The coronavirus (NCoV) SARs like virus

Since nCoV first emerged and was identified in September 2012, the WHO says it has been informed of a total of 40 laboratory-confirmed cases worldwide, including 20 deaths. Saudi Arabia has had most of the cases – with 30 patients infected, 15 of them fatally – but nCoV cases have also been reported in Jordan, Qatar, Britain, Germany and France. Are all the virus samples collected from the outbreak in different countries with the same DNA? If so, there is a missing host and it could be migratory birds. – Contributed by Oogle.

Saudi labs need help with the new SARS-like virus but ‘we’re not getting any feedback’

Characteristics

1) Spread by air in the environment, every living thing is infected including humans, animals and birds. 

2) The weather plays a part as it may seem like a cold flu with mild symptoms for some or a very bad flu for others. People will start taking notice when humans die or get very seriously ill when warded into the hospital, and these people will have mutated viruses that can become carriers or cause widespread pandemic when the virus break the human body defence systems in white blood cells.

3) This has yet to happen like bird flu so there is no vaccine available. A vaccine can only be developed when the human defence system contained the virus with it’s white blood cells and the human recovers, that will roughly take about a month and a furthur 2 weeks with the fastest technologies available in the markets. There are other technologies available in the market which may cut the process by half, so the risk factor will be about 3 weeks where the entire world has no cure.

4) Furthur studies may be required from those who recover from the strain of virus that attack the body immune systems, including their white blood samples and their DNA. Profiling will find the type of humans who are very likely to get the virus, and those who don’t.

5) Then this information can be passed to other researchers by WHO which is still in the process of understanding this virus and the work is still on-going, so that is why everybody is silent.

– Contributed by Oogle.

PS : When I have a confirmed outbreak, I will do contact tracing on the patient’s home and work place to find out everybody who has contact with the patient and put them into an observation ward, do testing to find out if they have been contaminated, and find out their body reactions to the virus. This is the most important step to contain the virus. When I do the autopsy I will take DNA, blood and urine samples, and the damage to the lungs, liver and kidneys and try to recreate how the virus attack in the different stages and note everything down for others to work on. How I will contain the spread of the virus. If there is an outbreak in Saudi Arabia and hundreds of people die, I will standby testkits on a chip with the sample from the virus from Saudi Arabia, and all incoming passengers from there will be required to compulsary provide samples in the airport, this is not difficult as results are almost instant, and it will take days to purchase and manufacture these to standby for an outbreak.

H7N9 : the start of human transmission testing the human immunity system

“White blood cells contain antibodies that will cause a reaction when it meets the H7N9 virus, but the virus will mutate and test this barrier, which is similar to an attack of influenza, but once this barrier is broken, you will have a pandemic because the common cold can easily be transmitted, and there is absolutely no medication, what you are seeing are the early signs of human-to-human transmission, tamiflu can only minimise but not cure H7N9, therefore do not anyhow administer it or the virus will develop a resistence to become a superbug. Birds are the best first detectors due to their delicate respitory systems. You need to straightaway isolate the entire family, do contact tracing for those who are in exposed and monitor them, and quickly develop a vaccine, or it will get out of control. There will be a miracle patient whose body develops it’s own defences to combat the virus, you need to find out how.” – Contributed by Oogle.

REUTERS
Health workers cull roosters at a government-state-run poultry farm in Gandhigram village, about 35 km (22 miles) west of Agartala, capital of India’s northeastern state of Tripura, March 7, 2011.

The Chinese Centre for Disease Control and Prevention said 40 per cent of the infected patients had no direct contact with poultry, making experts wonder just how the sick got infected with the new virus.

However, fears rose that the virus could pass between humans after a number of members of a family in Shanghai got infected.

“To me, the biggest question is the link between the virus in birds and how it gets to humans. This is not clear,” Dr Bai Chunxue, a Shanghai-based respiratory expert, was quoted by the South Morning Post. Dr Bai was the one who treated a family cluster, an 87-year-old man and his two sons, when they got sick due to the influenza A H7N9 virus.

Dr Bai said the patients had no contact with birds or poultry. “So this is indeed a mystery,” he said.

And just last week, reported the first ever human carrier of the new influenza A H7N9 virus, a 4-year-old boy in Beijing. His parents are poultry and fish traders. Even without showing symptoms of the potentially lethal virus, China reported the child carries the disease.

Of the 102 total infected cases, 70 remain in hospital while 12 have been discharged. Five of the new cases were in Zhejiang province and one came from Shanghai.

