Referral VDU Blog: Catching Ebola: mistakes, messages and madness

 

Credit CDC PHIL

 

 

# 9840

 

One of the early `voices of reason’  on the threat posed by the Ebola Virus outside of Africa, was Dr. Ian Mackay on his VDU Blog. 

While many in  the news media, social media, and the tabloids went nuts last August over improbable `Ebola doomsday scenarios’  (see A Look Down The Ebola Rabbit Hole) –   Ian produced a series of focused, and scientifically grounded looks at the `real risks’ from the virus, and debunked some of the rampant misinformation spreading on the net.

A few examples:

Fake/wrong Ebola virus disease images...

VDU Blog: Droplets vs Airborne - Demystifying Ebola Transmission

Ebola: Blood, sweat and tears...

And a review by Ian and Dr. Katherine Arden in The Lancet, published last November:

Lancet: Mackay & Arden On Ebola In Semen Of Convalescent Men

 

Today Ian and Kat Arden are back with a look back at the messaging (good and bad) during the height of the Ebola outbreak last fall, and a reality check on the threat Ebola poses to a modern society with decent public health resources.

 

Follow the link to read:

 

 

Catching Ebola: mistakes, messages and madness

Written by Dr. Ian M. Mackay and Dr. Katherine E. Arden

Despite obvious community and media fear, speculation and exclamation that Ebola virus would enter and spread widely within countries outside of the hotzone, such an event did not come to pass in 2014. The early public health messaging on Ebola virus and disease were, for the most part, spot on.

In 2014 and 2015, thousands of cases of Ebola virus disease (EVD) ravaged Guinea, Sierra Leone and Liberia in 2014 (the "hotzone"). A smaller outbreak was defeated in Nigeria [8] and another distinct Ebola virus variant drove an outbreak of EVD in the Democratic Republic of the Congo[7] - they too controlled spread of the virus. Ebola virus traveled from the hotzone to other countries including Senegal, Nigeria, the United States of America (USA), Mali and most recently, the United Kingdom. It did this by hitching a ride in a usually unknowingly infected human host.

(Continue . . . )

 

 

Referral: VDU Blog On Closure Of Guangdong’s Live Markets

Credit FAO

 

 

# 9725

 

Amid news of another H7N9 case reported from Guangdong Province (see CHP notified of additional human case of avian influenza A(H7N9) in Guangdong),  Dr. Ian Mackay weighs in with a blog on the importance of closing live bird markets (LBMs)  in China in order to reduce the spread of the virus.

 

Follow the link to read:

 

Guangdong sees sense among the feathers...

Guangdong province in southern China is suspending its poultry markets. All of them. From 15-Feb to 28-Feb.[1] While the closures are only for 2-weeks, this will be very important for stopping human cases of avian influenza, particularity of the H7N9 subtype, during the bustling spring period in China.

Live poultry market closures also remove a traditional dish of fresh cooked chicken. One can be certain that no-one will die because of the substitution of frozen or factory prepared chicken for a fresh chicken, even if chefs don't succumb to the tantrums of last year and refuse to prepare dishes made from anything but fresh market-selected poultry. One can be equally certain that if the markets remain operating during the peak season for influenza virus circulation as they have been, that human infections, and deaths, due to H7N9 infections, will also continue

(Continue . . . )

 

 

Last summer, in CDC: Risk Factors Involved With H7N9 Infection we looked at a case-control study conducted by an international group of scientists, including researchers from both the Chinese and the US CDC which concluded.

 

Exposures to poultry in markets were associated with A(H7N9) virus infection, even without poultry contact. China should consider permanently closing live poultry markets or aggressively pursuing control measures to prevent spread of this emerging pathogen. 

 

In October of 2013 we saw another study (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission) which found:

 

Closure of LPMs reduced the mean daily number of infections by 99% (95% credibility interval 93—100%) in Shanghai, by 99% (92—100%) in Hangzhou, by 97% (68—100%) in Huzhou, and by 97% (81—100%) in Nanjing. Because LPMs were the predominant source of exposure to avian influenza A H7N9 virus for confirmed cases in these cities, we estimated that the mean incubation period was 3·3 days (1·4—5·7).

