Kuwait Tests Camels - Finds 6% Positive For MERS-CoV

 

Photo Credit Wikipedia

 

 

# 8725

 

In a case of – If you look for MERS in camels, there’s a pretty good chance you will find it – Kuwait announced today that out of a random sampling of 83 camels, 5 tested positive (presumably by PCR testing) for  the virus. 

 

This works out to be about a 6% positive rate – not so far off from other samplings we’ve seen.

Earlier this year (see EID Journal: MERS Coronaviruses in Dromedary Camels, Egypt) we saw a sampling from Egypt that found  4 (3.6%) of nasal swabs (out of 110 tested) were positive for the MERS-CoV virus (via RT-PCR testing).

 

A positive PCR test is indicative of a current infection, with active viral shedding.

 

Serological tests in Egypt showed that 48 (92.3%) of 52 dromedary serum samples tested revealed titers from between 20 to >640, indicating prior infection.  Two rather important details not revealed in this media report are:

 

1. When these samples were taken (Spring is thought more conducive to seeing higher numbers)
2. The age of the camels sampled, and any age bias discovered among the positive cases (younger camels are thought more likely to have active disease, while older camels are more likely to have antibodies).

 

In any event, this adds Kuwait to the growing list of countries that have looked – and found – evidence of either current or past MERS virus infections in their dromedary population. 

 

Countries reporting positive results include: Oman, Saudi Arabia, the UAE, Jordan, Qatar, Spain, Egypt and Kenya)

 

 

Kuwait..Discover five Corona between the camel

Tuesday, June 10, 2014 18: 11

Way-the President of the Governing Council declared the Director-General of the public authority for Agriculture Affairs and fish resources in Kuwait (governmental) Jassem Al-Bader, Tuesday, five cases of the virus (SK) in the country.

Al-Badr said in a press release written, that I took random samples of some herds of camels in Kuwait to identify infected and isolation, noting that the number of cases detected with the disease amounted to five cases out of 83 samples examined.

Badr said that the Commission had taken precautions and protective of all cases, he was contacted by camel owners and visit the site and isolating the infected ones to make sure not to act and not to transfer to any other herd only after FDA approval.

The meeting between the Commission and the Ministry of health to monitor the health status of the herd together with a continuous coordination to follow up the situation of the other herds for the disease.

He said that the Commission will take all necessary actions recommended by world organizations such as the World Organisation for animal health and the food and Agriculture Organization and the World Health Organization along with GCC.

And Kuwait recorded three cases of human infection with coronavirus Kuwaiti Health Ministry announced at the end of last year 2013 and dealt with.

And officials in the Ministry of Health's all occasion free of human cases of the virus.
(Anatolia)

 

 

In late May we saw a renewed call by the FAO for Gulf States to increase their surveillance of camels for the MERS virus (see FAO: `Stepped Up’ Investigations Into Role Of Camels In MERS-CoV).

Kuwait MERS Coronavirus Updates: WHO & MOH

 

# 7986

 

On Wednesday of last week Kuwait announced one, then later in the day – two – MERS Coronavirus cases (see Kuwait MOH Announces Second MERS-CoV Case), but at the time the World Health Organization was waiting for additional testing before officially confirming these cases.  

 

Those test results are in, and today the WHO posted the following DON (Disease Outbreak News) update on their GAR (Global Alert & Response) webpage.

 

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

Disease outbreak news

18 November 2013 - WHO has been informed of an additional two laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) from Kuwait.

 

The first patient is a 47 year-old man who became ill on 30 October 2013 and was hospitalised on 7 November 2013. He is in critical condition. The second patient is a 52-year-old man with underlying medical conditions. He became ill on 7 November and was hospitalised on 10 November 2013. He is in critical condition.

 

Globally, from September 2012 to date, WHO has been informed of a total of 157 laboratory-confirmed cases of infection with MERS-CoV, including 66 deaths.

 

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

(Continue . . . )

 

Not specified in this report are any details on the patient’s recent travel history or possible exposures (in hospitals, to animals, etc.), making it impossible to even hazard a guess how they became infected.

