HIV pandemic's origins located: It may have emerged in Congo in 1920s

 Scanning electron micrograph of an HIV-infected H9 T cell. Credit: NIAID

 http://medicalxpress.com/

The HIV pandemic with us today is almost certain to have begun its global spread from Kinshasa, the capital of the Democratic Republic of the Congo (DRC), according to a new study.
An international team, led by Oxford University and University of Leuven scientists, has reconstructed the genetic history of the HIV-1 group M pandemic, the event that saw HIV spread across the African continent and around the world, and concluded that it originated in Kinshasa. The team's analysis suggests that the common ancestor of group M is highly likely to have emerged in Kinshasa around 1920 (with 95% of estimated dates between 1909 and 1930).
HIV is known to have been transmitted from primates and apes to humans at least 13 times but only one of these transmission events has led to a human pandemic. It was only with the event that led to HIV-1 group M that a pandemic occurred, resulting in almost 75 million infections to date. The team's analysis suggests that, between the 1920s and 1950s, a 'perfect storm' of factors, including urban growth, strong railway links during Belgian colonial rule, and changes to the sex trade, combined to see HIV emerge from Kinshasa and spread across the globe.
A report of the research is published in this week's Science.
'Until now most studies have taken a piecemeal approach to HIV's genetic history, looking at particular HIV genomes in particular locations,' said Professor Oliver Pybus of Oxford University's Department of Zoology, a senior author of the paper. 'For the first time we have analysed all the available evidence using the latest phylogeographic techniques, which enable us to statistically estimate where a virus comes from. This means we can say with a high degree of certainty where and when the HIV pandemic originated. It seems a combination of factors in Kinshasa in the early 20th Century created a 'perfect storm' for the emergence of HIV, leading to a generalised epidemic with unstoppable momentum that unrolled across sub-Saharan Africa.'
'Our study required the development of a statistical framework for reconstructing the spread of viruses through space and time from their genome sequences,' said Professor Philippe Lemey of the University of Leuven's Rega Institute, another senior author of the paper. 'Once the pandemic's spatiotemporal origins were clear they could be compared with historical data and it became evident that the early spread of HIV-1 from Kinshasa to other population centres followed predictable patterns.'
One of the factors the team's analysis suggests was key to the HIV pandemic's origins was the DRC's transport links, in particular its railways, that made Kinshasa one of the best connected of all central African cities.
'Data from colonial archives tells us that by the end of 1940s over one million people were travelling through Kinshasa on the railways each year,' said Dr Nuno Faria of Oxford University's Department of Zoology, first author of the paper. 'Our genetic data tells us that HIV very quickly spread across the Democratic Republic of the Congo (a country the size of Western Europe), travelling with people along railways and waterways to reach Mbuji-Mayi and Lubumbashi in the extreme South and Kisangani in the far North by the end of the 1930s and early 1950s. This helped establishing early secondary foci of HIV-1 transmission in regions that were well connected to southern and eastern African countries. We think it is likely that the social changes around the independence in 1960 saw the virus 'break out' from small groups of infected people to infect the wider population and eventually the world.'
It had been suggested that demographic growth or genetic differences between HIV-1 group M and other strains might be major factors in the establishment of the HIV pandemic. However the team's evidence suggests that, alongside transport, social changes such as the changing behaviour of sex workers, and public health initiatives against other diseases that led to the unsafe use of needles may have contributed to turning HIV into a full-blown epidemic – supporting ideas originally put forward by study co-author Jacques Pepin from the Université de Sherbrooke, Canada.
Professor Oliver Pybus said: 'Our research suggests that following the original animal to human transmission of the virus (probably through the hunting or handling of bush meat) there was only a small 'window' during the Belgian colonial era for this particular strain of HIV to emerge and spread into a pandemic. By the 1960s transport systems, such as the railways, that enabled the virus to spread vast distances were less active, but by that time the seeds of the pandemic were already sown across Africa and beyond.'
The team says that more research is needed to understand the role different social factors may have played in the origins of the HIV pandemic; in particular research on archival specimens to study the origins and evolution of HIV, and research into the relationship between the spread of Hepatitis C and the use of unsafe needles as part of public health initiatives may give further insights into the conditions that helped HIV to spread so widely.
More information: The early spread and epidemic ignition of HIV-1 in human populations, Science, 2014. www.sciencemag.org/lookup/doi/… 1126/science.1256739

Ebola virus: 'Biological war' in Liberia

http://www.bbc.co.uk/news/

 

 Ebola robs death of its dignity as victims' bodies are quickly

 burnt with the plastic suits they are wrapped in

Continue reading the main story

Ebola outbreak

• How bad can Ebola get?
• How to avoid Ebola
• Doctor's report
• Why so dangerous?

With warnings from officials that the Ebola virus is "spreading like wildfire" in Liberia, Sarah Crowe, who works for the UN children's agency (Unicef), describes her week on the Ebola front line:

Flights into disaster zones are usually full of aid workers and journalists. Not this time.
The plane was one of the first in after some 10 airlines stopped flying to Liberia because of Ebola, and still it was empty.
When I was last in Liberia in 2006, it was to work on reintegration of child soldiers in a time of peace. Now the country is fighting a "biological war" from an unseen enemy without foot soldiers.
As we enter the airport, an unnerving sight - a team of health workers kitted out with masks and gloves asks us to wash our hands with a chlorine solution and takes our temperatures.

 

Health workers themselves have to be frequently sprayed with disinfectant

It was to be the start of a new routine - the hours and days since, I have had my temperature taken about 15 times and have had to wash my hands with chlorine at the entrance to every building, every office, every store, and every hotel.

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“Start Quote

It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola”

Even in small villages. And yet ironically, despite all this, few health facilities are properly functioning.

The next morning, the breakfast room at the hotel is buzzing - a large group of scientists from the US Centers for Disease Control and Prevention (CDC) huddle around computers animatedly talking, checking charts and data.
The world's Ebola experts are here - writing the first draft of Ebola history in real time.
The capital, Monrovia, reveals itself as a city branded by Ebola posters shouting out what people know all too well by now - Ebola is deadly, protect yourself, wash your hands.
Human booby traps The talk in the car, on the radio is only about Ebola - people calling in want to know what to do when their child gets sick, they either fear health centres and hospitals or they are not treated.

