A Deadly Virus Is Spreading Around Saudi Arabia And It Might Be About To Go Global.


Reported cases of MERS have surged in Saudi Arabia in 2014 and no one seems to know why. posted on April 23, 2014 at

 

Saudi Arabia has been accused by health care experts of obscuring information about an outbreak of the deadly Middle East Respiratory Syndrome (MERS), after a surge in reported cases of the virus this month.

Over the last 30 days, MERS cases in Saudi Arabia have swelled from one to three daily to more than 10 reported cases each day, according to Ian MacKay, an associate professor at the Australia Infectious Diseases Research Centre at The University of Queensland. The first cases were reported in Jeddah and then spread to other areas around the country, raising alarm over how the royal kingdom will contain a virus for which no known treatment exists.

“We need the Kingdom of Saudi Arabia and United Arab Emirate’s health authorities to take the stage and help us understand what’s going on,” said MacKay. “In 2014 so far we’ve had more cases than in all of 2013.”

In April alone, there have been more than 140 reported cases so far, though MacKay warns that information about the cases is incomplete at best and it has been difficult for experts to get exact figures on the spread of the virus.

Saudi officials have refused to confirm whether their tests suggest that the virus is mutating leading to greater human-to-human infection rates, and will not even comment on whether such tests have been conducted. A statement released by the World Health Organization confirmed that they were not receiving timely data on the spread of MERS, as they did not have the latest infection count. On their website they advise, ” WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.”

Saudi Arabia has done little to answer criticism that it is mishandling a potential health crisis. On Monday, Saudi Health Minister Abdullah al-Rabiah was dismissed just days after visiting hospitals in Jeddah to calm public panic over the spread of the virus. His replacement was photographed days later appearing in hospitals, but without the surgical goggles virologists recommend to help prevent the spread of the virus.

MacKay said that concerns the virus had mutated were based on two clusters, one in Jeddah and the other in Abu Dhabi. He said that the outbreaks could be based on poor infection control and prevention protocols among health care workers, or that Saudi Arabia could be experiencing a mutation that makes human-to-human infection spread more widely. Until now, health professionals have argued that camels transmit MERS more easily to humans than humans do to one another, but that could be changing.

“There is too little virological information. An emerging virus is called that because it’s still ‘finding its way’ in a new host. Right now the MERS-CoV’s natural host seems to be the camel and then it makes forays into humans when conditions are right. Each and every time it does that there is a chance for the virus to evolve to become better at replicating in and transmitting from humans instead of camels. Because of that, an emerging virus needs to be carefully watched and that is done by gene or genome sequencing,” said MacKay.

In an interview with NPR earlier this week, Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said that once a virus readily transmits to humans, there is greater concern for a worldwide outbreak.

“It took us over a year to get the first hundred cases of this viral infection,” Osterholm told NPR. “Now in just the last two weeks, we’ve had a hundred cases. … There’s a major change occurring that cannot just be attributed to better case detection. Something’s happening.”

Yemen, Malaysia, the Philippines and Greece also reported their first cases last week, all linked to travelers from the Gulf.

Concerns voiced by global health professionals have been mounting as Saudi Arabia approaches the Hajj the first week of October. More than one million Muslims travel to Saudi Arabia each year to visit Mecca during the holy pilgrimage, in past years they have come from 188 countries. Virologists fear that unless Saudi Arabia takes great steps to ensure that they have contained and studied the MERS by October, it could be risking spreading the virus globally.

Kuwait Reports First MERS Coronavirus Cases.


Kuwait reported its first two cases of the deadly MERS coronavirus on Wednesday, the fifth Gulf Arab country where the strain has emerged since the outbreak began in neighbouring Saudi Arabia last year.

kuwait mers

A 47-year-old man is in a critical condition, Kuwaiti state news agency KUNA said, citing a statement from the Health Ministry. It gave no further details.

A second patient, a 52-year-old Kuwaiti citizen, recently travelled overseas, KUNA said in another report later on Wednesday, adding he had no contact with the first patient.

