Saudi Arabia Hires Israeli-Friendly Company for Hajj Security.

Saudi Arabia Hires Israeli-Friendly Company for Hajj Security.(AA).

This year, the mandatory Muslim pilgrimage to Mecca, or hajj, will compound the Palestinians’ woes. Palestinian pilgrims will be greeted by a company that assists in their repression – and even torture – under the Israeli occupation regime. Indeed, hajj this year will be brought to you by none other than G4S.

This is not the first time that the Saudi government has hired the private security firm, which has recruited a staggering 700,000 to provide hajj-related services this year, according to exclusive information obtained by Al-Akhbar. Most of the leaked reports indicate that security for the hajj season since 2010 has been entrusted to al-Majal G4S, an affiliate of the parent company G4S.

The private security contractor has also been implicated in enabling the torture of administrative detainees in Palestine, including children, according to BDS activist Zaid Shuaibi.

The CEO of al-Majal G4S is a former security official in Saudi named Khaled Baghdadi. The Saudi subsidiary is fully owned by the British-Danish firm.

The parent company has not disclosed the nature of the contracts it has signed with the Saudi authorities. In its periodic reports, G4S makes limited references to its Saudi operations, such as winning a contract with Jeddah Metro to assist with security during the hajj, or stating that the company assists in the transport of more than 3 million pilgrims who visit Mecca each year. In 2011, the website Asrar Ararabiya – Arab Secrets – published an ad by the company asking people to apply to work in Mecca for seven days only, during hajj.
The Boycott, Divestment, and Sanctions (BDS) campaign has not been sitting idly by. In a press conference on Wednesday, October 2, the campaign sent a clear message to the Saudi government, urging it to terminate the contract with the company that happens to provide equipment and security services to protect Israeli settlements, occupation checkpoints, and police facilities. The private security contractor has also been implicated in enabling the torture of administrative detainees in Palestine, including children, according to BDS activist Zaid Shuaibi.
BDS activists were not the only ones to react to the news. Sheikh Ekrima Sabri, the head of the Supreme Islamic Council in Jerusalem and the imam of al-Aqsa Mosque, has proclaimed, “This company operates in security, and has activities and commitments in areas under Israeli occupation. Those who help the occupation must be held accountable and are complicit in the crime, as those who help aggressors also are aggressors.”
Shuaibi, speaking to Al-Akhbar, said that the BDS campaign contacted the Palestinian Ministry of Economy, being the competent authority in the issue of boycotting settlements, such as the ones serviced by G4S. But according to Shuaibi, “The ministry did not bother to respond or take action to stop the abuse, even as the company violates Palestinian law by continuing to provide services to the settlements.”Hmmmm.....Must be a 'Zionist plot'.lol

MERS: Silence in the Gulf.

MERS: Silence in the Gulf.(Croft).

Click through to HAAD News, the English website of the Health Authority of Abu Dhabi, and you'll see the most recent news item is dated June 17. Yet The National, a newspaper in the United Arab Emirates, published a report on July 19 about four local doctors who'd contracted MERS. WHO reported the same cases on July 18. Meanwhile, the Saudi Ministry of Health reports only when it has new cases, when it also slips in any "passed away" cases. Other Gulf states' media are also silent in the face of the new threat.
In a sense, this is understandable. Unlike flu bloggers, few people like to dwell on bad news, and would rather not deal with it unless they have to. For governments, disease poses a threat far worse than mere illness—embarrassment. Hence the Cuban government's silence about cholera (see below).
But surely these governments' media experts (to say nothing of their public health experts) must be telling them this strategy is counterproductive. It only inspires skepticism in their publics about the competence and concerns of their rulers.
By contrast, consider the Centre for Public Health in Hong Kong, a continent away from the Gulf but studiously reporting every suspected MERS patient who turns up...and also keeping Hong Kongers aware of the confirmed cases in the Gulf.
Apart from informing its constituents, the CHP is also building credibility with every report. I like to poke affectionate fun at the CHP because it tells us about every outbreak of sniffles in every kindergarten in the region. But because it takes pains with the small stuff, a serious alarm from CHP will command instant public attention.
The Gulf strategy has another drawback: It defines MERS in terms of deaths and recoveries, not in terms of the public-health response to it. This turns the disease into a series of shocks, and conditions us to wait anxiously in the pauses for the next death.
If instead the Gulf states (especially Saudi Arabia) were releasing news about the condition of the patients, the research efforts being made to learn about the disease, and what's being learned, the death reports would be incidents in an ongoing story—not the bombshells they now are.

Earlier this month, the ministry issued health rules and regulations for Haj and Umrah pilgrims for the current year in the wake of an outbreak of Middle East Respiratory Syndrome (MERS). These included postponing Haj and Umrah rituals by those above the age of 65 as well as chronic patients, including those suffering from diseases of heart and kidney, and also those having respiratory problems. Pregnant women and children below the age of 12 were also discouraged from performing the rituals at least for the time being. 

MERS and the Hajj a recipe for pandemic?

MERS and the Hajj a recipe for pandemic?(Crofts).

Thanks to Jennifer Yang for tweeting the link to this PLOS Curents Outbreaks article: Potential for the International Spread of Middle East Respiratory Syndrome in Association with Mass Gatherings in Saudi Arabia. The abstract:

Background: A novel coronavirus (MERS-CoV) causing severe, life-threatening respiratory disease has emerged in the Middle East at a time when two international mass gatherings in Saudi Arabia are imminent. While MERS-CoV has already spread to and within other countries, these mass gatherings could further amplify and/or accelerate its international dissemination, especially since the origins and geographic source of the virus remain poorly understood. 

