COVID-19(18)(19) 中国，イラン，イタリア WHO
● COVID-19(19) 中国，イタリア，イラン WHO
PRO/AH/EDR> COVID-19 update (19): China, global, Italy & Iran. imported cases, WHO
Archive Number: 20200226.7029842
In this update:
[1] 中国: China National Health Commission 26 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:20 p.m. GMT-5]
[3] イラン: 139 cases, 19 deaths
[4] Countries reporting cases ex Iran: (Pakistan, Georgia, Kuwait, Bahrain)
[5] イタリア 400 cases 12 deaths
[6] Countries reporting cases ex Italy: (Romania, Brazil, Greece, Sweden, Norway, Finland)
[7] Selected media reports of transmission outside of mainland China
[8] WHO situation report 37 (as of 26 Feb 2020)
[1] 中国: China National Health Commission 26 Feb 2020
情報源 China National Health Commission [in Chinese] 2020年2月26日
At 04:00 on [26 Feb 2020], 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps reported 433 new confirmed cases and 29 new deaths (26 in Hubei and 1 in Beijing, Heilongjiang, and Henan). 508 new suspected cases were added.
On the same day, 2750 new cases were cured and discharged, ...
As of 24:00 on [26 Feb 2020], according to reports from 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps, there were 43 258 confirmed cases (among which, 8346 were severe cases), 32 495 were cured and discharged, and 2744 died. A total of 78 497 confirmed cases ... 湖北省の感染発生状況など。
［Mod.MPP 注－24時間に 433例の増加があり，中国国内で報告された患者数は a total of 78 497 cases of confirmed COVID-19 となった。死者 29人の報告のうち，26 (89.7%) が湖北省から報告されている]
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE [accessed at 9:20 p.m. GMT-5]
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月26日
Confirmed cases
2 Feb 2020 / ... / 24 Feb 2020 / 25 Feb 2020 / 26 Feb 2020/ Country / Region
17 187 / ... / 77 657 / 77 663 / 78,486 / Mainland China
20 / ... / 159 / 170 / 189 / Japan
15 / ... / 833 / 1146 / 1595 / South Korea
2 / ... / 229 / 322 / 453 / Italy
0 / ... / 61 / 95 / 139 / Iran
0 / ... / 691 / 691 / 705 / Others (Diamond Princess)
Total number of reported deaths: 2800
（中国以外）
Iran: 19
South Korea: 12
Hong Kong: 2
Italy: 12
Diamond Princess: 4
France: 2
Japan: 3
Philippines: 1
Taiwan: 1
Data sources: WHO, CDC, ECDC, NHC, and DXY
［Mod.MPP 注－中国国外の感染者は合計 3666例となり，24時間で 738例の増加があり，うち 449例を韓国が，131例をイタリアが，44例をイランが報告している]
[3] Iran: 139 cases, 19 deaths
情報源 BBC 2020年2月26日
全国にコロナウイルス感染が拡大する中，イランはどの市にも隔離措置を行う予定はないと，大統領が発言した。個人の隔離のみを行うと述べた。当局は Qom, the centre of the outbreak への渡航を控えるよう呼びかけているが，多数のシーア派巡礼者が訪れる寺院は閉じていない。139例の感染と19例の死者が報告され，隣国に対しても多数の患者の感染源になっている。26日にイラン保健省はイラン全国で COVID-19 が確認されていると発表した。しかし，入院または感染疑い患者のうち，24時間ごとに少なくとも 10％ が退院している，と楽観的な見方を示した ...
［Mod.MPP 注－ この 24時間に 44例が増加し，イランで確認されている症例は 95例から 139例となった。また死者数も 16例から 19例に 3例増加している]
[4] Countries reporting cases ex Iran: (パキスタン，ジョージア，クウェート，バーレーン)
A. Pakistan (Islamabad, Karachi)
情報源 Dawn 2020年2月26日
保健当局者 Special Assistant to Prime Minister on Health が，パキスタン国内初の 2例の感染例が確認されたと，26日ツイッターに投稿した。1例は Sindh, 2例目は "federal areas" で確認されたと述べ，過去 2週間以内にイランへの渡航歴があるとしたが，詳細は明らかにされていない ... イランへの渡航歴のある 22歳男性 ... 20日，イランからカラチ Karachi へ空路で到着し，イラン滞在時から症状のあった男性とその家族は隔離され，26日に検査で陽性と確認された。2例目の症例についての情報は明らかにされていない。
B. Georgia
情報源 GHN news [Georgian News Agency) [in Georgian] 2020年2月26日
ジョージア初のコロナウイルス感染例が報告されたと，保健相 Georgia's Health Minister が明らかにした。イランからアゼルバイジャンを経由してジョージアに帰国した，50歳のジョージア人男性で，感染症病院で感染が確認された。状態は落ち着いている。症状が認められていたため，病院に直行したと説明されている。
C. Kuwait 25 cases
情報源 Gulf News 2020年2月26日
26日に新たに 13例の感染が確認され，クウェート国内の感染者数は 25人となった。新たに確認された患者はすべてイランを訪れていた，と保健省が明らかにした。患者らの状態は安定しているとされている ...