The Middle East Respiratory Syndrome Coronavirus, or MERS-CoV, can cause coughing, fever and pneumonia. It has been reported in people in the Gulf, France, Germany, Italy, Tunisia and Britain. Oman reported its first case last month and the patient died on Sunday.

Saudi Arabia, where the vast majority of confirmed cases have been recorded, has confirmed 127 cases of the disease, of which 53 have died, since it was discovered in the kingdom more than a year ago.

Cases have also been reported in Qatar and the United Arab Emirates.

The World Health Organization said in August the number of confirmed infections worldwide in the year from September 2012 had been 102. Almost half of those infected had died.

Scientists say they believe dromedary camels in the Middle East may be the animal “reservoir” that is fuelling the outbreak.

Camel tests positive for Mers virus.


A camel has tested positive for the Sars-like virus that emerged in the Middle East last year and has killed 64 people worldwide.

The animal had been owned by a person diagnosed with Mers (Middle East respiratory syndrome) coronavirus, the Saudi health ministry said.

Dromedary camel

It remains unclear, however, if camels are responsible for passing the disease to humans.

Coronaviruses cause respiratory infections in humans and animals.

It is possible the virus is spread in droplets when an infected person coughs or sneezes.

Experts believe the virus is not very contagious – if it were, we would have seen more cases.

Globally, since September 2012, there have been 153 laboratory-confirmed cases of infection with Mers coronavirus.

The Saudi government statement said “preliminary” laboratory checks had proved positive.

The health ministry said it was working with the ministry of agriculture and laboratories to “isolate the virus and compare its genetic structure with that of the patient’s”.

If the virus carried by the camel and that of the patient “prove to be identical, this would be a first scientific discovery worldwide, and a door to identify the source of the virus”, it added.

The World Health Organization, which has been monitoring the global situation, says there is currently no reason to impose any travel restrictions because of the virus.

Can technology help avoid stampedes?


Crowds at the Hajj
The Hajj attracts millions of pilgrims each year, but they are very tightly packed together

It seems the cruellest and most unnecessary of deaths – to be crushed in the midst of a crowd.

But even in the 21st Century such deaths are still common, as a stampede at a recent Hindu festival in India, which killed about 115 people, proved all too sadly.

Horror quickly turned to anger as the Indian media reported that better crowd management could have prevented the tragedy.

But can technology also play a role in making sure that such disasters are not repeated?

At the Hajj pilgrimage, the world’s largest Islamic gathering, which takes place in October, the authorities now use live crowd analytics software, which can not only spot problems in the crowd but also claims to be able to predict where overcrowding is likely to happen.

Live data feeds come into a large operations room where they are analysed by military personnel, the police and other crowd managers.

The software provides accurate and real-time data on crowd numbers, densities, distributions and flows.

“Crowds can be dangerous places. Whether triggered by factions within the crowd, by natural disasters or misguided crowd managers, there is a long history of crushes, stampedes and failed evacuations,” said Fiona Strens who co-founded CrowdVision, the firm behind the software.

“It spots patterns of crowd behaviour that indicate potential danger such as high densities, pressure, turbulence, stop-and-go waves and other anomalies.”

As large-scale events go the Hajj is one of the biggest and it has a pretty bad track record; over the years thousands of lives have been lost.

One of the worst incidents occurred in 2006 when a stampede on the last day of the pilgrimage killed at least 346 pilgrims and injured another 200.

Crowd behaviour

As part of his PhD research, CrowdVision co-founder Dr Anders Johansson analysed the CCTV images of the pilgrims before and during the crush in 2006, and realised that there were patterns of behaviours that, spotted early enough, could have prevented it.

In 2007, his system was installed in Mecca and it has been monitoring the pilgrimage every year since.

Muslim pilgrims
The Saudi authorities believe such technology helps save lives

While the company doesn’t like to tempt fate, since its involvement, no fatalities have occurred.

That isn’t entirely down to the technology though, admits Ms Strens.

“In recent years the Mecca authorities have invested in better infrastructure, planning and technology to assure pilgrim safety but we play a very important role providing the real-time data and insights needed to inform operational decision-making,” she said.

For their part, the Saudi authorities are pleased to have such a technology partner.