Methods: We analyzed 2012 worldwide flight itinerary data and historic Hajj pilgrim data to predict population movements out of Saudi Arabia and the broader Middle East to help cities and countries assess their potential for MERS-CoV importation. We compared the magnitude of travel to countries with their World Bank economic status and per capita healthcare expenditures as surrogate markers of their capacity for timely detection of imported MERS-CoV and their ability to mount an effective public health response. 

Results: 16.8 million travelers flew on commercial flights out of Saudi Arabia, Jordan, Qatar, and the United Arab Emirates between June and November 2012, of which 51.6% were destined for India (16.3%), Egypt (10.4%), Pakistan (7.8%), the United Kingdom (4.3%), Kuwait (3.6%), Bangladesh (3.1%), Iran (3.1%) and Bahrain (2.9%). Among the 1.74 million foreign pilgrims who performed the Hajj last year, an estimated 65.1% originated from low and lower-middle income countries. 

Conclusion: MERS-CoV is an emerging pathogen with pandemic potential with its apparent epicenter in Saudi Arabia, where millions of pilgrims will imminently congregate for two international mass gatherings. Understanding global population movements out of the Middle East through the end of this year’s Hajj could help direct anticipatory MERS-CoV surveillance and public health preparedness to mitigate its potential global health and economic impacts.

CIDRAP: Four more MERS cases cited in UAE, 2 in Saudi Arabia.

CIDRAP: Four more MERS cases cited in UAE, 2 in Saudi Arabia.(Crofts).

Via CIDRAP, Robert Roos wraps up a surprising day: Four more MERS cases cited in UAE, 2 in Saudi Arabia. Excerpt:

The six new cases raise the unofficial global count of MERS cases to 90, including 45 deaths. The WHO count, which does not yet include the two new Saudi cases, is 88 cases with 45 deaths. Saudi Arabia's posted tally is now 70 cases and 38 deaths. 

The four UAE cases apparently bring that country's case count to six, which includes an 82-year-old man whose illness was reported last week and a UAE man who was flown to Germany for treatment and died there in March. In addition, a 65-year-old man from France fell ill with MERS in May after traveling in the UAE. 

The eight cases reported in the past 2 days are in keeping with a recent trend noted by the WHO last week: younger patients, less severe illness, and more women. In particular, eight other asymptomatic cases were reported in late June, including four in female healthcare workers and four in children, all in Saudi Arabia. 

The new unofficial tally of 90 cases and 45 deaths represents a case-fatality ratio of 50%—lower than the 56% cited by the WHO in its MERS situation summary on Jul 9. 

In that report, the WHO also observed that cases resulting from person-to-person transmission seem to be milder than those apparently involving transmission from non-human sources. The agency said it was unclear whether that phenomenon was an artifact of surveillance and case-finding efforts or signaled that infections acquired from non-human sources are more virulent.

Doctor helps hospitals in Middle East, US to prepare for MERS.

Doctor helps hospitals in Middle East, US to prepare for MERS.(Croft).

Report from Georgetown University: Doctor Helps Hospitals in the Middle East and U.S. Prepare for MERS. Excerpt:

A Georgetown expert on global viral outbreaks is helping health departments and hospitals in the Middle East and the United States prepare to fight a new deadly virus before millions of Muslims travel to Mecca in October. 

Dr. Daniel Lucey, an infectious disease and public health physician, and an adjunct professor of microbiology and immunology at Georgetown University Medical Center (GUMC), left for the Middle East on July 4 to help respond to Middle Eastern Respiratory Syndrome Coronavirus (MERS). 

“MERS is SARS until proven otherwise – and it is much more lethal so far in hospitalized patients,” Lucey says, referring to Severe Acute Respiratory Syndrome, which he worked on in the early 2000s. 

According to the Centers for Disease Control and Prevention (CDC), as of July 2 MERS has killed almost 55 percent of its 62 victims in Saudi Arabia, and infected a total of 77 people in eight countries, killing 40 people (64 percent) who contracted the virus. 

IDEAL BREEDING GROUND 

No cases have been reported in the United States, but a few have been in France, Germany, Italy, Tunisia and the United Kingdom. 

Of particular concern in Saudi Arabia is the time between Ramadan, which starts July 9 through the Muslim Hajj in mid-October. 

“The Hajj is the world’s largest annual pilgrimage, when more than 3 million Muslims make there way to Mecca in Saudi Arabia,” Lucey says. 

ENHANCED SURVEILLANCE 

Lucey’s expertise on SARS, MERS and other infectious diseases has led him to travel to five countries – Qatar, Jordan, Egypt, the United Arab Emirates, and France – since April to give lectures and work with hospitals on infection control. 

“This disease represents a significant public health risk under the International Health Regulations …,” the World Health Organization stated in a May 28 press release. “WHO has issue recommendations for enhanced surveillance and precautions for the testing and management of suspected cases, and is working closely with countries and international partners.”

Related:  India: Government indifference to MERS puts airlines in a fix

Over a thousand passengers arrive in Mumbai every day from the Gulf states, including several Umrah pilgrims who return from their Umrah to Saudi Arabia, which has seen the highest number of deaths due to MERS till now. Air India alone flies 600 passengers from Jeddah and Riyadh everyday. Umrah pilgrims fly back after spending 14 days in camps in the United Arab Emirates. 

"Most of the poor subsidised pilgrims fly Air India as it is the official carrier," said an airline official who did not want to be named. "Since they are travelling on a subsidy their camps are not very hygienic. Air India crew, thus, are at the highest risk. But neither the airline nor the government has taken any steps to address this issue." 

MERS likely to spread as UAE-Saudi travel increases.

MERS likely to spread as UAE-Saudi travel increases.(Croft).