Despite the evidence that it would greatly reduce the transmission of the virus, closing LMBs is a hard sell to the Chinese public. Purchasing live market birds is deeply ingrained in the culture, as it reassures the buyer that the bird is both fresh and healthy. 

 

China, Indonesia, and other countries have attempted to close or strictly regulate live bird markets in the past – only to be met with tremendous public resistance (see 2009 blog China Announces Plan To Shut Down Live Poultry Markets In Many Cities). 

 

That ambitious plan, announced more than 5 years ago to `shut live poultry markets in all large and medium-sized cities throughout China’, obviously never happened.

 

While the temporary closure of markets Guangdong will hopefully reduce the impact of this year’s H7N9 outbreak, as Ian points out temporary closures are only expected to provide temporary relief.  

Referral: VDU On Societal Change And H7N9

H7N9 Waves – Credit Dr. Ian Mackay VDU Blog

 

# 9633

 

With H7N9 surging once again in China (although how badly, is hard to tell), and H5N1 setting `personal best’ records in Egypt this winter, bird flu is back with a vengeance, and we once again find ourselves collectively playing `chicken’ with some very nasty avian threats.  

 

And if that weren’t enough, in the wings (and legs, breasts, and thighs) are upstarts like H10N8 and H5N6.

The primary conduit of these avian viruses to humans is through direct contact with infected birds - often at live markets - the preferred venue for purchasing meat for hundreds of millions of people around the globe.  Today Dr. Ian Mackay muses on the need for societal change if hope to head off these emerging avian viruses before they figure us out.   

 

Societal change and H7N9..

The importance of societal change for controlling infectious disease outbreaks really cannot be over-stated. 
For Ebola virus disease, it came down to stopping the tradition of direct contact with the body of those who have died and direct contact in general. For MERS it seems that occasional camel contact triggers insertion of the MERS-CoV virus into hospitals where lax infection prevention and control practices add to the case load.

For influenza A(H7N9) virus cases, it is the habit of obtaining live poultry from retail markets where rare virus-laden chooks are culled and handed over because of a desire to see, choose and purchase the tastiest fresh chicken.

(Continue . . .)

 

While closing live markets has been proven to reduce the spread of H7N9 (see The Lancet: Poultry Market Closure Effect On H7N9 Transmission), and seems an obvious mitigation step, generations of tradition (and practical considerations in places where home refrigeration is still rare) make it difficult to implement.

 

We’ve seen China, Egypt, and Indonesia repeatedly try – and fail – to permanently close live markets.

 

Of course, when it comes to taking what seems like sensible steps to stop the spread of deadly diseases, we in the `Western world’ don’t exactly have clean hands.  Literally.

Lapses in hand hygiene in hospitals still cause tens of thousands of (often fatal) infections each year (see Assessment Of Hand Hygiene Strategies In US Healthcare Facilities  & Hand Hygiene Among Doctors Exposed).

Half of all Americans eschew the flu vaccine every year, and you really don’t want to know the statistics on handwashing in public restrooms (well, if you do, see And Yet, They Still Call It Wellington  & Before You Ask To Borrow Someone’s Cell Phone . . .).

Some days it is hard to be optimistic about the reduction of infectious diseases around the globe when humans seemingly go out of their way to find  ways to aid and abet their spread.  

 

But on the plus side, as a disease blogger, I’m unlikely to run out of material to write about.

Referral: VDU On MERS In HCWs

Credit Dr. Ian Mackay VDU Blog 

 

# 9584

 

 

Dr. Ian Mackay has a new post up today that looks at the unusually high number of Health Care Workers infected with the MERS coronavirus over the past three years. 

