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MERS ALERT in Greece


How Can Travelers Protect Themselves?


Taking these everyday actions can help prevent the spread of germs and protect against colds, flu, and other illnesses:


  • Wash your hands often with soap and water. If soap and water are not available, use an alcohol-based hand sanitizer.
  • Avoid touching your eyes, nose, and mouth. Germs spread this way.
  • Avoid close contact with sick people.


  • Be sure you are up-to-date with all of your shots, and if possible, see your healthcare provider at least 4–6 weeks before travel to get any additional shots.


  • If you are sick:
    • Cover your mouth with a tissue when you cough or sneeze, and throw the tissue in the trash.
    • Avoid contact with other people to keep from infecting them.


by CDC, cdc.gov, MERS Page





To travellers: Greek CDC, April 2014

The Greek CDC reminds to all travellers to and from Greece, that due to the special geophysical thesis of the country, Greece could be " a transit point" for threatening infections as MERS that is spreading ACUTELY on these days from the Middle East Countries to the western world .

 

That's why travellers on international flights that include other transit lines from the Middle East Countries, or travellers on cruise ships with international passengers including the Middle East countries, should provide special caution to keep the Basic Hygiene Rules and suspect any strange symptoms.

       



Greek CDC recommends that travelers form countries in or near the Arabian Peninsula pay attention to their health during and after their trip

 

 Travelers should see a doctor right away if they develop

  • fever
  • and symptoms of lower respiratory illness, such as
  • cough or
  • shortness of breath,

within

14 days

after traveling from countries in or near the Arabian Peninsula.

 

They should tell the doctor about their recent travel.

Greece did show Rapid Emergency Response on restraining a possible imported cluster of MERS, at the Entry Points, says professor Sotiris Tsiodras, a top Greek CDC Public Health Advisor. But this time, he adds, it was the ill traveler's mask that made the difference, and became for this incident, the Global Health's and Greece's "happy chance...."!

go to our full story by Greek to me !



Worldwide caution. WHO talks of a new spike of human-to-human trms...


The World Health Organization (WHO) raised concerns on April 23, 2014 about the ongoing spike in cases, especially in healthcare settings, and offered to help the countries pull together a global team to help investigate and assess the risks


Ala Alwan, MD, EMRO's director, (of the

Eastern Mediterranean Office )of the WHO), said in the statement that 75% of recently reported infections are secondary cases, considered to have been spread from other people. "The majority of these secondary cases have been infected within the healthcare setting and are mainly healthcare workers, although several patients are also considered to have been infected with MERS-CoV while in hospital for other reasons," he added.

The WHO also raised concerns about a fresh round of MERS-CoV infections in people who visited Saudi Arabia or the UAE, as recent cases were reported in Greece, Jordan, Malaysia, and the Philippines. It said that though no further spread of the virus has been linked to those cases, earlier imported cases in France and the United Kingdom resulted in limited human-to-human spread.


go to full article of CIDRAP, on April 23, 2014



the Greek MERS case

 

 

The life--saving mask in the Health Village. Greece's success on a lucky-unlucky arrival





The Greek MERS case Saudi traveler was wearing a mask during all his flight to Athens and also all the way to the hospital where he seeked assistance, on the day he arrived in Greece

 

Nonetheless, from the first moment he addressed to the Greek Health System, the respiratory symptoms in reference with the country of origin , were indications urgent for the Public Health System to respond acutely for the MERS threat coronavirus, the Greek CDC scientists comment, emphasizing the long-term Preparedness for Travel Health Safety issues the Greek CDC has achieved to lead in such Awareness, despite the hard damaged Greek medical system due to the crisis. It is interesting though, that such Awareness seems to be leaking on the most critical moments from the epicenter of the MERS epidemic, despite the such well developed Public Health System and its deep , golden, financial back up, in the United Emirates country... 

April 2012 - Present

  • France
  • Greece
  • Italy
  • Jordan
  • Kuwait
  • Malaysia
  • Oman
  • Qatar
  • Saudi Arabia
  • Tunisia
  • United Kingdom (UK)
  • United Arab Emirates (UAE)


WHO for MERS Greek case report , April 20, 2014


20-04-2014

On 18 April 2014, the Ministry of Health in Greece reported one laboratory-confirmed case of infection with Middle East respiratory syndrome coronavirus (MERS-CoV).

The patient is a 69-year-old male Greek citizen residing in Jeddah, Saudi Arabia, who travelled back to Greece on 17 April. While in Jeddah, the patient consulted a hospital on 8 and 10 April for a febrile illness with diarrhoea. He was diagnosed with probable typhoid fever and treated. He had regularly visited his wife who was hospitalised from 31 March to 5 April in the same hospital for confirmed typhoid fever.