D Bahrain 33 total cases
情報源 Arab Times 2020年2月26日
バーレーン保健省は 26日，新たに 7例の患者を報告し，国内の患者数は合計 33例となった。7人はいずれも最近イランから到着していた。イランからの入国・帰国者はウイルスを保有し家族などへの感染源となる疑いがあるので，ただちに定められた番号に電話するよう呼びかけた。
地図 A good map of the region showing the countries and their locations with respect to Iran
[5] Italy 400 cases 12 deaths
情報源 Italian Government Health Ministry 2020年2月26日
イタリアの the new SARS-CoV-2 coronavirus 感染者は 400人となり，3人が治癒している。26日18時現在の公式の数字である。128人は症状があり入院中で，うち 36人が集中治療を受けており，一方 221人は自宅待機となっている。これまでに 8600検体以上の検査を行った。
地域別の発生状況
- Lombardy Region: 258
- Veneto Region: 71
- Emilia Romagna Region: 47
- Piedmont Region: 3
- Lazio: 3 (the 2 Chinese tourists and the researcher repatriated from Wuhan)
- Tuscany: 2
- Sicily: 3
- Liguria: 11
- Marche: 1
- Autonomous Province of Bolzano: 1
［Mod.MPP 注－25日の感染 322例と死者 10例から，現在は 400例と 12例となった。新たにマルケ Le Marche 州でも確認されている]
[6] Countries reporting cases ex Italy: (Romania, Brazil, Norway, Greece)
A. Romania
情報源 Antena 3 2020年2月26日
ルーマニア初の感染例が発表された。ルーマニア国内でイタリア人と接触のあった，Gorj 出身者だった。the Matei Bals Institute におけるウイルス診断検査で陽性が確認された，the Gorj group の患者である，と the Secretary of State in the Ministry of Health から説明されている。このイタリア人は 4日間ルーマニアを旅行し，コロナウイルスに感染しており，Rimini [Italy] の病院に入院した。(ルーマニア人の）71歳のこの患者に発熱は認められていない。認められていない。
［Mod.MPP 注－20200226.7026481 に記載があった，ルーマニアで妻の親類と過ごした後，クロアチアで感染が確認されたイタリア人とは別のようだ]
B. Brazil Sao Paulo confirmed
情報源 B news [in Portuguese] 2020年2月26日
州知事 the governor of Sao Paulo state が the 1st case of coronavirus in Sao Paulo でかつブラジル初の感染例について述べた。 the Albert Einstein Hospital と確認のための the reference lab at the Adolfo Lutz Institute での検査で確定された。2月9日から21日までイタリア北部を旅行したブラジル人男性で，咳などの軽い症状のため，自宅で隔離されている
［Mod.MPP 注－イタリアおよび他の欧州諸国から頻繁な渡航がある国はアルゼンチンで，イタリア系子孫が多く住んでいる］
C. Greece
情報源 CNN Greece [in Greek] 2020年2月26日
26日，専門医 the infectious disease specialist が，ウイルス肺炎を発症した 38-year-old woman from Thessaloniki について明らかにした。イタリア北部を旅行していたが，現在は in good health で他の健康上の問題はない。AHEPA Hospital in Thessaloniki 病院特別病棟で治療中の女性自身に加え，他の家族らは自宅隔離を行っている ...