 

As he points out, HCWs are considered `canaries’ in the coalmine, and when those who are supposed to be taking special care not to get infected continue to fall prey to the virus, it is considered a potential red flag.

Along with his patented graphics, Ian provides some excellent commentary the shedding for 42 days of the virus by an infected, but asymptomatic nurse, and how that might help explain some of the community infections for which there is no obvious exposure.

 

Follow the link to read:

 

 

MERS-CoV snapdate on canaries...

MERS-CoV detections among healthcare workers (HCWs)

HCWs are akin to the canary in the coal mine - when HCWs get sick with a particular bug, this can signal that the bug may well be more active in the the wider community.

(Continue . . . )

Referral: VDU On Recent Uptick In H7N9 Activity

Credit Dr. Ian Mackay VDU Blog 

# 9525

 

 

After a decade where the H5N1 virus reigned supreme in the avian flu world, a little less than two years ago a new virus emerged in Eastern China, called H7N9.  A reassortant between the ubiquitous, but low path H9N2 poultry virus and a couple of (as yet) unidentified bird flu viruses (see Evolution Of H9N2 And It’s Effect On The Genesis Of H7N9)  this new viral brew produces no symptoms in birds, but in humans produces significant morbidity and mortality.

As the chart above shows, we’ve seen two human waves of the virus - both beginning in mid-winter – and there are signs that a third wave may be beginning to surface. 

 

While the numbers remain small, there has been a decided uptick in case reports out of China in the past few weeks.  There are, of course, questions over just how well surveillance and reporting are picking up on these cases since they come at the same time as China’s seasonal flu season ramps up.  


As we’ve discussed often - and it doesn’t matter where, or what disease -  not every infection will be detected. And depending on the spectrum of symptoms (asymptomatic or mild – up to severe), the percentage picked up by surveillance can often be the tip of the iceberg – or in the case of the CDC graphic below – of the pyramid (see When No Number Is Right).

While the official count remains under 500 cases, there are some researchers who put the real number of symptomatic H7N9 cases in the tens of thousands (see Clinical severity of human infections with avian influenza A(H7N9) virus, China, 2013/14).  

 

Nobody knows of course, and so we must deal with the numbers we have.

Which is something Dr. Ian Mackay does exceedingly well, producing (along with astute commentary) some of the best Avian Flu, MERS, and Ebola graphics on the web on his Virology Down Under blog.   Today he starts off the new year with a `snapdate’ on China’s H7N9 activity.    Follow the link below to read:

 

Saturday, 3 January 2015

H7N9 outbreak #3 underway?

What better way to start 2015 than a snapdate!! For those who are new to them here on VDU, they were initiated here and defined here as snap updates - posts that don't have lots of detail and chat...although they almost always end up having lots of chat!

This one is an update of the situation of one of the many avian influenza viruses ("bird flus" if you must) around again - avian influenza A(H7N9) virus, or just 'H7N9'.

(Continue . . . )

 

Ian also produced a quick overview of the recently emerged H5N6 virus yesterday in:

 

Influenza A (H5N6) virus in humans...

Provinces hosting human cases of H5N6
Adapted from [8]
Click on image to enlarge.

VDU Blog: Droplets vs Airborne - Demystifying Ebola Transmission

Except from CDC Infographic

 

 

# 8962

 

Almost two weeks ago the CDC released a reassuring infographic (see above) that - among other things - stated that `You can’t get Ebola through Air’, which immediately set off an internet firestorm of disbelief and derision. I considered it a communications misstep at the time, and blogged about it in The Ebola Sound Bite & The Fury.

 

While I understand the need to reassure the public, and the desire to try to defuse some of more egregious tabloid-style reporting, sometimes reassurance can be overdone.

 

When people see moon-suited doctors ferrying Ebola patients into Emory University Hospital, and compare that to the CDC’s blanket assurance that `You can’t get Ebola through the Air’  – they rightfully come away confused, and perhaps even a bit suspicious.