Via The National, a report datelined Abu Dhabi: Mers virus likely to spread as UAE-Saudi travel increases. Excerpt:

The Mers virus is more likely to spread as travel increases between the UAE and Saudi Arabia, where most cases of the disease have been found, doctors have warned. 

The Haj will take place in October and Saudi authorities have advised the sick and elderly not to make pilgrimages this year. Those who do travel have been advised to wear face masks. 

More immediately, with unrest elsewhere in the Middle East disrupting holiday plans, increasing numbers of Saudi travellers are now heading for the UAE. That, too, increases the risk that the disease might spread, doctors say. 

The problem is that experts do not know how the Middle East respiratory syndrome coronavirus (Mers-CoV) is spread. 

"We have not confirmed how it is transmitted. We know that Mers-CoV is in the community and I would say everyone, especially medical establishments and emergency departments, needs to be vigilant," said NG Wai-Khuan, the infection prevention section head at Mafraq Hospital in Abu Dhabi. 

The 82nd victim of the virus is in intensive care in an Abu Dhabi hospital after the condition was diagnosed at the weekend. The Emirati, 82, was already being treated for multiple myeloma, a cancer of the bone marrow. Patients with existing conditions are particularly susceptible to Mers. 

Although Mers has a high mortality rate - of 65 people infected in Saudi Arabia, 38 have died - the spread of infection has been very low: about 20 cases a month.

Saudi Arabia warns pilgrims over MERS.

Saudi Arabia warns pilgrims over MERS.(Crofs).

Via BBC News: Saudi Arabia warns pilgrims over coronavirus. Excerpt:

Health officials in Saudi Arabia have asked pilgrims visiting its holy sites to wear masks in crowded places to stop the spread of the MERS coronavirus. 

A list of requirements issued by the health ministry also tells elderly people or those with chronic diseases to postpone their pilgrimage. 

Thirty-eight people have died from the virus in Saudi Arabia. 

Millions of Muslims from around the world are expected to take part in the Hajj this October. 

Once a year, pilgrims make the journey to Mecca in Saudi Arabia and pray together before the Kaaba. Muslims also travel to the site at other times, as well as visiting the Masjid Al-Nabawi, or Mosque of the Prophet, in Medina. 

Health officials urged people taking part to maintain personal hygiene standards, use a tissue when sneezing and coughing, and have the necessary vaccinations.

Emirati man diagnosed with MERS & CDC issues MERS preparedness checklists.

Emirati man diagnosed with MERS and CDC issues MERS preparedness checklists.(Croft).

Thanks to Helen Branswell for tweeting the link to this July 12 GulfNews.com report: Emirati man diagnosed with Sars-like virus .

An 82-year-old UAE national has been diagnosed with novel Coronavirus (MERS-CoV) in one of the hospitals in Abu Dhabi. The patient is male with multiple myeloma and is currently admitted in the ICU. 

The Health Authority in Abu Dhabi (HAAD) has confirmed that it is coordinating with the Ministry of Health and other authorities in the country and has taken the necessary measures as per the international standards and recommendations of the World Health Organization (WHO). 

The Ministry of Health stated that the WHO first issued an international alert in September 2012. Up to date the WHO confirmed a total of 80 laboratory-confirmed cases of infection with MERS-CoV worldwide. This case represents the first diagnosed case of the disease within UAE. 

MOH added that WHO confirmed that the virus is not a concern for public health at the moment, and that the current situation does not require a travel ban to any country in the world, nor screenings at different ports, nor any restrictions on trade.

In her tweet, Branswell says: "Not sure MOH is interpreting @WHO  correctly."

Thanks to Dr. Vincent Racaniello for tweeting the link to this CDC item: MERS-Preparedness. Click through to see the checklists and use the links. Excerpt:

CDC has compiled various tools that can be adapted for MERS-CoV. They were initially developed to assist public health, healthcare, and emergency management in preparing for and reducing surge on the healthcare system due to influenza pandemic and SARS.

WHO convenes emergency meeting on MERS - Updated report.

WHO convenes emergency meeting on MERS - Full report.HT: Crofs.

Margaret Chan, the director-general of the World Health Organisation, said yesterday that she had decided to convene the agency's emergency committee, for just the second time, to help protect travellers to the annual Haj pilgrimage from the coronavirus that has killed 38 people in Saudi Arabia. 

The 15-member committee, which includes the deputy health minister of Saudi Arabia, Ziad Memish, and health officials from six other predominantly Muslim countries, will meet via teleconference today to decide whether the Middle East respiratory syndrome coronavirus (Mers-CoV) represents a public health emergency of international concern. 

Ms Chan last convened the committee to battle the 2009 global flu pandemic.

"Millions of people are going to Mecca and to Medina - we cannot stop that and we should not stop that," said Ms Chan at the WHO's headquarters in Geneva.

"We need to say that it's OK to go, but these are the measures that governments must take."

The previously unknown virus has infected 80 people and killed 45 worldwide, according to the WHO. While most cases have been detected in Saudi Arabia, infections in the UK, France, Germany and Italy have sparked concern of a global outbreak similar to the 2003 Sars epidemic. 

Scientists still don't know where the new virus came from or how it is spreading.

That prompted Ms Chan to say at the WHO's annual World Health Assembly in May that the virus is her "greatest concern".

While the pace of new infections has slowed, Ms Chan said she wanted to be prepared in case it returns.

"Am I still worried? The answer is yes," she said. "Eventually I hope the disease will burn out. But what if it doesn't? We should always have plan A, plan B and plan C."

Recent guidelines

On 5 July, WHO published a guideline for investigation of MERS-CoV cases. It provides recommendations for early case investigation including further case finding, surveillance enhancements, and studies that need to be done around new cases.

On 3 July, WHO published revised case definitions for MERS-CoV confirmed and probable cases based on new epidemiological and clinical information. The document also contains recommendations on further evaluation for cases with inconclusive tests and asymptomatic infections.

