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 Post subject: Germany MERS ex-UAE 65M
PostPosted: Sun Mar 08, 2015 10:26 am 
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Media reports cite confirmation of MERS in case, 65M, in Lower Saxony, Germany, who returned from UAE.

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PostPosted: Sun Mar 08, 2015 10:27 am 
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Osnabrück - A 65-year-old man from the region of Osnabrück (Middle East Respiratory Syndrome) diagnosed with the deadly virus Mers.
The patient had returned early February from a vacation trip from Abu Dhabi (United Arab Emirates) to Germany, said the Lower Saxony Ministry of Health in Hanover. He will now be treated in an isolation hospital in Osnabrück.
Which hospital is, would not say the ministry. It is located in an ICU. Even people from his environment stood now under medical observation.
It is the third known case of Mers-disease in Germany, in Lower Saxony, it is the first time that Mers was detected.
In Munich in March 2013, a 73-year-Mers patient had died from the United Arab Emirates. Another patient treated in Essen, survived the dangerous disease.
Until March 6, 2015, the World Health Organization reported 1,040 laboratory-confirmed cases from around the world, about 40 percent of those infected died.
The diseases occur mainly in the Arabian Peninsula. Saudi Arabia is the most affected by Mers country in the world. Travellers who controlled the pathogen in the United States and in European countries such as France, Great Britain, Italy, the Netherlands, Austria and Turkey. The world's first appeared on the pathogen in 2012.
More News from Bremen and on bremen.bild.de , Facebook and Twitter .

http://www.bild.de/regional/bremen/brem ... .bild.html

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PostPosted: Sun Mar 08, 2015 10:30 am 
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Published Date: 2015-03-08 06:12:50
Subject: PRO/AH/EDR> MERS-CoV (31): Saudi Arabia, Germany ex UAE, RFI
Archive Number: 20150308.3215456
MERS-COV (31): SAUDI ARABIA, GERMANY ex UNITED ARAB EMIRATES, REQUEST FOR INFORMATION
*************************************************************************************
A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Germany ex UAE - RKI, RFI
[2] Saudi Arabia, 1 new case - MOH 7 Mar 2015

******
[1] Germany ex UAE - RKI, RFI
Date: 7 Mar 2015
Source: RKI (Robert Koch Institute) [mach, trans., edited]
http://www.rki.de/DE/Content/InfAZ/M/ME ... S-CoV.html


Information from the RKI on MERS-Coronavirus case - 7 Mar 2015
Situation in Germany
This is the 3rd time a MERS-CoV case has been diagnosed in Germany. As with the 2 previous cases, this case was an imported case of an individual arriving from the Arabian Peninsula. The case is a 65 year old German who had traveled to the United Arab Emirates and is currently being treated in a hospital in Lower Saxony. The Ministry of Health of Lower Saxony released the information in a press release on 7 Mar 2015. People with close contact with the patient were identified and are being monitored by the relevant health authorities -- [both] at the local and state level in close contact with the Robert Koch Institute. Generally MERS-CoV is not easily transmitted (person-to-person), so that even in the event of secondary cases one does not expect longer chains of infection to occur. In Germany, therefore, there is no increased risk of disease in the general population.

In the past, one patient was treated in Germany in 2012 and one in 2013 -- one was from Qatar and the other from the United Arab Emirates. One patient recovered, the other died. Contact investigation in both previous cases revealed no evidence of secondary infections (Buchholz et al. Euro Surveillance [21 Feb 2013] http://www.eurosurveillance.org/ViewArt ... leId=20406 ;. Epidemiological Bulletin No. 31/2013, http://www.rki.de/DE/Content/Infekt/Epi ... cationFile).

The 1st outbreak of Middle East respiratory syndrome Coronavirus (MERS-CoV) associated disease occurred in April 2012. Clinically proven cases initially present with an acute onset of a flu-like illness. The incubation period is usually 1-2 weeks. In severe cases, a pneumonia may develop, which may turn into an acute respiratory distress syndrome. A common accompanying symptom is diarrhea; severe cases may develop kidney failure. Severe reactions mainly occur in people with chronic underlying medical conditions such as diabetes, cancer or immunosuppression.

