As of 8 May 2013, 30 laboratory-confirmed cases of human infec­tion with novel coro­n­avirus (nCoV) have been reported to WHO: two from Jor­dan, two from Qatar, 23 cases from Saudi Ara­bia, two from the United King­dom (UK), and one from the United Arab Emi­rates. Most patients are male (79.3%; 23 of 29 cases with sex reported) and range in age from 24 to 94 years (median 56 years). The first cases had onset of ill­ness in late March or early April 2012; the most recent cases reported had onset on 1 May 2013 (13 cases with onset 14 April — 1 May 2013). Most patients pre­sented with severe acute res­pi­ra­tory dis­ease requir­ing hos­pi­tal­iza­tion and even­tu­ally required mechan­i­cal ven­ti­la­tion or other advanced res­pi­ra­tory sup­port. Eigh­teen patients have died.

Sev­eral cases have occurred in clus­ters, includ­ing in a health care set­ting in Jor­dan in April 2012 (of two con­firmed and 11 prob­a­ble cases, 10 were health care work­ers) and in the UK among fam­ily mem­bers of an infected patient who had recently arrived from Saudi Ara­bia. The Jor­dan­ian out­break illus­trated the poten­tial of this virus to spread through health care facil­i­ties and the UK out­break con­firmed the poten­tial of the virus to trans­mit between humans with close con­tact. In nei­ther instance did trans­mis­sion appear to go beyond the imme­di­ate out­break into the community.

Since 14 April 2013, 13 new cases of infec­tion have been con­firmed and reported in Saudi Ara­bia (ten males and three females, median age 58 years). Seven of these have died, four remain crit­i­cally ill in inten­sive care and two are hos­pi­tal­ized but clin­i­cally improved. All patients were reported to have at least one comor­bid med­ical con­di­tion and most had more than one. Most of the cases were patients at a sin­gle health care facil­ity. Two were fam­ily mem­bers of two patients from that facil­ity; no health care work­ers have been affected. Although inves­ti­ga­tions are still ongo­ing into the source of this out­break, early infor­ma­tion indi­cated that only a small minor­ity of these cases had con­tact with ani­mals in the time lead­ing up to their illness.

Five viruses from the United King­dom (n=2), Saudi Ara­bia (n=1), Jor­dan (n=1), and Ger­many (n=1) have been cul­tured and genome sequences have been made pub­licly avail­able. No sequence data are yet avail­able from the lat­est clus­ter. All five of the sequenced viruses have a high degree of genetic sim­i­lar­ity. Pre­lim­i­nary analy­ses show that the viruses are genet­i­cally some­what sim­i­lar to bat viruses. It should be noted, how­ever, that the sim­i­lar­ity does not nec­es­sar­ily imply that bats are the reser­voir for the human virus or that direct expo­sure to bats or bat exc­reta were respon­si­ble for infec­tion. The nCoV itself has not yet been found in an animal.

The full arti­cle may be accessed at http://www.who.int/csr/disease/coronavirus_infections/update_20130508/en/index.html

(WHO 5/8/2013)