Welcome to A Time's Memory Blog

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A TIME'S MEMORY - Flu, Bugs & Other Accidents Blog - Year: XIV - Here, Reader, you will find many items if your interests are in the field of emerging threats to global or public health, with a perspective that is not mainstream. Thank to You for the interest!

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16 Oct 2019

#Ebola in #DRC – #Situation #Report No. 63 (@WHO, October 16 ‘19)


Title:

Ebola in DRC – Situation Report No. 63.

Subject:

Ebola Virus Disease Epidemic in the Dem. Rep. of Congo, current situation.

Source:

World Health Organizaton (WHO), full PDF file: (LINK).

Code:

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Keywords: Ebola; DRC; Updates; WHO.

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15 Oct 2019

#Influenza #Update N° 352, 14 October ‘19, based on data up to 29 September ‘19 (@WHO, edited)


Title:

#Influenza #Update N° 352, 14 October ‘19, based on data up to 29 September ‘19.

Subject:

Seasonal Influenza, current global epidemiological situation.

Source:

World Health Organization (WHO), full PDF file: (LINK).

Code:

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Information in this report is categorized by influenza transmission zones, which are geographical groups of countries, areas or territories with similar influenza transmission patterns.

For more information on influenza transmission zones, see here.


Summary

  • In the temperate zones of the southern hemisphere, influenza activity was low in most countries, and appeared to decrease in Chile after a second wave of influenza activity of predominately B viruses.
  • In the Caribbean, and tropical South American countries, influenza activity was low overall.
    • In Central American countries, influenza activity increased in El Salvador and Nicaragua
  • In tropical Africa, influenza activity was low across reporting countries except for some countries in Western Africa.
  • In Southern Asia, influenza activity was low across reporting countries except in Bhutan where influenza activity continued to be reported above alert threshold.
  • In South East Asia, influenza activity was low in most reporting countries but appeared to increase in Lao PDR.
  • In the temperate zone of the northern hemisphere, influenza activity remained at interseasonal levels in most countries.
  • Influenza season appeared to have started across the countries of the Arabian Peninsula
  • Worldwide, seasonal influenza A viruses continued to account for the majority of detections, though the proportion of influenza B viruses increased in recent weeks. 
  • National Influenza Centres (NICs) and other national influenza laboratories from 94 countries, areas or territories reported data to FluNet for the time period from 16 September 2019 to 29 September 2019 (data as of 2019-10-11 01:51:30 UTC).
  • The WHO GISRS laboratories tested more than 63162 specimens during that time period.
  • 3494 were positive for influenza viruses, of which 1946 (55.7%) were typed as influenza A and 1548 (44.3%) as influenza B.
  • Of the sub-typed influenza A viruses, 447 (35.5%) were influenza A(H1N1)pdm09 and 813 (64.5%) were influenza A(H3N2).
  • Of the characterized B viruses, 56 (14.3%) belonged to the B-Yamagata lineage and 336 (85.7%) to the B-Victoria lineage.

For more detailed information, see the Influenza reports from WHO Regional Offices:

  • WHO Region of the Americas (AMRO);
  • WHO Eastern Mediterranean Region (EMRO);
  • WHO European Region (EURO);
  • WHO Western Pacific Region (WPRO).


Countries in the temperate zone of the southern hemisphere

  • In Oceania, influenza activity decreased across the transmission zone.
    • In Australia, despite some geographical variability across regions, at the national level influenza-like illness (ILI) and weekly laboratory-confirmed notifications of influenza were lower than average for this time of the year, decreased from a peak in activity in July.
    • Despite this year’s early season, activity has not returned to inter-seasonal levels.
    • The proportion of influenza B viruses among influenza positive samples continued to slightly increase this period. ILI and influenza activity were below their seasonal baseline thresholds in New Zealand
  • In South Africa, influenza and ILI activity remained below seasonal threshold.
  • In temperate South America, influenza activity was low in most countries.
    • In Chile, influenza activity appeared to decrease after a second wave of predominately B viruses. 