Since MERS 1st appeared in 2012 over a thousand laboratory confirmed cases have been reported by WHO, mainly from the Arabian Peninsula, and about 40 per cent of the cases have died.

MERS in the Arabian Peninsula
All previous cases were associated directly or via contact with another patient who had contact with the Arabian Peninsula and neighboring countries. Primary disease cases -- that is, cases with no prior exposure to human cases occurred mainly in Saudi Arabia, but also in other countries such as the United Arab Emirates, Iran, Jordan, Qatar, Oman and Kuwait. During the period March 2012-March 2013 more than 5 cases were reported on a monthly basis, the monthly number from April 2013 about a year rose to about 10-20. In April and May 2014, several large hospital outbreaks were reported in which up to 100 new cases occurred in a week. As of June 2014, the number of new cases has returned approximately to the state before April 2014.

Many of the cases classified as sporadic (or primary case) cases had contact with dromedaries, but a significant proportion of these primary cases are currently not attributable to a zoonotic source. Important for global risk assessment -- but also for Germany -- is that there is as yet no evidence of sustained transmission in the general population. However, imported cases of the disease are possible at any time, since about 1 million people fly every year from the countries of the Arabian Peninsula to Germany. In Europe, imported cases and secondary cases related to imported cases have occurred in small numbers from Germany, France, Greece, Hungary, Italy, the Netherlands, Austria and Turkey and have been reported. Additional imported cases have also been reported in Africa (Algeria, Tunisia), North America (the United States) and Asia (Malaysia, the Philippines). As part of the world intensified surveillance due to the pilgrimages to Saudi Arabia (Hajj or Umrah) single laboratory-confirmed MERS cases were identified at best.

There is increasing scientific evidence that camels are the source for the human, zoonotic infections. This is partly due to the finding that in a large proportion of camels from Arab countries, but also African countries, antibodies against MERS-CoV were found, and the virus itself could also be isolated in dromedaries. From stored samples from 1983 and 1984 antibodies against MERS-CoV were detected in the majority of specimens from camels originating from Somalia and Sudan. In an investigation of a MERS-CoV case (and previously serologically negative) owner of a small dromedary herd a MERS-CoV was identified, with gene sequences corresponding to 100 per cent with the virus of one of his diseased camels. This was regarded as conclusive evidence that at least in this situation, a dromedary had transmitted the virus to a human. Finally, a higher risk of infection with MERS-CoV in people who worked with camels when compared with those who do not work with dromedaries.

Regarding the risk of transmission, there is conflicting evidence. Although it has been described that the morbidity and infection rate was low in household contacts of primary cases, on the other hand, there have been several, some large, nosocomial outbreaks that have occurred.

Advice for travelers
For travelers to the countries of the Arabian Peninsula and its neighboring countries, the World Health Organization (WHO) has recommended no travel restrictions. Individuals with an underlying disease such as diabetes should consult a doctor or physician before traveling. Based on the findings in dromedaries. WHO notes that travelers should avoid contact with dromedaries, should not go to dromedary farms, and should not consume raw or incompletely cooked camel products. In addition, the usual rules of everyday hygiene should be observed, in particular people should wash hands often and maintain a distance for people with acute respiratory symptoms. WHO recommends those with acute respiratory illness and fever to postpone their trips.

