The Pandora Report 11.1.13

Highlights include polio in Syria (really not a highlight), bats and SARS (surprise, bats carry everything!), rabies in a French kitten, MERS in Oman, and cholera in Mexico. Happy Friday!

Polio outbreak in Syria threatens whole region, WHO says
For the first time since 1999, a polio outbreak has occurred in Northern Syria. This is not a spontaneous re-emergence of the otherwise eradicated disease. This is the same strain found in the recent Iraqi outbreak, as well as that found in sewage in Egypt, Israel, the West Bank, and Gaza, a strain which originates in Pakistan. Pakistan is one of just three countries globally in which polio remains endemic. Pakistan is also a country in which the Taliban has banned administration of the vaccine, and routinely kills the poor, often women, workers who administer the vaccine anyway. As a result of this tremendous bit of stupidity, polio is re-emerging in Syria, a country in the middle of a civil war, and therefore a ripe breeding ground for the crippling virus’ spread.

Reuters – “‘This virus has come over land which means the virus is not just in that corner of Syria but in a broad area,’ Bruce Aylward, WHO assistant director-general for polio, emergencies and country collaboration, told Reuters in an interview.’We know a polio virus from Pakistan was found in the sewage of Cairo in December. The same virus was found in Israel in April, also in the West Bank and Gaza. It… is putting the whole Middle East at risk quite frankly,’ he said by telephone from Oman.”

Bat virus clues to origins of SARS
Researchers at the Commonwealth Scientific and Industrial Research Organisation have discovered two viruses closely related to SARS in the Chinese horseshoe bats. The viruses both bind to the same receptor in humans as SARS does, the ACE2 receptor, which is primarily expressed in endothelial cells of the kidney and heart. The use of the same receptor in both species suggests that coronaviruses may be able to jump directly from bats to humans without a vector species. Our first thought here is MERS?

BBC – “According to Gary Crameri, virologist at CSIRO and an author on the paper, this research ‘is the key to resolving the continued speculation around bats as the origin of the Sars outbreaks’. This Sars-like coronavirus is around 95% genetically similar to the Sars virus in humans, the research shows. And they say it could be used to develop new vaccines and drugs to combat the pathogen.

WHO: Middle East respiratory syndrome Coronavirus (MERS-CoV) – update

The WHO has confirmed another four cases of the Middle Eastern Respiratory Virus, including the first case in Oman. The three other cases, including one fatality, were all located in Saudi Arabia. While none of the three had recent contact with animals, one of the Saudi cases had been in recent contact with an infected patient. All three however were immunocompromised. The Omani case had no recent contact with animals or travel to Saudi Arabia.

WHO – “The patient in Oman is a 68-year-old man from Al Dahkliya region who became ill on 26 October 2013 and was hospitalized on 28 October 2013…Globally, from September 2012 to date, WHO has been informed of a total of 149 laboratory-confirmed cases of infection with MERS-CoV, including 63 deaths. Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.”

France issues rabies warning after kitten’s death
It is no secret that rabies is scary. We’ve all joked at one point or the other about what a zombie apocalypse would look like, which is all fun and games until someone mentions rabies.  While our vaccine is very good, in order for it to be effective, you have to know you’ve caught rabies. The virus itself usually has an incubation period of a few weeks, although cases have occurred in which the virus lay dormant for years.  At that point it’s of course too late. So we definitely understand Paris health authorities preemptively vaccinating five people, setting up a public hotline, and imploring anyone who may have handled or come near the kitten to contact authorities to be vaccinated.

BBC – “France was first declared a rabies-free zone for non-flying terrestrial mammals 12 years ago following the elimination of fox rabies. The 2008 canine rabies outbreak led to that status being suspended for two years. The BBC’s Christian Fraser in Paris said that the urgent appeal seeking anyone who came into contact with the infected animal is likely to be fuelled by fears of a repeat of the 2008 outbreak. The rabies virus is present in the saliva of an infected animal and is usually transmitted to humans by a bite.”

Haitian Cholera in Mexico
The cholera strain introduced to Haiti three years ago has spread to Mexico, which has seen 171 cases of the disease since September 9th of this year. The Haitian epidemic has infected as many as 600,000 people and caused nearly 8,500 deaths in Haiti, before spreading to the Dominican Republic and causing a further 31,000 cases there.

IBT – “Mexico has reported 171 cases of the disease, which has been identified as the same strain that arrived in Haiti, Dominican Republic and Cuba and one that is different from the strain that circulated in Mexico during a 1991-2001 epidemic. The Pan American Health Organization (PAHO) is warning that the illness could spread worldwide. Mexican health authorities reported the 171 cases in Mexico City and in the states of Mexico, Hidalgo, Veracruz and San Luis Potosí between Sept. 9 and Oct. 18. According to the Mexican Ministry of Health, there has been only one fatality, while 39 other cases have required hospitalization. The recent devastation caused by hurricanes Ingrid and Manuel contributed to the spread of the disease, which had not been reported in Mexico since the previous epidemic.”

(image: CDC Global Health/Flickr)

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