 

Meanwhile Kuwait’s Ministry of Health has been supplying their media with a daily assurances that they are on top of the situation, and that MERS-CoV is unlikely to pose a serious epidemic threat to that nation.

 

A translation of today’s reportage from KUNA (Kuwait News Agency) reads.

 

11/18/2013
14:24

The good: the chances of turning 'Corona' to a very small B

(KUNA) - The head of the Unit for Combating epidemics Ministry of Health and spokesperson for the disease (Corona) in Kuwait, Dr. Musab al-Saleh said the presence of two مصابتين the disease do not live up to the stage of the epidemic is not considered a disease Corona and B. stressing that the opportunity to turn it into a pandemic "very slim" because of the nature of the disease.

 

Saleh said in a press conference at the Department of Public Health today, "There are no reasons to limit the movement and visit public places, hospitals, and in order to avoid Coruna travel."

Saleh said that the cases are still shall receive the necessary treatments under intense medical supervision in the intensive care rooms noting that the first case, lying in a hospital communicable diseases either second-Adan Hospital because the situation suffered heart muscle problems and must use the expertise Adan Hospital for treatment.

Saleh stressed that there was no new cases, explaining that since the announcement of the first case of an infected total number of suspected cases and that 64 people have been checked and the results were negative.

(Continue . . . )

 

Although the Kuwait MOH continues to stress that there have only been two cases – unless these patients recently traveled outside of the country - there would have to be some source for the virus within Kuwait.

 

Infection could come from direct contact with an infected animal or human (symptomatic or asymptomatic), or conceivably from environmental contamination left behind by an infected host.

 

But either way requires a local (perhaps temporary) source for the virus.

 

Last week we looked at a Lancet study (see Branswell: Transmission Estimates Of MERS-CoV – Lancet Infectious Disease) that estimated for every MERS case detected, there are probably 5 to 10 that go undetected.  While based on a mathematical model  – backed up by some high level statistical analysis - this does suggest that there are probably other (mild or asymptomatic) cases in Kuwait.

 

The real question is, does MERS-CoV transmit well enough to sustain an epidemic?

 

And so far, the answer appears to be `no, but it may be getting closer’.

 

The epidemiological yardstick by which human transmission of an infectious disease is measured is called the R0 (pronounced R-nought) or Basic Reproductive Number. Essentially, the number of new cases in a susceptible population likely to arise from a single infection.

With an R0 below 1.0, a virus (as an outbreak) begins to sputter and dies out. Above 1.0, and sustained human-to-human transmission can occur.

 

The lancet study from last week estimated the R0 of MERS-CoV to be `approaching 1.0’, or an efficiency high enough to provide for sustained human-to-human transmission.

 

The good news is, while an R0 of 1.0 or higher is thought to make an epidemic (or even a pandemic) possible – it does not mean that one is inevitable.  

 

The SARS coronavirus is believed to have had an R0 of 2.0 or greater, and yet once the world awoke to the threat and began to react, the virus was eventually contained and apparently eradicated in humans.

With aggressive prospective testing, along with isolation and quarantine those infected and/or exposed, and stringent  infection control procedures in hospitals, it may well be that MERS can be corralled in much the same way.

 

But for that to happen, public health officials – particularly on the Arabian Peninsula - must act quickly and decisively to find and isolate those cases that – for now – are sliding under the radar.

Kuwait MOH Announces Second MERS-CoV Case

 

Kuwait MOH Twitter Account

 

# 7972

 

 

Although details are scant right now, Kuwait’s Ministry of Health has announced via their twitter feed that they have two MERS cases hospitalized. Among the many Arabic news stories I’ve looked at over the past hour, the following one from www.elaph.com/ was the most readable.

 

GMT 21:38 2013 Wednesday, November 13th 

Kuwait announces record second-infected Coruna

KUWAIT: The Ministry of Health announced the Kuwaiti state registration of a second infected "Corona" to a Kuwaiti citizen under 52 years of age newly feet of travel abroad, and said that his health is now reassuring.