“Until the source of infection has been identified, it is expected that there will be further cases of human infection with the virus in China,” the World Health Organisation (WHO) said in a statement.

With 40 per cent of patients having no exposure to poultry or other birds, this virus is “very difficult to understand,” Dr Masato Tashiro, director of WHO’s influenza research center in Tokyo, said.

Every part of the body can be transplanted except the brain

“I hold the secrets to stop ageing of brain cells, where every organ can be transplanted, limbs can be artificially made, and humans will live beyond 100 years without issue, but fool around with me and I will take it up to Heaven with me.” – Contributed by Oogle.

Scientists at Massachusetts General Hospital in Boston have achieved a breakthrough in bioengineering by developing a kidney in laboratory for transplant. The kidney was transplanted into a rat, which successfully produced urine.

The scientists revealed that the kidney was taken for a dead rat. Old cells were stripped from the kidney that left a natural scaffold of collagen and other compounds. These are called extracellular matrix and work as a framework for the new cells.

The research was published online by the journal Nature Medicine. Dr. Harald C. Ott, senior author of the paper, said replacement organs made by using this technique hold advantages over artificial scaffolds or other techniques. He said the best advantage is that it is fully implantable in the shape of a kidney.

“If this technology can be scaled to human-size grafts, patients suffering from renal failure, who are currently waiting for donor kidneys, could theoretically receive an organ grown on demand”, he added.

Kidney is the most demanded organ and nearly 5,000 people in the US died in 2011 without getting a kidney for transplant. The current technique to make kidneys will certainly bring down long waiting lists. Nearly 17,000 people receive a kidney each year for transplant for which they have to rely on a donor.

The treatment for Hydrocephalus

Hydrocephalus treatment is surgical, generally creating various types of cerebral shunts. It involves the placement of a ventricular catheter (a tube made of silastic), into the cerebral ventricles to bypass the flow obstruction/malfunctioning arachnoidal granulations and drain the excess fluid into other body cavities, from where it can be resorbed. Most shunts drain the fluid into the peritoneal cavity (ventriculo-peritoneal shunt), but alternative sites include the right atrium (ventriculo-atrial shunt), pleural cavity (ventriculo-pleural shunt), and gallbladder. A shunt system can also be placed in the lumbar space of the spine and have the CSF redirected to the peritoneal cavity (Lumbar-peritoneal shunt). An alternative treatment for obstructive hydrocephalus in selected patients is the endoscopic third ventriculostomy (ETV), whereby a surgically created opening in the floor of the third ventricle allows the CSF to flow directly to the basal cisterns, thereby shortcutting any obstruction, as in aqueductal stenosis. This may or may not be appropriate based on individual anatomy.

Shunt complications

Examples of possible complications include shunt malfunction, shunt failure, and shunt infection, along with infection of the shunt tract following surgery (the most common reason for shunt failure is infection of the shunt tract). Although a shunt generally works well, it may stop working if it disconnects, becomes blocked (clogged), infected, or it is outgrown. If this happens the cerebrospinal fluid will begin to accumulate again and a number of physical symptoms will develop (headaches, nausea, vomiting, photophobia/light sensitivity), some extremely serious, like seizures. The shunt failure rate is also relatively high (of the 40,000 surgeries performed annually to treat hydrocephalus, only 30% are a patient’s first surgery)[9] and it is not uncommon for patients to have multiple shunt revisions within their lifetime.

The diagnosis of cerebrospinal fluid buildup is complex and requires specialist expertise.

Another complication can occur when CSF drains more rapidly than it is produced by the choroid plexus, causing symptoms -listlessness, severe headaches, irritability, light sensitivity, auditory hyperesthesia (sound sensitivity), nausea, vomiting, dizziness, vertigo, migraines, seizures, a change in personality, weakness in the arms or legs, strabismus, and double vision – to appear when the patient is vertical. If the patient lies down, the symptoms usually vanish in a short amount of time. A CT scan may or may not show any change in ventricle size, particularly if the patient has a history of slit-like ventricles. Difficulty in diagnosing overdrainage can make treatment of this complication particularly frustrating for patients and their families.

Resistance to traditional analgesic pharmacological therapy may also be a sign of shunt overdrainage or failure. Diagnosis of the particular complication usually depends on when the symptoms appear – that is, whether symptoms occur when the patient is upright or in a prone position, with the head at roughly the same level as the feet.