Ebola virus disease (EVD)

• Symptoms include high fever, bleeding and central nervous system damage
• Spread by body fluids, such as blood and saliva
• Fatality rate can reach 90% - but current outbreak has mortality rate of about 55%
• Incubation period is two to 21 days
• There is no proven vaccine or cure
• Supportive care such as rehydrating patients who have diarrhoea and vomiting can help recovery
• Fruit bats, a delicacy for some West Africans, are considered to be virus's natural host

A colleague tells me she has just lost a family member about to give birth.
It was a normal pregnancy, but she was turned away by every hospital as staff were too afraid to take her in case she had Ebola.
She did not have the virus, but she died because of delivery complications. Her baby at least survived.
News of the US obstetrician in Liberia who contracted the deadly disease while delivering a baby has helped fuel such worries.
So far 169 Liberian health care workers have been affected by Ebola and 80 have died - a massive blow to a fragile health system.
Next I prepare to go up country to Lofa county where more warehouse space was needed - Unicef has delivered tonnes of equipment, including personal protective suits, chlorine and oral rehydration salts to Liberia - and more monitoring was required of those other now-neglected childhood killers like measles, diarrhoea and cholera.
Ebola has turned survivors into human booby traps, unexploded ordinance - touch and you die. Ebola psychosis is paralysing.

 

The workers often look like crop sprayers

Heavy rains lash down over the weekend - I shudder to think of Medecins Sans Frontieres and health ministry workers and patients battling under plastic sheeting in such rains.
Luckily the skies over Monrovia clear for the hour-and-a-half helicopter ride to the hot-zone border between Sierra Leone, Guinea, and Liberia.
In Voinjama, I'm out with a team of social mobilisers who interact and educate communities.
They are playing our song - Ebola Is Here - on a megaphone through the village.

Ebola in Africa: Can we dodge a global pandemic?

By Chris Kilham

Published July 10, 2014

FoxNews.com

CDC/ Cynthia Goldsmith

Right now, a fight for survival is taking place in the West African nations of Guinea, Sierra Leone and Liberia. Ebola, one of the most lethal diseases on the planet, is on a killing rampage.  In Guinea, 303 people have died. In Sierra Leone, 99 have perished, and in Guinea, 65 lives have been claimed.
Within a few days, these figures will be higher. And the disease appears to just be getting warmed up. Spread by contact with bodily fluids, Ebola is flourishing in West Africa, and could be coming soon to a place near you.
When the outbreak began in Guinea in April, the mortality rate was higher than it is now. But the virus is still an extreme hazard, and health workers must work in full bio-hazard suits in order to keep themselves from being infected by the patients they are serving. The protective suits are extremely hot in the sweltering West African climate. They are like little mobile sauna units, slowly cooking the doctors, nurses and aids working inside them.
Named after the Ebola River, the virus was first discovered in 1976 in what was then Zaire and is now the Democratic Republic of Congo. A viral disease, Ebola starts out like a bad flu, exhibiting initial symptoms of fever, weakness, headache and muscle pain – but that’s where the similarities end.
The more severe symptoms commence as early as two days after contact with the virus. Ebola is a hemorrhagic fever, meaning it causes the rupturing of blood vessels throughout the body.  Victims may bleed from the eyes, nose, mouth, ears, anus and genitals, as well as through skin ruptures. The liver, lungs, spleen and lymph nodes can be overcome by Ebola, leading to massive organ failure, and an agonizing death can follow.
There are five strains of Ebola: Zaire, Sudan, Reston, Cote d’Ivoire, and Bundibugyo. Of these, four are known to cause the disease in humans, whereas Reston does not appear to do so.  The disease is transmitted from animals to humans. Fruit bats, monkeys, and wild game may host the virus and spread it to humans, but bats in particular are on the radar of health officials. They are known as reservoir species, carrying the virus without becoming sick from the disease.
Despite urgent, high level attention from the World Health Organization and the Centers for Disease Control and Prevention, Ebola has no specific treatment, no vaccine, and no effective medicines. Bed rest and remaining hydrated appear to be as effective as any course of treatment, with a disease whose mortality rate can be as high as 90 percent. In clinics, Ebola patients are kept isolated as much as possible, and any utensils used to diagnose them must be fastidiously sterilized. Health workers take a huge risk tending to the Ebola infected, and only bio-hazard suits afford enough protection. Still, even one accidental prick from a dirty needle can lead to infection. It is very risky business.
Now, we don’t have to worry, right? Ebola is, after all, over in Africa, far removed from us. Nothing could be further from the alarming truth.
Imagine this scenario: A health worker tends to Ebola patients in Guinea, and remains healthy due to good sanitation practices. Eventually, that health worker needs to travel to the United States or Europe, and he or she boards a plane. Unknowingly, they are infected but symptom-free so far. On the long flight home, they start to feel some aches and chills, and at one point, they sneeze, sending thousands of viruses into the air through the atomized mucus expelled from the nose. Other passengers breathe that air, taking in a few viruses here and there, and they become infected.
And a global pandemic starts to roll.
This is neither a far-off scenario nor science fiction. It is a real possibility. And this is why health officials are so gravely concerned about the current Ebola outbreak. Unlike previous smaller outbreaks which have occurred in rural locations, this one is happening in hot, humid cities where crowds are dense and sanitation is sketchy; where basic hygiene is often hard to manage and many people eat wild game that might be infected. It is a perfect recipe for a massive, uncontrolled outbreak. Infecting another person is as easy as a sneeze, a kiss, cleaning up after someone, making contact with mucus, urine or feces.
The question, then, is what can you do? Except for staying away from anyone infected, you can’t do much. Right now it’s up to the health workers laboring in excessively hot bio-hazard suits, and to officials who are working hard on containment. This situation in West Africa could in fact be the start of a global disaster, or it may be another near-miss. The threat is real, and the disease is on the move. Will we dodge the Ebola bullet? Right now, all we can do is watch and wait.
Chris Kilham is a medicine hunter who researches natural remedies all over the world, from the Amazon to Siberia. He teaches ethnobotany at the University of Massachusetts Amherst, where he is Explorer In Residence. Chris advises herbal, cosmetic and pharmaceutical companies and is a regular guest on radio and TV programs worldwide. His field research is largely sponsored by Naturex of Avignon, France. Read more at MedicineHunter.com.

Study: Early Human Ancestors Got Herpes From Chimpanzees

June 16, 2014 1:55 PM

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File photo of chimpanzees. (credit: SIA KAMBOU/AFP/Getty Images)

ATLANTA (CBS Atlanta) — A new study finds that early human ancestors got herpes from chimpanzees.

