Photo Credit NIAID
# 7191
While we remain primarily focused on the expanding H7N9 outbreak in Asia, a month ago our attentions were directed towards a different emerging epidemiological enigma; the Novel Coronavirus (NCoV).
Some NCoV blogs from last month include:
ECDC: Epidemiological Update On NCoV
WHO: Update On NCoV Fatality In Germany
Saudi Arabia: `Mild’ NCoV Case With Contact Hx With Case #15 – WHO
WHO: Revised NCoV Surveillance Recommendations
While we can find it a bit difficult to concentrate on more than one viral threat at a time, nature seems to have no trouble with multi-tasking. The emergence of a novel influenza virus does nothing to mitigate the potential risks from this emerging coronavirus.
One of the reasons, no doubt, that the World Health Organization’s Global Alert & Response division released the following update yesterday, with links to a number of recent studies in the literature.
Novel coronavirus summary and literature update – as of 24 April 2013
As of 24 April 2013, 17 cases of human infection with novel coronavirus (nCoV) have been reported to WHO: two from Jordan, two from Qatar, 10 cases from Saudi Arabia, two from the United Kingdom (UK), and one from the United Arab Emirates. Most patients are male (81.3%; 13 of 16 cases with gender reported) and range in age from 25 to 73 years old (median 45 years old). The first cases had onset of illness in late March or early April 2012, the most recent case reported had onset on 8 March 2013. Most patients presented with severe acute respiratory disease requiring hospitalization, and at least 11 have required mechanical ventilation or other advanced respiratory support. Only 2 of the 17 presented with mild disease. Twelve patients have died. One was co-infected with influenza A virus.
Four clusters of cases have been identified. The first occurred in April 2012 in a health care setting in Jordan, with 2 confirmed cases, and 11 probable cases. Both of the confirmed cases died. Ten of the 13 persons in this cluster were health care workers. Two additional clusters occurred among family contacts of cases in Saudi Arabia and one among family members of a resident of the United Kingdom who had recently visited Saudi Arabia. Human-to-human transmission can be confirmed only in the latter as none of the family members who were infected had recently been outside of the United Kingdom and their only known exposure was to the first case (see UKHPA reference below). No sustained community transmission was observed in any of the clusters.
Although some of the cases may have become infected from animal exposures and zoonotic transmission, information on animal exposures is limited. An animal reservoir has not been identified. Investigations into animal sources are on-going.
Four viruses from the United Kingdom (n=2), Saudi Arabia (n=1) and Jordan (n=1) have been cultured and complete genome sequences have been posted to GenBank, a public database. All four of the viruses have a high degree of genetic similarity. Analyses show that the viruses are similar to a bat virus. It should be noted, however, that the similarity of the human virus to the bat virus does not necessarily imply that bats are the reservoir for the human virus. Given the living environment of most of the patients, direct exposure to bats appears unlikely.
