WHO Africa EPR Update On Algeria MERS Cases

Location of Algeria

 

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Although we’ll probably see a World Health Organization GAR update later in the week, WHO’s  Regional Office for Africa has posted the following update on their Epidemic & Pandemic alert and Response (EPR) page on Algeria’s first two confirmed imported MERS cases.

We learn that both cases fell ill on May 23rd while still in Saudi Arabia, and each was hospitalized upon their return to Algeria.  Positive test results were provided by the National Reference Laboratory of the Pasteur Institute of Algeria on May 30th.

 

A hat tip to Ronan Kelly on FluTrackers for posting this link.

 

 

Middle East respiratory syndrome coronavirus (MERS-CoV) disease in Algeria

 

31 May 2014 -  The Ministry of Health, Population and Hospital Reform of Algeria notified the World Health Organization of two cases of Middle East respiratory syndrome coronavirus (MERS-CoV) on May 31, 2014.

The two patients stayed in Saudi Arabia for the performance of Umrah. The date of onset of illness for both patients is 23 May 2013. The diagnosis and confirmation of the new coronavirus infection was established for both cases on May 30, 2014 by the National Reference Laboratory of the Pasteur Institute of Algeria. The first case, a 66 year old man presented with fever and dyspnoea on 23 May 2014 upon arrival from Mecca the same day. He was admitted to the Kolea Hospital EPH. The second case, a 59 year old man, also presented with Influenza like illness (ILI) and diarrhoea on May 23, 2014 in Saudi Arabia. He was hospitalized on May 29, 2014 and is being treated at the University Hospital (CHU) of Tlemcen hospital of Algeria.

This is the first laboratory confirmed human case of MERS-CoV in the WHO African region. The early detection and confirmation of these two cases is a result of intense preparedness activities implemented over the past months by the Ministry of Health, Population and Hospital Reform of Algeria in close collaboration with WHO and partners.

The following measures are being taken by national authorities: enhancement of surveillance particularly at points of entry; strengthening of infection prevention and control; case management; and sensitization of the population and health care workers on preventive and control measures that should be taken to prevent the spread of coronavirus infection. A meeting of the national epidemic management committee is planned for early next week to review the situation, carry-out a detailed risk assessment and provide additional recommendations on preventive and control measures that should be taken at all levels.

Based on the current information available for this event, WHO does not recommend that any travel or trade restrictions be applied to the Republic of Algeria

Media Reports: Two MERS Cases In Algeria

Location of Algeria

 

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Although I find no sign of an announcement on the Algerian MOH website, Arabic and French language media are reporting on a pair of MERS cases - apparently involving two men recently returned from performing Umrah – in Algeria.

 

Details at this time are scant. This first report comes from Al-Arabiya.

 

Corona virus, two of the injuries in Algeria for the first time

Saturday, 2 August 1435 e - May 31, 2014 AD

A statement of the Ministry of Health, Population and Hospital Reform, Friday, to confirm two cases infected with the deadly virus Coruna in Algeria. The source explained that it concerns two men Algerians (66 and 69 years old) were in the Kingdom of Saudi Arabia under perform Umrah.

It was declared scored the health interests of the party to Olaty Tipaza and Tlemcen.

(Continue . . .)

 

 

A second report, from Hespress.com:

 

Algeria recorded the first two cases of HIV "Corona"

Hespress - Anatolia

Saturday 31 May 2014 - 16:10

The Ministry of Health of Algeria, on Saturday, for the first two cases of Corona virus for two people returned from Saudi Arabia after performing Umrah.

The ministry said in a statement published by the official news agency: "Today has been confirmed two cases infected with the deadly virus Coruna in Algeria," adding that "It's about two men Algerians (66 and 69 years old) were in the Kingdom of Saudi Arabia under perform Umrah," and that in the states "Tipaza and Tlemcen."

The virus "Corona", or so-called Severe Acute Respiratory Syndrome, is one of the viruses that infect the respiratory tract, and do not yet exist in the world accurate information about the origin of this virus nor its modes of transmission, as there is no vaccine or preventive antibiotic to treat it.

This third report (translated from the French), has the most detail, and comes from the Algerian news agency Maghreb Emergent.

 

Algeria: two cases of infection confirmed Coronavirus

•   APS
• Saturday 31 May 2014 16:32

Two coronavirus infections were confirmed in Algeria, said Saturday a statement from the Ministry of Health, Population and Hospital Reform.

These two Algerian men, aged 66 and 59 years, with stayed in Saudi Arabia for performing Umrah, the source added.

The two patients concerned were reported respectively by health services wilaya of Tlemcen and Tipasa.

The first topic was presented the first signs of fever and difficulty breathing, as well as the second, which presented the first respiratory and digestive signs during their stay in Mecca, the ministry statement said, adding that they were taken care of after their admission to health facilities in their respective wilaya.

Ministry of Health has strengthened since April 27 the monitoring and be alert in place June 12, 2013 due to the evolution of the epidemiological situation of the infection with this new virus in the Middle East, according to the same source.