On 27 June, WHO published interim surveillance recommendations for human infection with MERS-CoV. The two major changes include a stronger recommendation for the use of lower respiratory tract specimens in addition to nasopharyngeal swabs for diagnostic testing and a longer observation period for contacts of cases.

MERS-CoV summary and literature Update Here.  

Two more die in Saudi Arabia from MERS coronavirus.

Two more die in Saudi Arabia from MERS coronavirus. HT: Crofs.

Via Reuters: Two more die in Saudi Arabia from MERS coronavirus. Excerpt:

Two more people have died of the SARS-like coronavirus MERS, Saudi Arabia's Health Ministry said, bringing to 38 the number of deaths from the disease inside the country shortly before Islam's Ramadan fast when many pilgrims visit. 

A two-year-old child died in Jeddah and a 53-year-old man died in Eastern Province, where the outbreak has been concentrated, the ministry said late on Saturday in a statement on its website. Four people have died outside the kingdom.   

The ministry said another three people had been confirmed as being infected with Middle East respiratory syndrome (MERS), bringing the total number of confirmed cases inside the kingdom to 65 since it was identified a year ago. 

On Friday the World Health Organization said MERS, which can cause fever, coughing and pneumonia, had not yet reached pandemic potential and may simply die out. 

Ramadan, Islam's fasting month, is expected to start in Saudi Arabia on Monday night and is traditionally a time when hundreds of thousands of Muslims come to Mecca for umrah, a pilgrimage that can be carried out at any time of year. 

Millions are also expected to travel to Mecca for the main pilgrimage, haj, that will take place in October, although the authorities have cut the number of visas this year, citing safety concerns over expansion work at the main mosque site.

The Ministry of Health's own statement is here. Arab News also has the story. It mentions that one of the three new cases is a health worker. Saudi Gazette spins the story to the bright side, stating that "only three" new cases have been reported.

Via his blog Virology Down Under, Dr. Ian Mackay muses on MERS-CoV cases at ~ 80.

...and at least 42 deaths (WHO have 79 and 44 in recent press conference). My numbers say that 66% of cases are male as are 76% of mortalities. 

I think it's worth noting, again, that (and these are my numbers only) 9 cases have no discernible age and 8 have no sex noted in press releases. 25 cases have no date of illness onset, 11 no date of death and 69 no specific date of hospitalisation. 

A recent Saudi Arabian Ministry of Health release noted the death of the 2-year old boy, who was already suffering from chronic underlying lung disease.

This brings up something that's been bothering me about the Saudis' MERS reports. They don't report their cases in a consistent manner, never mind a detailed one.
Sometimes we learn where a case has been identified, or we learn the age of a patient, but we never get a clear, progressive description of the progress of MERS in Saudi Arabia. If it's a case in the Eastern Region, is that the same as Al-Ahsa? And which of the Al-Ahsa cases is this one? When was onset?
Go back to last year's first English-language accounts in the Jordan Times of what we now call MERS; you'll see the same vagueness. But no one knew what it was then, or whether it would spread. Everyone, including the Saudis, now understands that this could be a very nasty bug. The whole world needs to know about it, and the world's entire health community may be needed to stop it.
Some virologist in Manila or Minneapolis, given enough information, might figure out where the source of MERS might be hiding. Some public-health veteran of H1N1 in Hanoi or Hong Kong, or some group of expert Americans, might imagine a way to slow down the rate of nosocomial infection.
But to do that, they need a lot more information than the Saudis (or WHO) have provided so far.

Will WHO declare MERS a PHEIC?

Will WHO declare MERS a PHEIC? HT: Crofs.

 PHEIC stands for Public Health Emergency of International Concern.

Via epidemi, a very interesting Norwegian website: WHO convenes Emergency Committee for MERS. The author, Dr. Preben Aavistland, is former state epidemiologist of Norway. Excerpt:

On July 5, WHO announced that the organization is appointing an Emergency Committee under the International Health Regulations (IHR) for the Middle East Respiratory Syndrome (MERS). This is the first such committee to be appointed since the committee for Swine Flu in April 2009. 

Procedures and legal framework 

The Emergency Committee will meet by telephone on July 9 and, if needed on July 11. The membership will be announced on July 8. (After 2009, WHO was criticised for keeping the membership list secret until after the committee had ended its function.) 

According to the IHR (Article 12), the Director-General of WHO may, based on inter alia the advice of an Emergency Committee, determine that an event, such as an outbreak of an infectious disease, constitutes a public health emergency of international concern (PHEIC). 

A PHEIC is defined in the IHR (Article 1) as «an extraordinary event which is determined, as provided in these Regulations: (i) to constitute a public health risk to other States through the international spread of disease and (ii) to potentially require a coordinated international response». 

The ad hoc Emergency Committee is made up of technical experts that are drawn from the IHR Expert Roster (Article 47) and from advisory panels to WHO. WHO Member States and intergovernmental organizations have since 2007 proposed members to this roster. 

The tasks of the Emergency Committee (Article 48) are to advise the Director-General on whether an event constitutes a PHEIC, when this PHEIC is terminated, and proposals for temporary recommendations (Article 15) to member states on health measures to «prevent or reduce the international spread of disease and minimize interference with international traffic» (Article 1), including modification and termination of these recommendations. These measures may concern travel advice, surveillance, clinical management, infection control and other areas. 

Member states are expected to follow the recommendations. If member states want to implement additional health measures, they must justify this according to a certain procedure (Article 43). 

The main effect of a PHEIC declaration, is thus that WHO is given the power to issue temporary recommendations. 

          How dangerous is MERS?