According to LiveScience, researchers at the University of California, San Diego found that the “herpes simplex virus 1 infected hominids before their evolutionary split from chimps 6 million years ago.” In comparison, the herpes simplex 2 virus was transferred from chimps to human ancestors nearly 1.6 million years ago.
“Before we were human, there was still cross-species transmission into our evolutionary lineage,” Joe Wertheim, study author and assistant research scientist at the university’s AntiViral Research Center, told LiveScience.
Wertheim noted in his study that herpes simplex virus 2 was caused by “cross-species transmission” from modern chimp ancestors to humans, while the herpes simplex virus 1 is a split between the chimp and human viruses.
“Understanding how and when we acquired viruses that currently infect us can give us perspective on future, potential cross-species transmission events that would lead to the introduction of new human viruses,” Wertheim told LiveScience.
According to the Centers for Disease Control and Prevention, most people infected with herpes do not know they have it and there is currently no cure for the disease.
Wertheim’s study was published in the Molecular Biology and Evolution journal.

Dengue-like chikungunya virus reported in El Salvador

11 hours ago

Employees of the Dominican Ministry of Public Health stick posters on a wall during an information campaign to prevent the spread of the mosquito which transmits the Chikungunya virus in Santo Domingo on May 30, 2014 (AFP Photo/Erika Santelices)

San Salvador (AFP) - Salvadoran health authorities confirmed Saturday that a dengue-like disease that has been spreading across the Caribbean has now appeared in the Central-American country.

Health Minister Violeta Menjivar said at least 1,200 people have been formally diagnosed with the chikungunya viral disease, although the positive testing must still be confirmed by the US Centers for Disease Control and Prevention.

Menjivar, interviewed by state-run Channel 10 television, said that cases were found on the outskirts of the Ayutuxtepeque municipality just outside the capital San Salvador.

In that area at the end of May, the ministry's epidemiologists and infectious disease specialists detected an outbreak of a rare viral disease that caused fever and skin rash, which they said affected at least 181 people.

She said suspected cases were also found in residents in two other area on the edge of northern San Salvador.

The mosquito that transmits chikungunya -- the Aedes aegypti -- is the same one that spreads dengue.

The health ministry has asked people "to eliminate breeding sites" at their homes.

There is no vaccine or treatment for chikungunya, which has infected millions of people in Africa and Asia since the disease was first recorded in 1952.

It has also spread to southern Europe -- with an outbreak in Italy in 2007 and southern France in 2010 -- and arrived in the Caribbean last year, appearing in Martinique and Saint Martin.

Chikungunya produces symptoms similar to dengue, including high fever, joint pain and skin rash.

The disease's name is derived from an east African word meaning "that which bends up," referring to the way that patients are stooped over in pain.

Whooping Cough Epidemic in California as Cases Surge

  http://www.bloomberg.com/

By Marie French Jun 13, 2014 11:01 PM CT

20 Comments E

California’s whooping cough outbreak has reached epidemic levels, with 800 new cases in the last two weeks, according to the state’s public health agency.
There have been 3,458 cases of the respiratory infection, formally known as pertussis, in California as of June 10, the state’s Department of Public Health reported. That’s more than were reported in all of 2013. Most at risk are newborns, and two have died in California so far this year.
“Our biggest concern is always infants,” Stacey Martin, an epidemiologist with the U.S. Centers for Disease Control and Prevention’s division of bacterial diseases, said in a telephone interview. “There’s a gap in coverage between birth and the first vaccine.”
Whooping cough carries different symptoms at different ages. For children, a case can begin with a cough and runny nose before the cough worsens, characterized by a whooping sound that gives the disease its nickname. Infants don’t always have a cough but their faces may turn red or purple.
More than 900 of California’s cases occurred in April and May, a fivefold increase on the typical number seen in non-peak years, said Corey Egel, a spokesman for state health department.
The high number of cases isn’t unexpected because of the cyclical nature of the disease. California last had a widespread outbreak, or “peak,” in 2010. Martin said the priority is to encourage pregnant women to get the vaccine for pertussis, which the CDC has recommended since 2013.
Vaccinating pregnant women and infants helps prevent the spread of the disease, Ron Chapman, the state’s health department director, said yesterday in a statement.
The CDC recommends infants be vaccinated as early as six weeks after birth, because the effect of a vaccination given to their mother during pregnancy soon wears off, Martin said. The CDC also suggests shots for those spending time with newborns.
Nationwide, there have been three other deaths reported from whooping cough this year, Martin said. In total, 9,964 cases of whooping cough were reported in the U.S. through June 8, compared with 7,573 at the same time last year, the CDC said.

Fingers to Ashes: The Millennial Disconnect with HIV

Tyler Curry Become a fan Freelance columnist and fiction writer; creator, The Needle Prick Project

Posted: 06/11/2014 5:17 pm EDT Updated: 06/11/2014 5:59 pm EDT 

http://www.huffingtonpost.com/the-blog

It is hard to imagine that it was only 34 years ago when the first case of HIV was first documented in the United States. Shortly after, the virus seemed to spread like wildfire, burning a path of hysteria, frustration and sadness across the U.S. and throughout the world. In a short period of time, and thanks to a series of political blunders from the Reagan administration and many other political figures across the nation, HIV went from hundreds to millions and became the closest we have ever come to a modern plague.

