Iran Notifies WHO Of 1 MERS Case

 

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Last summer the Iranian government notified the World Health Organization of a cluster of MERS cases that appears to have started  with an unidentified `woman who had an Influenza Like Illness (ILI) and had travelled to Saudi Arabia to perform Umra’ , who likely infected an Iranian woman (with no history of travel or camel contact) sometime in early May, who in turn, is suspected of infecting her younger sister (who also had no travel history or camel contact).

 

The WHO risk assessment published in February of 2015, stated:

 

The WHO team concluded that the cluster of MERS-CoV cases in Kerman, Iran, in May and June 2014, showing epidemiological evidence of healthcare-associated transmission, could possibly have been caused by a combination of factors. These included inconsistent application of infection prevention and control measures in a healthcare setting at the beginning of the outbreak, as well as weakness in the surveillance system to actively follow and identify cases.

 

Today, in the first report out of Iran in nearly a year, we learn that Iran has recently notified the World Health Organization of a new MERS case.   Like last summer’s case, this patient appears to have had contact with recently returned Umrah travelers to Saudi Arabia.

 

 

Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Iran

Disease outbreak news
8 May 2015

On 1 May 2015, the National IHR Focal Point for the Islamic Republic of Iran notified WHO of 1 additional case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the case are as follows:

A 61-year- old male from Kahnooj city developed symptoms on 18 March and was admitted to hospital in Kahnooj city on 26 March. The patient was transferred to another hospital in Kerman city on 28 March. He has no comorbidities. On 13 March, the patient had contact with two individuals with influenza-like illness (ILI) who returned from Umrah on 10 March. He has no history of contact with other known risk factors in the 14 days prior to onset of symptoms. The patient was discharged from hospital on 27 April.

Contact tracing of household and healthcare contacts is ongoing for this case. Also, investigation of the two ILI cases is ongoing. The two ILI cases have no history of exposure to any of the known risk factors while performing Umrah.

Globally, WHO has been notified of 1112 laboratory-confirmed cases of infection with MERS-CoV, including at least 422 related deaths.

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Iranian MOH Statement On Testing Of `Suspected’ MERS Cases

Screen shot from Iranian MOH Site.

 

 

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The story has been filtering out via the media for a couple of hours (see Crofsblog Iran: Six other suspected MERS cases), but exactly what the status of these additional cases really is, isn’t exactly clear. Previously we’d been told that two cases had tested positive, and four others were suspected and undergoing testing. 

 

This evening the Iranian MOH has issued a statement in Farsi- which doesn’t translate particularly well – that seems to indicate as many as 9 more cases are being tested. 

 

The headline denies these 9 cases are MERS-CoV positive, but the body of this syntax challenged machine translation suggests test results are still pending.  

 

Hopefully we’ll get a better read on the situation over the next day or so.

 

Announced the death of a patient with corona virus in Kerman / denies HIV infection 9 others

Director of Communicable Disease Control, Ministry of Health said in Kerman, who was the first person to corona virus this

Director of the Center for management of contagious diseases in the Ministry of Health said: the first person who had been infected with the virus کرونا in Kerman, this morning (Thursday) died.

Dr Mohammad Mehdi Goya in a dedicated dialogue with reporter news site and inform the Ministry of health and medical education (Web master) added nine more to determine the accuracy of کرونا virus and suspected of being definitive because of the virus on the NIT this is not definitive as soon as the diagnosis of disease and the positive results observed in patients will be notified.

Rational doctor said: as was anticipated in spite of all the efforts of the medical staff come to take patients with infections of the virus کرونا was his patient died, unfortunately, more patient. the second General had said well and was discharged from the hospital.

Doctor patient, noting that there have been very bad with the general condition of the feet to see the hospital, added: "this patient Ms 53 with high blood pressure when you visit extreme respiratory problems, Medical Center, and the patient's immune system due to having chronic diseases along with the disease, could not fight with this virus.

He went on saying it's sick as soon as they refer to the treatment center, a special section with specific conditions immediately in a negative pressure isolation room with a bed, and the last within 4 days the therapeutic team finally their efforts to save the lives of the patient take effective measures which, unfortunately, was brought in and leads to death.

Also, a symptoms of mild symptoms of the virus could be diarrhea and severe respiratory symptoms and continue to lead to hospitalization a person at the hospital that if no timely or refer to underlying illnesses, diabetes and hypertension, pulmonary heart with, could lead to the deaths of patients./208

Details Emerge On The Iranian MERS Cases

 

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Even though the number of Saudi MERS cases being reported by the MOH has decreased dramatically in recent weeks, concerns remain high as the Holy month of Ramadan approaches (June 28th-July 28th), when hundreds of thousands of international pilgrims will travel to the Holy cities in Saudi Arabia for Umrah pilgrimages.

 

All of which makes today’s report on Iran’s first two MERS cases – filed by AFP – of particular interest, as they are reporting these two sisters were infected through exposure to a traveler recently returned from performing Umrah in Saudi Arabia.

 

A caveat is in order here, as despite the best efforts of reporters covering the Middle East, Iran ranks among the ten most restrictive press environments in the world (ranked #172 out of 180 by Reporters Without Borders). 

 

Making it more than a bit dicey to put complete faith in the details that are being released.

 

That said, the following report suggests nosocomial transmission, although we don’t learn much more than the location where these sisters were believed infected (an Iranian hospital in Kerman), and the fact they were apparently exposed to a recently returned traveler from Saudi Arabia.  

 

While intriguing, with no details on this returning traveler’s health (and MERS-CoV testing status), or even a suggestion as to the type or duration of exposure (direct prolonged, casual, etc.), we are left with far more questions than answers.