 

The head of the epidemiology unt at the ministry Dr. Musab al-Saleh told Kuwait News Agency "KUNA" Tonight it was confirmed diagnosis and convert the case to the Communicable Diseases Hospital for isolation and treatment, and is currently the precautionary measures according to the approved technical guidance.

 

Dr. Saleh added that the second case does not have anything to do with the situation first, which was announced earlier in the day, stressing that all contacts of the first case are still enjoying good condition. He stressed that the Ministry of Health and the basis of the principle of transparency will continue to announce any developments in this regard, first hand.

 

The Kuwaiti Ministry of Health had announced earlier in the day for the first case of infection with "Corona" in Kuwait, a Kuwaiti citizen aged 47 years, which have diabetes, high blood pressure and high level of fat in the body, has been isolated in intensive care in a hospital in Adan, was also am transferred to the Communicable Diseases Hospital for isolation and treatment.

 

Based on this report, and several others, it appears this second case had no contact or connection with the first patient.

As I’ve noted twice earlier today, local lab confirmations will have to be verified by the World Health Organization before these become official cases. 

 

I would also mention that at least one report I’ve seen is accusing the MOH of delaying the announcement of the first case, but since I’m dealing with syntax challenged machine translations, have zero knowledge of the politics of the region, and am only seeing it reported on one website  I’m going to set that aside for now and hope we get some clarity in reporting over the next day or so.

 

KUNA On Kuwaiti MERS Announcement

 

Coronavirus – Credit CDC PHIL

 

# 7971

 

 

KUNA, the Kuwait News Agency has a long and fairly detailed report on yesterday’s reported MERS case, which tells us a bit more about the patient, and the tests conducted. Earlier today (see Kuwait MOH Confirms First Coronavirus Case)  Gregory Hartl, spokesperson for the World Health Organization, cautioned that despite the reportage in the Arabic media, `the case is not lab confirmed yet’.

This KUNA report indicates the patient has tested positive for MERS-CoV by a local lab.  My guess is the WHO is awaiting a confirmatory test by a WHO reference laboratory.

So, until the WHO confirms, this remains a suspected case.

The patient is reported to be a 47 year old male, with multiple comorbidities (Diabetes, hypertension, obesity), who is in critical condition.

 

(Machine translation)

 

Ministry of Health announces infecting citizen Coruna

13/11/2013 | 03:43 PM
|
Kuwait News

Kuwait - 13 - 11 (KUNA) - The Ministry of Health announced the injury citizen at the age of 47 new Corona virus after it has been diagnosed by competent laboratories in Kuwait and being treated in a hospital.

Said Head of the Unit for Combating epidemiologist at the Ministry of Health, Dr. Musab al-Saleh in a press conference today that the citizens have diabetes, high blood pressure and high level of fat in the body indicated that he was isolated patient in intensive care, hospital Adan and transferred this morning to a hospital contagious diseases for the isolation and treatment.

He said he immediately suspected the situation of running public health officials apply the treatment protocol and procedures to prevent infection with the application of the precautionary measures between the contacts and the hospital staff in accordance with the indicative evidence.

He said the ministry will be fully prepared for this disease since it appeared in the Kingdom of Saudi Arabia where he has been the development and application protocols and technical procedures for dealing with cases of Corona virus to be followed and the work of training courses for doctors and technicians in both the public and private sectors.

Saleh stressed the ministry's keenness to follow up on the latest developments regarding the flu and Corona disease regionally and globally in coordination with the Regional Office of the World Health Organization and other international organizations, and to work on circulation to the concerned ministry.

He called on all citizens and residents to follow the tips guidance, including maintenance Wash hands with soap and water 20 seconds at least, or materials cleared usual which is used for cleansing and the use of tissue when coughing or sneezing, cover your mouth and nose by maintaining the cleanliness of the body and clean floors and bathrooms places residential or work.