Although there is still no cure for the virus, this plague is now classified as a chronic illness with those who are HIV positive living long and healthy lives. So the obscene terror that lived in the hearts of every gay man in the world merely three decades ago has all but been erased in the mines of the millennial age. In its place now lives a vague but often-impenetrable fear of those who carry HIV and a diluted sense of safety based on the idea that the transmission of HIV is related to a character flaw of promiscuity. This blind faith that the virus is relinquished to "other" types of people has allowed for this disease to continue affecting the millennial generation at staggering rates.
According to the Center for Disease Control's National Progress Report of 2013, an estimated 1.1 million people are living with HIV in the United States with 50,000 more becoming infected each year. One out of every six people living with the virus are unaware that they are infected, thus continuing the cycle of transmission. And worse, one out of every five gay men are living with HIV, yet the millennial generation often treats the disease as if it is only reserved for the history books.
But beyond the numbers, just what exactly does it mean to live HIV in today's world? For starters, HIV is now officially classified as a chronic disease. Although most people assume that treatment involves a series of toxic cocktails that HIV positive men and women take throughout the day, a person diagnosed today will most likely be on one daily pill to manage the virus. And reports suggest that, given a person is compliant with their medication; they can expect the same estimated lifespan as they did when they were HIV negative.
"A person who is 20-years-old and diagnosed today can expect to live into their 70s, roughly the same lifespan they would expect prior to being diagnosed," says Dr. Gary Blick, HIV Specialist and Founder of World Health Clinicians, an international HIV treatment organization.
However, it isn't all good news. The span of your life may be the same, but your worries certainly are not. People living with the virus run an increased risk of developing other life-threatening diseases such as cancer, heart attack and stroke. Combined with other STI's, these risks are even bigger, making it even more important for a person living with HIV to manage all aspects of their health, not just their pillboxes. However, an HIV positive diagnosis is merely a charge to be drastically more responsible with a person's health instead of an order to make arrangements for a pending funeral.
To many of the people living with the disease, it is also a scarlet branding that induces emotional and psychological symptoms that far outweigh the side effects listed on the side of their medication bottles.
The organizations charged with delivering the message of HIV awareness and prevention have grappled with advancing their messaging with the advancements of modern medicine. Managing HIV is a drastically different animal than it was merely a decade ago, but many still view the virus with the same gravity that they did in the 1990s. The few organizations who have tried to modernize the approach to HIV education have been lambasted for "making light" of the disease, trying to "make HIV cool," or downplaying the severity of living with the virus.
This struggle over messaging has never been more contentious then in the present as institutional juggernauts like the AIDS Healthcare Foundation (AHF) battles with more progressive activists and organizations over the promotion of PrEP, or pre-exposure prophylaxis. This new drug, nicknamed the birth control pill for HIV, now personifies the crux in HIV treatment debate.
PrEP is an Antiretroviral Therapy drug that, if taken correctly by an HIV negative individual, has a 99 percent efficacy rate in preventing the transmission of HIV from someone who is HIV positive. This drug has been on the market since 2012, but several prominent organizations such as AHF, the largest HIV treatment provider in the U.S., have taken an active stance against the HIV prevention pill.
Michael Weinstein, the Executive Director of AHF, has publicly referred to PrEP as a party drug and suggested that the "people who would be taking the drug" could not be trusted to be compliant with their dosage. This stigmatizing rhetoric, combined with the pharmaceutical company, Gilead's, unwillingness to advertise the drug to at-risk populations, has led to a virtual standstill in people seeking a prescription for the prevention pill.
People like J Nick Shirley, a 24-year-old gay man from Dallas, represent the most at risk demographics for HIV transmission, and yet has never heard of PrEP. When asked about the new form of prevention, he was shocked that this was the first time he was hearing about it.
"I just can't believe that we have such a ground-breaking tool at our disposal and so many people don't know about [PrEP]," Shirley said. "I am pretty sure none of my friends know about it. We have never talked about it before."
Long term HIV survivor, activist and former reality T.V star, Jack Mackenroth, is mortified that organizations like AHF have taken on such a damaging approach to PrEP.
"If this were the '90s, people would be lining up down the streets to take PrEP," says Mackenroth. "It is so sad that the fear that we went through has given way to the judgment and stigma from gay men onto other gay men. HIV isn't going anywhere if we don't wake up and realize that condom-only messages don't work."
Which leads us to the use of the problem; organizations using worn out methods of education and prevention, further stigmatizing others looking for prevention methods beyond condoms and leaving the vast majority of millennial, at-risk individuals to believe that HIV is a virus that "other" people get.
Movies like The Normal Heart serve as history lessons, leading young gay men to cry, "Never forget," while failing to realize the dangers they face. LGBT youth are left grappling for connection, because most of the visible reminders of the risk of HIV are only ashes, while the living, more relevant examples prefer to remain in silence for fear of public ridicule and castigation. Sadly, the community that was once unified under the call to fight the virus is now complacent in a pseudo-class system of HIV status that only serves to perpetuate transmission.
But change is on the horizon. Grassroots campaigns such as HIV Equal, The Stigma Project, The Needle Prick and several others have worked to change the climate of HIV stigma for those living with the virus and educate the public on the real vs. perceived danger of HIV transmission. A new wave of young, HIV positive faces, such as Josh Robbins, Cory Lee Frederick and Jake Forth are making their presence known in the public eye, humanizing the virus for the millennial generation while serving as living examples that HIV is still an issue for their age group. And this year, as the Obama Administration unveiled the HIV Care Continuum at the third annual HIV/AIDS Strategy, President Obama's HIV prevention policy recognized Antiretroviral treatment as a valid form of prevention, giving authority to the fact that HIV positive men who achieve undetectable viral load levels are actively preventing the spread of HIV.
While the level of danger has waned over the past three decades, the threat of HIV still remains. Unlike the generations first affected by the virus, the millennial age is now armed a wealth of information and a variety of prevention tools to change the course of HIV for good. And this young generation should take note that these tools came at a very heavy cost.
If you have had sex even once since your last HIV test without a condom, it is worth it educate yourself on PrEP and determine if it is right for you. It only takes one time to transmit the virus, and it only takes one pill a day to stop it. The millennial generation no longer has to face a multitude of limitations when concerning HIV, so there is no excuse to get tested, know your status and pick up the slack in the fight against HIV. After all, most of the heavy lifting has already been done.

Five dead as Sierra Leone records first Ebola outbreak

16 hours ago

ABID (Reuters) - Five people have died in Sierra Leone's first confirmed outbreak of Ebola virus, the World Health Organisation (WHO) said on Monday, signalling a new expansion of the disease which regional officials said had been brought under control.

Ebola, a haemorrhagic fever with a fatality rate of up to 90 percent, is believed to have killed some 185 people in neighbouring Guinea and Liberia since March in the first deadly appearance of the disease in West Africa.

Previously, several suspected cases of Ebola were recorded in Sierra Leone early on in the West African outbreak, but they later tested negative for the disease.

In a statement posted on its website, the WHO said the outbreak in Sierra Leone was located in an area along the country's border with Guinea's Guéckédou prefecture, where some of the earliest cases of the disease were recorded.

"Preliminary information received from the field indicates that one laboratory-confirmed case and five community deaths have been reported from Koindu chiefdom," it said.