“The live crowd analysis greatly improves safety of pilgrims,” said Dr Salim al Bosta, crowd management expert, at the ministry of municipal and rural affairs.

But crowd scientist Keith Still, who was special adviser on the Hajj from 2001 and 2005, is more sceptical about how much technology can help in such places.

“Any technology has to be coupled with a crowd management plan,” he told the BBC.

In fact he thinks that technology installed at the Hajj in 2006 – before CrowdVision’s involvement – actually contributed to the tragedy that unfolded.

“Tech firms offered the Saudis new systems and there was an over-reliance on technology. There was lots of digital signage put up to direct the crowds but it was just a mess,” he said.

He is also sceptical about whether the technology used by CrowdVision can work in a live situation.

“It spots shockwaves in the crowd but if these are happening then you are already at a point where people could be crushed or seriously injured. Whoever is in control has fundamentally lost control of the situation by then,” he said.

“It could become an exercise in futility.”

For him, the value of CrowdVision lies more in its ability to precisely count how many people are at an event.

“If you need to track capacity such tools are great but it is a long way away from being a risk management system,” he said.

Street protests

City crowd
People seem to be spending more time in crowds

Cities around the world are getting more and more overcrowded. By 2050 the UN expects the world’s population to top nine billion, with nearly 70% of them living in towns.

And people are spending more time in crowds. Large-scale music and sporting events are commonplace, as are big screens that beam events to public places to allow those outside of venues to watch the action.

Spontaneous street protests are also on the rise, thanks to the proliferation of social media and smartphones.

Technology that can monitor crowds is going to become increasingly important, thinks Ovum analyst Joe Dignan.

“Understanding how people move through a city will help develop smart transport systems and keep people safe in times of danger whether natural or manmade,” he said.

Whether crowds gather to protest, to party or just to be entertained, things can turn ugly in an instant.

Heat maps created by CrowdVision to show how people behaved during a practice evacuation of a city skyscraper illustrate how danger points can build up even when the crowd is flowing well and is relatively calm.

The maps showed that even when the crowd was re-entering the building after the evacuation, there were some dangerous queues building up.

CrowdVision’s heat map of a crowd at a music festival

Nowhere is crowd control more important than at a music festival and the software developed by CrowdVision suggests that organisers may be making fundamental errors by posting stewards at the front of crowds.

“The maps suggested the problems were actually in the middle of the crowd,” said Ms Strens.

“If the stewards had tablets with real-time information on them, they could see exactly where they needed to be,” she added.

Such a solution may not have been realistic for Madhya Pradesh, the Indian state where the recent stampede occurred.

It seems likely the stampede was sparked by panic, following rumours a bridge people were crossing was about to collapse.

The bridge had itself been built in response to a stampede at the same temple some seven years earlier, when attendees had been crushed crossing the river.

It illustrates that, however carefully planned an event is, there is often no accounting for human behaviour.

Technology may help but it is only ever going to be part of the solution, according to Prof Still.

“The best way to avoid this in the future is education on crowd safety,” he said.

Morbidly obese two-year-old from Saudi Arabia youngest person to have gastric bypass surgery.


The child had a Body Mass Index of 41 had continued to gain weight despite efforts to control his diet

A morbidly obese two-year-old in Saudi Arabia is the youngest person in the world to have gastric bypass surgery.

The boy, who weighed 72.2lb – five stone – suffered from sleep apnoea and bow legs as a result of being massively overweight.

Sleep apnoea is a condition which causes people to stop breathing while asleep.

The child had a Body Mass Index of 41 and had continued to gain weight despite efforts to control his diet.

The procedure, a laparoscopic sleeve gastrectomy (LSG), involves the removal of a section of the stomach and is irreversible. According to theInternational Journal of Surgery Case Reports the LSG proceedure was ‘well tolerated and without complications’.

The report notes that at the age of just 14 months the child weighed 46lbs and already had a Body Mass Index of 29.

On seeing an endocrinologist the child was put on a doctor-prescribed diet, but over the next four months gained 17 more pounds.

“Although the parents were informed about the importance of a strict dietary regimen a full compliance cannot be ascertained mainly due to the different socio cultural habits and the absence of the practice of calculating the calorific value of the diet,” the report said.

