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Jordan records coronavirus case of national coming from Saudi Arabia

Amman, August 25 (Petra) -- A new Middle East respiratory syndrome coronavirus (MERS-CoV) case has been recorded for a man who has recently come from Saudi Arabia, the country where most cases of this disease are reported.

The man, who is in his 60s, was admitted to a private hospital suffering from breathing difficulty, coughing and fever, the ministry of health said. He was diagnosed to have the Middle East respiratory syndrome coronavirus (MERS-CoV) and he is now in critical condition, the ministry added.

Since 2012, 13 MERS cases have been recorded in Jordan, according to official data.

//Petra// AA 
25/8/2015 - 08:54:08 PM



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New MERS virus case registered in Jordan, patient critical

By Petra - Aug 25,2015 - Last updated at Aug 25,2015

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AMMAN — The Kingdom has registered a new Middle East Respiratory Syndrome (MERS) coronavirus-related infection, the Health Ministry said on Tuesday.

A Jordanian in his sixties, who works in Saudi Arabia and who recently entered the Kingdom, was diagnosed with the virus and is receiving treatment at a private hospital, where he was listed in critical condition, Bashir Qaseer, head of the Health Ministry’s primary health directorate, said.

Mohammad Abdallat, director of the ministry’s communicable diseases control department, said 13 coronavirus-related infections have been recorded in Jordan so far, including two in 2012 and 10 in 2014, besides the case announced Tuesday.

- See more at: http://www.jordantimes.com/news/local/new-mers-virus-case-registered-jordan-patient-critical#sthash.SwaLHKWX.dpuf

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Jordan reports travel-linked MERS case, Riyadh outbreak total grows

Jordan's health ministry yesterday announced a MERS-CoV detection in a man who had recently traveled from Saudi Arabia, where the number of newly confirmed cases grew by three, including two that are likely part of a large hospital-linked outbreak in Riyadh.

The apparently travel-linked illness in Jordan comes at a time when global health officials are on edge for spread of the virus in the wake of a travel-related case in May that triggered a large hospital outbreak in South Korea and as Saudi health officials battle a large hospital outbreak in Riyadh that began toward the end of July.

In related developments, the World Health Organization (WHO) today released details about 29 recently reported Middle East respiratory syndrome coronavirus (MERS-CoV) infections reported by Saudi Arabia, 24 of them linked to Riyadh's hospital outbreak.

Jordan announced imported case

Jordan's latest imported MERS-CoV case involves a man in his 60s who was admitted to a private hospital with symptoms that included breathing problems and fever, according to a report yesterday from Petra, Jordan's news agency.

The report, which cited Jordan's health ministry, didn't say where in Saudi Arabia the man traveled from, when he arrived in Jordan, or how he arrived in the country. The man's illness lifts Jordan's MERS-CoV total to 13, according to the report.

Jordan confirmed its last MERS-CoV cases in May.

Riyadh total grows by two

Meanwhile, Saudi Arabia's Ministry of Health (MOH) today reported three more MERS-CoV cases, two from Riyadh and one from Hofuf, a city in the northeastern part of the country that experienced an outbreak in May and June.

The two cases from Riyadh may be associated with an outbreak linked to King Abdulaziz Medical City, with an exposure under review for one of the patients and contact with a confirmed case in the community or hospital noted for the other. The patients include a 60-year-old Saudi man who is hospitalized in critical condition and a 32-year-old Saudi man who is a healthcare worker and is listed in stable condition.

The country's third newest lab-confirmed patient is a 65-year-old Saudi man from Hofuf who is hospitalized in critical condition.

The MOH said 56 people are still being treated for their illnesses and six more are in home isolation.

Five more people, all from Riyadh, have recovered from their MERS-CoV infections, the MOH said, boosting the number of people who have recovered since the virus was first detected in 2012 to 603.

Saudi Arabia's latest MERS-CoV detections lift its overall total to 1,165 cases, 498 of them fatal.

WHO update details hospital connections

A new update from the WHO today shed more light on the Riyadh outbreak, covering 29 cases from the city reported by Saudi Arabia between Aug 18 and Aug 21, including 24 linked to the main hospital outbreak and one linked to a smaller hospital outbreak in Riyadh. Last week an official from the WHO said five MERS-CoV cases had been detected at another hospital but that the outbreak had been contained.

All of the patients are adults ranging in age from 28 to 109 years old. Seventeen are men and 12 are women. Illness onsets ranged from Jul 30 through Aug 19.

Four of the patients covered in the report are contacts of earlier confirmed cases.

Three are healthcare workers, two of them foreigners: a 40-year-old woman and a 35-year-old woman. The third is a 59-year-old woman.

Four people were infected with MERS-CoV while hospitalized for an unrelated medical condition. Three others had visited the emergency department (ED) of a hospital experiencing an outbreak before they got sick.

Six patients died from their illnesses. All were seniors, except for a 35-year-old man. However, all six had underlying medical conditions. Also, the WHO said it had been informed by Saudi Arabia of an additional death in a previously reported patient.

Eighteen of the patients are hospitalized in stable condition, and five are listed as critical.

Globally, the WHO said it has received reports of 1,461 lab-confirmed MERS-CoV cases, at least 514 of them fatal.

See also:

Aug 25 Petra story 

Aug 26 Saudi MOH update

Aug 26 WHO update


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Saudi Arabia's MERS burden spills over to Jordan


Issam Abo Rabia, a lab technician at the Jordanian Ministry of Heath's Central Public Lab in Amman, watches the real-time PCR monitor display results for recently-tested specimens from Jordanian patients suspected of having MERS coronavirus on August 27, 2015. 