Countries in the tropical zone

Tropical countries of Central America, the Caribbean and South America

  • In the Caribbean countries, influenza activity remained low overall.
    • In Central American countries, influenza activity continued to increase in El Salvador and Nicaragua, with influenza A(H1N1)pdm09 predominately detected in the former and all seasonal influenza subtypes co-circulating in the latter.
    • Respiratory syncytial virus (RSV) activity was high in Jamaica.
  • In the tropical countries of South America, influenza activity was low in general among those countries reporting data for this period. 

Tropical Africa

  • In Western Africa, increased influenza activity was reported in some countries.
    • Côte d’Ivoire and Guinea continued to report increased detections of predominately influenza B/Victoria lineage viruses.
    • ILI activity continued to increase in Senegal with detections of influenza A(H3N2) viruses.
    • Influenza activity continued to increase in Togo with increased number of SARI cases and detections of influenza A(H3N2) and B viruses.
    • Burkina Faso reported influenza A(H3N2) detections.
  • In Middle Africa, influenza detections were low across reporting countries.  
  • In Eastern Africa, influenza detections appeared to decrease across reporting countries, with influenza A and B viruses co-circulating.
    • However, the French island La Réunion did report an increase of ILI consultations and hospitalizations for influenza. 

Tropical Asia

  • In Southern Asia, influenza detections were low across reporting countries, except for Bhutan, where influenza percent positivity remained above alert threshold though decreased.
    • Influenza-associated ILI were most frequently reported in persons aged 15-29 years.
    • Influenza B/Victoria lineage viruses predominated, followed by A(H3N2).
    • Influenza activity decreased in Nepal, with detection of A(H3N2) and B/Victoria lineage viruses.
  • In South East Asia, influenza activity was low in most reporting countries. Influenza activity appeared to increase in Lao PDR, with influenza A(H3N2) and B/Victoria-lineage cocirculating.
    • Detections of predominantly influenza A(H1N1)pdm09 and B viruses decreased in Myanmar


Countries in the temperate zone of the northern hemisphere 

  • In the temperate zone of the northern hemisphere, influenza activity remained at interseasonal levels in most countries, with exception of the Arabian Peninsula.
    • In Western Asia, influenza activity started to increase across the countries of the Arabian Peninsula, with influenza A(H3N2) viruses predominating in Qatar and all seasonal influenza subtypes cocirculating in Kuwait and Oman


Sources of data

The Global Influenza Programme monitors influenza activity worldwide and publishes an update every two weeks. The updates are based on available epidemiological and virological data sources, including FluNet (reported by the WHO Global Influenza Surveillance and Response System) FluID (epidemiological data reported by national focal points) and influenza reports from WHO Regional Offices and Member States.

Completeness can vary among updates due to availability and quality of data available at the time when the update is developed. 

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Seasonal influenza reviews: A review of the 2018–2019 influenza season in the northern hemisphere, was published in August 2019 and can be found here;

Epidemiological Influenza updates;  

Epidemiological Influenza updates archives 2015;

Virological surveillance updates;

Virological surveillance updates archives.

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Keywords: WHO; Updates; Worldwide; Seasonal Influenza.

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#Avian #Influenza [#H7N9, #H5N6, #H5N1] #Report - October 6 – 12 ‘19 (Wk 41) (#HK CHP, October 15, 2019)


Title:

#Avian #Influenza [#H7N9, #H5N6, #H5N1] #Report - October 6 – 12 ‘19 (Wk 41).

Subject:

Influenza A of Avian Origin, H5, H7 & H9 subtypes, global poultry panzootic and human cases in China and worldwide, weekly update.

Source:

Centre for Health Protection (CHP), Hong Kong PRC SAR, full PDF file: (LINK).

Code:

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Keywords: HK PRC SAR; Updates; China; Worldwide; Human; Poultry; H5N1; H5N6; H7N9; H9N2; Avian Influenza.

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14 Oct 2019

#Influenza virus characterisation – #Summary #Europe, September 2019 (@ECDC_EU, summary)


Title:

#Influenza virus characterisation – #Summary #Europe, September 2019.

Subject:

Seasonal Influenza, current virological situation in the European Region.

Source:

European Centre for Disease Prevention and Control (ECDC), full PDF file: (LINK). Summary, edited.

