Saturday, July 04, 2015

Korean MERS Cluster Rises To 185

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As was mentioned yesterday morning (see Korea: MERS Cases Moved From Samsung Hospital), a third Samsung Hospital HCW over the past days has tested positive for the virus, bringing to 23 the number of doctors and nurses infected during this Korean outbreak.

 

Exactly how, more than six weeks into this outbreak, numerous healthcare workers at one of the most prestigious hospitals in Korea continue to become infected remains a bit of a mystery.

 

On the plus side, the fatality count remains unchanged at 33 for the fourth day in a row, and the number of patients discharged has climbed to 2 to 111.

 

Homers ( Middle respiratory diseases ) one days Tracking

 

- the treatment of 41 patients (22.2%), hospital 111 patients (60.0%) died 33 persons (17.8%) diagnosed with total 185 persons

- day of treatment compared to 1 people feel small , discharge character 2 persons increased , the death toll unchanged , confirmed 1 persons increased

- being treated 41 patients condition is stable for 30 persons (73.2%), unstable 11 patients (26.8%).

- Confirmed type of hospital patients 82 patients , families / visit 64 people , hospital workers 39 people

<1> General Status

□ Department of Health and Human Services Homers central management task force is 7.4 at 06 o'clock today , are treating patients with 41 patients (22.2%) in the first juleotgo people , who discharged two persons increases the total 111 patients (60.0%) it said hayeotdago increased .

○ deaths 33 persons (17.8%) had no change in , confirmed personnel 1 people increased total 185 persons were aggregated .

○ condition being treated patients 30 were stable and 11 were unstable .

<SNIP>

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Friday, July 03, 2015

WHO Statement On The Recurrence Of Ebola Transmission In Liberia

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Five days ago Liberia Announced Their 1st Ebola Case In Three Months, news that was followed over the next two days of two more cases (contacts of the first case) testing positive, and well over 100 contacts being tracked. 

 

While a worrisome turn of events - the recurrence of Ebola in Liberia had always been considered a possibility - and so teams have been diligently testing the deceased whenever someone dies with symptoms consistent with the disease, and the infrastructure to deal with new cases has remained intact.

 

Today the World Health Organization has published the following statement on the return of Ebola to Liberia, and the steps that are currently underway to contain this outbreak.   We are, however, still left with no answers as to how the virus was reintroduced into Liberia.

 

 

Recurrence of Ebola transmission in Liberia

Ebola situation assessment
3 July 2015

On 9 May 2015, Liberia marked an important milestone in the management of their Ebola outbreak. On that day, the country was declared free of Ebola transmission because no new cases had been identified for 42 days after the safe burial of the last person confirmed to have been infected with Ebola virus disease.

Although transmission of the virus had ceased, Liberia remained at high risk of a recurrence of Ebola due to ongoing transmission in neighbouring Guinea and Sierra Leone. For this reason Liberia then entered a 90-day period of vigilance involving testing anyone with features of Ebola virus disease and testing post-mortem swabs for Ebola virus.

On Monday, 29 June 2015, midway through that 90 day period, a post-mortem swab taken from a seventeen-year-old male who died on June 28 from a febrile illness managed as malaria tested positive for Ebola virus disease. In accordance with standard practice for the current period of heightened vigilance throughout Liberia, a Safe and Dignified Burial team buried the young man’s body safely on the same day that he died. That team also took the swab that later tested positive for Ebola virus.

Every week, Liberia has been testing hundreds of such swabs and blood samples taken from anyone with symptoms that may be caused by Ebola virus disease. When this first sample proved positive, the Liberian ‘incident management system’ immediately activated a team to carry out a detailed investigation in the area, and began tracing people who had been in contact with the young man while he was symptomatic.

The investigation revealed that close to 200 people had been in contact with the young man while he had symptoms of Ebola and these people are now being closely monitored. Two of those people have developed symptoms and have tested positive for Ebola virus. Both of these people are being treated in an Ebola treatment centre that had been kept at the ready as part of the 90-day heightened vigilance period.