 

Last week, in Ebola: Parsing The CDC’s Low Risk vs High Risk Exposures, we looked at CDC guidance that acknowledged the (low) risks of casual contact; defined as spending a prolonged period of time in the same room with, or within 1 meter, of an infected patient – even without direct physical contact. 

 

What I dubbed `spittle range’  where large droplets of mucus, blood, sweat, or other bodily fluids could potentially be coughed, sneezed, or otherwise propelled or flung onto another person.  

 

Today, I’m very pleased to report that Dr. Ian Mackay (along with three other researchers) – all far more qualified to weigh in on this subject than I  – have penned a detailed essay on what we know about Ebola transmission, which will hopefully clear up some of the confusion.  

 

Follow the link to read:

 

Ebola virus may be spread by droplets, but not by an airborne route: what that means

An article collaboratively written by (alphabetically)..

Dr. Katherine Arden
A postdoctoral researcher with interests in the detection, culture, characterization and epidemiology of respiratory viruses.

Dr Graham Johnson
A post-doctoral scientist with extensive experience investigating respiratory bioaerosol production and transport during breathing, speech and coughing and determining the physical characteristics of these aerosols.

Dr. Luke Knibbs
A Lecturer in Environmental Health at the University of Queensland. He is interested in airborne pathogen transmission and holds an NHMRC Early Career Fellowship in this area.

A. Prof Ian Mackay
A virologist with interest in everything viral but especially respiratory, gastrointestinal and central nervous system viruses of humans.

________________________

The flight of the aerosol

Understanding what we mean when we discuss airborne virus infection risk

A variant Ebola virus belonging to Zaire ebolavirus (EBOV) is active in four West African countries right now. Much is being said and written about it, and much of that revolves around our movie-influenced idea of an easily spread, airborne horror virus. Many people worry about their risks of catching EBOV, particularly since it hopped on a plane to Nigeria. However, all evidence suggests that this variant is not airborne. The most frequent routes to acquire an EBOV infection involve direct contact with the blood, vomit, sweat or stool of a person with advanced Ebola virus disease (EVD). But what is direct contact? What is an “airborne” route? For that matter what is an aerosol and what role do aerosols play in spreading EVD? How is an aerosol different from a droplet spray? Can droplets carry EBOV through the air?

Direct contact includes physical touch but also contact with infectious droplets; the contact is directly from one human to the next, rather than indirectly via an intermediate object or a lingering cloud of infectious particles. You cannot catch EVD by an airborne route, but you may from droplet sprays. Wait, what?? This is where a simple definition becomes really important.

(Continue . . . )

VDU Blog: A Deeper Look At The MacIntyre MERS-CoV Paper

Credit FAO

 

 

# 8898

 

 

Yesterday, in  Debating A Controversial MERS Paper, we looked at a rebuttal in the online academic forum The Conversation - by researchers @influenza_bio, @MackayIM, @maiamajumder, @neva925, @stgoldst & @kat_arden -  of a controversial paper by Professor Raina MacIntyre  that suggested that the  `human release’  of MERS-CoV could be behind the erratic outbreaks we’ve seen in the Middle East.

At just over a thousand words, this rebuttal was geared for the general reader, and so a lot of details were glossed over.

 

Today Dr. Mackay and company have posted a much longer analysis of the MacIntyre paper – one that runs well over 3,000 words – which dissects the MacIntyre paper more thoroughly. 

 

While acknowledging that bioterrorism is always `possible’, they argue that – based on the evidence – it  is an extremely unlikely scenario for MERS.

 

Follow the link below to read:

 

Virus variability, dopey data and insufficient infection control do not support the theory that bioterrorism is behind the ongoing MERS-CoV outbreak.

A collaborative note from (alphabetically): @influenza_bio, @MackayIM, @maiamajumder, @neva925, @stgoldst, @kat_arden

Referral : VDU Ebola Pages

VDU Blog Interactive Ebola Maps

 

# 8869

 

Dr. Ian Mackay has recently added a pair of static Ebola graphic pages to his VDU blog (check the tabs at the top of the home page).  One with Ebola maps, and the other with charts and graphs. 

