At U.N., Obama's BFF Rouhani calls for investigation into haj crush.

At U.N., Obama's BFF Iran's Rouhani calls for investigation into haj crush. (Taz).

Iranian President Hassan Rouhani used a major United Nations speech on Saturday to demand an investigation into a crush that killed over 700 people at the haj pilgrimage in Saudi Arabia, Reuters reported.

The fact that Rouhani used a U.N. summit meeting on global development goals to reiterate Iran's outrage over the haj tragedy was a sign that Tehran does not intend to tone down criticism of its regional rival Saudi Arabia. Both Iran and the Saudis see themselves as leaders in the Muslim world.

In his speech to the 193-nation U.N. General Assembly, Rouhani emphasized the need for an investigation into "the causes of this incident and other similar incidents in this year's haj." He describe the crush as "heart-rending."

Speaking to reporters before a meeting with U.S. Secretary of State John Kerry, Iranian Foreign Minister Mohammad Javad Zarif repeated that "we need to address the disastrous event in Saudi Arabia."  Hmmmm....... Zarif while meeting Kerry also mentioned the "the unfortunate developments in Saudi Arabia over the last week," which he said need to be addressed in the "proper international forum." Seems the 'love' the Obama 'admin' had for the Saudis is dead and buried.

Saudi Arabia: 2 new MERS-CoV cases reported

Saudi Arabia: 2 new MERS-CoV cases reported.HT: Croft.

In their first announcement of new cases since August 1st (see MERS-CoV: KSA Announces 3 More Cases), the Saudi MOH reports this morning on two patients (ages 50 & 59) from the Riyadh region, both with histories of (unstated) chronic ailments, who are both in intensive care diagnosed with MERS.

Although no word has appeared on the English language KSA MERS website, its Arabic counterpart carries the following (very brief) report on these two new cases and an updated graphic (see above).

India: Suspected MERS-CoV case in Mumbai.

India: Suspected MERS-CoV case in Mumbai.HT: Croft.

Report in The Times of India: 40-year-old man Mumbai's first suspected Gulf virus case. Excerpt:

MUMBAI: In the first suspected case of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the city, a Vashi resident has been quarantined at Kasturba Hospital in Chinchpokli. 

The viral respiratory illness, termed deadly because of a 60% mortality rate, is currently wreaking havoc in Gulf countries. 

The 40-year-old man was admitted to the hospital's ward 30, meant for infectious diseases, on Wednesday afternoon with complaints of fever and a progressing pneumonia (inflammation of lungs). The patient had returned to India on August 12 after spending 35 days in Saudi Arabia. 

Of the 46 deaths due to MERS-CoV reported globally, a majority were from Saudi Arabia, where the virus had first emerged in 2012. 

The Vashi resident had contacted a local physician in Navi Mumbai after his fever did not subside for almost a week. 

In most cases detected globally, MERS-CoV has been found to cause a lung infection. Fever with chills, cough, breathing problems and gastrointestinal ailments were some of the other symptoms. While the Vashi resident had pneumonia in the left lung, he did not show any signs of breathlessness. 

After the patient tested negative for H1N1, doctors suspected that he had caught the virus during his stay in Saudi Arabia. His samples have been sent to the National Institute of Virology (NIV) in Pune. 

A civic official said, "The patient has been started on antiviral oseltamivir. He is responding well to medication." The NIV report is expected to arrive by Friday. 

Executive health officer Dr Arun Bamne said the patient was doing well. "He is not critical and we have kept him in isolation for observation," he added. The patient does not live with his family, another civic official said.

It's a Bird....A Bat...Oh No....Scientists find MERS-like antibodies in camels.

It's a Bird....A Bat...Oh No....Scientists find MERS-like antibodies in camels.HT: Ottowa citizen.By By Helen Branswell.

European scientists have uncovered a clue to the mystery of where the new MERS coronavirus resides in nature, reporting evidence that dromedary camels can be infected with the virus.

