Another MERS case in Riyadh; no MERS-CoV in Bactrian camels

Another MERS-CoV case today in Riyadh boosts the number of MERS cases in Saudi Arabia this month to 13, 12 of which have been in Riyadh. The country's Ministry of Health (MOH) also confirmed a death in a previously reported patient.

In related news, a study today found no evidence of the virus in Bactrian (two-humped) camels.

The MOH said today that the MERS-CoV (Middle East respiratory syndrome coronavirus) infection involves a 59-year-old Saudi woman who is not a healthcare worker (HCW). She is hospitalized in stable condition and had preexisting disease.

She had no recent animal exposure or contact with MERS-CoV cases in the community, the MOH said. Exposure to the virus in a healthcare setting is under investigation.

The death was in a 70-year-old Saudi woman from Riyadh. She was not an HCW but had preexisting disease. The MOH also reported that a 48-year-old male expatriate HCW in Dammam has recovered from the disease.

The case and death bring the Saudi total to 933 cases since June 2012, including 401 deaths. Twenty-eight patients are still being treated for MERS, while 504 have recovered.
Mar 4 MOH update

Meanwhile, a study today in Emerging Infectious Diseases found no evidence of MER-CoV in Bactrian camels, a species not typically found on the Arabian Peninsula. Earlier studies have noted evidence of the virus in dromedary camels, including those found in the Middle East.

In a letter to the journal, scientists from Hong Kong and Mongolia reported that they sampled 127 Bactrian camels that were 5 years old or older in 12 herds across two Mongolian provinces in November 2014. None of the samples tested positive for MERS-CoV.

The authors conclude, "Even if Bactrian camels are susceptible to MERS-CoV infection, geographic separation may be an alternative explanation for the absence of MERS-CoV among camels in Mongolia."

Early last year European researchers reported in the same journal that they found no MERS-CoV in 16 Bactrian camels tested at a zoo in Germany.
Mar 4 Emerg Infect Dis letter
Jan 3, 2014, CIDRAP News story on previous camel findings

WHO panel extends polio emergency for 3 more months

In the face of a continued threat of the international spread of poliovirus, a World Health Organization (WHO) expert panel has recommended that the public health emergency declaration regarding polio risk continue for another 3 months, the WHO reported today.

The WHO committee said one polio case was exported from Pakistan to Afghanistan in November and that transmission is continuing in four Pakistani provinces and its Federally Administered Tribal Areas.

"The Committee assessed that the spread of polio still constitutes a Public Health Emergency of International Concern and recommended the extension of the Temporary Recommendations for a further 3 months," the WHO said in a statement.

In making the recommendation, the committee cited the threat of polio to the growing number of countries whose immunization systems have been "disrupted by armed conflict and complex emergencies," especially in the Middle East and Central Africa, the WHO said. "Populations in these fragile states are vulnerable to infection and outbreaks of polio which are exceedingly difficult to control."

Although Pakistan continues to be a potential source of exported cases, the statement said, the panel "appreciated that Pakistan has prepared a new robust 'low season' vaccination plan, established national and provincial emergency operations centres, and resumed campaigns in South and North Waziristan."

But the main factors fueling the risk of international spread of poliovirus from Pakistan have not changed much since the committee's third meeting in November 2014, the WHO said. Pakistan has been plagued by a series of assassinations of polio workers in recent years.

In other observations, the WHO said Cameroon, Syria, and Equatorial Guinea will reach the 1-year mark since they last exported a polio case on Mar 11, Mar 17, and Apr 4, respectively. They will then meet the criteria for states infected with wild polio virus but not currently exporting cases.
Mar 4 WHO statement

Cholera cases up in Haiti, Dominican Republic in early 2015

Cholera cases in both the Dominican Republic and Haiti so far this year are being reported at a faster clip than this time last year, the Pan American Health Organization (PAHO) said in a Mar 3 update.

Through the first week of February, the Dominican Republic had 99 suspected cholera cases, including 6 deaths. That is more than double the number of cases for the same period in 2014, PAHO said. For all of last year the country reported 597 suspected cholera cases, including 10 deaths, which was a 70% reduction in cases and a 76% reduction in deaths from 2013.

Haiti tabulated 7,225 cases through the third week of February, including 5,794 hospitalizations, for a hospitalization rate of 80%, and 86 deaths. The number of both cases and deaths is higher than the same 7-week period in 2014, PAHO reported.

Also, the hospitalization rate is markedly higher than for the outbreak overall. Since the outbreak began in October 2010, Haiti has recorded 731,880 cases, 8,741 deaths, and a 57% hospitalization rate. Its fatality rate (CFR) remains at 1.2%, PAHO said.

The Dominican Republic has reported 32,171 suspected cholera cases since its outbreak began in November 2010 and 484 deaths, for a CFR of 1.5%.
Mar 3 PAHO report