 

Both are updated often (give the graphics a moment to re-initialize with the latest data when you visit), and both have interactive components.

 

Ebola Virus Disease (EVD) 2014 West African outbreak..

Mackay’s Interactive MERS Charts

Credit VDU Blog 

 

 

# 8850

 

 

It has been a busy couple of days and I’ve been remiss in not highlighting a new set of interactive MERS-CoV charts from Dr. Ian Mackay that deal with gender and ages.  By hovering your cursor over individual elements of each chart, you are provided with additional information.

 

The static graphic at the top of this blog doesn’t do it justice, but you can view the fully interactive version at:

Middle East respiratory syndrome coronavirus (MERS-CoV): Age and Sex

 

Ian’s Virology Down Under blog is a terrific repository of information, and its archived content is well worth exploring.

Referral: Are MERS Cases In Saudi Arabia & UAE Linked To Camel Imports?

Credit VDU Blog 

 

# 8783

 

One of the great advantages (and pleasures) of following scientists on Twitter is you get to hang around – like a fly on the wall – while they discuss and hash out theories, possibilities, and SWAGs on various issues.   On the downside, the 140 character format often leads to cryptic conversations.

 

So I’m very pleased to see that @Influenza_bio (A Biologist) has returned to Dr. Ian Mackay’s VDU blog today with another guest article – one  that fleshes out a running twitter conversation (with graphics) from earlier this week.

 

You may recall that @Influenza_bio previously penned a couple of terrific guest articles at VDU, including Watching zoonoses evolve... and Can we believe every H7N9 seroprevalence study we see? – both of which are absolutely worth taking the time to read.

 

Today’s offering is a lengthy, step-by-step analysis of the potential role that imported camels may play in the spread of MERS in Saudi Arabia and the UAE.   While the author describes it as a `very speculative hypothesis’, it is also both well reasoned, and well presented.

 

Follow the link to read:

 

 

Thursday, 26 June 2014

Are MERS cases in Saudi Arabia and the UAE linked to camel imports?

Special Guest writer: @influenza_bio

Looking at the history of MERS coronavirus infections to date, many puzzling questions come to mind.

Evidence of MERS infection has been detected in dromedary camels from Spain to Egypt to the Arabian Peninsula. Why have we seen human cases arise only in a handful of countries in the Arabian Peninsula?

Why have nearly all MERS cases originated in Saudi Arabia (KSA)?

As of June 22, 2014, 718 cases are thought to have been contracted in KSA. The UAE, a distant second, has had 69 cases. Jordan has had 17; Qatar has had 9 (although 1 had a travel history to KSA), Kuwait 3, Oman 2 and Yemen 1. All of these countries have a lot of camels.

(Continue . . . )

 

 

Given the quality of these first offerings from @Influenza_bio, I look forward to future installments.

A Pair Of MERS Updates From Ian Mackay

Daily MERS-CoV detections from 20-March. Credit Ian Mackay  VDU Blog 

# 8643

 

Dr. Ian Mackay – after taking a few days off from the blogging routine – has returned with a flourish, producing two feature (and graphic!) rich posts on the MERS outbreak in Saudi Arabia.  Both deserve to be read in their entirety, so skip the excerpts and go ahead and read them on Ian’s blog.

 

First, a look at how camels may be spreading the virus, in:

 

Camels at the centre, aerosol all around...

An airborne-centric view of how the camel could be a source of sporadic human infection by MERS-CoV, a virus that is genetically very similar whether found in camels or humans.

The inner ring (orange) is more about droplets and aerosols-if you must differentiate on size. 
These are potential routes by which a human in contact with, or near to, camels might acquire virus from them, when those camels are actively infected.

It's worth noting that camels are not all infected all the time. This is why there hasn't been a rash of camel herdsmen coming down with MERS after the YouTube camel-kissing outbreak...at least as far as we know there hasn’t.