The WHO said it was deploying six experts to the area along with essential supplies.
The West African outbreak spread from a remote corner of Guinea to the capital, Conakry, and into Liberia, causing panic across a region struggling with weak healthcare systems and porous borders.
A total of 258 clinical cases have been recorded in Guinea since the outbreak was first identified as Ebola, including 174 deaths - 95 confirmed, 57 probable and 57 suspected - according to the WHO.
No new cases of Ebola have been detected since April 26 in Conakry, where an outbreak could pose the biggest threat of an epidemic due to the city's role as an international travel hub.
However Guinean health officials announced two new confirmed cases on Friday in an area previously untouched by the virus. [ID:nL6N0O94X8]
The disease is thought to have killed 11 people in Liberia.
Ebola is endemic to Democratic Republic of Congo, Gabon, Uganda and South Sudan, and scientists initially believed that Central Africa's Zaire strain of the disease was responsible for the infections in Guinea and Liberia.

However researchers later published a study saying the West African outbreak was caused by a new strain of Ebola. [ID:nL6N0N94AE]

(Reporting by Joe Bavier; Additional reporting by Tom Miles in Geneva; Editing by Alison Williams)

MERS in the U.S.: Why You'll See More of It

By Maggie Fox

Health officials reported the second U.S. case of the mysterious new Middle East respiratory syndrome virus, or MERS, on Monday. Like the first case, it’s in a health care worker who traveled from Saudi Arabia.

Second US Case of MERS Found in US

Here are six things you need to know about MERS:

It’s new.

MERS was first seen in Saudi Arabia in 2012. Since then it has spread to 16 countries, most in the Middle East but also in Europe and Asia and now including the United States. It’s a coronavirus, a distant relative of the SARS — severe acute respiratory syndrome virus — that infected more than 8,000 people around the world and killed 774 before it was stopped in 2004.

You can expect more US cases.

"This is unwelcome, but not unexpected," Centers for Disease Control and Prevention Director Dr. Tom Frieden says. Health officials note that just about any disease is just a plane ride away. But most Americans are at very low risk of ever becoming infected. In 2003, eight SARS cases were confirmed in the U.S., all of them in travelers who were infected overseas and who did not infect anyone else.

It can be deadly.

WHO reports more than 530 confirmed cases and 174 deaths since the virus was identified in 2012. It’s killed between a quarter and a third of victims, which is a very high death rate for an infectious disease. But health experts say as officials look more closely for people infected with MERS they are finding milder cases, which takes the mortality rate down. Most who die have been either elderly or had another illness, such as diabetes or kidney failure. MERS

It doesn’t spread easily.

Health officials have closely studied the known patients, and the people who become infected usually have been in close and prolonged contact. One-fifth of the cases have been among health care workers who were treating patients intensively. There’s been no documented spread on an airplane, for instance. A patient in France who died infected a person who shared his hospital room, and family clusters have been reported from Saudi Arabia.

"We believe that if good infection control precautions are used during healthcare the risk to healthcare workers is also exceedingly low," says Dr. William Schaffner of Vanderbilt University, an infectious diseases expert. That includes wearing masks, gowns and gloves when treating patients.

There’s no treatment.

There’s no vaccine against MERS, although some groups are working on one, and antiviral drugs don’t appear to be of much use against it, either. The CDC has told U.S. hospitals to take strict precautions if someone shows up with symptoms. Patient care is mostly support, such as providing oxygen or breathing care.

No one knows where it came from.

The latest research suggests camels, but many patients have had no known contact with camels. Camel meat or milk might be a source, and the virus can live on surfaces and potentially could spread when people touch an infected surface. SARS was eventually traced to an animal called a civet, often sold in Asian markets as food.

Some health officials say it's possible MERS has been circulating but no one knew what it was because there wasn't a test for it. Many respiratory diseases are never diagnosed.

“While experts do not yet know exactly how this virus is spread, CDC advises Americans to help protect themselves from respiratory illnesses by washing hands often, avoiding close contact with people who are sick, avoiding touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently touched surfaces,” the agency advises.

First published May 12th 2014, 2:59 pm

Chikungunya Virus Outbreak Likely in the U.S., Say Experts

Yahoo Health

By Dana K. Cassell
Thu, May 08, 2014

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• California Detects Disease-Carrying Mosquitoes

Chikungunya (pronounced chik-en-gun-ye) is a viral disease transmitted to humans by the bites of infected Aedes aegypti and Aedes albopictus mosquitoes, which are found across the globe. First described during an outbreak in southern Tanzania in 1952, the virus then spread to Africa, Asia, and the Indian subcontinent.
Originally believed to be a “tropical” disease, experts were surprised when an outbreak occurred in northeastern Italy in 2007. Now it has spread farther—to 14 Caribbean island countries since it was first detected on the island of St. Martin in December 2013. On May 1, 2014, the Caribbean Public Health Authority declared it an epidemic, with 4,108 probable cases across the region.
Get the Facts: Chikungunya Symptoms and Treatments

Symptoms, Diagnosis, and Treatment of Chikungunya

The most common symptoms of chikungunya are acute, high fever and intense joint pain. The infected person may also experience headaches, muscle pain, swollen joints, and/or a rash.
According to the U.S. Centers for Disease Control and Prevention (CDC), chikungunya infection should be considered as a possibility in anyone who develops a high fever and joint pain, and who has traveled to the location of an active outbreak within the previous three to seven days.
A blood test is used to diagnose chikungunya and to differentiate it from dengue, a more serious viral infection, which is also transmitted by Aedes mosquitos. Outbreaks of dengue usually occur in tropical urban areas, according to the CDC.
Even though chikungunya symptoms can be severe, the disease is rarely fatal, unlike dengue, which can be lethal if not treated in a timely manner. Most patients with chikungunya begin feeling better within a week; a few may experience joint pain for several months. Some cases result in persistent arthritis symptoms. People at risk for more severe cases of the disease include newborns, adults over the age of 65, and patients with underlying medical conditions.
There is no cure for chikungunya, and no vaccine to prevent it, so treatment is focused on relieving the symptoms. An infected person needs to rest, drink lots of fluids, and take medicines like ibuprofen, naproxen, or acetaminophen to relieve fever and pain until the symptoms fade.
Learn More: The Big Dangers of Small Bug Bites

Mosquitoes May Spread the Virus to the Southeastern U.S.