The severe weight gain led to the severe sleep apnoea as well as “bowing of the legs”, after which the child was referred to an obesity clinic.

Despite the dietary advice of the clinic he gained a further 18 pounds.

When he hit 72 lbs at 30-months-old the doctors decided to perform the Laparoscopic Sleeve Gastrectomy. Following the surgery the child’s weight dropped to 52.9 lbs.

Despite the success of the operation the report notes that after the surgery the parents missed follow-up appointments: “The parents of the child did not comply with the provided instruction/s and more often showed a tendency to miss appointments and hence a regular time bound follow up was not possible.”

Source: http://www.independent.co.uk

StarLink resurfaces: GM corn banned decade ago found in Saudi Arabia.


The Saudi Arabian food chain has been widely contaminated with GM ingredients, according to a new study. The findings include controversial StarLink maize banned for human consumption in the US over ten years ago.

corn.si

The study published in the journal Applied Biochemistry and Biotechnology found that genetically modified StarLink maize, allowed for domestic animal feed only in the US, has been contaminating Saudi Arabian products.

StarLink is a trade mark for a type of GM maize manufactured by Aventis Crop Science at the time when it was going through the American apparatus. Later it was bought by Bayer. 

Back in 1998 the US Environmental Protection Agency (EPA) approved the maize for domestic animal feed only, so the company manufacturing StarLink decided not to apply for separate approval for human and animal consumption.

Nevertheless, residues of StarLink maize were detected in taco shells in September 2000, indicating that it had entered the human food chain.

Following the findings all genetically modified food was recalled causing widespread disruption to the corn markets in 2000 and 2001.

Aventis then withdrew its registration for StarLink maize varieties in October 2000 and promised it would no longer be produced.

Despite these assurances, aid sent by the UN World Food Program and the US to a number of Central American nations was found to be highly contaminated with StarLink corn. 80% of the 50 samples tested came back positive for StarLink maize and Guatemala, Nicaragua, Honduras and El Salvador were all compelled to refuse the aid, according to the journal Green Med.

In 2005 Saudi Arabia approved the import of GM food, but banned the import and agricultural use of genetically modified animals, their byproducts and GM seeds, dates and decorative plants. The law also stipulated that any product containing GM material was required to be labeled in both Arabic and English.

In the 2013 study, 200 samples were collected from the Saudi Arabian provinces of Al-Qassim, Riyadh and Mahdina between 2009 and 2010 and were screened for GM ingredients. 26% of soybean samples were positive for GM gene sequences, while 44% of maize samples came out positive for GM gene sequences.

The overall findings pointed to a discovery of more than 1% contamination of maize samples with StarLink maize, as according to the detection sensitivity of the test kits used in the research the likelihood of a false positive reading is extremely low.

The authors of the report conclude that “establishing strong regulations and certified laboratories to monitor GM foods or crops in the Saudi Market is recommended.”

An earlier study published in the African Journal of Food Science in 2010 also found that the food chain in Saudi Arabia had been contaminated with GM ingredients.

The study analyzed 202 samples of mainly imported food, which was sampled from local markets in Ridyadh. Of the 202 samples 20 tested positive for GM ingredients.

The authors of the 2013 finding raise questions of why GM corn, banned in the US is resurfacing in a distant country like Saudi Arabia. They also question the level of contamination in the US, considering the fact the labeling and import of GM products is more stringent in Saudi Arabia than in the states.

“Mandatory labeling of GM-containing products and/or a total boycott of manufactures who are not already complying with this objective, or do not already have plans to do so in the immediate future,”the study concludes.

Deadly coronavirus found in bats.


Discovery hints at virus’s source, but how it spreads to humans remains unknown.

Bats have been pinpointed as a source of the coronavirus that has infected 94 people, killing 47 of them, since it emerged in the Middle East in April last year.

An international team of researchers has found a tiny genetic fragment that seems to be from the virus in a faecal sample from an Egyptian tomb bat1. The scientists surveyed 96 bats in Saudi Arabia in October and April, after the first cases of Middle East respiratory syndrome coronavirus (MERS-CoV) were reported there.

bat

“Although it’s a short fragment, because it’s 100% identical, it indicates this is the same virus,” says epidemiologist Ian Lipkin of Columbia University in New York city who led the study. His team reported the result on 21 August in the journal Emerging Infectious Diseases.

