The First 2014 Corona Wave Peaked in Late April

About three week ago, I posted a graph that suggested the first wave of Middle East Respiratory Syndrome (Corona) infections in 2014 peaked about April 20th and was starting to decline (Number ofCurrent Corona Infections on the Arabian Peninsula May Be Declining).

Since April 30 almost 200 additional Corona cases have been reported. Extending the graph to include data through May 17, the additional data clearly show that the number of Corona cases (based on the plotting criteria) started to decline about April 20 and has continue to decline since then. The date associated with each individual case varies with the publicly available information. Where possible, the onset date is used. If the onset date is not provided, the date of hospitalization is used or the date of death. If the case is asymptomatic, the date of confirmation is used if available, if not, the date of the official report is used. If no other calendar information is available, the date of the report is used.  Importantly, the distribution of these additional cases by onset date, hospitalization or death date, or date of report, did not appreciably alter the shape of the graph or shift it closer in time. The plotted 5-day central moving average (incorporating all of the additional cases) is almost coincidental with the moving average plotted through April 30 as show on the graph below. 

Since most Corona cases are being reported from Saudi Arabia, the decline in cases is welcome news.  However, the number of exported Corona cases from Saudi Arabia to other countries seems to be increasing and should of concern for public health officials worldwide.

 

World Map of the Corona Outbreak through May 18, 2014

More than 650 cases of Middle East Respiratory Syndrome (Corona) have been reported from around the world by official national and international public health agencies in 20 countries through May 18^th, 2014.  These countries are the highlighted countries in map below.  This is more than a three-fold increase in countries reporting Corona cases in the last year. In May of 2013, only six countries, France, Germany, Jordan, Saudi Arabia and Tunisia, and the United Kingdom had officially reported Corona cases.

The next map depicts the geolocation of both imported cases and local infections of Corona in Europe, North Africa, and the Middle East.  The Corona cases included on this map include both confirmed and probable/suspected cases.   The size of the circles represents the relative number of Corona cases at each location.  Saudi Arabia has reported the largest number of Corona cases;  more than 80% of all the Corona cases in the world have occurred in Saudi Arabia.  

H5 HPAI outbreaks in poultry flocks in the USA

Since December 2014, the United States Department of Agriculture (USDA) has confirmed H5 Highly Pathogenic Avian Influenza (HPAI) in commercial and backyard poultry flocks in the United States. At least 142 separate incidents have been detected through May 7, 2015; most are the H5N2 virus.[1] According to USDA, more than 29 million birds have been infected including chickens, ducks, pheasants, and turkeys mostly in commercial poultry flocks. Chickens represent about 81% of all infected poultry followed by turkeys with 18% of the total.

In addition to the poultry flock infections in the United States, at least 60 incidents of detection of H5 HPAI in wild birds have also been reported since early December 2014 from the 13 states [2] shown in the map below.

H5 HPAI has been detected in poultry flocks in 13 states as well. However, there is no on-to-one correspondence between the states reporting wild bird infections and those with poultry flock infections as show on the map below.

Based on the number of infected birds, the geographic distribution of the H5 HPAI poultry outbreaks is concentrated in the Upper Midwest. There is no sign that the poultry flock infections are declining. The good news is that no human cases of these H5 subtypes have been reported from the United States. And according the Center for Disease Control, the risk of human infection from these H5 avian influenza subtypes is low.[3]

[1] Update on Avian Influenza Findings - Poultry Findings Confirmed by USDA’s National Veterinary Services Laboratories

[2] Wild Bird Highly Pathogenic Avian Influenza Cases in the United States (USDA)

[3] H5 Viruses in the United States