The finding is the first confirmation of MERS infection in a species other than humans, though it does not prove that the animals are the source of infections in people, the authors were quick to say.
"I think it shows that something — either MERS or something that looks very similar to it — has been going around in camels, and that that really needs to be looked at as a possible source. That's as far as we can go, I would say," senior author Dr. Marion Koopmans said in an interview about the study, published in this week's issue of Lancet Infectious Diseases.
Koopmans and colleagues found antibodies to MERS or a closely related coronavirus in the blood of camels from Oman on the Arabian Peninsula and also on the Canary Islands, an archipelago off northwestern Africa which is part of Spain.
The fact that camels may be a source of the virus adds urgency to the task of finding out how people are getting infected and trying to prevent future infections.
That's because the animals are among a number slaughtered for sacrifice as part of the Hajj, the massive annual pilgrimage that draws several million Muslims to the holy city of Mecca in Saudi Arabia. All Muslims who are able are required by their faith to make the pilgrimage at least once in their lifetime.
To complete the responsibilities of the Hajj, each pilgrim must participate in the sacrifice of an animal. That participation often takes the form of contributing to the cost of buying and slaughtering the animal and then distributing the cooked meat to family members and the poor.
The animal sacrifices take place during Eid al Adha — the feast of sacrifice — that concludes the Hajj. This year the pilgrimage will occur in early to mid-October.
"Given that animal sacrifice is an essential and a mandatory component of the Hajj of the pilgrims ... finding an answer as quickly as possible would be quite important," said Dr. Kamran Khan, an infectious diseases physician at Toronto's St. Michael's Hospital who specializes in using airline traffic data to predict the global movement of diseases.
"I do think what this really does is helps guide some of the further investigations now. But there is certainly some time sensitivity around it."
The World Health Organization's lead expert on the MERS virus agreed getting answers sooner rather than later would be a good idea in light of the fast-approaching Hajj.
"If this virus is actually transmitting and circulating in camels and-or other animals, that could be a time of exposure," said Dr. Anthony Mounts. "It does mean that we need to do the investigations to find out the routes of transmission."Read the full story here.

Saudi Arabia confirms more MERS cases.

Saudi Arabia confirms more MERS cases.

JEDDAH, SA – Three more confirmed cases of Middle East Respiratory Syndrome (MERS) coronavirus infections in Saudi Arabia have been recorded, the Ministry of Health said on Thursday. 

A statement posted on the ministry’s website said one of the patients is a 67-year-old woman in Riyadh, who had been suffering from various chronic diseases. She is now under intensive care, receiving the health care and proper treatment. The two other cases are both women health workers, one of them living in Asir region and the other in Riyadh. “They have mild symptoms but their health status is stable,” said the MOH. The new cases bring to 92 the total number of people who have contracted the virus worldwide, including 71 in Saudi Arabia.
Of the 92 cases registered with the World Health Organization since last year, 46 have died, including 39 in Saudi Arabia. The latest MERS death in the Kingdom, announced by the Ministry of Health on July 25, was an 83-year-old man in Asir. Saudi and UK scientists studying MERS said the coronavirus is more deadly, unpredictable and has significant differences from severe acute respiratory syndrome (SARS) virus that erupted in Asia in 2003 and infected 8,273 people, nine percent of whom died. Ziad Memish, Saudi deputy minister for public health, earlier said: “MERS coronavirus appears to be more deadly, with 60 percent of patients with co-existing chronic illnesses dying, compared with the one-percent toll of SARS.”

He said that the MERS infecting humans is unpredictable because the source of the virus is not yet known. While sharing clinical similarities with the SARS-like fever, cough and incubation period, he said there are also some important differences such as the rapid progression to respiratory failure of up to five days. The progression occurs earlier than in SARS. In a Lancet Infectious Diseases publication, Saudi and UK scientists also noted a trend of older patients with more men and patients with underlying medical conditions succumbing to the disease. The symptoms of patients suffering from MERS coronavirus are fever (98 percent), chills (87 percent), cough (83 percent), shortness of breath (72 percent), and muscle pain (32 percent). A quarter of patients also experience gastrointestinal symptoms, including diarrhea and vomiting. However, in SARS, the majority of cases (96 percent) occurred in people with underlying chronic medical conditions including diabetes (68 percent), high blood pressure (34 percent), chronic heart disease (28 percent), and chronic renal disease (49 percent).

Read the full story here, Albawaba.

Related: NEJM on person-to-person spread of MERS

All Confirmed Hospitalized Al Hasa MERS-CoV Dialysis Cases Died. - Case fatality rate of 76 percent.

All Confirmed Hospitalized Al Hasa MERS-CoV Dialysis Cases Died. - Case fatality rate of
 76 percent .HT:Recombinomics.

The New England Journal of Medicine report on the MERS-CoV nosocomial outbreak at 4 hospitals in the Eastern Region of Saudi Arabia clearly demonstrates the role of the index case and super spreader in the infection of 23 confirmed cases. 

However, in addition to the 23 confirmed cases, the authors identified 11 probable cases, who were defined as pneumonia cases linked to confirmed cases, but who were not laboratory confirmed because no sample was available or only one negative test was run.

The confirmed dialysis cases did not fare well. One patient had a mild case and was not hospitalized. However, all 8 of the cases who were hospitalized died.

The status of patients was updated on June 12. For the 23 confirmed cases, 15 had died and 6 had been discharged (including the case who was not hospitalized). 2 cases were still hospitalized in critical condition on June 12, but have since died. The two probable cases in supplement figure 2 also died. Thus, for the 25 cases with public outcomes (23 confirmed and 2 probable - index case and super spreader), 19 died and 6 survived to produce a case fatality rate of 76%. The survivors were concentrated in the cases who were previously healthy. All three of the family members (patient M, O, and S) who were linked to three confirmed cases (patient G, S, and A) survived, as did the nurse (patient R) infected by the index case.

