Credit Wikipedia
# 7364
Although the dust has settled in the Italian press in the 24 hours since the ISS announced that a second round of testing had found `8 contacts’ of their MERS case negative – there remain a great many questions about how these patients initially tested positive, and their actual status.
Italy’s Ministry of Health website has remained silent on MERS since their June 3rd statement on the first three cases. The `big’ health news on the site today apparently involves an MOH report on e-cigarettes.
A visit to Italy’s National Institute for Health (ISS) – which reportedly conducted the second round of testing – fails to turn up anything as well.
Which leaves us with the mystery of how the first round of tests came out positive.
Dr. Ian MacKay - associate professor of clinical virology at the University of Queensland – who runs the terrific Virology Down Under website, has some thoughts on how this testing might have gone astray.
I’ve only included an excerpt. Follow the link to read all of Ian’s comments over the past few days.
MERS asymptomatic cases: NOT CONFIRMED
In other words, the reference lab could not confirm the testing described by Professor Alessandro Bartoloni of the Azienda Ospedaliera Universitaria Careggi yesterday.
This from Drs Giovanni Rezza and Isabella Donatelli of the Department of Infectious Diseases, Istituto Superiore di Sanita (ISS; National Institute of Health), Rome via ProMED.
Not a very inspiring performance.
We now await some information on what actually happened.
- Was the wrong test used (see comment yesterday about panCoV primers-picking up a known, endemic CoV like OC43, 229E, NL63 or HKU1) Did/does this lab have a contamination problem (false positives due to positive control contamination, carry-over contamination from previous PCR product or cross-reaction with something else)
- A long shot - is there another related but different virus or MERS-CoV genetic variant, that cross-reacted with Prof Batoloni's(?) MERS-specific PCR but not the ISS MERS-CoV assay.
Given the difficulties in testing earlier MERS-CoV cases – particularly when dealing with throat swabs, and the extended incubation period (said to be 10 to 14 days) – it may be another week or so before anyone can say with absolute certainty that all of these contacts are out of the woods.
For now, the news looks promising, as the latest reports still have these (and roughly 50 other) contacts under surveillance, at home, and all asymptomatic.
The latest press report I can find this morning is dated June 5th from il Firenze.
New Sars: No new cases. There remain 3 affected
Wed, 05/06/2013 - 01:02 - The Editors
No new case of SARS so far. Samples of eight people, which in Florence in a first screening were tested positive, according to tests carried out by the Istituto Superiore di Sanita 'are negative and therefore have contracted the virus. Remain thus three people with coronavirus - the first case, the forty-five Jordanian, her granddaughter and her co-worker - are all well and will be discharged as soon as their exams will fail.
The surveillance but 'remains and will continue' until the people - sixty - come into contact with them will not have exceeded 10 days of incubation, ie from the moment of their first 'close encounter' with the carriers of the virus.