(Continue . . .)

 

And in a second post, Ian discusses the usefulness of serology tests in pinpointing cases, and the drop in reported MERS cases during the month of May.

 

MERS-CoV detections: The April wave recedes...

So welcome to the 114th Week of MERS-CoV among us. That week numbering may change shortly. Stay tuned if week numbering is your thing.

 

We currently have a tally of 649 detections of MERS-CoV or viral antibodies in humans. I don't list camel numbers. My count says 192 fatalities among infected people, resulting in a proportion of fatal cases of 29.6%. That seems high. Because, until very recently, the Kingdom of Saudi Arabia's Ministry of Health did not regularly report deaths alongside their date of illness onset, it has been an interesting hobby to try and link them. The number is solid so along as the MOH has not been doubling up in the reporting or coming back later to re-report deaths. You'll be familiar with these issues if you follow me on Twitter.

(Continue . . .)

Mackay: Updated MERS-CoV By Month Graphs

 

Credit Ian Mackay VDU Blog

# 8566

 

Dr. Ian Mackay has been busy updating and improving his MERS graphics, adding in – among other things - the camel `birthing season’ as a possible factor in the annual spring outbreaks we’ve seen. Ian also charts what may be early signs of a peak in the cases coming out of Saudi Arabia.

 

Follow the link below for his graphs, and commentary.

 

MERS-CoV by month, now with added camels and hospital outbreaks...

Referral: Mackay Updates The Current MERS Outbreak

Credit Dr. Ian Mackay VDU Blog

 

# 8532

 

Dr. Ian Mackay has five new charts, and a good many thoughts to share on this month-long acceleration in Saudi and UAE MERS virus detections in his VDU blog this morning.  Ian covers a lot of territory, ranging from camel festivals to the rate of new infections to the importance of extensive testing when dealing with a new virus like MERS.

Follow the link to read:

 

Saturday, 26 April 2014

An update on the April outbreak of MERS-CoV...

We are in week 110 of the MERS-CoV outbreak event, that's 2.12 years and 386 cases including approximately 113 deaths (PFC of 29.3%, the lowest to date) since the first known cases became ill in Mar of 2012.

Just a few quick charts to keep track of things.

Virus detections continue to accrue at a double-digit rate, as has been the case each day except 2 (one of which was blip) between 18-Apr and 25-Apr this year. Thanks mainly to the Jeddah outbreak (no more calling it a "cluster").

(Continue . .. )

Referral: VDU Blog On MERS-CoV Partial Spike Sequence Results

MERS detections by month  - Credit VDU Blog

# 8526

 

This morning Dr. Ian Mackay – Virologist, researcher, and editor of the VDU blog – takes a look at a report posted yesterday on Science Insider by Kai Kupferschmidt called Soaring MERS Cases Cause Pandemic Jitters, but Causes Are Unclear, that announces the results of some rapid genetic sequencing of the MERS virus  from the Jeddah cluster.

 

Last week virologist Christian Drosten  of the University of Bonn in Germany received 31 samples of the virus, and since then has sequenced (n=30)  a subset of the genome (a section from  the `spike protein’) – that, at least with the SARS virus – was considered probative for finding genetic changes of significance.

Early results found `nothing special’ to suggest an evolutionary change in the virus, but as we learn from Ian’s article, this isn’t the end of the story.  As Ian underscores, there are a lot of different factors at play, and much more that needs to be learned.

 

Although some of this discussion is - by its very nature - a bit technical and the issues involved complex, Ian does a great job sorting things out.  Follow the link to read:

 

MERS-CoV partial spike gene sequences do not implicate viral change in April's Jeddah human case cluster

Friday, 25 April 2014

With a new article at ScienceInsider written by Kai Kupferschmidt (@kakape on Twitter)[1], it seems that the idea of a Spring start to human detections of MERS-CoV in Saudi Arabia is gaining some support from other scientists.