Code:

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ECDC SURVEILLANCE REPORT


Summary

  • This is the tenth and final report for the 2018–19 influenza season.
  • As of week 39/2019, 205 947 influenza detections across the WHO European Region had been reported; 99% type A viruses, with A(H1N1)pdm09 prevailing over A(H3N2), and 1.2% type B viruses, with 86 of 165 (52%) ascribed to a lineage being B/Yamagata.
  • Since the July 2019 characterisation report{1}, a further three shipments of influenza-positive specimens from EU/EEA countries were received at the London WHO CC, the Francis Crick Worldwide Influenza Centre (WIC).
  • A total of 1 511 virus specimens, with collection dates after 31 August 2018, have been received.
  • The 85 A(H1N1)pdm09 test viruses characterised antigenically since the last report showed equivalent good reactivity with antisera raised against both the A/Michigan/45/2015 2018–19 vaccine virus and the A/Brisbane/02/2018 2019–20 vaccine virus.
    • The 613 test viruses with collection dates from week 40/2018 genetically characterised at the WIC, including two H1N2 reassortants, have all fallen in subclade 6B.1A, defined by S74R, S164T and I295V HA1 substitutions;
    • 564 of these viruses also have HA1 S183P substitution, often with additional substitutions in HA1 and/or HA2.
  • Since the last report, 37 A(H3N2) viruses successfully recovered had sufficient HA titre to allow antigenic characterisation by HI assay in the presence of oseltamivir; all were poorly recognised by antisera raised against the vaccine virus, eggpropagated A/Singapore/INFIMH-16-0019/2016.
    • Of the 505 viruses with collection dates from week 40/2018 genetically characterised at the WIC, 399 were clade 3C.2a (with 43 3C.2a2, 17 3C.2a3, eight 3C.2a4 and 331 3C.2a1b);
    • 106 were clade 3C.3a.
  • Ten B/Victoria-lineage viruses have been characterised in this reporting period.
    • All recent viruses have HA1 amino acid substitutions of I117V, N129D, and V146I compared to B/Brisbane/60/2008 (clade 1A), a previous vaccine virus.
    • Groups of viruses defined by deletions of two (Δ162-163, 1A(Δ2)) or three (Δ162-164, 1A(Δ3)) amino acids in HA1 have emerged, with the Δ162-164 group having subgroups of Asian and African origin.
    • These virus groups are antigenically distinguishable by HI assay.
    • Of 20 viruses from EU/EEA countries this season that have been characterised genetically, one has been clade 1A, two 1A(Δ2) and 17 1A(Δ3) (16 African and one Asian subgroup).
  • Nine B/Yamagata-lineage viruses have been characterised antigenically in this reporting period, giving a total to 23 for the 2018–19 season.
    • All have HA genes that encode HA1 amino acid substitutions of L172Q and M251V compared to, but remain antigenically similar to, the vaccine virus B/Phuket/3073/2013 (clade 3) recommended for use in quadrivalent vaccines for the next northern hemisphere influenza season.

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(…)

{1} European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, July 2019. Stockholm: ECDC; 2019. Available from: https://ecdc.europa.eu/sites/portal/files/documents/influenza-virus-characterisation-report-Jul-2019.pdf

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This report was prepared by Rod Daniels, Burcu Ermetal, Aine Rattigan and John McCauley (Crick Worldwide Influenza Centre) for the European Centre for Disease Prevention and Control under an ECDC framework contract.

Suggested citation: European Centre for Disease Prevention and Control. Influenza virus characterisation, summary Europe, October 2019. Stockholm: ECDC; 2019. 

© European Centre for Disease Prevention and Control, Stockholm, 2019. Reproduction is authorised, provided the source is acknowledged.

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Keywords: ECDC; Updates; Seasonal Influenza; European Region.

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Highly pathogenic #avian #influenza #H5N2, #Taiwan [a #poultry #outbreak] (#OIE, October 14 ‘19)


Title:

Highly pathogenic #avian #influenza #H5N2, #Taiwan [a #poultry #outbreak].

Subject:

Avian Influenza, H5N2 subtype, poultry epizootic in Taiwan.

Source:

OIE, full page: (LINK).