Because the Caribbean islands are close to the U.S., there is some concern that chikungunya will spread to the U.S., perhaps via Florida.
The disease has been diagnosed in the U.S. before, but only in travelers returning from areas where there are outbreaks, according to the Center for Infectious Disease Research and Policy. So far, no U.S.-based infections have occurred. But Dr. Gio J. Baracco, an associate professor of clinical medicine at the University of Miami Miller School of Medicine, told Healthline that the mosquitoes spreading the virus are already in the southeastern part of the U.S. “This fact, and the large amount of travelers passing through South Florida en route to and from the Caribbean islands, makes it very likely that chikungunya will be introduced into the U.S.,” he said.
Another infectious disease expert, Dr. William Schaffner, a professor of preventive medicine at Vanderbilt University, explained how this “spreading” might occur. “Patients can acquire the infection while in the Caribbean through mosquito bites, and be incubating the infection. They’re feeling well as they come to the U.S. and then when they get sick, the virus is circulating in their blood streams.”
Then, an Aedes mosquito could bite that person and become infected itself, said Schaffner. “The mosquito thus infected in the U.S. infects another U.S. person, and that person in turn infects further mosquitoes. That’s how the virus appeared for the first time in a temperate zone, in Italy in 2007."
The virus could be carried beyond Florida, Schaffner said, but he added, “It might be established more readily in Florida, partly due to the volume of travel.”
Dr. Aileen M. Marty, a professor of infectious diseases at the Herbert Wertheim College of Medicine in Miami, agreed. “It can spread to any part of the U.S. where the mosquitoes live and breed,” she said.
Although an outbreak may occur at any time, Baracco said that summer is a vulnerable time. “The likelihood of an outbreak is related to the amount of vectors [infected mosquitoes] present. Aedes mosquitoes breed in stagnant water, and therefore are more common during the rainy season.”
The CDC's Dr. Erin Staples told Healthline that although it’s not possible to say at this point when local cases may occur here, it becomes more likely as more travelers return from areas where there are currently outbreaks, as mosquito populations grow, and as the weather gets warmer.

How Can I Protect Myself from Chikungunya?

To avoid becoming infected, Baracco said, “People should prevent mosquito bites by using adequate clothing, applying repellent, and getting rid of potential mosquito breeding sites."
Business travelers and vacationers in the Caribbean should exercise extra caution, Schaffner added. “Cruise travelers and people who stay in the islands for a period of time will need much more awareness about the prevention of mosquito bites. Use repellant—especially if you go out in the evening or in the early morning, when most of these mosquitoes like to bite. Wear longer trousers and long sleeves.”
Schaffner also envisions a wider use of bed netting. “People like to go to the islands, open the windows, and let the Caribbean breezes come through—they’re not always in hermetically sealed, air conditioned rooms. If you do that now, you might have to sleep under a bed net.”
The CDC is taking several steps to educate travelers to the Caribbean about the risks of chikungunya and how to protect themselves. Staples explained, "We are continually updating our travel notice with the latest on the spread of the virus and recommendations to prevent infection. In addition, the CDC has been working with its partners at airports with flights to the Caribbean to educate outgoing travelers about how to stay safe from chikungunya while in the Caribbean, and returning travelers about what symptoms to watch for and when to seek care. We’re also working to post them at additional airports and to translate them into Spanish."
Read this article at Healthline.com

Exclusive: Specter of SARS weighs on CDC as MERS virus lands in U.S.

http://www.reuters.com/

By Julie Steenhuysen

CHICAGO Sun May 4, 2014 10:04pm EDT

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(Reuters) - When the SARS outbreak arrived in Toronto on Feb. 23, 2003, carried by a woman traveling from Hong Kong, the disease quickly spread to hospital workers and patients in area hospitals, ultimately infecting 257 individuals and killing 33 people.
It's a memory that hangs fresh in the mind of Dr Michael Bell, deputy director of the division of healthcare quality promotion at the Centers for Disease Control and Prevention. The Atlanta-based federal agency last week sent a team of infectious disease experts to Community Hospital in Munster, Indiana, to attend to the first confirmed U.S. case of Middle East Respiratory Syndrome or MERS.
"We take this very seriously," Bell told Reuters in an exclusive interview. "In a worst-case scenario, this could spread rapidly."
MERS is caused by a coronavirus, a family of viruses that includes Severe Acute Respiratory Syndrome or SARS, which emerged in China in 2002-2003 and killed some 800 people.
"If you recall the SARS experience in Toronto, that was something that managed to be transmitted into the healthcare facility, leading to severe illness and death," he said.
"This is not something that we want to take lightly."
State health officials in Indiana report the man is in good condition and improving daily. Hospital personnel who may have been exposed to the virus are being kept in home isolation and watched daily for the emergence of pneumonia-like symptoms. Generally the incubation period of MERS is 14 days.
The patient is a healthcare worker who on April 28 was admitted to the hospital just 30 minutes south of Chicago after having worked in healthcare in Saudi Arabia, the center of the MERS outbreak that began in 2012. So far, 262 people in 12 countries have had confirmed infections that have been reported by the World Health Organization, and another 100 MERS patients have been confirmed by other ministries of health. So far, 93 people have died.
U.S. health officials are now checking airline manifests and contacting patients who may have been seated near the man who took a plane from Riyadh, Saudi Arabia, to London and then to Chicago, where he then took a bus to an undisclosed city in Indiana.
'ABSOLUTELY METICULOUS'
To keep the infection from spreading within the hospital, the man is being treated in an isolation room from which air is expelled through a filter, preventing it from being shared in the hallway.
"It's not because we have proof that this virus spreads easily through the air, but we don't want to take any chances," Bell said.
People who enter the room wear a respirator, a type of filtering mask that keeps them from breathing in any airborne particles in the room.
And because MERS is in a family of viruses called coronaviruses that can also be spread through contact with the patient's stool, the team is taking measures to keep all possibly infectious materials from leaving the room.
"You put on gowns and gloves before you go in the room. You take them off before you leave. You pay a lot of attention to washing your hands afterwards with alcohol gel or soap and water," Bell said.
Finally, because tear ducts in the eyes are connected to the throat, healthcare workers wear goggles or face shields to prevent any droplets from entering the eyes.
All of these measures are part of standard hospital protocols for treating various infectious diseases. People with tuberculosis are placed in airborne isolation rooms. With diarrheal diseases, healthcare workers use contact prevention measures.
"None of this is different from what the hospital is already accustomed to doing. We're just making sure the implementation in this case is absolutely meticulous," Bell said.
Bell said current hospital control measures became common practice during the HIV epidemic, when hospital workers had to assume anyone coming in the doors could be infected with the virus that causes AIDS.
"I think it's safe to say every healthcare worker, even in an outpatient setting, understands that whatever comes in the doors, they could be exposed to something infectious," Bell said.
"That ranges from something as common as seasonal influenza, or, if you work in a pediatric facility, there any number of diarrheal diseases," he said.
Despite the best efforts, however, hospitals remain a major source of infection. In March, the CDC reported that roughly one of every 25 U.S. hospital patients contracts an infection during their stay.
DISEASE POORLY UNDERSTOOD
Standard procedures for patients walking into the emergency department with a fever and respiratory complaints, as the MERS patient did in Indiana, are to put a mask on the patient and place them in room with a closed door.
"My understanding is the patient was placed in a private room very quickly," Bell said of the Indiana patient.
As for treatments, there are no specific drugs that can treat MERS, but there are basic treatments that can help the patient fight off the infection, including oxygen, which can reduce the burden on the lungs.
In addition to disease prevention experts, the CDC has sent a team of virologists to the hospital to study the MERS virus, which is still poorly understood. Although the virus first surfaced in 2012, its presence in the United States will give U.S. scientists the opportunity to study it up close.
Currently, it is not clear how the virus is transmitted, but it is clear that it can pass among individuals who have close contact with infected patients.
"The good news is that it's a group of viruses that have a very delicate envelope or membrane on the outside. Because of that, the virus tends to be rapidly inactivated by disinfectants," Bell said.
Since March of 2014, there has been a spike in the number of cases reported in Saudi Arabia. Bell said it is not clear whether that represents a change in the virus that makes it easier to spread, or an increase in the number of cases being reported to health officials.
"That is completely unknown at the moment. It's still rather early in terms of the viral characterization. Since this has all been happening outside the U.S., it's not something we've had a lot of time to work on."
At this point, the CDC has not issued any restrictions on air travel, but Bell said the case makes clear just how easily infections can spread. He recommends that people traveling through airports try to limit what they touch, and wash their hands frequently.