(Continue . . . )

 

Referral: VDU Blog - Watching Zoonoses Evolve

The acceleration of MERS Cases – VDU Blog

# 8508

 

I’m not quite sure how I missed it (I can only plead a recent lack of sleep & Arabic-twitter-reading induced psychosis) – but only now have I stumbled upon Saturday’s terrific guest blog by @influenza_bio on Dr. Ian Mackay’s VDU blog, that discusses the ever present threat posed by zoonotic diseases.

 

After providing a suitable background, and a quick overview of recent MERS outbreak history, @influneza_bio proceeds to explain why the MERS virus’s recent surge may be an early warning sign that this emerging coronavirus is evolving, and adapting to human hosts.

 

I’ll not give anymore away, other than to say you really want to read this article.   Follow the link below to read:

 

Watching zoonoses evolve...

Special guest writer: @influenza_bio

For the first time in human history, we are watching diseases jump from animals to humans on a large scale. We've seen diseases appear for the first time in humans before; that's not new. We've seen HIV and several new strains of influenza emerge over the past century or so, for example. What is new is that we can now watch this process as it happens. We are able to watch animal diseases trickle case by case into humans, and we wonder whether any of these diseases might some day become human diseases. We wonder whether we might be watching pandemics develop in real time.

(Continue . . .)

 

 

For another highly informative blog by @influenza_bio, check out  Can we believe every H7N9 seroprevalence study we see?.

VDU Blog: Charting The Mounting MERS Outbreak

Credit Dr. Ian Mackay

 

# 8500

 

With the MERS coronavirus numbers changing literally by the hour (yesterday we saw 19 new cases announced, and media hints of several others), keeping track has become a full time job. Since I can’t even keep track of where I left my reading glasses, I’m thankful that this onerous task has been taken up by two of Flublogia’s more organized individuals.

 

Sharon Sanders on Flutrackers began keeping a detailed (and linked to reports) MERS Case List roughly 18 months ago, long before anyone knew this virus would become a serious threat.

Meanwhile Dr. Ian Mackay  provides us with charts, graphs, and expert commentary on his VDU blog, that adds much needed clarity to the numbers.

 

They aren’t alone, by the way.  You’ll find other blogs, newshounds, and journalists making important contributions as well. Flublogia is a large and industrious community.

 

Overnight (my time) Ian has prepared a new blog and updated three charts showing the impact of the latest MERS cases announced out of the UAE and Saudi Arabia yesterday. 

 

 

Sunday, 20 April 2014

MERS-CoV cases and deaths by month and growing tallies: a look at the impact of 2 clusters on a "slowly growing epidemic"

The 2 healthcare-associated clusters (paramedic cluster and Jeddah cluster) are the driving factors underpinning the case number spike in April. Cases in other regions are either linked or relatively few in number. 

With a dozen new cases noted by the United Arab Emirates (UAE) early this morning (my time) I've updated the case and epidemic curve chart below as well, again. This makes UAE the clear second place hotzone for MERS-CoV cases.

Whether these cases, all asymptomatic, are liked to the paramedic cluster or just the result of enhanced testing (there was mention of contacts in the media release though) is unknown and awaits clarification as do more details on most of the recent 90 cases .

(Continue . . . )

 

As always with Ian’s blog: go for the graphics, but stay for the commentary.

Referral: VDU Blog - Professor Ali Mohamed Zaki On MERS-CoV

Coronavirus – Credit CDC PHIL

 

 

# 8465

 

During the summer of 2012 Egyptian virologist Dr Ali Mohamed Zaki, working at the Virology Laboratory of Dr Soliman Fakeeh Hospital in Jeddah, Saudi Arabia isolated a previously unknown coronavirus from a 60-year old male patient with pneumonia and acute renal failure.  That virus, we know today as MERS-CoV.

 

The story of his discovery, and eventual `reward’ (he was fired for going public with his discovery) was well told by Jennifer Yang in her article How medical sleuths stopped a deadly new SARS-like virus in its tracks, which exemplifies the old adage that `no good deed goes unpunished’.