Code:

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Information received on 14/10/2019 from Dr Wen-Jane Tu, Chief Veterinary Officer, Deputy Director General, Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, Taipei, Chinese Taipei

  • Summary
    • Report type    Follow-up report No. 150
    • Date of start of the event    07/01/2015
    • Date of confirmation of the event    11/01/2015
    • Report date    14/10/2019
    • Date submitted to OIE    14/10/2019
    • Reason for notification    Recurrence of a listed disease
    • Date of previous occurrence    23/07/2014
    • Manifestation of disease    Clinical disease
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5N2
    • Nature of diagnosis    Clinical, Laboratory (advanced)
    • This event pertains to    the whole country
  • Summary of outbreaks   
    • Total outbreaks: 1
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of    - Slaughtered
        • Birds    - 35336    - 991    - 991    - 34345    - 0
    • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
      • Birds    - 2.80%    - 2.80%    - 100.00%    - 100.00%
        • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive
  • Epidemiological comments   
    • Samples from Yunlin County were sent to the National Laboratory, Animal Health Research Institute (AHRI) for diagnosis.
    • Highly pathogenic avian influenza H5N2 subtype was confirmed by AHRI.
    • The infected farm has been placed under movement restriction.
    • All animals on the infected farm have been culled.
    • Thorough cleaning and disinfection have been conducted after stamping out operation.
    • Surrounding poultry farms within 3 km radius of the infected farm are under intensified surveillance for three months.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N2 ; Poultry; Taiwan.

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Highly pathogenic #avian #influenza #H5N5, #Taiwan [a #poultry #outbreak] (#OIE, October 14 ‘19)


Title:

Highly pathogenic #avian #influenza #H5N5, #Taiwan [a #poultry #outbreak].

Subject:

Avian Influenza, H5N5 subtype, poultry epizootic in Taiwan.

Source:

OIE, full page: (LINK).

Code:

[     ]

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Information received on 14/10/2019 from Dr Wen-Jane Tu, Chief Veterinary Officer, Deputy Director General, Bureau of Animal and Plant Health Inspection and Quarantine, Council of Agriculture, Executive Yuan, Taipei, Chinese Taipei

  • Summary
    • Report type    Follow-up report No. 1
    • Date of start of the event    09/09/2019
    • Date of confirmation of the event    13/09/2019
    • Report date    14/10/2019
    • Date submitted to OIE    14/10/2019
    • Reason for notification    New strain of a listed disease in the country
    • Causal agent    Highly pathogenic avian influenza virus
    • Serotype    H5N5
    • Nature of diagnosis    Laboratory (advanced)
    • This event pertains to    a defined zone within the country
  • Summary of outbreaks   
    • Total outbreaks: 1
      • Total animals affected: Species    - Susceptible    - Cases    - Deaths    - Killed and disposed of    - Slaughtered
        • Birds    - 18699    - 775    - 775    - 17924    - 0
    • Outbreak statistics: Species    - Apparent morbidity rate    - Apparent mortality rate    - Apparent case fatality rate    - Proportion susceptible animals lost*
      • Birds    - 4.14%    - 4.14%    - 100.00%    - 100.00%
        • *Removed from the susceptible population through death, destruction and/or slaughter
  • Epidemiology
    • Source of the outbreak(s) or origin of infection   
      • Unknown or inconclusive
  • Epidemiological comments   
    • Samples from Pingtung County were sent to the National Laboratory, Animal Health Research Institute (AHRI) for diagnosis.
    • Highly pathogenic avian influenza H5N5 subtype was confirmed by AHRI.
    • The infected farm has been placed under movement restriction.
    • All animals on the infected farm have been culled.
    • Thorough cleaning and disinfection have been conducted after stamping out operation.
    • Surrounding poultry farms within 3 km radius of the infected farm are under intensified surveillance for three months.

(...)

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Keywords: OIE; Updates; Avian Influenza; H5N5 ; Poultry; Taiwan.

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13 Oct 2019

#Cholera #Outbreak in #Yemen, 29 September 2019 #Update (@WHO EMRO, Oct. 13 ‘19)


Title:

#Cholera #Outbreak in #Yemen, 29 September 2019 #Update.

Subject:

Acute Watery Diarrhea and Cholera Outbreak in Yemen, current situation.

Source:

World Health Organization (WHO), Office for the Eastern Mediterranean Region (EMRO), full page: (LINK).

Code:

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10 November 2019


The Ministry of Public Health and Population of Yemen reported 16 625 suspected cases and 15 associated deaths during epidemiological week 39 (23 – 29 September) of 2019.