It is within this "heightened alert and sustained "that these two infections were reported and confirmed by the national reference laboratory for the coronavirus Pasteur Institute of Algeria, the statement added.

Department continues to monitor the developments epidemiological and take, if necessary, all the necessary measures that will be brought to the attention of the public, the source added.

The statement said further that at present factual epidemiological data, the World Health Organization (WHO) reports that "human transmission remains low."

However, the organization recommends that travelers to the Middle East, including Saudi Arabia, to comply with hygiene rules the "frequent and thorough" washing hands with liquid soap or rubbing with an alcohol-based solution.

Algeria: Masking Their Hajj Concerns

 

Credit CDC Yellow Book.

 

 

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Despite reassuring statements from the Saudi government (see Middle East Online Hajj pilgrimage without MERS outbreaks: Saudi Arabia remains optimistic), mass gatherings like the Hajj have the potential to spark disease outbreaks, and the emergence of the MERS coronavirus on the Arabian peninsula this year only serves to accent those concerns.

 

Earlier this summer, during Ramadan, the KSA MOH Updated Health Protection Advice For Umrah & Hajj, where they urged thee elderly, those with chronic illnesses, immune dysfunctions, as well as pregnant women and children not to make a pilgrimage this year. This, however, was only a suggestion – not a mandate.

 

The  KSA’s document Hajj and Umrah requirements for the year 1434 AH, issued September 04, 1434  (July 12th, 2013), also contains this advice:

 

It also included requirements set of tips and guidance health awareness for citizens, residents and pilgrims of them; pollutants to wash your hands thoroughly with soap and water or disinfectant other allocated to it, especially after coughing and sneezing, as well as the use of tissue when coughing or sneezing and dispose of the waste basket, in addition to not touch eyes, nose and mouth by hand, and the reduction of direct contact with the injured and non-participation tools personal, as well as the wearing of masks in crowded locations, and maintaining personal hygiene as a whole.

 

 

The advice to wear a facemask is not exactly new, as ARIs (Acute Respiratory Infections) have been common health complaints during the Hajj and Umrah, and calls for wearing masks have been made often over the years.

 

Last year, in The Hajj: communicable and non-communicable health hazards and current guidance for pilgrims masks were recommended to reduce the spread of TB and other respiratory illnesses, and similar calls have been made in the past, including in 2009 during the H1N1 pandemic.

 

The wearing masks is mentioned repeatedly on the KSA MOH web page on Health Tips to Be Followed During Hajj. 

 

Which brings us to a (machine translated) report today from El Watan, in Algeria (h/t Pathfinder on FluTrackers) indicating that the Algerian government is providing 50 facemasks for each pilgrim as they depart for the Hajj.

 

Protective masks for Algerian Hajjis

the 09.22.13 | 10:00

Each of the 28,800 Algerian pilgrims received 50 masks in anticipation of risks related to the development, Saudi Arabia, severe respiratory syndrome in the Middle East (coronavirus), said the Ministry of Health, Population and Hospital Reform in a statement.

 

"Before their departure, pilgrims each received 50 masks in anticipation of risks related to the development, Saudi Arabia, severe respiratory syndrome in the Middle East by the novel coronavirus," says do we. A first group of 200 Hajis left Wednesday afternoon at Houari Boumediene International Airport (Algiers) to the two holy places of Islam, while the deadline for the submission of the visa for pilgrimage set by the Ministry of the Interior and Local Government in September 23. "A pilgrim's guide with important guidelines and health recommendations was presented to each of them," Does it said.

(Continue . . .)

 

While the distribution of nearly 1.5 million masks would be cheap insurance if they prevented the spread of the MERS virus back to Algeria, compliance may be spotty, as Islam teaches that women may not `cover their face’ while in Ihram (a sacred state which a Muslim must enter in order to perform the Hajj or Umrah).

 

During the 2009 Pandemic the Grand Mufti of Saudi Arabia permitted the use of masks while performing the Umrah, stating that it was not the same as `covering the face’, but stated `that it should not be used unless needed.’

 

In the November 2009 edition of the EID Journal, a report entitled Hajj Pilgrims’ Knowledge about Acute Respiratory Infections, noted that:

 

National Health Service for England does not advise the use of masks, considering compliance with this advice unlikely because many Muslims believe that covering the face during the Hajj is prohibited and because masks need to be of high quality and changed at least every 6 hours to remain effective (7).

 

There are also concerns that masks could give the wearer a false sense of security, and that might lead to more risky behavior, or a failure to maintain hand hygiene.

 

The best use of surgical or procedure masks is undoubtedly having the person who is sick and symptomatic wear one.

 

Those contemplating using masks for personal protection should be aware that there’s considerable debate over how effective surgical or procedure masks are at preventing respiratory virus transmission.  Topics we’ve explored before, including:

 

Survival Of The Fit Tested

Why Size Matters

Study: Aerosolized Transmission Of Influenza

NPI’s and Influenza

NEJM Perspective: Respiratory Protection For HCWs