(Continue . . . )

 

Kuwait MOH Confirms First Coronavirus Case

 

NOTE:  Despite multiple news reports now – including this one from Reuters  - there appears to be some uncertainty over this announcement, as  Gregory Hartl, spokesperson for the World Health Organization,  just tweeted (@ roughly 1400 hrs Geneva time) that `the case is not lab confirmed yet’.  

Until the WHO confirms, this remains a suspected case.

 

 

# 7969

 

We’ve a follow up to, and an an apparent confirmation of, last night’s report (see Kuwait: Media Report Of A Suspected MERS Case) this morning, as Dr. Musab al-Saleh, Director of the Disease Control Unit at the Kuwaiti Ministry of Health,  held a press conference today announcing that nation’s first case.

 

• The patient’s doctor, who was originally suspected of being infected, has apparently tested negative. 
• The patient was hospitalized on the 7th with a high fever and cough, and had a history of recent (unspecified) travel outside of Kuwait.
• The patient is currently on a respirator, and in critical condition.

 

This report (translated) from Kuwaitnews.com.

 

 

Kuwait announces first case of HIV, "Corona" .. And the patient's condition critical

Published on Wednesday, November 13, 2013 13:49

Source: Local Editor

Musab al-Saleh during today's press conference

Said the spokesman for the Committee of the virus, "Corona" in the Ministry of Health and head of the combat epidemics d. Musab good for the registration of the first case of a citizen Corona virus, stressing at the same time that the patient was isolated at the Communicable Diseases Hospital, pointing out that the situation is believed to be the product of travel.

 

Saleh said in a press conference held today in the management of public health that medical teams had to limit the contacts of the situation and show the absence of any symptoms of the disease, and that one of the doctors suspected of being infected, but tests proved their safety.

 

The interest that the patient Access Hospital Adan Day 7 of this month and was suffering from high temperature and cough, was transferred to a hospital in communicable diseases and deposited intensive care to impeach him in a good place and conveniently away from the proliferation risks based on policies protocol to deal with such cases, pointing out that the critical condition of the patient is on a respirator.

 

He stressed the good that the patient's condition is under control and will continue to be the case in contact with him to make sure they are free from any symptoms to check on their safety and this may take 14 days, noting that medical devices on alert and continue with all sides, whether public or private to monitor any communication باشتباه infected " Corona ".

 

Between good that a new disease has no vaccination and the best way is to prevent it.

 

 

 

 

Note: edited @ 9:30am EST to emphasize this remains a suspected case until confirmed by the WHO - MPC

Kuwait: Media Report Of A Suspected MERS Case

 

 

# 7966

 

A hat tip to Sharon Sanders on FluTrackers for picking up a pair of media reports that indicate at least one suspected MERS case is hospitalized in Kuwait, with the added suspicion that his doctor may be infected as well.  You can follow these, and future reports on this thread.

 

The translation of first report Sharon posted is severely syntax challenged, but the second one is clearer.  Aden is located to the immediate south of Kuwait City.

 

machine translation

Alert in the 'force' after suspected transmission of the infection to the doctor

The first injury 'Corona' in Kuwait

Sources healthy familiar with «opinion» About the appearance of the first cases of HIV «Corona» of a citizen lying in intensive care in a hospital in Adan, described the doctors his condition as «dangerous».

Sources healthy familiar with «opinion» About the appearance of the first cases of HIV «Corona» of a citizen lying in intensive care in a hospital in Adan, described the doctors his condition as «dangerous».

Sources said he also suspected of infecting the physician supervising the patient, where she developed symptoms of high temperature.

The sources pointed out that Doctors Hospital of communicable diseases were not able to transfer the patient to the hospital due to his poor health, referring to the lifting of the state of emergency in the «force» in anticipation of receiving infected cases, and joins Kuwait to the rest of the Gulf states, which appeared «Corona» except Bahrain.

http://www.alraimedia.com/Alrai/Arti...&date=13112013

I’ve checked KUNA, the English Language Kuwait Press Agency, but so far have not found any mentions of this case.