 

Today Dr. Ian Mackay has details on some comments Dr. Zaki made in an interview on the recent behavior of the virus in Saudi Arabia, along with some comments of his own.  

 

So, without further ado I would strongly encourage you to leave here and read:

 

Professor Ali Mohamed Zaki on MERS-CoV: camels a secondary concern to person-to-person spread

There have been a seemingly continual and growing stream of Middle East respiratory syndrome coronavirus (MERS-CoV) cases of late, with a particular emphasis on what seem to be increasing numbers of healthcare worker infections, a possibly younger age group and less severe disease.

Professor Ali Mohamed Zaki, Faculty of Medicine, Ain Shams University, Cairo Egypt recently spoke to this in an MBC 2 TV interview.

(Continue . . . )

Referral: VDU Charts The Ebola Outbreak

Photo Credit - CDC

 

# 8442

 

 

Dr. Ian Mackay, after a well-deserved week’s respite from blogging, has returned with a summary and case chart on the Ebola outbreak in Western Africa.   Follow the link below to read:

 

Ebola virus disease (EVD) outbreak in West Africa: chart of cases to 04-Apr

Credit Dr Ian Mackay VDU Blog.

The Ebola virus disease (EVD) case chart adjacent is based on the latest Disease Outbreak News (DON) from the World Health Organization (WHO) posted at the Global Alert and Response (GAR) site [1] and at the African Regional Office (WHO-AFRO) [2].

There are roughly 163 suspected, probable and laboratory-confirmed cases including 95 deaths (58.3% proportion of fatal cases) for which only 56 (34.4%) have been confirmed by laboratory testing.

(Continue . . .)

Referral: VDU Blog- Can we believe every H7N9 seroprevalence study we see?

 

# 8431

 

While Dr. Ian Mackay is taking a well deserved (but hopefully brief) blogging break, guest blogger @influenza_bio has penned an absolutely terrific piece on how seroprevalence studies are conducted, and how they can sometimes go wrong. 

I’ll not spoil this beyond saying that - not only do I now know a whole lot more about seroprevalence studies than ever before -  I’ve converted this essay into a PDF file, and it now sits on my desktop for future reference. 

 

By all means, get out of here and go read:

 

Friday, 4 April 2014

Can we believe every H7N9 seroprevalence study we see?

Special Guest writer: @influenza_bio

 

Highly Recommended.

Referral: Dr. Ian Mackay On H7N9 Cases & Possible Alternative Avian Hosts

Heat map of H7N9 Cases – Credit Dr. Ian Mackay

 

 

# 8365

 

 

Professor Ian Mackay has posted a pair of H7N9 centric blogs overnight (my time) on his Virology Down Under blog, and as usual, they are both well worth jumping away from this blog to read. 

 

First Ian takes a look at the H7N9 virus in non-poultry hosts, and examines a recent EID Journal report on the  Possible Role of Songbirds and Parakeets in Transmission of Influenza A(H7N9) Virus to humans.

 

 

H7N9 and human infections: not just a paltry matter

Jones and an all-star cast of colleagues from Hong Kong, Shenzen, Beijing and Tennessee have looked at songbirds and their susceptibility to a human isolate (infectious virus recovered from a human case of H7N9 influenza) H7N9 infection (1).

But before I note the good bits of their study, this paper is one of importance for adding a lot to our understanding of how H7N9 is jumping to people from poultry/live bird/wet markets. It's also a great reference if you want to better understand influenza and birds overall.

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Next up, Ian updates 6 of his terrific charts and maps showing the current case count and status of the H7N9 virus in China.

 

An update on avian influenza A(H7N9) virus cases in humans: Week 56

As we currently stand (this minute), there are 389 laboratory confirmed human cases of infection including perhaps 122 deaths (31% PFC).

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As with all of Ian’s work, both are highly recommended.