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Saturday, Apr 13, 2013 AFP
By Arindam Dey

JIRANIA KHOLA, India – A desperate Indian father whose young child suffers from a condition that caused her head to swell up to an enormous size said Saturday he is praying for a “miracle” to save her life.
Eighteen-month-old Roona Begum was diagnosed with hydrocephalus, in which cerebrospinal fluid builds up in the brain, just weeks after her birth in a government-run hospital in remote Tripura state in northeast India.
The potentially fatal illness has caused Roona’s head to swell to a circumference of 91-centimetres (36-inches), putting pressure on her brain.
Her father, Abdul Rahman, 18, who lives in a mud hut with his family in the village of Jirania Khola, told AFP he prays for “a miracle” that will save his only child.
“Day by day, I saw her head growing too big after she was born,” said the illiterate labourer who works in a brick-making factory.
Doctors told him to go to a specialist hospital in a big city such as Kolkata in eastern India to get medical help but Rahman, who earns 150 rupees ($2.75) a day working in the brick plant, said he does not have the money to take her.
“It’s very difficult to watch her in pain. I pray several times a day for a miracle – for something to make my child better,” he said.
The US government’s National Institute of Neurological Disorders and Stroke estimates about one in every 500 children suffers from hydrocephalus.
The most common treatment involves the surgical insertion of a shunt system to drain cerebrospinal fluid away from the brain and towards another part of the body where it can be easily absorbed into the bloodstream.
Cases like Roona’s, where the head has doubled in size in a relatively short span of time, are extremely rare, according to leading Indian neurosurgeon Sandeep Vaishya.
“It’s difficult to assess the situation without seeing the patient, but a surgery, even at this late stage, would give her brain the best chance it has to grow and develop normally,” Vaishya told AFP.
Vaishya, who is the head of neurosurgery at the privately run Fortis flagship hospital in Gurgaon, a satellite city of the national capital Delhi, said that surgeries to treat hydrocephalus cases are “not particularly risky.”
Although the cost differs from case to case, he estimated that a complex surgery like this one would cost about 125,000 rupees ($2,300) and require a three-day hospital stay.
Roona now is confined to her bed and unable to move her head but she is a playful child, quick to smile and giggle and is able to move her limbs, according to her father.
She has outlived an initial prognosis by doctors that she would survive only two months.
But her mother, Fatema Khatun, 25, says the little girl’s health is getting worse and that she urgently needs help.
“She is deteriorating. She eats less and less, vomits often and I can see that she is getting thinner,” Khatun told AFP.

H7N9 can also be spread from pets, it will lie dorment and will not be detected

“In coal mines, miners use birds to detect the presence of poisonous gas, because birds will die first before humans, likewise H7N9 will show up first in birds instead of other animals, but the presence of H7N9 is still there, and everybody is still exposed.” – Contributed by Oogle.

BEIJING — China is investigating four possible cases of human-to-human transmission of a deadly bird flu that has killed 17 people, but so far there has been “no sustained” evidence of transmission between people, the World Health Organization said Thursday.

Three families in Shanghai and two young children in Beijing were being examined as possible examples of human-to-human transmission, Gregory Hartl, the spokesman for W.H.O. in Geneva, said in a telephone interview.

“Even if two family members are positive, it is not necessarily the case they got it from each other,” Mr. Hartl said. “They may have gotten it from the same bird.”

As investigators looked at the possibility of human-to-human transmission, there was mounting concern that the new virus, known as H7N9, may not originate in poultry but in other animals, he said.

To that end, a team of international influenza experts from the agency’s headquarters in Geneva and a regional office in Manila, as well as scientists from the United States Centers for Disease Control and Prevention who were invited by China to help investigate the virus, arrived in Beijing on Thursday. The experts would be looking at possible sources for the virus other than birds, Mr. Hartl said.

A Chinese expert on the disease, Feng Zijian, the director of the health emergency center at the Chinese Center for Disease Control and Prevention, said Wednesday that an estimated 40 percent of people infected with the virus said they never had contact with poultry.

Mr. Hartl concurred with Mr. Feng about that statistic. “It is not clear all cases so far have had contact with poultry,” Mr. Hartl said.

Because it seemed possible that the virus originated in animals other than poultry, the international investigating team would be casting a wide net for possible sources, Mr. Hartl said.

Seventeen people have died since China told the W.H.O. in March of the bird flu outbreak, according to China’s state-run news agency, Xinhua. There were 83 cases of infection, the news agency said.

Even as the international investigators would be seeking other sources of infection, China’s agricultural authorities were insisting the H7N9 virus was still confined to live poultry markets. The news agency said that 47,801 samples had been collected from 1,000 poultry markets, habitats and farms from across China, and that agricultural authorities said that 39 tested positive for H7N9.

