committee discussed the information provided. Based on current information, the Committee indicated that the situation remains serious in terms of public health impact. However, the upsurge in cases that began in April has now decreased and there is no evidence of sustained human-to-human transmission in communities. There have been significant efforts made to strengthen infection prevention and control measures. As a result, the Committee unanimously concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met.

However, the Committee emphasized that the situation continues to be of concern, especially given the anticipated increase in travel to Saudi Arabia related to Umra, Ramadan and the Hajj. The Committee focused attention on the need to further analyse the hospital outbreaks to better understand where breaches in infection prevention and control are taking place, including where patients who have not yet received a diagnosis gather and wait, often under crowded conditions, such as in emergency departments and clinics. The Committee also noted that recent investigative findings increasingly support the hypothesis that camels are an important source of exposure to MERS-CoV in the community.

The Committee reiterated that its previous advice remains relevant, and that all countries should:
strengthen efforts to implement basic infection prevention and control measures, and increase education on these measures, especially among health care workers;
continue efforts to complete critical investigations as soon as possible, including case-control, serological, environmental, and animal studies, to better understand the epidemiology, especially risk factors; and to assess where breakdowns in infection prevention and control measures are occurring , and to share preliminary findings;
support strengthening capacities in vulnerable countries, especially those in Africa, and that these countries, and particularly those in Africa, should take concrete action in anticipation of Umra, Ramadan and Hajj with respect to basic public health actions such as conducting surveillance for MER CoV, raising awareness about and implementing basic infection prevention and control measures;
improve awareness about MERS CoV among the pilgrims who are planning to go for Umra and Hajj, especially for those with chronic illness, and for accompanying medical delegations to be made aware of how to detect MERS, and personal hygiene and basic infection control precautions;
continue to enhance awareness through effective risk communication concerning MERS-CoV to the general public, health professionals, and policy makers;
strengthen intersectoral collaboration and joint activities between animal and human health sectors;
share with WHO all relevant information needed to assess and manage MERS, in a timely manner, as required by the International Health Regulations (2005); and
use WHO recommendations, including for groups at higher risk of infection with MERS-CoV:
WHO travel advice on MERS-CoV for pilgrimages
Update on MERS-CoV transmission from animals to humans, and interim recommendations for at-risk group
pdf, 226kb
Assessment of potential risk factors of infection of Middle East respiratory syndrome coronavirus (MERS-CoV) among health care personnel in a health care setting
pdf, 521kb
Interim surveillance recommendations for human infection with Middle East respiratory syndrome coronavirus
pdf, 135kb

Finally, the Committee indicated that there was no solid information to support the use of thermal screening as a means to stop or slow the entry of MERS-CoV infections, and that resources for supporting such screening could be better used to strengthen surveillance, infection control and prevention or other effective public health measures.

Based on the Committee’s advice, and information currently available, the Director-General accepted the Committee’s assessment. She thanked the Committee for its work.

The WHO Secretariat will continue to provide regular updates to the Committee Members and Advisors. In view of the Committee’s ongoing concerns, the Emergency Committee will be reconvened in September 2014, or earlier if circumstances require.

For further information, please contact:

Christy Feig
Director of Communications
Telephone: +41 79 251 7055
Email: feigc@who.int

http://www.who.int/mediacentre/news/sta ... erscov/en/

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PostPosted: Tue Jun 17, 2014 7:47 am 
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niman wrote:
WHO statement
17 June 2014

and there is no evidence of sustained human-to-human transmission in communities.
http://www.who.int/mediacentre/news/sta ... erscov/en/

From last update:

the Committee indicated that the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission.

http://www.who.int/mediacentre/news/sta ... 140514/en/

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PostPosted: Tue Jun 17, 2014 7:52 am 
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niman wrote:
niman wrote:
WHO statement
17 June 2014

and there is no evidence of sustained human-to-human transmission in communities.
http://www.who.int/mediacentre/news/sta ... erscov/en/

From last update:

the Committee indicated that the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission.

http://www.who.int/mediacentre/news/sta ... 140514/en/

The new qualifier on H2H, which now says no sustained transmission in community, indirectly admits that the same sequences are found in humans over an extended period of time, especially in hospital settings, which was clearly the case for the Jeddah export to Jordan, where the index case developed symptoms in April, but the transmission chain is still ongoing.