 

 

Because bats carry many types of coronavirus, it was widely thought that they were the ultimate source of MERS-CoV, which causes severe pneumonia in humans. But researchers have struggled to gather information that could help them to understand how the virus spreads, including which animals transmit the infection.

Identity crisis

Lipkin believes that he has got solid proof that bats are a reservoir for the virus. But other researchers are not convinced that the fragment his team has identified confirms the presence of MERS-CoV. Chantal Reusken, an infectious-disease researcher at the National Institute for Public Health and the Environment in Bilthoven, the Netherlands, points to weaknesses in the data linking the bat virus to the MERS-CoV that infects humans.

Reusken notes that the study authors could sequence only a 190-nucleotide-long segment of the 30,000-nucleotide coronavirus genome. Studies have suggested that sequences of at least 800 nucleotides are necessary to accurately determine how closely viruses are related2.

“It can absolutely not be ruled out that it is a sequence derived not from MERS-CoV but from another, closely related MERS-CoV like virus,” Reusken says.

Patrick Chiu Yat Woo, a bat-coronavirus expert at the University of Hong Kong, agrees. “The finding is, of course, important, but it has to be reproduced by others, and it has to be found in other bats.” Woo says that when a new coronavirus is found, the whole genome should be sequenced if possible. Small differences in the genomes of related viruses can hint at the types of animal that a virus infects.

So far, camels are the only other animal implicated in the spread of MERS-CoV, on the basis of the results of blood antibody tests3. But because few people encounter bats or camels, researchers speculate that other animals spread the virus to humans.

Despite the gaps in these latest findings, Stanley Perlman, a coronavirus researcher at the University of Iowa in Iowa City, says the research is important because it confirms that bats carry MERS-CoV or a related virus. “It’s certainly closely related,” he says, “but you can’t say how closely related.”

Source:Nature

MERS Coronavirus — An Update.


A novel coronavirus originating in the Middle East and exported to Europe causes severe respiratory disease with a high case-fatality rate.

The first report of a novel coronavirus causing human infection on the Arabian Peninsula was received in September 2012. By June 7, 2013, the Middle East respiratory syndrome coronavirus (MERS-CoV) — as is it now known — had caused 55 confirmed cases, all of which were linked to four countries: Saudi Arabia (40 cases), Qatar, Jordan, and the United Arab Emirates. Four additional countries — the U.K., Italy, France, and Tunisia — have reported cases in returning travelers and their close contacts. To date, no cases have been reported in the U.S.

Person-to-person spread in nosocomial environments, both to other patients and to healthcare personnel, has been documented. The median age of patients is 56 years; 72% are female. The incubation period is now estimated to be 9 to 12 days (an increase from the 1–9 days initially described), and the case-fatality rate is 56%.

Because tests of upper respiratory samples have sometimes yielded negative results for patients later confirmed to be infected, testing of lower respiratory tract specimens (e.g., from cough or bronchial washing) with a newly approved polymerase chain reaction assay is recommended.

Comment: In new outbreaks, it is common for cases with the shortest incubation period to surface first, and for estimates of incubation periods to increase. Also, it would appear that respiratory symptoms may be mild or even absent at the outset of illness caused by the Middle East respiratory syndrome coronavirus. Clinicians should be alert to the possibility of infection with this pathogen and should contact the CDC if they encounter patients who develop severe acute lower respiratory illness within 14 days after returning from the endemic area — or are close contacts of such individuals. Current information and guidance are available on the CDC’s MERS website.

Source:  Journal Watch Infectious Diseases

 

 

 

CDC Issues Update on Novel SARS-like Coronavirus.


Reports of new cases of the novel SARS-like coronavirus, now known as MERS-CoV, indicate continued risk for transmission in the Arabian Peninsula, according to an update from MMWR.