SARS-Like MERS Virus Spreads to New Countries

By GILLIAN MOHNEY | Good Morning America – 17 hours ago

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  Good Morning America - SARS-Like MERS Virus Spreads to
   New Countries (ABC News)

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Cases of the MERS Coronavirus have significantly increased in the last few months, and in recent weeks there have been reports of the virus in new countries including Egypt, Malaysia, the Philippines, and Indonesia, leaving officials struggling to figure out why infections have increased.

See How The MERS Coronavirus Affects the Body
The MERS Coronavirus, which stands for Middle Eastern Respiratory Coronavirus, was first identified in late 2012 and causes acute respiratory illness, shortness of breath and in severe cases kidney failure. The virus is related to the SARS virus and the common cold.
There have been 350 cases and more than 100 deaths reported worldwide from the virus, although the World Health Organization (WHO) has laboratory-confirmed only 254 cases with 93 deaths. Most of the reported infections have come from Middle East countries including Saudi Arabia, Jordan and the United Arab Emirates.
While public health experts have been tracking the disease for nearly two years, in recent weeks health officials are reporting a sharp rise in cases. The WHO reported at least 78 confirmed cases since the beginning of the year, and that diagnosed cases sharply increased in mid-March.
This week the WHO released a report, which said that among newly diagnosed cases up to 75 percent could be human-to-human transmission, since a large number of health workers were infected with the disease. However there is evidence that the reason for the increase could be related to increased testing for the virus and a seasonal increase in the disease rather than virus mutation.
Dr. Ian Lipkin, an epidemiologist and professor of Epidemiology at the Mailman School of Public Health at Columbia University, has been investigating the virus and said 75 percent of camels in Saudi Arabia have had the disease. Lipkin points out that as camels are born in the spring the virus can spread from the young animals to people who interact with them.
"The younger animals have the virus and become infected and become little virus factories," said Lipkin, who explained that camels are extremely common in Saudi Arabia and surrounding countries.
"It's almost like dogs in the U.S. Except they eat the camels ... there's so much opportunity," for the virus to spread, he said.
Lipkin also pointed out that when patients are treated with invasive pulmonary measures, the virus "deep in the lungs" can come to the surface and infect health care workers treating these patients. Lipkin said to combat the spread, more oversight will be needed to both regulate people's interactions with camels and to protect healthcare workers from infection.
Currently there is no vaccine for the MERS Coronavirus. There have been no reported cases in the U.S. and the CDC has not issued any travel advisories related to the disease.
Follow the Latest News on the MERS Coronavirus Outbreak

Egypt discovers first case of potentially deadly MERS virus

3 hours ago

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CAIRO (Reuters) - Egypt has discovered its first case of the potentially deadly Middle East Respiratory Syndrome (MERS) in an Egyptian citizen who had recently returned from Saudi Arabia, Egypt's Ministry of Health said on Saturday.
The virus, which can cause coughing, fever and pneumonia, has spread from the Gulf to Europe and has already caused over 90 deaths.
The patient, 27, is being treated for pneumonia at a Cairo hospital and is in a stable condition, the ministry said in a statement.
The man, who is from the Nile Delta, was living in the Saudi capital Riyadh, the ministry said.
Saudi Arabia, which has been hardest-hit by the MERS virus, announced on Friday it had discovered 14 more cases in the kingdom, bringing the total number to 313.
Although the number of MERS infections worldwide is fairly small, the more than 40 percent death rate among confirmed cases and the spread of the virus beyond the Middle East is keeping scientists and public health officials on alert.
A spokesman for the World Health Organization in Geneva said on Friday it was "concerned" about the rising MERS numbers in Saudi Arabia urging for a speedy scientific breakthrough about the virus and its route of infection.

Saudi authorities have invited five leading international vaccine makers to collaborate with them in developing a MERS vaccine, but virology experts argue that this makes little sense in public health terms.