 

Other reports indicate there may be two other family members who have been infected, although tests are supposedly pending in those.  This from Middle East Online:

 

Iran records first MERS cases month before Ramadan

Both among patients who had been in hospital with a pilgrim returning from Saudi Arabia.

Middle East Online

TEHRAN - Iran has recorded its first two cases of the deadly MERS virus, both among patients who had been in hospital with a pilgrim returning from Saudi Arabia, reports said Wednesday.

The two infected women are sisters and one is in a critical condition, transmissible diseases unit chief Mohammad Mehdi Gooya told the Fars news agency.

Both are receiving specialist treatment in the hospital in the southern province of Kerman where they are believed to have been infected.

There was no immediate word on whether the returning pilgrim who was the suspected carrier had tested positive for the coronavirus that causes Middle East Respiratory Syndrome.

<SNIP>

Gooya said Iranian authorities would test all returning pilgrims and that anybody displaying potential symptoms would be kept under quarantine for two weeks.

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Details on the promised testing for `all returning pilgrims’ are not provided.  Hopefully we’ll get a more detailed version of this chain of transmission from the World Health Organization in due time. 

Iran’s MOH Reports 2 MERS Cases

 

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The news has gone viral on twitter over the past 30 minutes thanks to Helen Branswell,  Crof, and Treyfish at FluTrackers who have all picked up on an Iranian Ministry of Health & Medical Education post confirming two MERS cases – and the suspicion of at least four more cases.

 

We’ve been hearing rumors of MERS in Iran, but until now we’ve only seen official denials. Today, however, their MOH (http://www.behdasht.gov.ir) has posted a lengthy notice (in Farsi) on two confirmed MERS cases.

I’ve tried translating this report using both the Google and Bing translation services, and both yield disappointingly syntax-challenged results.  I’ve gone with the Bing translation below:

 

In any event, this report seems to say that two members of a family (sisters?) have tested positive for the virus, while four other family members are suspected, and being tested.   I think  ...

 

 

Identification of 2 case of virus infection of the new country/crona consideration of health issues is the only way to prevent this disease

Monday 5 June ١٣٩٣

Director of the Center for management of contagious diseases in the Ministry of health of the identification of 2 case of infection of the virus in the country, crona.

According to a news site and inform the Ministry of health, treatment and medical education (da Web); Dr Mohammad Mahdi gooya announce this news added: 4 new Corona virus infection to a family in the province of Kerman has been observed that 2 cases of it corresponds to 2 sisters in Kerman has been confirmed that one of them treated in the Pediatric conditions.

Director of the Center for contagious diseases at the disease management said: the people who get in touch with these 2 have been items, within less than 48 hours and are under the care of if you see potential in clinical symptoms, special care of them.

His cooperation between the Ministry of health, the Medical Board of the Hadj and pilgrimage organization, and the Islamic Republic of Iran Red Crescent society during 8 months in order to create a precise planning and preparation necessary to take care of the pointed and said the disease in this way, information for زائرين the country's airports and also on the Hajj during the holidays in Saudi Arabia as active.

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OIE: Iran Reports H5N1 In Ducks

 

 

 

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While surveillance of bird flu is notoriously limited in many parts of the world, reports out China, North Korea, and Iran have been particularly rare. 

 

The last `official’ report out of Iran was in February of 2008, involving free range chickens and no human infections have ever been reported.

 

Today the OIE was notified of two outbreaks of H5N1 in Iran among free-range ducks, resulting in the deaths of 345 birds, and the culling of an additional 2337 ducks.

 

OIE REPORT LINK

 

There’s not much in the way of detail beyond the fact that two outbreaks occurred in separate villages in Mazandaran Province, starting on September 15th.

 

Mazandaran Province was also the location of the 2008 outbreak.  The OIE map of the location of today’s outbreak is below.

 

 

 

This is an unresolved, and ongoing outbreak, and the following steps are reportedly being taken.

• Control of wildlife reservoirs
• Stamping out
• Quarantine
• Movement control inside the country
• Screening
• Zoning
• Disinfection of infected premises/establishment(s)

 

According to OIE procedures, weekly follow-up reports are expected.

Iran: Closing Schools, 28 Deaths Reported

 

 

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Updated:  PressTV.Ir now reporting 33 Deaths. 

(hat tip Crof at Crofsblog)

 

From Chen Qi, the excellent daily newspaper-style blog on emerging infectious diseases out of the Netherlands, this report from Iran’s Press TV.

 

 

3,000 Iranians contract swine flu, 28 dead

Tue, 03 Nov 2009 10:18:24 GMT

 

An Iranian health official says 3,000 Iranian citizens have been infected with the A-H1N1 flu across the country as the virus's death toll reached 28.

“Closure of 70 schools in Tehran and many other schools around the country is alarming for authorities,” Majlis Health Commission spokesman told Mehr News Agency.

 

“Majlis Health Commission will meet the country's Health and Education ministers on Tuesday to discuss the latest state of the fatal virus spread in the country,” Mohammadreza Rezaei Kuchi said.

 

The country's health officials urge parents to keep a child with flu-like symptoms such as fever, cough and sore throat at home until the symptoms are gone.

 

“Apart from children and students, tourists, especially Hajj pilgrims, are also another group at serious risk of infection to A-H1N1 virus,” he added.

 

“Majlis will put extra focus on the matter,” continued Kuchi who is a representative form Jahrom.

 

Health officials stressed that adopting simple precautionary measures such as frequently washing hands, using a tissue to cover the mouth when coughing and sneezing, avoiding kissing and touching face and eyes can help contain the virus from spreading.