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PostPosted: Tue Jun 17, 2014 7:56 am 
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niman wrote:
niman wrote:
niman wrote:
WHO statement
17 June 2014

and there is no evidence of sustained human-to-human transmission in communities.
http://www.who.int/mediacentre/news/sta ... erscov/en/

From last update:

the Committee indicated that the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission.

http://www.who.int/mediacentre/news/sta ... 140514/en/

The new qualifier on H2H, which now says no sustained transmission in community, indirectly admits that the same sequences are found in humans over an extended period of time, especially in hospital settings, which was clearly the case for the Jeddah export to Jordan, where the index case developed symptoms in April, but the transmission chain is still ongoing.

Sustained MERS Transmission From Saudi Arabia To Jordan
Recombinomics Commentary 18:00
June 04, 2014
The case is 26-year-old male health-care worker. He presented with fever on 23 May 2014. His condition deteriorated as he developed pneumonia and gastrointestinal symptoms and he was admitted to the hospital on 30 May 2014. A specimen was collected and tested positive for MERS-CoV on 31 May 2014. He is currently in a stable condition. He has no known comorbidities, but does have a history of contact with a laboratory confirmed MERS-CoV health-care worker case reported to WHO on 11 May 2014.

The above comments from today’s WHO MERS update describe the PCR confirmed quaternary transmission of MERS with disease onset dates extending from April 9 to May 23, raising serious sustained transmission from Jeddah, Kingdom of Saudi Arabia (KSA) to Amman, Jordan. The index case (25M) developed symptoms in Al Grayat (Al Quarayyat in Al Jawf province) on April 9, shortly after travel through Jeddah and Mecca. He was locally hospitalized between April 10-14, where he was diagnosed with pneumonia. He then traveled to Amman, Jordan where he was MERS PCR confirmed. His asymptomatic brother (28M) and a paramedic contact (28M) were then PCR confirmed on a sample collected on May 22 from the brother, and a sample collected after the paramedic developed symptoms on May 22. A tertiary case (50M HCW) who was a contact of both secondary cases, developed symptoms on May 7 and was also PCR confirmed. The quaternary case, 26M HCW, developed symptoms on May 23 and was also PCR confirmed, raising sustained transmission concerns.

Since all symptomatic cases in the transmission chain were HCWs......

http://www.recombinomics.com/News/06041 ... ained.html

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PostPosted: Tue Jun 17, 2014 9:03 am 
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The Post's View
Killer virus demands open accounting
18 More

BY EDITORIAL BOARD June 15
FOR MANY months in 2012 and 2013, Saudi Arabia reassured the world that it was paying close attention to the outbreak of a novel coronavirus in the kingdom, known as Middle East respiratory syndrome, or MERS. But events this year have begun to pull back the curtain on a disease outbreak that was — and remains — dangerous and not fully explained or explored. This is more than just an accident, and the Saudi authorities are finally waking up to the full extent of the lapses, just in time for the pilgrimages that are expected to bring millions to Mecca and Medina in the months ahead.

There is no known antiviral or vaccine for the MERS virus. So far it does not appear to transmit rapidly among humans in a way that could create a pandemic, although some transmission has occurred among those in close contact. It has infected 701 people and killed 287 in Saudi Arabia, with additional cases elsewhere. Public health experts have been puzzled and frustrated for most of the past two years about why so little information about the virus and the outbreak was coming out of Saudi Arabia, governed as a closed society by rulers who do not permit — and often punish — dissent.

Now the Ministry of Health has made a startling admission: The number of cases in Saudi Arabia was undercounted by 113, or about 20 percent, according to Reuters. The new cases were found in a review of records and included 92 deaths. The Center for Infectious Disease Research and Policy at the University of Minnesota quotes Tariq Madani, head of the scientific advisory board at the Saudi Ministry of Health, as saying that many of the cases were confirmed by government hospitals and labs that didn’t notify the ministry of the results.

This is an alarming systemic failure and speaks volumes about such a closed society: People and institutions react out of fear and keep painful information secret from each other. The consequences of coverup can be grave. Clearly there were many more people infected with MERS in Saudi Arabia’s health-care system last year than the world knew. Some labs and hospitals had the facts but kept quiet. Without a free and open media or other channels to reveal the truth, the secret lay undisclosed. Only when a major outbreak appeared this spring in a hospital in Jiddah did the government begin to react by firing the health minister and pledging more openness. Since then, more data have been forthcoming, but gaps remain. Much more needs to be learned about the origin and behavior of the virus, which appears to stem from camels.


There is a lesson for the whole world here: Secrecy greatly multiplied the danger of the disease. The first line of defense in the months ahead must be absolute transparency.

http://www.washingtonpost.com/opinions/ ... story.html

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