The main factors in a risk assessment is virulence («severity»), transmissibility and population immunity. Information may come from studies of the virus, the reservoirs, the population, animal experiments, and epidemiological investigations around cases.

Virulence: The MERS-CoV is highly virulent and seems to be causing severe disease or even death in most patients (as of today 42 of 79 known patients have died). However, we do not yet know the full clinical spectrum of this disease. There may be several milder cases that remain undiagnosed.

Transmissibility: The reservoir of MERS-CoV is unknown and so is the source of infection for most known cases. There have been a few instances of transmission between humans, especially in hospital and family care settings. Probably, the route of transmission between humans is droplet spread and direct contact with body fluids. Still, the transmission seems to be not very effective.

Population immunity: It is likely that very few people have protective immunity against this virus.

In conclusion, MERS is currently not a great danger to global health. However, the case-fatality risk seems very high, much is still unknown about the virus, and cases are still occurring in the Middle East with occasional leakage to European countries by returning travellers

Will WHO declare MERS a PHEIC? 

Since the IHR went into force on June 15 2007 there have been several events that fulfil the definition of a PHEIC. Still, only the 2009 swine influenza pandemic has been declared a PHEIC (lasting from April 25, 2009 till 10 august, 2010). This probably means that WHO considers that not all such events need to be declared a PHEIC. The WHO probably will make such a determination only when it sees an actual need now or in the near future. 

There are some costs of declaring a PHEIC: 

Firstly, the administrative burden of convening an Emergency Committee, communicating with member states and so on may be substantial. 

Secondly, the actual determination in itself may cause worries, influence people’s risk perception and lead to unnecessary measures, such as screening in airports or quarantining travellers. Labelling MERS as a PHEIC may lead to false beliefs in the dangers of this outbreak. (And this tendency is worsened by the fact that the only previous PHEIC was the 2009 influenza pandemic.) Thus, any declaration of a PHEIC needs to be accompanied by clear risk assessment and risk communication. 

Still, the fact that WHO is convening an Emergency Committee, in my view, means that WHO is seriously considering declaring MERS a PHEIC.

I advice my readers to add the website Crofs to their daily reading portion STAY INFORMED on MERS.

Related: Thanks to Greg Folkers for sending the link to this Journal of Virology report: Bilateral Entry and Release of Middle East Respiratory Syndrome-Coronavirus Induces Profound Apoptosis of Human Bronchial Epithelial Cells. According to Wikipedia, apoptosis is "programmed cell death." The abstract:

The newly emerged MERS-CoV infects human bronchial epithelial Calu-3 cells. Unlike SARS-CoV which exclusively infects and releases through the apical route, this virus can do so through either side of polarized Calu-3 cells. Infection results in profound apoptosis within 24 hrs irrespective of its production of titers that are lower than those of SARS-CoV. Together, our results provide new insights into the dissemination and pathogenesis of MERS-CoV and may indicate that differs markedly from SARS-CoV.

MERS virus doesn’t yet have pandemic potential, but that could change: study.

MERS virus doesn’t yet have pandemic potential, but that could change: study.(Crofs).

Via Globalnews.ca, a fascinating report by Helen Branswell of The Canadian Press: MERS virus doesn’t yet have pandemic potential, but that could change: study. Read her whole article as well as the Lancet article it discusses. Excerpt:

The new MERS coronavirus currently doesn’t spread well enough among people to trigger a pandemic, says a new study that calculates the rate at which the virus is transmitting person to person. 

But the senior author says the pattern of how the virus is spreading now cannot be used to predict whether MERS will become a bigger threat in the future. 

“There is absolutely no guarantee that this virus will stay as it is. It could very well follow the same path as SARS did 10 years ago,” Dr. Arnaud Fontanet, who heads the emerging diseases epidemiology unit at the Institut Pasteur in Paris, said in an interview. 

Others too say the study should not be used to write off the new virus. 

“The virus has shown a potential for human-to-human transmission. And whether such transmission is sustained depends on the intensity of control measures as well as the characteristics of the people involved in transmission,” said Marc Lipsitch, an infectious diseases specialist who teaches at Harvard University. 

“For that reason, I think it’s premature to say that this virus does not present a pandemic threat.” 

The study, published in the journal The Lancet, analyzes what is known about how often people who have been infected with the MERS virus spread it to one or more other people. The authors used the data to calculate what is called the basic reproduction number, known in the parlance of infectious diseases as the R nought. 

In order for a disease to achieved sustained spread, the average infected person must spread a bacterium or virus to at least one other person. That is an R nought of one. A pathogen with a basic reproduction number of less than one would peter out. 

The measles virus, which is very contagious, has a basic reproductive number of between 12 and 18, meaning that among people who are susceptible to the virus, each infected person would be expected to pass the virus to between a dozen and 18 other people. In a 2003 study in the journal Science, Lipsitch and colleagues estimated the R nought of SARS to be three. 

Using the publicly available data on MERS cases, Fontanet and his co-authors set out to figure out what the basic reproduction number for the new coronavirus has been to date. 

There are many holes in the available data. For instance, Saudi Arabia, which is responsible for 63 of the 77 confirmed MERS cases, often does not disclose if new infections have links to previous ones – which might mean they caught the virus from another person – or are what are called sporadic cases, people thought to have been infected by an animal or exposure to the virus in the environment. 

The authors tried to work around the gaps by calculating best- and worst-case scenarios. Both, it turns out, came up with a reproductive number of less than one, which suggests the virus doesn’t yet have pandemic potential, they said. Those rates were 0.60 and 0.69 respectively. 

The authors noted that in the early stages of SARS it had a reproductive number of 0.80, closer to one than what is currently seen with the MERS virus. But they suggested that even though the viruses are cousins, people should be cautious about drawing too many comparisons because the viruses are different and have cropped up in different parts of the world.