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[As mentioned above, this is now the 3rd case of MERS-CoV infection confirmed in Germany since 2012. The 1st case was a patient transferred to Germany from Qatar for a severe respiratory illness in late October 2012 (see Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664, Novel coronavirus - East. Med. (07): Saudi Arabia, UK, Germany 20130221.1554109, and the Eurosurveillance article referred to in the above report). The 2nd case was a patient transferred to Germany from a hospital in Abu Dhabi UAE, also for management of a severe respiratory illness in March 2013 (see Novel coronavirus - Eastern Mediterranean (14): Germany ex UAE, WHO, fatal 20130326.1604564 and Novel coronavirus - Eastern Mediterranean (13): Germany ex UAE 20130326.1603038). More information on the epidemiologic investigation of this case (location traveled within the UAE, possible high risk exposures while in the UAE would be greatly appreciated. Of note, the UAE has reported the 2nd highest number of cases of MERS-CoV infection. According to figures maintained by the ECDC, as of 6 Mar 2015 there have been a total of 74 cases of MERS-CoV infection reported by the UAE, including 10 deaths. (http://ecdc.europa.eu/en/publications/P ... r-2015.pdf).

For a map of Germany showing Lower Saxony, see http://www.map-of-germany.org/map.htm. Lower Saxony is called Niedersachsen and is located in the North West of the country.

For the HealthMap/ProMED map of the UAE, see < http://healthmap.org/promed/p/132>. - Mod.MPP]


******
[2] Saudi Arabia, 1 new case - MOH 7 Mar 2015
Date: 7 Mar 2015
Source: Saudi MOH - 7 Mar 2015
http://www.moh.gov.sa/en/CCC/PressRelea ... 7-001.aspx


As of 12 noon today 7 Mar 2015 there have been a total of:
939 laboratory confirmed cases of MERS-CoV infection, including
403 deaths,
509 recoveries and
27 currently active cases (including 3 on home isolation)

Newly confirmed case today 7 Mar 2015:
Riyadh: 59 year old Saudi male, non-healthcare worker, currently in stable condition, history of pre-existing co-morbidities, history of contact with suspected/confirmed case in the community, no history of animal exposure or contact with case(s) in the healthcare environment.

Newly reported recovery:
Riyadh: 37 year old expat male, healthcare worker, history of pre-existing co-morbidities

--
communicated by:
ProMED-mail
<promed@promedmail.org>

[The addition of this newly reported case in Saudi Arabia brings the total number of cases reported by Saudi Arabia since June 2012 to 939, including 403 deaths (case fatality rate 43 per cent). Since the beginning of March 2015, a total of 19 newly confirmed cases of MERS-CoV infection [including 8 deaths] have been reported by Saudi Arabia. 15 of the 19 reported cases since the beginning of March 2015 have been reported from Riyadh. Six of the cases gave a definite history of contact with suspected/confirmed cases in either the healthcare environment or the community and another 3 had a possible history of contact with cases that was under investigation.