People in the community where the young man died - Nedowein, Margibi - are now very involved in ensuring that all people who have been in contact with others infected with Ebola do not leave the area and are monitored closely. Where households are quarantined, food and supplies such as bedding and tents to ease household crowding are being provided by UN agencies including UNICEF and the World Food Programme.

The United Nations system and nongovernmental organizations are supporting the Government with necessary supplies such as protective equipment, alcohol-based hand sprays, temperature monitors, and staff already based in Liberia. WHO is sending additional experts in epidemiology and social mobilization to ensure the community is fully involved in identifying contacts and preventing any further disease spread.

The Government has informed the people of Liberia about what is happening, and has reminded them of the key steps needed to take to keep themselves and their communities safe.

WHO MERS Update – Saudi Arabia July 3rd

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The World Health Organization has published a DON update describing 6 recent MERS cases in Saudi Arabia;  two from Riyadh and four linked to the ongoing outbreak in Hofuf which started in mid-April.

 

No known risk exposures are listed for the two Riyadh cases, highlighting the fact that the source of many community-acquired infections remains elusive.   As we discussed yesterday, there remain major gaps in our understanding of how this virus is spreading – particularly outside of the hospital environment.


The four Hofuf cases involve a HCW at a facility where MERS cases are being treated, the relative of an infected HCW, and two patients who appear to have contracted the virus while hospitalized in facilities treating MERS cases.

 

The Hofuf cluster – which now runs roughly 40 cases – has shown signs of slowing with no new cases reported from Hofuf in more than a week, and only 1 case reported from nearby Dammam two days ago. It is  unknown whether the Dammam case is related to the Hofuf cluster. 

 

 

 

Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news
3 July 2015

Between 19 and 30 June 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 6 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the cases are as follows:
  1. A 65-year-old female from Riyadh city developed symptoms on 15 June and was admitted to hospital on 25 June. The patient, who has comorbidities, tested positive for MERS-CoV on 27 June. Currently, she is in critical condition in ICU. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  2. A 40-year-old male from Riyadh city developed symptoms on 24 June and was admitted to hospital on 26 June. The patient, who has comorbidities, tested positive for MERS-CoV on 27 June. Currently, he is in critical condition in ICU. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  3. A 41-year-old male from Hofuf city developed symptoms on 19 June and tested positive for MERS-CoV on 21 June. He is a family relative of a laboratory-confirmed MERS-CoV case that worked in a hospital with an ongoing MERS-CoV outbreak and that was reported in a previous DON on 23 June (case n. 1). The patient, who has comorbidities, was in home isolation; however, as symptoms worsened, he was admitted to hospital on 23 June. The patient has no history of exposure to other known risk factors in the 14 days prior to onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
  4. A 60-year-old, non-national, female health care worker from Hofuf city developed symptoms on 14 June, was admitted to hospital on 15 June and tested positive for MERS-CoV on 19 June. The patient, who has comorbidities, works in a hospital that has been experiencing a MERS-CoV outbreak. Currently, the patient is in stable condition in a negative pressure isolation room on a ward. Investigation of possible links with MERS-CoV cases admitted to this hospital is ongoing.
  5. A 61-year-old female from Hofuf city developed symptoms on 30 May and, on the same day, was admitted to a hospital with an ongoing MERS-CoV outbreak. The patient, who has comorbidities, tested positive for MERS-CoV on 17 June. Currently, she is in critical condition admitted to ICU. Investigation of possible links with MERS-CoV cases admitted to the hospital is ongoing. Investigation of history of exposure to other known risk factors in the 14 days prior to the onset of symptoms is also ongoing.
  6. A 52-year-old male from Hofuf city developed symptoms on 16 June while admitted to hospital for an unrelated medical condition since 29 April. This hospital has been experiencing a MERS-CoV outbreak. The patient, who has comorbidities, tested positive for MERS-CoV on 18 June. Currently, the patient is in stable condition in a negative pressure isolation room on a ward. Investigation of possible links with MERS-CoV cases admitted to the hospital is ongoing.