And the commentary, by researchers from the applied mathematics department of the University of Waterloo in Waterloo, Ont., said the future behaviour of the virus could also be affected by factors like changes in the season, or events like the Hajj, in which as many as three million pilgrims from around the world flock to the Muslim faith’s holiest site, Mecca.

“In terms of what the public should take home from this, it’s that we’re definitely not out of the woods,” said Waterloo’s Chris Bauch.

“It could go up not only because it (the virus) evolves but because the Hajj is coming up. And not only are you going to have slaughter of (potentially) infected animals, but you’re also going to have a possibility for transporting it to other countries.”

Fontanet said the priority now should be finding the source of the virus and limiting the chances it has to spread to people. The more times the virus infects people, the more chances it has to develop mutations that would help it adapt to spreading easily among humans, he said.

“It’s precisely because it is not yet that transmissible that it’s the perfect timing for identifying the animal reservoir and stopping it at the source,” he continued.

Man being treated in a London hospital for a lethal 'Sars-like' MERS has died.

Man being treated in a London hospital for a lethal 'Sars-like' MERS has died. HT: AstuteBlogger.(Telegraph).

"In the end his lungs were worn down, so secondary infection is the real problem. The virus effectively turns your lungs to jelly."

The man, a Qatari national, had been admitted to a private clinic in London in September, before being transferred to the specialist centre at Guy's and St Thomas' Hospital.He was diagnosed as suffering from the Mers virus – Middle East Respiratory Syndrome – which has affected 77 people worldwide, with 43 deaths.

"Guy's and St Thomas' can confirm that the patient with severe respiratory illness due to novel coronavirus (MERS-nCV) sadly died on Friday 28 June, after his condition deteriorated, despite every effort and full supportive treatment," said Robin Wilkinson, a spokesman for the hospital.

The death of the Qatari man brings to three the number of victims who have died in the UK.

In February two members of the same family died from the virus. One, a 39-year-old man, died in Birmingham having picked up the virus from his father, who had recently travelled to Saudi Arabia. The father then died around a month later in Manchester's Wythenshaw hospital. A female relative was also treated for mild Mers symptoms, raising fears of human-to-human contact.
 The disease is spread by people coughing or sneezing and can cause breathing difficulties, lung damage and pneumonia.

"We still don't know exactly what killed him," said Dr Jon Bible, a virus expert at Guy's and St Thomas'."In the end his lungs were worn down, so secondary infection is the real problem. The virus effectively turns your lungs to jelly."

Known cases of the illness have quadrupled since April, and it is deadlier than Sars, which killed 774 people in 2003. SARS killed one in ten affected people; Mers has proved fatal in 65 per cent of cases.
The majority of the cases have been in Saudi Arabia, or in patients who have recently travelled to the region.

But with the annual Hajj pilgrimage due in October, and an estimated three million people travelling to Mecca, concerns are mounting that the deadly virus could spread swiftly."We need to get the facts clear and get the appropriate advice to all your countries where your pilgrims want to go to Mecca," said Margaret Chan, head of the World Health Organisation, in May. "It is something quite urgent."

Cases have been reported in Jordan, Qatar, United Arab Emirates, Britain, France, Italy, Tunisia and Saudi Arabia – the country with the most confirmed infections.
Belgian medics have warned Muslims not to travel to Mecca, because the Hajj threatens to spread the virus worldwide. Doctors expressed concerns that the mass gatherings are "ideal hotbeds for respiratory diseases" and that numbers of Mers cases are greater than actually reported in Saudi Arabia.
The unnamed man in London had been treated in a "negative pressure room" – an isolation chamber within the hospital, which means that contaminated air is not pumped back out into the hospital. All doctors treating the patient would have been equipped with protective suits, which were incinerated after use.
He had initially shown signs of improvement, but his condition deteriorated and he passed away last week. It is unclear how he contracted the disease, although there are known cases in Qatar. Read the full story here.

For more in depth info on The MERS - Corona Virus and other click HERE.

Saudi Arabia reduces Iran’s Hajj quota, could MERS Virus be the reason?

Saudi Arabia reduces Iran’s Hajj quota, could MERS Virus be the reason?(TI).

Hajj Ministry of Saudi Arabia reduced the Hajj quota for several countries including Iran, IRNA agency reported.

According to the record, the number of Hajj piligrims from Iran had to be 70 thousand this year. But this number was reduced by 20 percent to 55 thousand.This year the Hajj season starts in October.Read the full story here.

Related: Saudi Arabia reports four more deaths from MERS coronavirus

Saudi Arabia says 4 more die from new respiratory virus MERS related to SARS.

Saudi Arabia says 4 more die from new respiratory virus MERS related to SARS.(Yahoo).

RIYADH, Saudi Arabia - Saudi Arabia says four more people have died from a new respiratory virus related to SARS, bringing the total number of deaths to 32 in the kingdom at the centre of the growing crisis. 

Overall, nearly 40 people have died from the virus since September, mostly in Europe and the Middle East. That's according to local officials and the World Health Organization. The Saudi Health Ministry also said on Monday that it confirmed three more cases of the virus, including in a 2-year-old child. Officials are still seeking clues on how easily it is spread between humans.
The virus continues to spread into new countries, raising concern ahead of the Islamic pilgrimage periods which will occur this summer and autumn.
Most of the victims suffered from underlying medical conditions. The WHO says the virus spreads by means including interpersonal contact, and possibly via airborne transmission between people in closed quarters. 

