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On 3 August 2015, WHO was notified by the National IHR Focal Point for Spain of a case of chikungunya infection in the city of Gandia, Valencian Community. The patient, a 60-year-old man, had no history of travel outside the European Region. The patient was identified after detection at the regional laboratory of IgM in his serum by ELISA in samples taken on 23 July. A second sample taken on 19 August showed an IgG seroconversion at the same laboratory. View the full article

On 14 September 2015, the National IHR Focal Point for Portugal notified WHO of a confirmed human case of West Nile virus (WNV) infection. The patient is a 71-year-old male from the town of Almancil (Loulé municipality) – Algarve Region, Portugal with no recent history of travel. On 20 July, he was hospitalized with neurological symptoms. Following a full recovery, on 4 August, the patient was discharged from hospital. Seroconversion (IgM and IgG) was confirmed in two separate samples on 7 and 19 August. Real-time PCR was negative in the first sample. Neutralization tests were positive for WNV on samples collected on 14 September.View the full article

Between 6 and 11 September 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 22 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Three (3) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city. Five (5) of these reported cases are associated with another MERS-CoV outbreak occurring in a hospital in Madinah city. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

On 9 September 2015, the Ministry of Health and Social Affairs (MOHSA) of Senegal notified WHO of active circulation of chikungunya virus in the region of Kédougou. The circulation began on 27 August 2015. Samples were collected from 14 suspected cases for laboratory-confirmation at the Institut Pasteur of Dakar. Ten (10) samples tested positive for chikungunya virus. As of 8 September 2015, ten (10) chikungunya confirmed cases were reported. The latest active circulation in the affected area was reported between 2009 and 2010. On 7 September 2015, the MOHSA discussed the situation during the routine weekly meeting. The meeting provided technical directives to the different teams and departments involved in the response. The overall coordination of the response will be led by the MOHSA’s Preventive department with the support of WHO and partners. View the full article

The Ministry of Health and Social Welfare (MOHSW) of Tanzania has notified WHO of foci of cholera outbreaks in the country. Rorya district in the Mara region of Tanzania was the first area to report a cholera outbreak. By late July 2015, the Kigoma region also became affected – although no new case has been recorded in this area in more than three weeks. On 25 August, new foci of cholera were identified in Dar es Salaam, Pwani (Coast), Iringa and Morogoro. The cholera outbreak in the Dar es Salaam region began on 15 August, whilst the outbreak in the Morogoro region started on 18 August. As of 6 September, the cumulative number of cholera cases (both suspected and confirmed) is 971 cases, including 13 deaths. Laboratory tests confirmed the presence of Vibrio cholerae O1 Ogawa in the affected areas. Rapid assessment has been conducted to identify gaps and urgent needs. Regional authorities, the MOHSW, WHO and partners are holding bi-weekly meetings to coordinate the response efforts. A national task force has been activated to control the outbreak. With support from WHO and partners, five treatment centres have been established in Dar es Salaam and Morogoro to manage cases. The MOHSW has deployed technical experts to provide assistance with surveillance activities including case finding, water supply and sanitation monitoring, laboratory management and social mobilization interventions.View the full article

Between 1 and 5 September 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 25 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Ten (10) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

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Between 26 and 31 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 22 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 3 deaths. Fifteen (15) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

Between 30 and 31 August 2015, the National IHR Focal Point of Jordan notified WHO of 2 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Both cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city. Contact tracing of household and healthcare contacts is ongoing for these cases.View the full article

The Ministry of Health of Madagascar has notified WHO of an outbreak of plague. The first case was identified on 17 August in a rural township in Moramanga district. The case passed away on 19 August. As of 30 August, 14 cases, including 10 deaths, were reported. All confirmed cases are of the pneumonic form. Since 27 August, no new cases have been reported from the affected or neighbouring districts. The national task force has been activated to manage the outbreak. With support from partners – including WHO and the Pasteur Institute of Madagascar – the government of Madagascar is implementing thorough public health measures, including active case and contact finding, provision of chemoprophylaxis, case and contact management, enhanced epidemiologic surveillance, infection prevention and control (house disinfection), vector control activities, social mobilization, coordination and resource mobilization. View the full article

Between 24 and 25 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 15 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 2 deaths. Eleven (11) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

In Ukraine, 2 cases of circulating vaccine-derived poliovirus type 1 (cVDPV1) have been confirmed, with dates of onset of paralysis on 30 June and 7 July 2015. Both are from the Zakarpatskaya oblast, in south-western Ukraine, bordering Romania, Hungary, Slovakia and Poland. One child was 4 years old and the other 10 months old at the time of onset of paralysis. Ukraine had been at particular risk of emergence of a cVDPV, due to inadequate vaccination coverage. In 2014, only 50% of children were fully immunized against polio and other vaccine-preventable diseases.View the full article

Between 26 and 28 August 2015, the National IHR Focal Point of Jordan notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. All these cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city. Contact tracing of household contacts and healthcare contacts is ongoing for these cases. The National IHR Focal Point of Jordan informed the National IHR Focal Point for the Kingdom of Saudi Arabia about the index case to trace contacts in Saudi Arabia.View the full article