Thirteen percent of cases were severe.

The cumulative total number of suspected cholera cases from 1 January 2018 to 1 September 2019 is 1 067 863, with 1418 associated deaths (CFR 0.13%).

Children under five represent 25% of total suspected cases during 2019.

The outbreak has affected 22 of 23 governorates and 305 of 333 districts in Yemen.

From week 8 in 2019, the trend of weekly reported suspected cholera cases started increasing and reached more than 29 500 cases by week 14. These were the maximum number of cases reported so far.

The trend of suspected cases has been fluctuating over the past weeks.

From week 37 to week 39 the trend of suspected cases has been decreasing at the country level.

The governorates reporting the highest number of suspected cases of cholera during 2019 were Al Hudaydah (104 169), Amanat Al Asimah (94 985), Sana’a (86 278), Hajjah (64 886), Dhamar (57 076), Ibb (62 905) and Amran (43 649).

Of a total of 96 280 samples tested since January 2019, 4704 have been confirmed as cholera-positive by culture at the central public health laboratories.

During this reporting period the governorates reported the highest number of positive culture were Taizz (1136), Amanat Al Asimah (1267) and Sana’a (446).

WHO continues to provide leadership and support for activities with health authorities and partners to respond to this ongoing cholera outbreak, including case management, surveillance and laboratory investigations, hotspot mapping and oral cholera vaccine (OCV) campaign planning, water, sanitation and hygiene (WaSH) and risk communication.

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Keywords: WHO; Updates; Cholera; Yemen.

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Two New #MERS #Coronavirus Cases reported by #Saudi Arabia (MoH, October 13 '19)


Title:

Two New MERS Coronavirus Cases reported by Saudi Arabia (MoH, October 13 '19).

Subject:

Middle East Respiratory Syndrome in Saudi Arabia, daily update.

Source:

Ministry of Health, full page: (LINK).

Code:

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October 13 2019


New Case(s) Reported:

[Date report - Sex, Age, Hospitalized in (Resident in), Health Status, Note]

  1. 10/13 - Female, 26, Khamees City (Aseer Region), ...; **
  2. 10/13 - Female, 72, Buraidah City (from Wadi Al Dwasir City) (Riyadh Region), ...; *

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{*} Primary case (unknown source of exposure).
{**} Secondary case  (unknown source of exposure).

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Cumulative number of confirmed cases and deaths since 2012:

  • Total No. of Cases: 2077  {§}
  • Total No. of Deaths: 773 {§}
  • Patients currently under treatment: ...
  • Case-Fatality Rate: 37.2%

{§} WHO data as of October 9, 2019, see more: http://applications.emro.who.int/docs/EMROPub-MERS-SEP-2019-EN.pdf?ua=1

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Keywords: MERS-CoV; Updates; Saudi Arabia.

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#Zika #Virus #Research #References #Library–October 13 2019 #Update, Issue No. 187


Title:

#Zika #Virus #Research #References #Library–October 13 2019 #Update, Issue No. 187.

Subject:

Zika Virus Infectoin and related complications research, weekly references library update.

Source:

AMEDEO, homepage: https://amedeo.com

Code:

[  R  ]

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This Issue:

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  1. RIEDL W, Acharya D, Lee JH, Liu G, et al.
    • Zika Virus NS3 Mimics a Cellular 14-3-3-Binding Motif to Antagonize RIG-I- and MDA5-Mediated Innate Immunity.
      • Cell Host Microbe. 2019;26:493-503.
  2. ABREU LS, do Nascimento YM, Costa RDS, Guedes MLS, et al.
    • Tri- and Diterpenoids from Stillingia loranthacea as Inhibitors of Zika Virus Replication.
      • J Nat Prod. 2019 Oct 10. doi: 10.1021/acs.jnatprod.9b00251.
  3. VAN DER LINDEN V, Lins OG, Petribu NCL, de Melo ACMG, et al.
    • Diaphragmatic paralysis: Evaluation in infants with congenital Zika syndrome.
      • Birth Defects Res. 2019 Oct 9. doi: 10.1002/bdr2.1597.
  4. FREITAS LP, Cruz OG, Lowe R, Sa Carvalho M, et al.
    • Space-time dynamics of a triple epidemic: dengue, chikungunya and Zika clusters in the city of Rio de Janeiro.
      • Proc Biol Sci. 2019;286:20191867.
  5. GONCALVES RL, de Lima Menezes G, Sussuchi L, Moreli ML, et al.
    • Dynamic Behavior of Dengue and Zika viruses NS1 protein reveals monomer-monomer interaction mechanisms and insights to rational drug design.
      • J Biomol Struct Dyn. 2019 Oct 8:1-13. doi: 10.1080/07391102.2019.1677504.
  6. STOWER H.
    • Tracking hidden Zika.
      • Nat Med. 2019 Oct 7. pii: 10.1038/s41591-019-0616.
  7. XIMENES RAA, Miranda-Filho DB, Brickley EB, Montarroyos UR, et al.
    • Zika virus infection in pregnancy: Establishing a case definition for clinical research on pregnant women with rash in an active transmission setting.
      • PLoS Negl Trop Dis. 2019;13:e0007763.
  8. MOHD A, Zainal N, Tan KK, AbuBakar S, et al.
    • Resveratrol affects Zika virus replication in vitro.
      • Sci Rep. 2019;9:14336.
  9. VENANCIO FA, Bernal MEQ, Ramos MDCBV, Chaves NR, et al.
    • Congenital Zika Syndrome in a Brazil-Paraguay-Bolivia border region: Clinical features of cases diagnosed between 2015 and 2018.
      • PLoS One. 2019;14:e0223408.
  10. KOBRES PY, Chretien JP, Johansson MA, Morgan JJ, et al.
    • A systematic review and evaluation of Zika virus forecasting and prediction research during a public health emergency of international concern.
      • PLoS Negl Trop Dis. 2019;13:e0007451.
  11. ROWINSKA-ZYREK M, Wiech A, Wa Tly J, Wieczorek R, et al.
    • Copper(II)-Binding Induces a Unique Polyproline Type II Helical Structure within the Ion-Binding Segment in the Intrinsically Disordered F-Domain of Ecdysteroid Receptor from Aedes aegypti.
      • Inorg Chem. 2019;58:11782-11792.
  12. MORDECAI EA, Caldwell JM, Grossman MK, Lippi CA, et al.
    • Thermal biology of mosquito-borne disease.
      • Ecol Lett. 2019;22:1690-1708.
  13. BARZILAI LP, Schrago CG.
    • The range of sampling times affects Zika virus evolutionary rates and divergence times.
      • Arch Virol. 2019 Oct 9. pii: 10.1007/s00705-019-04430.
  14. PEREGRINE J, Gurung S, Lindgren MC, Husain S, et al.
    • Zika virus infection, reproductive organ targeting, and semen transmission in the male olive baboon.
      • J Virol. 2019 Oct 9. pii: JVI.01434-19. doi: 10.1128/JVI.01434.
  15. MUSSO D, Ko AI, Baud D.
    • Zika Virus Infection - After the Pandemic.
      • N Engl J Med. 2019;381:1444-1457.

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Keywords: Research; Abstracts; Zika References Library.

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12 Oct 2019

One New #MERS #Coronavirus Case reported by #Saudi Arabia (MoH, October 12 '19)


Title:

One New MERS Coronavirus Case reported by Saudi Arabia (MoH, October 12 '19).

Subject:

Middle East Respiratory Syndrome in Saudi Arabia, daily update.

Source:

Ministry of Health, full page: (LINK).

Code:

[     ]

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October 12 2019


New Case(s) Reported:

[Date report - Sex, Age, Resident in, Health Status, Note]

  1. 10/12 - Male, 80, Buraidah city (Qassim Region), ...; *

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{*} Primary case (unknown source of exposure).

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Cumulative number of confirmed cases and deaths since 2012:

  • Total No. of Cases: 2077  {§}
  • Total No. of Deaths: 773 {§}
  • Patients currently under treatment: ...
  • Case-Fatality Rate: 37.2%

{§} WHO data as of October 9, 2019, see more: http://applications.emro.who.int/docs/EMROPub-MERS-SEP-2019-EN.pdf?ua=1

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Keywords: MERS-CoV; Updates; Saudi Arabia.

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