GroundTruth Project

Amman — It wasn’t even noon yet at the Jordanian Ministry of Health’s central lab here on Thursday last week, but already the small research team was busy testing some 20 swab samples for the MERS coronavirus and fielding calls from Jordanian officials, physicians and the press.

On August 25, the lab confirmed the country’s first MERS case this year after a 60-year-old Jordanian man checked into a private hospital in Amman, complaining of some of the virus' tell-tale signs — shortness of breath and a fever.

Similar to the SARS virus, MERS is a lung infection that has affected some 1,400 people and killed more than 500 worldwide since being first identified in Saudi Arabia in 2012. Researchers believe an animal source of the virus could be dromedary camels, but it can also spread from person-to-person through close contact.

The respiratory illness came into sharp international focus after this summer's outbreak in the South Korean capital Seoul, when a local man returned from a Middle East business trip and brought with him a MERS infection that killed 36 people within three months.

Issam Abo Rabia, a lab technician at the Jordanian Ministry of Health's Central Public Lab in Amman, shows a swab sample awaiting testing for the MERS coronavirus on August 27, 2015.
Alisa Reznick

That’s why Jordan’s central lab had so many samples to test after just one positive infection — every healthcare worker, family or friend the patient came into close contact with during the last few weeks could be at risk.

Just 24 hours after the country’s first infection, another, unrelated, positive case followed — a 38-year-old Jordanian man with a travel history local officials will only describe as “abroad.” Within a week, the first man had died and the country’s caseload had risen to six, at least a few of which are the result of contact with MERS patients. 

Across Jordan’s eastern border, Saudi Arabia has reported at least one new case almost every day since August 9, most of which can be traced back to an initial outbreak in a central hospital in the country’s capital Riyadh. The identification of 13 new infections over just two days in mid-August saw the country’s number of MERS deaths top 500, according to the Ministry of Health, though those numbers differ from the World Health Organization’s global fatality count.

With six lab confirmed cases this year and 18 total since 2012, Jordan's MERS numbers pale in comparison to those figures. But making sure the situation stays that way hinges on strict adherence to a robust infection control system put in place by the country’s Ministry of Health and the central lab.

Mohammed Abdallat, the ministry’s director of communicable diseases control department, says that the first step after finding a positive result is to identify people who cross paths with the patient.

“First we look for close contacts, and we use this investigation to see if there is any link between the cases,” he said. “Then we look at preexisting diagnoses, whether he came from outside Jordan, or if he went from hospital-to-hospital.”

A ministry team is sent out to understand the patient’s circumstances, including travel history, exposure to camels, and, perhaps more importantly, the people who might unknowingly have been infected.

The investigation the Jordanian team carried out for the first, 60-year-old patient rendered only five contacts, all of whose samples came out negative. But the second 38-year-old’s close contacts included some 20 people, one of whom became Jordan’s third case — a 47-year-old female family member.

Last week, the kingdom’s fourth case, a 76-year-old man from Amman confirmed late that day, was still under investigation.

But so far, Abdallat said the researchers hadn’t uncovered any history of exposure to camels, nor any worrying travel history. As with the others, Jordanian officials collected information about the man's close contacts, investigating a radius of possible impacts to test at the central lab.

The MERS virus is classified by Jordanian health officials as a Severe Acute Respiratory Infection (SARI) and is tested using a technology called real-time Polymerase Chain Reaction, or PCR.

Central Public Lab Head of PCR Unit Mahmoud Gazo stands in front of the unit's office in Amman on August 27, 2015. The central lab's PCR unit conducts all MERS tests in the country, as well testing for other ailments spanning HIV, Hepatitis and a wide array of respiratory illnesses.
Alisa Reznick

Jordanian Ministry of Health Laboratory Director Aktham Haddadin told me in addition to testing specimens for ailments spanning HIV, Hepatitis and several SARI strains, the central lab's PCR office is the landing strip for all MERS samples in the country.

“It was a national decision to test all SARI cases [for MERS],” he said. “That way we can identify the index case very soon.”

Like conventional PCR methods, the rapid test amplifies the coronavirus’ DNA so laboratories can identify it. But real-time PCR uses fluorescent dye to highlight different volumes of the virus and allows technicians to produce faster results. Using this method, Haddadin says the central lab can identify a MERS-positive specimen within four hours.

“The physicians, nurses and labs are very well trained, they collect specimens and preserve them as required and we bring them to the lab on a weekly basis,” he told me. “We do this so that if any outbreak, respiratory case or infectious disease occurs, we can detect it immediately.”

Bulked up by regular reminders about the coronavirus’ case definition and warning signs, Haddadin says MERS events like the one that began last week are controlled by the same infection control procedures in place since the H1N1 swine flu, another respiratory epidemic, rose to international attention in 2009. The repetition is part of what he thinks makes the procedure effective in addressing the MERS threat.

“It started in 2009 with H1N1,” he said. “So once you have the system you can operate with any virus — the people here have it in their blood now.”

Sharing a border with Saudi Arabia that stretches almost 500 miles, in many ways Jordan is always at risk to receive its neighbor’s viral burdens. But Abdallat says that with international travel, anyone and everyone could come down with MERS.

“We learned in South Korea that one person can infect more than 100 people,” he said. “No country is protected from this, so the most important thing is to be aware, watch for the signs, and isolate the virus.”

Alisa Reznick is reporting for The GroundTruth Project in Amman. She is part of the global health reporting team working on "The Next Outbreak," a collaboration of The GroundTruth Project and NOVA Next. 

This story is presented by The GroundTruth Project.


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