Contact tracing of household and healthcare contacts is ongoing for these cases.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of a MERS-CoV case that was reported in a previous DON on 23 June (case n. 3).

Globally, since September 2012, WHO has been notified of 1,363 laboratory-confirmed cases of infection with MERS-CoV, including at least 487 related deaths.

Saudi MOH: 1 Additional MERS Case

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The intermittent trickle of MERS Cases from Saudi Arabia continues today with a lone case reported from Turubah, in Makkah province.   Details, as usual, are scarce and so we don’t have any clue as to how this person was infected.

 

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Thailand Discharges Their First (and Only) MERS Case

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In sharp contrast to the South Korean experience, Thailand has successfully identified, isolated, treated and now released their first imported MERS case – all without incurring secondary cases among patients, staff or visitors to their healthcare facilities.

 

The case was described by the WHO in a June 20th update:

The case is a 75-year-old, Omani male that travelled from Oman to Thailand to seek medical care. The patient, who has comorbidities, developed symptoms on 10 June and was admitted to hospital in Oman. As symptoms did not improve, he decided to travel to Thailand to seek treatment. He took a flight with three family members and arrived in Bangkok on 15 June. Neither the patient nor his family members reported fever upon arrival in Thailand. He was admitted to hospital on 15 June and tested positive for MERS-CoV on 18 June. On 18 June, the patient and his three family members were transferred to another health care facility where they were put in isolation. Currently, the patient is in stable condition.

 

Although it never hurts to get lucky in these sorts of situations, nothing trumps good infection control and contact tracing. Over the following 2 weeks 176 contacts were quarantined or isolated, and none developed the illness.   Today, the Omani patient has been certified free of the virus and has been discharged.


This from Reuters.

 

 

Thailand's first MERS case to leave hospital

July 3, 2015 2:50 pm

BANGKOK (Reuters) - An Omani man who became Thailand's first case of Middle East Respiratory Sydnrome (MERS) has made a full recovery and will be discharged from hospital on Friday, the health minister said.

The 75-year-old man, who had travelled to Bangkok for treatment for a heart condition and was then diagnosed with the virus, was declared free of the disease earlier this week.


"The medical team looking after the patient and three of his relatives have decided that they can return home," Public Health Minister Rajata Rajatanavin told reporters, adding that the man and three of his relatives who travelled with him to Bangkok were preparing to leave an infectious diseases facility.

(Continue . . .)

 

 

Korea: MERS Cases Moved From Samsung Hospital

koream Map

 

 

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As one of the largest, most respected, and best equipped hospitals in Korean, Samsung Hospital in Seoul, South Korea would seem to be the ideal place to isolate and treat MERS cases.  The reality, however, has been that nearly half of the 184 cases to date have been acquired by patients, staff, and visitors to that facility, and new cases continue to appear.


Over the past two nights we’ve seen two nurses announced infected, and there are reports today of a doctor being tested for the virus.  Final results should be available by the end of the day.

 

Between the hospital’s inability to stop the spread of the virus, and the attrition amongst their medical staff (14 have been infected), the decision has been made to move  12 of their 15 MERS cases to two other hospitals. 

 

Of the three others, one is ready to go home and two are unable to be moved due to the treatment they are receiving for pre-existing conditions.

 

Follow the link below to read the entire report in the Korea Times.

 

MERS patients at Samsung Medical moved


By Kim Se-jeong

Middle East Respiratory Syndrome (MERS) patients at Samsung Medical Center (SMC) have been transferred to two state-run hospitals in Seoul, according to the Ministry of Health and Welfare, Friday.

The transfer came after concerns SMC could breed further cases because new outbreaks keep on occurring there, including two nurses who were diagnosed the previous day.

At SMC, 15 patients were treated. Nine of them were transferred to either the National Medical Center or the Seoul Metropolitan Government-Seoul National University Boramae Medical Center. Three more are waiting to be moved.

(Continue . . . )