Sars-like virus in UK

First UK death from Sars-like virus

Health experts have moved to reassure the public after a patient diagnosed with a Sars-like virus died in a hospital in Birmingham.

the Independent,

19 February, 2013

He was one of three members of the same family who have caught the virus, apparently by human to human transmission. Of the 12 people known to have been infected with the virus globally, half have died. The coronavirus responsible is distantly related to the one that gave rise to Sars (Severe Acute Respiratory Syndrome), which caused global panic and hundreds of deaths a decade ago.

But – critically – it lacks Sars’ ability to spread easily among populations, experts said. So far human-to-human transmission has only been observed among close family contacts and the virus has not spread into the wider community.

The patient who died on Monday was being treated as an outpatient at Queen Elizabeth hospital, Birmingham for an unrelated condition which made him more susceptible to respiratory infections, the Health Protection Agency said.

He is believed to have caught the virus from his father who had recently travelled to Saudi Arabia and Pakistan. The father remains severely ill in hospital in Manchester, where he was transferred for treatment on an ECMO machine, which oxygenates the blood when the lungs fail.

A third member of the same family who was also infected with the virus, developed a mild flu-like illness and has since recovered, without needing admission to hospital.

An earlier, unrelated case was diagnosed last September in a patient who had flown to London for treatment after falling ill in Qatar. He remains seriously ill, the HPA said.

Everything You Need To Know About The Mysterious New Virus From The Middle East

the Guardian,

February, 2013

How many cases have been reported to date?

Only two have been confirmed by laboratory tests. The first patient, who was 60, died in Saudi Arabia after the virus was confirmed in July in a Dutch laboratory. The second patient, a 49-year-old Qatari, has been flown to London for treatment after travelling recently to Saudi Arabia. He first showed symptoms on 3 September, was admitted to intensive care in Doha, Qatar, on 7 September, and was flown by air ambulance to London on 11 September. The virus was confirmed in this case by the Health Protection Agency's laboratories in Colindale, north London.

Other cases are being investigated. Reports from Saudi Arabia suggest the new virus has also been identified in a patient being treated in Jeddah.

What are coronaviruses?

They were first identified in the 1960s, and were named after the crown-like projections on the surface of the virus. They cause respiratory infections in both humans and animals.

What type is this, and what are the main symptoms?

The new strain has been confirmed in only two cases so there is very limited information on its impact, transmission and severity at this stage. In these cases, patients had a fever, cough, shortness of breath and breathing difficulties. It is not known whether these symptoms are typical or whether the virus may be circulating more widely but causing milder illness.

What is the treatment?

Experts do not have enough information on the virus to make specific treatment recommendations, and can only provide acute respiratory support to those in hospital, the Health Protection Agency says.

How do you catch the infection?

Such viruses typically spread in a similar manner to the flu virus. The new coronavirus is therefore likely to be passed from person to person when an infected person coughs or sneezes.

How contagious is it?

Transmission appears to be "very limited", says the agency: if it were very contagious, there would have been more cases in more countries, as well as in those caring for the two cases, the first of which happened more than three months ago. The incubation period is currently thought likely to be seven days.

However, the agency says it is bests to err on the side of caution. The patient in the London hospital is being treated in strict isolation, and staff are wearing appropriate protective equipment and clothing, including respirators, goggles, gowns and gloves.

Coronaviruses are fairly fragile, surviving outside the body for only about 24 hours. They are easily destroyed by detergents and cleaning agents.

Where has this virus come from?

No one knows. It may be a mutation of an existing virus. Some new infections come from viruses that have been circulating in animals or birds. These are known as zoonoses. These may sometimes cause mild infection in some species and more serious ones in others. There is no evidence at the moment that this is a zoonosis.

Is there a vaccine?

No.

Is there a laboratory test?

Yes but it is complex, using a system know as PCR, which involves amplifying small pieces of DNA and then sequencing the genetic material.

What should I do if I am planning on travelling to the Middle East?

Continue with your plans. The authorities are keeping travel advice under review, however.

If I visited the Middle East and have signs of a cold or fever, should I be worried?

If the symptoms are mild, you almost certainly have an infection caused by a common respiratory virus. However, if the symptoms worsen considerably and you become very breathless, contact your GP or NHS Direct, mentioning whereabouts in the Middle East you have travelled. Even with severe respiratory illness, another, more common pathogen is a more likely diagnosis.

Is this similar to Sars?

Sars (a particularly severe form of pneumonia) was also caused by a coronavirus, but these viruses can cause a range of symptoms, from mild to serious. The two confirmed cases have experienced a serious respiratory illness, which makes it similar in this respect.

• Source: Health Protection Agency