To date, MERS-CoV has been confirmed in 55 people, 31 of whom have died. All cases have been linked to Saudi Arabia, Qatar, Jordan, or the United Arab Emirates. Infections among close contacts of cases, including healthcare personnel and family members, “provide clear evidence of human-to-human transmission,” MMWR says.

The CDC recommends that MERS-CoV be considered in people who develop severe acute lower respiratory illness within 14 days of traveling from the Arabian Peninsula or nearby areas. The virus should also be considered for close contacts of symptomatic travelers. To improve detection, specimens should be taken from multiple locations (for example, the nasopharynx and lower respiratory tract); the CDC is performing testing.

 

Source: MMWR 

WHO urges information sharing over novel coronavirus.


corona

The World Health Organisation (WHO) has urged countries with possible cases of novel coronavirus to share information.

The move comes after Saudi Arabia said the development of diagnostic tests had been delayed by patent rights on the NCoV virus by commercial laboratories.

Twenty-two deaths and 44 cases have been reported worldwide since 2012, the WHO says.

NCoV is from the same family of viruses as the one that caused Severe Acute Respiratory Syndrome (Sars).

An outbreak of Sars in 2003 killed about 770 people. However, NCoV and Sars are distinct from each other, the WHO says.

The virus first emerged in Saudi Arabia, which is where most cases have since arisen.

Saudi Deputy Health Minister Ziad Memish raised his concerns at the World Health Assembly in Geneva.

“We are still struggling with diagnostics and the reason is that the virus was patented by scientists and is not allowed to be used for investigations by other scientists,” he said.

“I think strongly that the delay in the development of … diagnostic procedures is related to the patenting of the virus.”

‘Uncertainty’

WHO chief Margaret Chan expressed dismay at the information.

“Why would your scientists send specimens out to other laboratories on [sic] a bilateral manner and allow other people to take intellectual property rights on a new disease?” she asked.

“Any new disease is full of uncertainty.”

She is urging the WHO’s 194 member states to only share “viruses and specimens with WHO collaborating centres… not in a bilateral manner.”

She added: “I will follow it up. I will look at the legal implications together with the Kingdom of Saudi Arabia. No IP (intellectual property) should stand in the way of you, the countries of the world, to protect your people.”

WHO’s assistant director-general for health security, Dr Keiji Fukuda, said his agency had also been “struggling with diagnostics” because of property rights concerns and ill-defined international rules for sharing such materials, AP news agency reported.

Cases of novel coronavirus have been detected in Saudi Arabia, Jordan, Qatar, the United Arab Emirates, Germany, the UK and France.

Twenty-two of the 44 cases reported worldwide have been in Saudi Arabia, WHO says.

Out of the 22 deaths, 10 of them have been in the kingdom, it adds.

Source: BBC

e�Tr 8(� �� noticing the movement of the bars when observing the smallest image – but they were slower at detecting movement in the larger images.

 

Michael Melnick of the University of Rochester, who was part of the research team said the results were very clear.

“From previous research, we expected that all participants would be worse at detecting the movement of large images, but high IQ individuals were much, much worse.

The authors explain that in most scenarios, background movement is less important than small moving objects in the foreground, for example driving a car, walking down a hall or moving your eyes across the room.

People with higher IQs appear to be able to concentrate better

As a person’s IQ increases, so too does his or her ability to filter out distracting background motion and concentrate on the foreground.

In an initial study on 12 people, there was a 64% correlation between motion suppression and IQ scores. In this larger study on 53 people, a 71% correlation was found.

In contrast, previous research on the link between intelligence and reaction times, colour discrimination and sensitivity to pitch found only a 20-40% correlation.

But the ability to ignore background movements is not the only indicator of intelligence.

“Because intelligence is such a broad construct, you can’t really track it back to one part of the brain,” says Duje Tadin, who also worked on the study.

“But since this task is so simple and so closely linked to IQ, it may give us clues about what makes a brain more efficient, and, consequently, more intelligent.

“We know from prior research which parts of the brain are involved in visual suppression of background motion.

“This new link to intelligence provides a good target for looking at what is different about the neural processing, what’s different about the neurochemistry, what’s different about the neurotransmitters of people with different IQs.”

Source: BBC