Mr. Hartl noted that the percentage of positives was very low.

Early suspicions that pigs might be the carrier of the virus have not been confirmed, Mr. Hartl said. Pigs were tested soon after the outbreak was announced, he said, and there were no positive results.

The Chinese authorities had informed the W.H.O. about three families in Shanghai where more than one person was infected with the virus, Mr. Hartl said. In two, two people were infected, he said, and in the other, three were infected. In that case, an 87-year-old man and his 55-year-old son died, and his other son, 69, was sick, Mr. Hartl said.

The two children infected in Beijing, a boy and a girl, were neighbors and often played together, Mr. Hartl said. It is possible, he said, that they may have picked up the virus from the same infected bird.

In a news conference on Wednesday, Mr. Feng played down the possibility of “effective” human-to-human transmission.

“Effective human-to-human transmission is the case when a disease becomes a human flu virus, as seen in the case of H1N1, where groups of people would be infected at once, such as in schools and communities,” Mr. Feng said. “Effective human-to-human transmission means one patient could infect many and the virus continues to pass on to first, second and third patients. Effective human-to-human transmission has a clear chain of infection.”

The H1N1 virus was a new flu virus strain that caused a worldwide pandemic in humans from June 2009 to August 2010.

There was “currently no evidence showing that H7N9 carries continuous infecting power,” Mr. Feng said.

Mia Li contributed research.

These bird flu cases are re-emergent from dorment, mutated cases which can be as long as 1 year

“Which means you need to trace back as long as 1 year for those areas of infections, to study those who are exposed but show no symptoms, but only show up mutated H7N9 bird flu virus later, monitoring is difficult as bird to bird, then to human transmission happen all the time, but the genetic sequence should leave clues behind.” – Contributed by Oogle.

Five people have died from the new strain of bird flu that’s emerged in eastern China as authorities detected the virus in pigeon samples collected from a marketplace.

Shanghai, China’s financial hub, has reported six of the 14 human cases of the H7N9 strain of avian influenza confirmed by local authorities since the country’s health ministry reported the first cases last month, China’s official Xinhua News Agency reported yesterday.

One of the people who died in Shanghai transported poultry, Xinhua said. There’s no evidence of human-to-human transmission of the virus, the World Health Organization said yesterday in a statement. The extent of the outbreak, the source of infection and the mode of transmission are being investigated, and it’s too early to tell whether the cases may signal a pandemic, according to the WHO.

“How widespread the illness is at this very early stage, we don’t know,” said Alan Hampson, chairman of the Australian Influenza Specialist Group, in an e-mailed statement. “We don’t know whether we’re seeing the tip of the iceberg or whether we’re actually seeing most of the existing cases presenting as severe infection. If it’s the latter then it’s a concern.”

Animal health authorities have intensified their investigations into the possible sources of the virus, the WHO said. The H7N9 strain was detected in pigeon samples collected at a marketplace in Shanghai, Xinhua said, citing China’s Ministry of Agriculture. Officials in Shanghai closed a live poultry trading area and began culling birds there after the test results on the pigeons, Xinhua reported.

New Strain

The new strain of H7N9 hasn’t previously appeared in humans, the WHO said. The virus’s genetic sequence shows it’s a combination of an H7N9 virus that circulates in birds and an H9N2 pathogen, the Stockholm-based European Center for Disease Prevention and Control said in an April 3 report. One of the earliest infections was in a pork butcher, according to the ECDC report.

The flu pandemics of the past century, including the 1918 Spanish flu that killed as many as 50 million people, have all been triggered by the mixing of human and animal flu viruses that create new pathogens to which people have no pre-existing immunity.

The poultry worker who died was a 48-year-old man who had symptoms including coughing and a fever, Xinhua reported. China Central Television reported April 2 that a woman who slaughtered birds at a farmers’ market had contracted the bird-flu strain.

Contacts Monitored

“While poultry and pigs are infected globally with various strains of influenza, and there are isolated cases of human infection by direct contact, usually the disease is mild,” said Jenny McKimm-Breschkin, virology project leader at Commonwealth Scientific and Industrial Research Organization Materials Science and Engineering in Australia, in a statement. “It is more of a concern when those infected are dying or seriously ill as seen with this new virus.”

More than 400 contacts of the infected people are being closely monitored, and none of them have developed any symptoms of illness, the Geneva-based WHO said. Retrospective testing of recently reported cases of severe respiratory infection may uncover additional cases, the United Nations health agency said.

