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
The World Health Organization (WHO) is to launch a vigorous response to the worrying emergence of resistance to the antimalarial drug artemisinin in the Greater Mekong Subregion of South-East Asia.
Artemisinin is the frontline drug in the fight against malaria, and WHO says the emergence of resistance in Cambodia, Myanmar, Thailand and Viet Nam poses a serious global health threat. “We are taking the situation very seriously,” says Dr Shin Young-soo, WHO Regional Director for the Western Pacific. “If resistance to artemisinin emerges elsewhere—particularly in Africa, which has the world’s greatest number of malaria cases—the consequences for global health could be incalculable.”
Artemisinin-based combination therapies (ACTs) are the most effective antimalarial treatments available today. They have been central to recent successes in global malaria control. Artemisinin-based combination therapies combine artemisinin—a traditional Chinese herbal drug—with another antimalarial drug. The artemisinin component kills the majority of parasites at the start of the treatment, while the partner drug clears the remaining parasites.
In response to the threat to resistance, WHO is to launch its “Emergency Response to Artemisinin Resistance in the Greater Mekong Subregion” (ERAR) —a strategic framework of support for the six countries of the Greater Mekong Subregion. Apart from the four affected countries, the region also includes China’s Guangxi Zhuang Autonomous Region and Yunnan province and the Lao People’s Democratic Republic—both of them seen as potentially at risk of resistance to artemisinin in a region that is highly inter-connected. The response will involve many partners working together across the region to scale up efforts to contain resistance.
The full article may be accessed at http://www.wpro.who.int/mediacentre/releases/2013/20130423/en/index.html
(WHO WPRO 4/23/2013)
Coming about a year since the first known novel coronavirus (nCoV) patient got sick with the disease, the World Health Organization (WHO) on 24 April 2013 posted an update on what is known about the new virus, which has resulted in 17 infections, 11 of them fatal. No new cases have been reported since a man from the United Arab Emirates was treated for the disease in Germany, where he died in March 2013. Though four clusters have been identified, person-to-person transmission has been confirmed in only three UK cases, suggesting no sustained transmission. Four viruses have been posted to GenBank, and all are highly similar. The WHO said serologic tests and a new sensitive polymerase chain reaction test may help reveal how common the virus is in the community. Other unanswered questions include how humans are exposed to the virus, the pathogen’s geographic extent, and optimal clinical management. So far, evidence points to a zoonotic source, though experts are exploring the role of human-to-human spread and the possibility of an intermediary host. Protocols are clinical management trials should be developed to help treat future cases, the group said. The emergence of nCoV shows the importance of global vigilance and surveillance for unusual respiratory disease clusters, according to the WHO.
The full WHO update may be accessed at http://www.who.int/csr/disease/coronavirus_infections/update_20130424/en/index.html