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Friday, November 30, 2012

New SARS-related coronavirus claims a third life


New SARS-related coronavirus claims a third life


Jennifer Yang

Three people have now died from the new coronavirus in the Middle East — two of whom were relatives from the same Saudi Arabian household, the World Health Organization confirmed Friday.
There are now a total of seven confirmed cases, which is up one from last week. An eighth case has been deemed “probable” but confirmation of infection may not be possible, according to WHO spokesperson Glenn Thomas, who said tests are still underway.
So far, this new virus — which is genetically related to the virus that caused SARS — has been popping up in three regions: Doha, Qatar, where two citizens have been infected, and the Saudi Arabian cities of Jeddah and Riyadh, which are approximately 850 kilometres apart.
The first case was a 60-year-old Saudi Arabian man who was hospitalized in Jeddah on June 13.
“The newly reported cases demonstrate that the virus has persisted over a period of at least 5 months and is geographically distributed over a wider area than was evidenced by the first two cases,” the WHO said in a Nov. 28 surveillance recommendation report.
“Given that the exact extent of the distribution is unknown, WHO is taking the precaution of recommending an expansion of surveillance to monitor for the appearance of the virus in other countries.”
All of the victims have been male but “the significance of this is unknown,” the release said.
The WHO said it still does not know the source of the virus or its mode of transmission but the family cluster of cases has raised questions over whether the virus might be transmitting from person to person — as was the case with SARS.
Three members of the same Saudi Arabian family have now been infected, two fatally. A fourth relative is the probable case. All were treated in Riyadh, according to Thomas.
But last week, WHO spokesperson Fadéla Chaid cautioned that it is difficult to know if the family members may have infected each other or simply been exposed to the same environmental source, since they all lived in the same household.
Early investigations show that the coronavirus is closely related to one found in bats, but the WHO said there is no proof yet that bats are the animal reservoir. It is not known whether the family members who have been infected worked with animals.
“The timing of the cases in the Saudi cluster does raise that concern (of human-to-human transmission),” Chaib said last week. “But when a cluster occurs in a setting such as a household, where everyone has similar environmental exposures, it can be very difficult to separate out exposure to the same environmental source versus spread from one person to another.”
There has been some inconsistency around the number of cases and the way in which new cases have been publicized.
The first case, the 60-year-old Saudi Arabian man, died in mid-June but information about his death and the novel coronavirus was not widely disseminated until late September, when a Jeddah hospital microbiologist investigating his case posted an email on ProMed, an infectious disease reporting website.
The second case came to light after microbiologists in the United Kingdom’s Health Protection Agency noticed the ProMed posting — at the time, they were looking into a case involving a Qatari patient who had been airlifted to a London hospital with serious respiratory problems. He was quickly confirmed as the second case.
A third case was publicized by the Saudi Arabian Ministry of Health in early November in a news release. Then on Nov. 23, the WHO announced the total of cases as six, with two confirmed deaths — that same day, Germany’s national health institute published a news release confirming that a German clinic had been treating a Qatari citizen with the novel coronavirus, who had recovered and been released.
The WHO announcement said at the time that two of the confirmed cases were from the same family, one of whom had died; two other relatives had also sickened but one tested negative and the other, who passed away, still had laboratory tests pending.
On Nov. 28, the WHO published its interim surveillance recommendations for the novel coronavirus and included an update that brought the case total up to seven, with one probable case. It did not directly state the total number of deaths but said four patients had “developed acute renal failure; one of these has died.”
The recommendations were revised two days later to say that five of the seven confirmed cases had “developed acute renal failure and three of these died.”
According to Thomas, the surveillance recommendations are in the process of being updated with clarifications on the number of cases. “Significant information” about the novel coronavirus will be announced on the WHO’s website, under the Disease Outbreak News section, Thomas said in an email Friday morning.
The WHO recommendations describe the clinical picture of the new coronavirus as an acute respiratory infection. All of the confirmed cases showed signs of pneumonia.
The coronavirus is named for its crown-like appearance under the microscope and prior to 2002, there were only two known coronaviruses, both associated with the common cold. SARS was the third known coronavirus and caused an outbreak in 2003 that swept across 30 countries and killed approximately 800 people, including 44 Torontonians.  http://www.thestar.com/news/world/article/1295819--new-sars-related-coronavirus-claims-a-third-life