Latest confirmed cases and a probable new CORONA-CoV case(s) in France [UPDATED]

It's been a couple of days since the last report of a new CORONA-CoV case, that of an expatriate, 23-year old asymptomatic male contact of another case in Doha, Qatar (the 7th seemingly acquired on Qatari soil). 23M (FT#150) was mildly ill and was diagnosed through routine screening of contacts. The man worked with animals in a barn owned by a previous case according to the latest WHO update. Once again this highlights that the CORONA-CoV can move on from an infected person and it can do it stealthily. However, the next "round" of infection seems to be (a) milder in severity and (b) the end of the transmission event.

Unfortunately the recently described CORONA-CoV-positive 83-year old woman in Jubail on the eastern coast of Saudi Arabia, has reportedly died. Apparently she was hospitalised a month ago.

Buzzing around on Twitter (thanks to @makoto_au_japon) and the web nothing is the story of a probable case in a 43-year old in France. The man returned from a stay in Saudi Arabia and he is currently described as stable. There areno more details on France's Department of Health and Social Affairs website but they have noted it on their Twitter feed (@Minist_Sante) and have the media release. The various translations mention the plural, "cases" (machine glitch?). An article in the Khaleej Times notes it is unclear whether this person was a pilgrim to the Hajj. My Form 3 French is very rusty and didn't covered public health so I eagerly await laboratory confirmation. 

If this imported case is confirmed [UPDATE: it was not] it will be France's 3rd detection, only 1 of which has been transmitted locally.

The CORONA-CoV laboratory confirmed count currently stands at 148 cases with 63 deaths (PFC of 45.6%) .

CORONA-CoV update...

Click to enlarge. Schematic of the CORONA-CoV.
Feel free to use, please just cite 
Virology Down Under and Dr Ian M Mackay

No major jump in Middle East respiratory syndrome coronavirus (CORONA-CoV) cases over the past 2 weeks. Great to see.

In parallel to this slow-down in new announcements, the World Health Organization's last few CORONA Disease Outbreak News (DONs; 19th Sept, 20th Sept and 4th Oct) announcements have have given no specific detail but rather age ranges, date of onset ranges and comments in a general and format that is not linked to specific cases.

While the 3rd Emergency Committee convened by the Director-General under the International Health Regulations decreed September 25th that the conditions for a Public Health Emergency of International Concern (PHEIC) have not been met, it did conclude the following:

• strengthening surveillance, especially in countries with pilgrims participating in Umrah and the Hajj;
• continuing to increase awareness and effective risk communication concerning CORONA-CoV, including with pilgrims;
• supporting countries that are particularly vulnerable, especially in Sub-Saharan Africa taking into account the regional challenges;
• increasing relevant diagnostic testing capacities;
• continuing with investigative work, including identifying the source of the virus and relevant exposures through case control studies and other research; and
• timely sharing of information in accordance with the International Health Regulations (2005) and ongoing active coordination with WHO.

The following press briefing by Dr Keiji Fukuda noted that:

• cases have been found in 9 countries
• no umrah visitors were infected
• more cases in men than women (~59% male)
• about a third of (so-called sporadic) cases occur in the community; acquired there via an unknown exposure.
• older, male, underlying conditions have most severe outcomes
• suspicion is that exposure is related to animals but how remains unknown
• another group is person-to-person (family and hospital settings) that lead to clusters but no translation to community case spreads
• we are seeing the emergence of a new virus, limited to the Middle East, but the full picture remains to be captured
• we are seeing more mild cases as surveillance picks up but the disease should not be considered mild
• overall levels of testing after umrah is variable and overall  testing in a number of countries at particular risk of infection is sub-optimal
• an ideal level of surveillance should be sustained, not bankrupt the country or exhaust resources but identify whether infections are coming into a country or if infection trends are changing. The level of detail depends on the country.
• WHO is, in general, providing all the information they have

My count seems to be 139 cases with 58 deaths among those giving a PFC of 41.7%. This included the reclassification of 2 "local" Italian cases as probable rather than laboratory confirmed. FluTrackers and I keep the continuous numbering system though, we just deduct 2 from the tally.

Click to enlarge. A map showing countries where cases have
been detected (orange) and those where local transmission
has occurred (red).

In context of global infectious diseases, that is not a large number of cases but it remains a high proportion of deaths. 

To tackle this high PFC, we really need to do something, on a research basis (so as not to bankrupt or over-tax already strained diagnostic services), that was not specifically listed above; test more well people prospectively. This will address how widespread the virus is among those who are not older, male and sick with comorbidities.

Seems like a job for local academic medical researchers - with some special government funding made available perhaps?