It doesn’t appear to spread easily in communities at large, but what about transmission between travelers in airports and planes?
Authorities believe initial transmission of the virus was from animal to human, but the animal source remains unidentified. The European Center for Disease Prevention and Control noted the many unanswered questions about the Middle East-based virus, issuing a statement saying, “It is unusual to have such a degree of uncertainty at this stage in an outbreak.”
The new virus is related to SARS, which killed some 800 people in a global epidemic in 2003, and belongs to a family of viruses that most often causes the common cold.Read the full story here.

MERS Coronavirus: Will the Hajj Trigger a Global Pandemic?

MERS Coronavirus: Will the Hajj Trigger a Global Pandemic?(ABC).

A new virus spreading through the Middle East has claimed three more lives, according to Saudi health officials, bringing the death toll to 30.
At least 50 people have been sickened by the virus, newly-dubbed MERS-CoV for “Middle East respiratory syndrome coronavirus.” The majority of cases have clustered in Saudi Arabia. But infections have also emerged in Jordan, Qatar, the United Arab Emirates, Tunisia, Germany, the United Kingdom and France.
All of the cases have ties to the Middle East, according to the World Health Organization.
A Frenchman, who became ill after travelling to Dubai, died earlier this week roughly one month after being hospitalized with respiratory symptoms. His roommate at the hospital also contracted the virus, reaffirming suspicions that MERS-CoV can be passed from person-to-person.

The virus has also spread through a health care facility Al-Ahsa, Saudi Arabia, where at least 22 patients have been sickened and 10 have died. In light of such cases, doctors on Wednesday recommended quarantining patients for at least 12 days.

Until recently, MERS-CoV was known widely as the “SARS-like virus” because of its semblance to the deadly SARS virus, which a decade ago sickened more than 8,000 people and killed 774. But experts caution that while both viruses can cause pneumonia and organ failure, MERS-CoV appears to spread less readily than SARS — so far.

Unlike SARS, this is spreading much slower.  The first case was identified in April 2012 and to date there have been 50 cases and 30 deaths.   The majority of cases have occurred in Saudi Arabia.  All patients either traveled to the Middle East or had close contact with someone who did. There is evidence of transmission within hospitals, but it has not been determined how community transmission is occurring.  According to CDC, the MERS coronavirus is most similar to coronaviruses seen in bats.

At this point, there is not much that the public needs to do. If you are traveling to the Middle East, check out the precautions recommended by the CDC. Basically, they recommend following standard practices to avoid infections: frequent hand washing, avoiding close contact with sick people. In addition avoid contact with wildlife. If you travel to the Middle East and develop any flu like symptoms (fever, chills, muscle aches) tell your doctor where you have been so you can be tested.Read the full story here.

WHO calls new coronavirus MERS ‘threat to the entire world’, Will the Hajj turn it in to a pandemic?

WHO calls new coronavirus MERS ‘threat to the entire world’, Will the Hajj turn it in to a pandemic?(DM).

HEALTH - Three more people have died from a deadly new SARS-like virus, taking the total death toll to 27. The unnamed victims were from Saudi Arabia and died in the country’s eastern region, the Saudi health ministry confirmed today. 

Yesterday, a 65-year-old man died in France as health officials warned the MERS-CoV virus is now a global threat with 49 confirmed cases worldwide.
Earlier this week, the World Health Organization warned that the disease, first identified in humans in September, is now their greatest global concern.
The MERS-CoV virus is related to SARS, which killed some 800 people in a global epidemic in 2003.

Dr Margaret Chan, head of the WHO, singled out the illness in a speech on Monday in Geneva. ‘We understand too little about this virus when viewed against the magnitude of its potential threat,’ Chan said at the annual WHO meeting. ‘We do not know where the virus hides in nature. We do not know how people are getting infected. Until we answer these questions, we are empty-handed when it comes to prevention. 

These are alarm bells. And we must respond. She said the ‘novel coronavirus is a threat to the entire world.’
WHO said in an update earlier this month that 20 of the 40 confirmed cases of the disease have ended in death. 
Most of those infected since the virus was identified last year had traveled to Qatar, Saudi Arabia, Jordan or Pakistan. There also have been cases in Britain and Germany. Saudi Arabia accounts for the majority of confirmed cases, which stands at 33, according to WHO officials. Tunisia last week became the ninth country in which the virus has been confirmed.
It is believed the disease is transmitted mainly from person-to-person contact, but so far does not spread easily among larger communities. Authorities believe initial transmission of the virus was from animal to human but have yet to identify the animal sources. French authorities earlier this month began handing out leaflets at airports to travelers to the Middle East advising them to wash their hands frequently and limit contact with animals. The French victim had been in hospital for more than a month, spending the last 20 days in a room of the intensive care unit of the hospital where he was on life-support systems. Speaking about the death of the patient from the virus, French health minister Marisol Touraine said ‘There is no cause for additional concern.’ Hmmmm.....A FIFTY percent mortality rate.......No cause for concern?????Read the full story here.

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

Will the Hajj pilgrimage unleash the MERS, 'Middle Eastern respiratory syndrome coronavirus' on the world?(OttowaCitizen).

The World Health Organization has issued a blunt assessment of the coronavirus outbreak in Saudi Arabia, acknowledging for the first time that there are concerns the virus may be spreading from person to person, at least in a limited way. 