The HealthMap/ProMED map of Saudi Arabia can be found at http://healthmap.org/promed/p/131. - Mod.MPP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/101.]
See Also
MERS-CoV (30): Saudi Arabia, new cases, deaths, WHO, RFI 20150306.3213079
MERS-CoV (28): Saudi Arabia, cases, deaths, WHO 20150303.3197017
MERS-CoV (27): Saudi Arabia, animal reservoir, camel 20150302.3200502
MERS-CoV (26): Saudi Arabia, new cases, deaths, WHO, RFI 20150225.3186568
MERS-CoV (25): Saudi Arabia, new cases, deaths, Philippines, RFI 20150222.3180612
MERS-CoV (24): Saudi Arabia, new cases, new deaths, RFI 20150217.3173370
MERS-CoV (23): Saudi Arabia, new cases, comment, WHO 20150216.3170662
MERS-CoV (22): Saudi Arabia, new cases, RFI 20150215.3168873
MERS-CoV (21): Saudi Arabia, new cases, new deaths, RFI 20150214.3167451
MERS-CoV (20): Saudi Arabia, Philippines, WHO, RFI 20150213.3165359
MERS-CoV (19): Saudi Arabia, Qatar, UAE, Philippines, WHO, RFI 20150212.3160052
MERS-CoV (18): animal reservoir, camel, Israel survey, bat, RFI 20150210.3156453
MERS-CoV (17): Saudi Arabia, new cases, WHO 20150207.3148681
MERS-CoV (16): Qatar, Saudi Arabia, RFI 20150203.3138313
MERS-CoV (15): Saudi Arabia, new cases 20150130.3126681
MERS-CoV (14): Saudi Arabia, Oman, WHO 20150124.3114951
MERS-CoV (13): Saudi Arabia, new cases 20150122.3111739
MERS-CoV (12): animal reservoir, camels debated, case-control study, RFI 20150122.3109335
MERS-CoV (11): Saudi Arabia, new cases, deaths, WHO 20150121.3108145
MERS-CoV (10): Saudi Arabia, new cases, new death 20150119.3103976
MERS-CoV (09): Saudi Arabia, animal reservoir, camels debated 20150117.3098294
MERS-CoV (08): Oman, Saudi Arabia, WHO 20150117.3097488
MERS-CoV (07): Saudi Arabia, new cases 20150114.3092794
MERS-CoV (06): Oman, new case, RFI 20150111.3085228
MERS-CoV (05): Saudi Arabia, new cases 20150109.3082724
MERS-CoV (04): Oman, Saudi Arabia, RFI 20150108.3079584
MERS-CoV (03): Saudi Arabia, new cases, new fatality, Jordan, WHO 20150107.3077259
MERS-CoV (02): Saudi Arabia, new case, new fatality, WHO 20150105.3072814
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
2014
---
MERS-CoV (69): Saudi Arabia, new case, RFI 20141230.3063059
MERS-CoV (68): Jordan, Saudi Arabia, RFI 20141229.3057913
MERS-CoV (67): Iran (SB) animal reservoir, camel, ex Pakistan, RFI 20141219.3039497
MERS-CoV (66): Saudi Arabia, new cases, deaths 20141216.3037408
MERS-CoV (65): Saudi Arabia, new case, new death, RFI 20141209.3020468
MERS-CoV (64): Saudi Arabia, new case, camel workers 2012 20141206.3014451
MERS-CoV (01): Bangladesh, KSA, Algeria, UAE, Iran, WHO, RFI 20140616.2541707
MERS-CoV - Eastern Mediterranean (80): S Arabia, Iran, Algeria, Tunisia 20140612.2534478
2013
---
MERS-CoV - Eastern Mediterranean: Saudi Arabia, new case, RFI 20130518.1721601
Novel coronavirus - Eastern Mediterranean (29): MERS-CoV, ICTV nomenclature 20130516.1717833
Novel coronavirus - Eastern Mediterranean (14): Germany ex UAE, WHO, fatal 20130326.1604564
Novel coronavirus - Eastern Mediterranean (13): Germany ex UAE 20130326.1603038
Novel coronavirus - East. Med. (07): Saudi Arabia, UK, Germany 20130221.1554109
2012
---
Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664
Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733
.................................................mpp/sh

http://promedmail.org/direct.php?id=20150308.3215456

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PostPosted: Mon Mar 09, 2015 11:47 am 
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Middle East respiratory syndrome coronavirus (MERS-CoV) – Germany

Disease outbreak news
9 March 2015

On 7 March 2015, the National IHR Focal Point for Germany notified WHO of 1 case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the case:

The case is a 65-year-old, male, German citizen who returned on 8 February to Germany from Abu Dhabi, United Arab Emirates. He developed symptoms on 10 February and was hospitalized in an intensive care unit one week later. The MERS-CoV infection was laboratory confirmed on two samples; the latest sample was taken on 5 March. Currently, the patient is in a severe but stable condition.

All necessary, recommended, preventive and control measures have been applied since 23 February at the hospital where the patient is being treated. Contact tracing of all possible contacts is ongoing for this case. So far, no additional cases have been identified.

Globally, WHO has been notified of 1041 laboratory-confirmed cases of infection with MERS-CoV, including at least 383 related deaths.

WHO advice

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health-care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

http://www.who.int/csr/don/9-march-2015 ... ermany/en/

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