However, it remains unclear as to why the 11 suspect cases were not confirmed, since most were dialysis case and all eight of the confirmed dialysis cases died and the unconfirmed cases developed symptoms in the same time frame as the confirmed cases.

The dramatic spread of MERS-CoV in the Al Hasa hospitals raised concerns that more such spread would be seen, which was confirmed by reports of additional cases in the eastern region which were at unnamed hospitals in unnamed cities. 

More recently MERS-CoV has been confirmed in health care workers in Taif (in western KSA), as well as Riyadh (also west of the eastern region), but 4 of the health care workers (2 in Taif and 2 in Riyadh) were asymptomatic.

Thus, it is unclear why MERS-CoV was not confirmed in fatal and serious pneumonia cases in Al Hasa, but MERS-CoV was detected in asymptomatic HCWs and children in the most recent KSA reports.Read the full story here, with more indepth info and with more links.

Related: From ForeignPolicy:

When the Black Death exploded in Arabia in the 14th century, killing an estimated third of the population, it spread across the Islamic world via infected religious pilgrims. Today, the Middle East is threatened with a new plague, one eponymously if not ominously named the Middle East respiratory syndrome (MERS-CoV, or MERS for short). This novel coronavirus was discovered in Jordan in March 2012, and as of June 26, there have been 77 laboratory-confirmed infections, 62 of which have been in Saudi Arabia; 34 of these Saudi patients have died.

Saudi Arabia - MERS-coronavirus breakthrough.

Saudi Arabia - MERS-coronavirus breakthrough.(SG).By Saeed Al-Khotani.

RIYADH – In a breakthrough to help identify the mysterious Middle East Respiratory Syndrome-coronavirus (MERS-CoV) which has killed 31 people mostly in Saudi Arabia, the Ministry of Health announced on Tuesday the completion of the genetic sequence of four infections in Al-Ahsa.

This is a significant move that could lead to a breakthrough in revealing the genetic mystery and generate more information on the virus, which will eventually lead to finding a quick diagnostic methodology and a vaccine against it, said Dr. Khalid Marghalani, adviser to the minister and MOH spokesman.

The study was conducted by a selected team of Saudi and British researchers and scientists from the ministry and two British institutions: the University College in London (UCL) and the Wellcome Trust Sanger Institute in Hinxton, south of Cambridge.

Marghalani said that the complete genome of the four Al-Ahsa infections has been recorded on the GenBank database, which is available for all in accordance with the established norms, through the bank’s website.

For update on the detail of these latest developments, the Ministry of Health asked local and international researchers and health professionals to refer to updates from No. kf186564 to kf186567 at the GenBank website.

The ministry hoped that these new findings might help these researchers and professionals in finding ways to develop a vaccine against the virus.

The World Health Organization on Monday urged health workers around the world to be on the alert for symptoms of the deadly MERS, which has the potential to circle the globe and cause a pandemic. The United Nations agency, which issued new, long-awaited guidance to countries on influenza pandemics, said the world was also in the same “alert phase” for two human strains of bird flu – H5N1, which emerged a decade ago, and H7N9, first detected in China in March.

“We are trying to find out as much as we can and we are concerned about these (three) viruses,” Andrew Harper, WHO special adviser for health security and environment, told a news briefing on its new scale for pandemic risk.Read the full story here.

WHO to help Saudi Arabia investigate MERS coronavirus before haj.

WHO to help Saudi Arabia investigate MERS coronavirus before haj.(AA).

The World Health Organization (WHO) said on Friday that it would help Saudi Arabia dig deeper into deadly outbreaks of a new SARS-like virus to draw up advice ahead of the annual haj pilgrimage, which attracts millions of Muslims.

The U.N. agency, which is not currently recommending any restrictions on travel to the kingdom or screening of passengers at airports or entry points, will sent a second team of experts in the coming weeks, WHO director-general Margaret Chan said.

The virus, which can cause coughing, fever and pneumonia, emerged in Saudi Arabia last year and has been found in 33people there, killing 17. They are among 44 cases and 22 deaths worldwide, according to the WHO, which has called it the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

“Without that proper risk assessment, we cannot have clarity on the incubation period, on the signs and symptoms of the disease, on the proper clinical management and then, last but not least, on travel advice,” Chan told the WHO’s annual ministerial meeting in Geneva.

The WHO, which sent a first team to Saudi Arabia this month, will provide a fresh risk assessment ahead of this year’s haj, which takes place in October.

“We need to get the facts clear and get the appropriate advice to all your countries where your pilgrims want to go to Mecca. It is something quite urgent,” Chan said. The virus has also been found in Jordan, Qatar, Tunisia, United Arab Emirates, while isolated cases have been exported to France, Britain and Germany by visitors.

Saudi Arabia said on Friday that tighter controls had helped to stamped out a MERS-CoV outbreak in a hospital in the eastern region of al Ahsa, which infected 22 people, killing 10. Read the full story here.

Related:  Will the Hajj pilgrimage unleash the MERS, 'Middle Eastern respiratory syndrome coronavirus' on the world?