Concerns that the spread of infections may prompt consumers to eat less poultry led soybeans to decline for a second day. Soybean meal is a primary ingredient in chicken feed. The contract for May delivery lost as much as 1 percent to $13.66 a bushel on the Chicago Board of Trade on April 4 at 12:38 p.m. New York time. Futures fell 1 percent April 3.

H5N1 Infections

More than 600 people have been infected with the H5N1 bird flu strain since 2003, and almost 60 percent have died, according to the WHO. Most had direct contact with infected poultry, and the virus hasn’t acquired the ability to spread easily between people.

The H1N1 virus responsible for the 2009 swine flu pandemic originated in pigs, then mixed with human and avian viruses, touching off the first global influenza outbreak in more than 40 years and killing about 284,500 people, according to the U.S. Centers for Disease Control and Prevention.

The new virus is sensitive to Roche Holding AG (ROG)’s Tamiflu and GlaxoSmithKline Plc (GSK)’s Relenza treatments, the WHO said, citing preliminary test results from the WHO Collaborating Centre in China.

To contact the reporters on this story: Simeon Bennett in Geneva at sbennett9@bloomberg.net; Kristen Hallam in London at khallam@bloomberg.net

To contact the editor responsible for this story: Phil Serafino at pserafino@bloomberg.net

One day, there will be no rejection for transplanted cells

“We are coming to the age where every part of our body can be transplanted except the brain, where all kinds of cells can be cultured in the lab, it is the study of the body immunity system that will open the doors to prevent rejection.” – Contributed by Oogle.
Dec. 17, 2012 — How can the immune system be reprogrammed once it goes on the attack against its own body? EPFL scientists retrained T-cells involved in type I diabetes, a common autoimmune disease. Using a modified protein, they precisely targeted the white blood cells (T-lymphocytes, or T-cells) that were attacking pancreatic cells and causing the disease. When tested on laboratory mice, the therapy eliminated all signs of the pathology. This same method could be a very promising avenue for treating multiple sclerosis as well. The scientists have just launched a start-up company, Anokion SA, on the Lausanne campus, and are planning to conduct clinical trials within the next two years.

Their discovery has been published in the journal PNAS (Proceedings of the National Academy of Science).
To retrain the rebellious white blood cells, the researchers began with a relatively simple observation: every day, thousands of our cells die. Each time a cell bites the dust, it sends out a message to the immune system. If the death is caused by trauma, such as an inflammation, the message tends to stimulate white blood cells to become aggressive. But if the cell dies a programmed death at the end of its natural life cycle, it sends out a soothing signal.

In the human body there is a type of cell that dies off en masse, on the order of 200 billion per day — red blood cells. Each of these programmed deaths sends a soothing message to the immune system. The scientists took advantage of this situation, and attached the pancreatic protein targeted by T-cells in type I diabetes to red blood cells.

“Our idea was that by associating the protein under attack to a soothing event, like the programmed death of red blood cells, we would reduce the intensity of the immune response,” explains Jeffrey Hubbell, co-author of the study. To do this, the researchers had to do some clever bioengineering and equip the protein with a tiny, molecular scale hook, that is able to attach itself to a red blood cell. Billions of these were manufactured and then simply injected into the body.

Complete eradication of diabetes symptoms

As these billions of red blood cells died their programmed death, they released two signals: the artificially attached pancreatic protein, and the soothing signal. The association of these two elements, like Pavlov’s dog, who associates the ringing of a bell with a good or bad outcome, essentially retrained the T lymphocytes to stop attacking the pancreatic cells. “It was a total success. We were able to eliminate the immune response in type I diabetes in mice,” explains Hubbell.

Minimizing risks and side effects

Co-author Stephan Kontos adds that the great advantage of this approach is its extreme precision. “Our method carries very little risk and shouldn’t introduce significant side effects, in the sense that we are not targeting the entire immune system, but just the specific kind of T-cells involved in the disease.”

The scientists are planning to conduct clinical trials in 2014, at the earliest. To demonstrate the potential of their method, they plan to first test applications that would counteract the immune response to a drug known for its effectiveness against gout. “We chose to begin with this application before we tackled diabetes or multiple sclerosis, since we knew and were in control of all the parameters,” explains Hubbell.

Currently, the researchers are also testing the potential of this method in treating multiple sclerosis. In this disease, T-cells destroy myelin cells, which form a protective sheath around nerve fibers. They are also studying the potential of their method with another kind of white blood cell, B-lymphocytes, that are involved in many other autoimmune diseases.