Saudi Arabia's MERS burden spills over to JordanIssam 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. Alisa ReznickGroundTruth ProjectAmman — 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 ReznickThat’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 ReznickJordanian 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. http://www.globalpost.com/article/6640388/2015/09/01/saudi-arabias-mers-burden-spills-over-jordan

Saudi Arabia's MERS burden spills over to JordanIssam 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. Alisa ReznickGroundTruth ProjectAmman — 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 ReznickThat’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 ReznickJordanian 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. http://www.globalpost.com/article/6640388/2015/09/01/saudi-arabias-mers-burden-spills-over-jordan

Between 22 and 23 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 13 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Twelve (12) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

Between 18 and 21 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 29 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 6 deaths. Twenty-four (24) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh city.View the full article

MERS sickens six more in Riyadh outbreakFiled Under: MERS-CoVLisa Schnirring | News Editor | CIDRAP News |Aug 21, 2015ShareTweetLinkedInEmailPrint & PDFriyadhsignmed.jpgBuen Viajero/ Flickr ccThe total in a MERS-CoV outbreak in Riyadh grew by six today—including a 109-year-old man—as the hospital linked to many of the cases announced new steps to curb the outbreak. Newly announced Middle East respiratory syndrome coronavirus (MERS-CoV) confirmations from Saudi Arabia's Ministry of Health (MOH) boost the number of cases reported since Jul 21 in Riyadh to 81. New case detailsIn its daily update today, the Saudi MOH said five of the six patients had contact with a suspected or confirmed case in the community or hospital, suggesting that they could be part of an outbreak at Riyadh's King Abdulaziz Medical City. The 109-year-old man is hospitalized in stable condition, as are the other five patients. One of the new confirmed cases is a 40-year-old woman who is healthcare worker from outside of Saudi Arabia. Others include three men, ages 87, 72, and 71 years old, and a 58-year-old woman who apparently didn't have contact with an earlier case. In addition to the new cases, the MOH reported one death in a previously announced case-patient from Riyadh, an 86-year-old man who had underlying health conditions. The MOH said 52 people are still being treated for their infections, and 4 more are in home isolation. Today's additional cases lift Saudi Arabia's overall total from the disease, first detected in 2012, to 1,134, which includes 486 deaths. So far 592 people have recovered from their infections. Hospital response updateKing Abdulaziz Medical City said today in Twitter posts that it had postponed most outpatient appointments scheduled for Aug 23 and Aug 24 to curb spread of the virus. The only exceptions are for chemotherapy, obstetrics, and valve replacement clinics. A specialty children's hospital that is part of the medical city will continue with business as usual, with no cancelled clinics or admissions. It said the Saudi MOH will continue to publish the number of positive MERS-CoV cases. Earlier this week the hospital announced that since June, 31 illnesses had been linked to visits to its emergency department, a pattern seen in a recent MERS-CoV outbreak in South Korea. It also said several more illnesses were suspected. Global health officials are discussing the possibility of a joint World Health Organization mission to help the country investigate the outbreak. See also: Aug 21 Saudi MOH statement National Guard Hospital Twitter feed http://www.cidrap.umn.edu/news-perspective/2015/08/mers-sickens-six-more-riyadh-outbreak

Posted : 2015-08-21 14:18 Updated : 2015-08-21 14:18 Man suspected of MERS confirmed negative/ Yonhap A Korean man who showed suspected symptoms of Middle East Respiratory Syndrome (MERS) after his trip to the United Arab Emirates has been confirmed negative. The result came after the 38-year-old man was taken to a hospital in the city of Dongducheon, north of Seoul, after he returned from Dubai on Thursday. He had showed high fever and other possible symptoms when he was taken to the hospital. The case, if confirmed otherwise, would have meant a fresh MERS outbreak case after a 46-day gap. The previous outbreak had claimed 36 lives. https://www.koreatimes.co.kr/www/news/nation/2015/08/116_185309.html

Between 13 and 17 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 19 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Fifteen (15) of these reported cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Riyadh. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

Between 10 and 12 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

Between 3 and 9 August 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 17 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 3 deaths. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article

On 3 August 2015, WHO was notified by the National IHR Focal Point for Spain of a case of chikungunya infection in the city of Gandia, Valencian Community. This is the first time that an individual with no history of travel to a chikungunya-endemic area tests positive for the disease in Spain. The patient is a 60-year-old man. He developed symptoms on 7 July in France and sought medical care on 8 July while still in France. Following his return to Spain, the patient was hospitalized on 11 July and discharged on 16 July. Patient blood samples were collected on 23 July. On 31 July, he was laboratory confirmed to be positive for chikungunya by identification of IgM in serum by ELISA testing. During his probable incubation period and while symptomatic – this is the period when a patient can acquire the infection and transmit it to others – the patient stayed in the Valencian Community, Spain and in the Languedoc-Roussillon region, France where the competent vector Aedes albopictus has been shown to be present.View the full article

Between 28 and 29 July 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 2 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Contact tracing of household and healthcare contacts is ongoing for these cases. View the full article