The statement called for urgent investigations to find the source of the virus and learn how it is infecting people. And it reminded countries they have a duty to the international community to rapidly report cases and related information to the WHO.
The worrying appraisal of the situation was echoed in a revised risk assessment issued Friday by the European Centre for Disease Control. It warned hospitals in Europe to be on the lookout for coronavirus cases coming in by air ambulance, saying the numbers of such patients may rise if the public in affected countries are afraid to seek care in their own hospitals.
The warnings come as health leaders from around the world are gathering in Geneva for the World Health Assembly, the annual general meeting of the WHO. The eight-day meeting begins Monday. Though other nations have not publicly pressed leaders of coronavirus-affected countries for more transparency to date, it is likely that concerns about the virus and the opaque way investigations into it are being handled will be aired during the meeting.
“There is no formal agenda for novel coronavirus but I would be surprised if it didn’t come up,” WHO spokesman Gregory Hartl said in an interview.
Saudi Arabia, after all, is the home of Mecca. The holy site draws roughly three million Muslims from around the world every year to the Hajj, a mass pilgrimage Muslims are meant to perform at least once in their lifetimes. 
As well, nearly one million international tourists travel to Mecca during Ramadan — the Muslim month of fasting — to take part in another pilgrimage called Umrah. Ramadan starts in the second week of July this year. And the 2013 Hajj will take place in mid-October, only five months from now. 
Experts watching the coronavirus situation are already worried about the potential for spread of the new virus, both within Saudi Arabia and internationally. “I don’t think anyone necessarily knows for certain what is or isn’t happening,” said Dr. Kamran Khan, an infectious diseases specialist at St. Michael’s Hospital in Toronto.
In his research, Khan tracks global travel patterns as a tool to predict and interpret spread of diseases. “I’m not sure that there’s an easy way to get at this information unless it’s more forthcoming from within Saudi Arabia or any of the partners that are working with Saudi Arabia inside the country.”
To date, the WHO has been notified of 41 confirmed infections with the virus, which has been recently named MERS, for Middle Eastern respiratory syndrome coronavirus.
Of those cases, 20 have been fatal. The bulk of the infections have occurred in Saudi Arabia, which is investigating a large and ongoing outbreak in the eastern part of the country, near the Persian Gulf.
The most recent case — an 81-year-old woman whose illness was announced Saturday — is part of that outbreak. In its statement, the WHO said two of the cases in that outbreak have no links to either other coronavirus patients or a hospital where some transmission is known to have occurred. These unconnected cases suggest two possibilities. They could have contracted the virus from its as-yet unidentified reservoir, which is thought to be one or more animal species. Or these cases could be a signal that undetected human transmission is happening there. “The continued appearance of cases that are not part of larger clusters, and who do not have a history of animal contact, increases concerns about possible community transmission. This possibility is being investigated by authorities in Saudi Arabia,” the WHO statement said.Hmmm.......Start wearing a mask at airports and on planes. Read the full story here.

Khamenei says US, Israel seek to divide Muslims in his annual Hajj message.

Khamenei says US, Israel seek to divide Muslims in his annual Hajj message.(JPost). In his annual message to 2012 Hajj Pilgrims on Thursday, the Leader lauded the popular uprisings and revolutions across the Arab countries as "one of the most crucial issues of the Muslim world". DUBAI - Iran's most powerful authority, Ayatollah Ali Khamenei, on Thursday accused the United States and Israel of fomenting divisions among Muslims to undermine "Islamic uprisings" across the Middle East. "By exploiting inattention ... corrupt American, NATO and Zionist agents are trying to divert the deluge-like movement of Muslim youth and bring them into confrontation with one another in the name of Islam," he said in an annual message to Iranians who have gone to Saudi Arabia for the haj pilgrimage. "They are trying to turn the jihad against colonialism and Zionism into blind terrorism in the streets ... so that Muslims shed each others' blood." Officials in Shi'ite Muslim Iran often describe the "Arab Spring" uprisings as an "Islamic Awakening". Some of those uprisings have brought Islamists to power, while others, notably in Syria and Bahrain, have pitted Sunnis against Shi'ites or Alawites, members of an offshoot of Shi'ite Islam. 

Ayatollah Ali Khamenei: "The enemy wants to hit these foundations. By exploiting inattention and shallow-mindedness on behalf of some, corrupt American, NATO and Zionist agents are trying to divert the deluge-like movement of the Muslim youth and bring them into confrontation with one another in the name of Islam, thus converting an anti-colonial and anti-Zionist struggle into blind terrorism waged in the streets of the Islamic world, so that the blood of Muslims is spilled at their own hands and the enemies of Islam are rescued from their dead-end while Islam and its warriors are maligned in public opinion.

After despairing of eliminating Islam and Islamic slogans altogether, they have now turned to inciting discord among Muslim sects and frustrating the unity of the Islamic Ummah through the gimmicks of Shiaphobia and Sunniphobia.

They have created a crisis in Syria with the assistance of their agents in the region, in order to divert the attention of the nations away from important problems of their own countries and the dangers that lie in ambush for them, and towards a gory scenario deliberately staged by them. The civil war in Syria and the bloodshed of her Muslim youth at their own hands is a criminal enterprise launched by the United States, Zionism and their docile governments who keep on blowing into the fire. Who will believe that erstwhile supporters of black dictatorships in Egypt, Tunisia and Libya have now turned into champions of the democratic aspirations of the Syrian people?

The Syrian issue is one of wreaking vengeance upon a government that has stood singly against the Zionist usurpers and defended resisting groups in Palestine and Lebanon."

"If Muslims let go this great opportunity without using it to reform the Islamic Ummah, they would incur great losses," he added. "The aggressive and interventionist arrogant powers are making every effort to divert the course of these significant Islamic movements," Ayatollah Khamenei pointed out, according to Iranian state television, urging Muslims to show solidarity.

Iran has aligned itself with its regional ally Syrian President Bashar Assad and Lebanon's Shi'ite Hezbollah movement in what it calls an "axis of resistance" against Israel. At the same time it denies accusations from Sunni-ruled Gulf monarchies that it is encouraging Shi'ite uprisings in their countries.
He reiterated Iran's opposition to outside intervention in Syria, saying only Syrians could decide their own future, and said other unspecified nations could also be engulfed by Syria's turmoil.Read the full story here.