(Reporting by Yasmine Saleh and Mahmoud Mourad, Editing by Raissa Kasolowsky)

Study: Antibiotic-Resistant MRSA ‘Superbug’ Found In US Homes

http://atlanta.cbslocal.com/

April 22, 2014 8:32 AM

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Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is resistant to many of the strongest antibiotics, and although recent prevalence has been limited to hospitals and nursing homes, a new study of 161 New York City residents who contracted the MRSA infections finds that the these people’s homes were “major reservoirs” for the bacteria strains. (Photo by Christopher Furlong/Getty Images)

Atlanta (CBS ATLANTA) – An anti-biotic resistant “superbug” that has long affected hospitals and other health care locations around the world has now found a new “reservoir” location: inside U.S. homes.
Methicillin-resistant Staphylococcus aureus (MRSA) is a bacteria that is resistant to many of the strongest antibiotics, and although recent prevalence has been limited to hospitals and nursing homes, a new study of 161 New York City residents who contracted the MRSA infections finds that the these people’s homes were “major reservoirs” for the bacteria strains, HealthDay reports.
The Centers for Disease Control and Prevention notes that in communities outside of health care settings, most MRSA strains are skin infections that are spread by physical contact, such as the sharing of towels or razors. Athletes, military barracks, prisons and other close-quarter living areas are at an increased risk of contracting and spreading the bug.
In medical facilities, MRSA causes life-threatening bloodstream infections, pneumonia and surgical infections.
But the new study shows that the MRSA has spread into average U.S. homes.
“What our findings show is it’s also endemic in households,” lead researcher Dr. Anne-Catrin Uhlemann, of Columbia University Medical Center in New York City, tells HealthDay, from the study published in the Proceedings for the National Academy of Sciences.
According to a report released by the CDC last September, more than 2 million Americans get drug-resistant infections each year. And about 23,000 die from these diseases that are increasingly resistant to the strongest antibiotics that doctors use to fight the infections.
Uhlemann and fellow researchers took samples from those affected by MRSA strains along with samples of a comparison group of people how had not fallen ill. The researchers then took samples from these patients’ household surfaces and other social contacts to see if the bacteria had spread.
Ultimately, the research showed that many homes outside of just those affected by MRSA were “major reservoirs” for the MRSA strain, USA300, which HealthDay notes is the primary cause of MRSA infections in communities throughout the country.
Bedding, clothes and other everyday surfaces used by someone affected by MRSA are suggested to be cleaned by bleach and hot water, although Uhlemann says the role of surfaces in transmitting the disease is not “well delineated.”
“We can’t just treat the person with the infection,” Uhlemann told HealthDay. “We have to attempt to remove the (MRSA) colonization from the home,” and another MRSA expert not involved in the study added that the new study “confirms what we’ve suspected all along.”
Correct bandaging, protection of wounds, and hand-washing were suggested by experts as the best ways to protect family members and others who one may come in physical contact with regularly, thereby spreading the bacteria to others.
The CDC has estimated that nearly one-in-three people carry staph bacteria in their nose, and typically feel no symptoms of sickness. About 2 percent of people carry MRSA.
The World Health Organization has previously stated that the overuse of antibiotics has become so common that even normal infections may become deadly in the future, due to the evolution of these bacteria strains.
“It is not too late,” CDC director Dr. Tom Frieden said to CBSNews.com during a press conference. “If we’re not careful, the medicine chest will be empty when we go there to look for a lifesaving antibiotic for someone with a deadly infection. If we act now, we can preserve these medications while we continue to work on lifesaving medications.”
Dr. Henry Chambers, chair of the antimicrobial resistance committee for the Infectious Diseases Society of America, told HealthDay he agreed, and that “about half of antibiotics prescribed aren’t needed.” 
A report earlier this month found that the drug-resistant bacteria caused a fatal blood infection in a Brazilian patient, according to Live Science. His body had developed a resistance to the powerful antibiotic vancomycin – used widely to treat the infection – during the course of his stay at the hospital.
– Benjamin Fearnow

MERS death toll hits 81 in Saudi

April 22, 2014 12:09 PM

Riyadh (AFP) - The MERS death toll has climbed to 81 in Saudi Arabia, which sacked its health minister as cases of infection by the coronavirus mount in the country.

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A 73-year-old Saudi who suffered from chronic illnesses died in Riyadh and a compatriot diagnosed with the virus, aged 54, died in the port city of Jeddah, the health ministry said late Monday.

The ministry said it has registered 261 cases of infection across the kingdom since the discovery of the Middle East Respiratory Syndrome in September 2012.

The World Health Organisation said on April 17 that it has been informed of 243 laboratory-confirmed cases of infection with MERS worldwide, including 93 deaths.

Saudi Arabia on Monday dismissed its health minister, Abdullah al-Rabiah, without any explanation.

Rabiah last week visited hospitals in Jeddah to calm a public hit by panic over the spread of the virus among medical staff that triggered the temporary closure of a hospital emergency room.

MERS was initially concentrated in eastern Saudi Arabia but now affects other areas.

The virus is considered a deadlier but less-transmissible cousin of the SARS virus that erupted in Asia in 2003 and infected 8,273 people, nine percent of whom died.

Experts are still struggling to understand MERS, for which there is no known vaccine.

A recent study said the virus has been "extraordinarily common" in camels for at least 20 years, and it may have been passed directly from the animals to humans.

SARS-Like MERS Virus Spreads Among Health Care Workers

By GILLIAN MOHNEY 8 hours ago Good Morning America

SARS-Like MERS Virus Spreads Among Health Care Workers (ABC News)

A sudden uptick in the SARS-like corona virus called MERS-CoV for Middle Eastern Respiratory Coronavirus is partially related to health care workers becoming infected with the disease.

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This month the World Health Organization (WHO) has confirmed 32 cases of the virus so far, including a cluster of 10 health care workers, all of whom worked with an infected patient who died on April 10. Nearly all the cases were located in the Middle East countries of Saudi Arabia, United Arab Emirates and Jordan. One case was found in Malaysia.

Of the 32 cases reported this month, 19 were health care workers, according to the WHO.

See How the MERS Coronavirus Attacks the Body

For the first time, the disease has been found in Asia, after a Malaysian man was found to have contracted it this month. The 54-year-old man was diagnosed with the disease after traveling to Jeddah, Saudi Arabia. The man traveled for a pilgrimage and during his vacation spent time at a camel farm, where he had camel milk. He died on April 13 and had undisclosed underlying health conditions.

The virus is a respiratory virus in the same family as the deadly SARS virus and common cold. Symptoms can include fever, shortness of breath, pneumonia, diarrhea and in severe cases kidney failure.

Since the virus was first identified in April 2012, the WHO has found a total of 243 confirmed cases of the deadly virus and 93 people have died from it.

The virus has been shown to spread between people in close contact. Currently officials do not know where the virus originated, but suspect it was likely from an animal.

No MERS-CoV infections have been reported in the United States. The U.S. Centers for Disease Control and Prevention recommends that travelers to the Arabian Peninsula monitor their health during the trip and in the weeks after.

CDC officials recommend that if a recent traveler to the region develops a fever or symptom of respiratory illness, including a cough or shortness of breath, they should see a doctor immediately.