The patient sought medical care upon arrival in Greece on 17 April. The evaluation revealed a bilateral pneumonia and the diagnosis of MERS-CoV infection was made at the National Reference Laboratory for Influenza.

The patient is in stable condition and is receiving appropriate treatment.

This is the first case of MERS-CoV infection in Greece.

Individuals who had close contacts with the patient in the plane, the hospital in Greece and in the community have been identified and are being contacted. So far, none of the contacts has fallen ill.

Hellenic health authorities issued a press release to inform the population and informed all Greek hospitals on measures that need be taken to identify suspect patients and implement appropriate preventive measures.

Globally, from September 2012 to date WHO has been informed of a total of 250 laboratory-confirmed cases of infection with MERS-CoV, including 93 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual pattern.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions





ECDC: Epidemiological update on first imported Greek MERS case

Via ECDC: Epidemiological update: First imported case of MERS-CoV in Greece. Click through for important links.

On 18 April 2014, the Hellenic Centre for Disease Control and Prevention (KEELPNO) announced a laboratory confirmed case of MERS-CoV infection in a 69 year old male patient. The individual is a Greek citizen, permanently residing in Jeddah, Saudi Arabia, who arrived in Athens on 17 April on a flight via Amman, Jordan. 
Close contact tracing is ongoing; there are no suspected or confirmed cases of MERS-CoV infection associated with this individual to date. 
The individual first sought medical attention with signs of illness on 8 April in Jeddah and was discharged on 10 April with a diagnosis of probable typhoid fever. His wife was hospitalised in the same hospital in Jeddah from 31 March to 5 April with laboratory confirmed typhoid fever. He sought medical attention the same day of his arrival in Greece (17 April 2014) for prolonged fever and diarrhea. 
The patient is currently in stable condition receiving antimicrobial therapy and oseltamivir. 
As of 22 April 2014, 333 laboratory confirmed cases of MERS-CoV have been reported by local health authorities worldwide, including 107 deaths. Of these, only fifteen have been reported outside of the Middle East including only ten in Europe. 
ECDC is working closely with KEELPNO, the World Health Organization and other international partners with regard to this public health event.
In earlier Rapid Risk Assessments, ECDC concluded that the risk of importation of MERS-CoV to the EU was expected to continue and the risk of secondary transmission in the EU remains low.

April 23, 2014 at 07:27 AM in MERSTravel & health | Permalink


cdc.gov

When Should Someone See a Health Care Provider?

You should see a health care provider if you develop a fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in or near the Arabian Peninsula*.You should tell the health care provider about your recent travel.

Clinician Information:

Health care providers should be alert to patients who develop severe acute lower respiratory illness (e.g., requiring hospitalization) within 14 days after traveling from countries in the Arabian Peninsula* or neighboring countries, excluding those who transited at airports without entering the countries.

  • Consider other more common causes of respiratory illness, such as influenza.
  • Evaluate patients using CDC’s case definitions and guidance.
  • Immediately report patients with unexplained respiratory illness and who meet CDC’s criteria for “patient under investigation (PUI)” to CDC through the state or local health department. A PUI is a person with -
    • an acute respiratory infection, which may include fever (≥38°C, 100.4°F) and cough; AND
    • suspicion of pulmonary parenchymal disease (e.g., pneumonia or acute respiratory distress syndrome based on clinical or radiologic evidence of consolidation); AND
    • history of travel from countries in the Arabian Peninsula* or neighboring countries* within 14 days; AND
    • not already explained by any other infection or etiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines.


  • Collect specimens for MERS-CoV testing from all PUIs.


More, at cdc.gov website

 Greek CDC (HCDCP) MERS : Less Infectious More Fatal



Published on June 2013, by the


The WHO has not recommended any MERS-related travel restrictions, but says countries should monitor unusual respiratory infection patterns.

The first recorded MERS death was in June last year in Saudi Arabia.

All confirmed cases have had respiratory disease and most have had pneumonia. Complications during the course of illness have included severe pneumonia with respiratory failure requiring mechanical ventilation, acute respiratory distress syndrome (ARDS) with multi-organ failure, renal failure requiring dialysis, consumptive coagulopathy and pericarditis. Immunocompromised patients also reported gastrointestinal symptoms including diarrhea during the course of their illness.


It has also been reported co-infection of novel coronovirus with influenza A.


It should however be noted that the clinical spectrum of disease, is not yet fully known.


BY GREEK CDC(HCDCP)  on MERS, June, 2013


Saudi Arabia reports 24 case, one from Mecca The statements from Saudi Arabia included details about the first cases reported in the holy city of Mecca, including one in a Turkish pilgrim.  0 are listed as contacts of other confirmed cases. Most of the patients who had known contact with a lab-confirmed case-patient have no symptoms or only mild symptoms.

Go to CIDRAP article,


The Hajji transportation fatality prognosis

The danger of the Hadji spread of the virus worldwide. Look on the map above. Greece seems close to the epicenter

 

A world map depicting the city level destinations of travelers and the national origins of foreign Hajj pilgrims is shown, demonstrating that while no region of the world is isolated, Central and South America see the fewest number of travelers.On the contrary, Greece seems close to the epicenter

The study  describes worldwide air travel patterns out of the Middle East between Ramadan and the month following the Hajj ,as a means to anticipate the most likely pathways of spread, to help the international community identify countries that have strong travel connections to Saudi Arabia and the Middle East but which have limited capacity to detect MERS-CoV in a timely manner, and if necessary, to mobilize an effective public health response to imported cases including the implementation of rigorous infection control practices.

Go to PLOS Current outbreaks


*Countries considered in the Arabian Peninsula and neighboring include:

Bahrain,

 Iraq,

Iran,

 Israel,

Jordan,

 Kuwait,

 Lebanon,

 Oman,

 Palestinian territories,

 Qatar,

Saudi Arabia,

Syria,

 the United Arab Emirates (UAE),

and Yemen.


BY CDC.GOV, Traveler's Health




Scientists have some clues, but they still don't know what animal the virus came from or how it jumps from animals (like the camels) to people or from person to person. Nor do they know how long an infected person can spread the virus to others.

While it's known that some people can get infected and have no symptoms, no one knows whether those people can pass the virus along. An effective, widely available treatment for the illness remains a distant goal, as does a vaccine.




Visas for the elderly and children pilgrims denounced for the Hadji of June last year by the Saudi Arabia government .

Saudi Health Ministry had announced that the country will no issue visas to the elderly, pregnant women, or children for both pilgrimages , in order to prevent the Middle East respiratory syndrome (MERS) from turning pandemic and reaching countries around the world


""Elderly persons (for whom no precise age threshold has been specified), pregnant women, children and people affected by chronic diseases, notably people with cardiac, diabetic or respiratory disease, kidney or immune-system deficiencies, will be unable to obtain a visa this year," the Saudi statement read.


See more by medicaldaily.com


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Two years of MERS, World Science still asks

MERS, which first appeared in Saudi Arabia in September, has been kicking around the Middle East for nearly a year, infecting at least 79 people. It causes fever, cough and shortness of breath, and so far it has been a killer about half the confirmed cases so far have resulted in death


On July 9 the World Health Organization (WHO) convened an emergency meeting to determine whether the new coronavirus that causes MERS constitutes a “public-health emergency of international concern,” as WHO assistant director general Dr. Keiji Fukuda put it. (go to WHO’s latest update.)


The good news is that a recent report published in the Lancet indicates that the virus has a relatively low level of infectiousness — less so than the measles and strong cases of the flu — which may limit its potential to ignite a global pandemic. 


A similar lack of infectiousness also kept SARS from becoming a lasting global menace, though the disease did cause nearly $50 billion in damages. But there’s no guarantee that MERS won’t mutate or worsen over time



Read more Time MAGAZINE, July 2013 




GREECE ON THE CROSS-ROAD 



From 

South2North & East2West,

Greece  the Crossroad Transit of travel  and infection


Proactive Care urged on Airports, Hotels and Transit travelers who should be aware of the early warning symptoms     


Human-to-human transmission

Human-to-human transmission of MERS-CoV has been documented in several clusters of cases, including among family members and in health care facilities, but it is evident that for the time being, human-to-human transmission is not sustained.

Public Health Measures

The World Health Organization (WHO) and the European Centre for Disease Control (ECDC), issued immediate instructions to alert Public Health Authorities of all countries, for the need of early detection, epidemiological and laboratory investigation, of suspected MERS-CoV cases and for the implementation of infection control measures to decrease the risk of human to human transmission.

Following these recommendations, our country has issued recommendations both for the early detection and epidemiological investigation of cases and for the infection control measures, which are available on the Hellenic Center for Disease Control and Prevention (H.C.D.C.P)

website, www.keelpno.gr.