D. North Macedonia
情報源 Novinite Sofia News Agency 2020年2月26日
北マケドニア初の感染例 The 1st case of a coronavirus in northern Macedonia が確認された。1970年 Skopje で生まれたこの人物はイタリアに 1か月間滞在していた。the Infectious Diseases Clinic の隔離病棟に入院中で，2週間症状が続いており，イタリアの医療施設で検査を受けていた。北マケドニアに帰国後そのまま the Infectious Diseases Clinic in Skopje を受診している
E. Croatia
情報源 Vecernji [in Croatian] 2020年2月26日
クロアチアで 3人がコロナウイルスに感染した；2 in Zagreb and one in Rijeka 。1例目はミラノで the Champions League match 観戦した若年男性。21日は就業し，23日に発病し the Infectious Diseases Clinic "Dr. Fran Mihaljevic."に入院中。双子の兄弟も観戦していた。2人の健康状態は良好。26日，Rijeka で入院中の 3例目の感染が確定した。
F. Sweden
情報源 Goteborgs-Posten [in Swedish] 2020年2月26日
新型コロナウイルス検査が陽性となり，30歳の男性が the Eastern Hospital, Sahlgrenska University Hospital, in Gothenburg で治療を受けている。男性はイタリア北部を旅行し，先週 Gothenburg に戻っていた。スウェーデンに帰国して 3日後に発熱と呼吸器の症状を発症した。25日に感染症クリニックを受診し検査が行われ，26日に陽性であることが判明した。イタリアで感染したものとみられている。
G. Finland
情報源 Ilta Sanomat [in Finnish] 2020年2月26日
HUS, the hospital district of Helsinki and Uusimaa 保健当局によると，フィンランド初の感染例が 26日確認された。イタリア北部のミラノで感染した。フィンランド人の就労世代の女性で，入院して治療を受けており，発熱はみられるが状態は良好とされている。
[7] Selected media reports of transmission outside of mainland China
A. South Korea: 1261 total cases, 12 deaths
Official report from KCDC
情報源 Ministry of Health and Welfare, Korean CDC [in Korean] 2020年2月26日
25 Feb 2020 16:00 (4:00 PM) KT 977 confirmed cases, 10 deaths
26 Feb 2020 9:00 AM KT 1146 confirmed cases, 11 deaths
26 Feb 2020 16:00 (4:00 PM) KT 1261 confirmed cases, 12 deaths
Change: 115 newly confirmed infections; 2 new deaths from 25 Feb 2020 reported cases, among previously confirmed case
地域別の発生状況
Seoul 49
Busan 58
Dae-gu 710
Gyeonggi 51
Gyeongbuk 317 ...
Total: 1261
［Mod.MPP 注－ ... Dae-gu province and Gyeongbuk provinces が the highest number of cases, 710 and 317 respectively を報告している。Dae-gu は周りを Gyeongbuk province に囲まれた，中東部の都市で the epicenter of this ongoing outbreak となっている]
B. Korea USA and Korean military
情報源 AP news 2020年2月26日
韓国軍内で新たな感染が発表され，20 cases on its bases and some 9570 people in isolation となっている ...
C. Japan total 186 cases
情報源 Taro Kono [in Japanese] 2020年2月26日
２月26日、新型コロナウイルス感染症の20名及び無症状病原体保有者２名が報告されました。国内感染者は186名（うち無症状病原体保有者19名）となりました。
D. Norway ex China
情報源 VG 2020年2月26日
26日夕，the Public Health Institute (FHI) によると，ノルウェー北部在住の感染者は健康で症状は現れていない。弱い陽性反応で，感染リスクはきわめて低いと考えられている。中国のアウトブレイク発生地域に滞在し，今週末に帰国した。
E. USA (CA) no known exposure
情報源 5KPIX, CBS SF Bay Area 2020年2月26日
This would be the 1st case in the state not associated with the Diamond Princess cruise ship or with someone who had returned to Northern California from visiting China ...
Solano County において 26日，感染源不明の新型コロナウイルス感染例が診断され，現在 Sacramento County で治療を受けている ...
[8] WHO Situation Report 37 (as of 26 Feb 2020*)
情報源 World Health Organization 2020年2月26日
Highlights
- Four new Member States (Algeria, Austria, Croatia, and Switzerland) reported cases of COVID-19 in the past 24 hours. Algeria is the 1st Member State of the AFRO Region to report a case of COVID-19.
- 初めて，中国国外からの報告数が中国国内を上回った。 ...
関連項目
COVID-19 update (18): China, global, Iran, Italy imported cases, WHO 20200226.7026481
● エボラ(11) コンゴ(民)
PRO/AH/EDR> Ebola update (11): Congo DR (NK, IT) cases, summary, vaccine
Archive Number: 20200226.7028853
In this update:
[1] Case updates
- CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) update 25 Feb 2020，24 Feb 2020
[2] Summaries
- CIDRAP (Center for Infectious Disease Research and Policy) News Scan for 24 Feb 2020
[3] Vaccine
[1] Case updates
- Tue 25 Feb 2020. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) [in French]
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 24 Feb 2020:
Since the start of the epidemic, the cumulative number of cases has been 3444, of which 3310 have been confirmed and 134 are probable. In total, there were 2264 deaths (2130 confirmed and 134 probable) and 1167 winners (people healed, or survivors);
- No new confirmed cases ...
[WHO AFRO dashboard]
- Mon 24 Feb 2020. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) [in French]
News
Interception of a suspect contact from Beni at the Loya checkpoint in Komanda
- A contact from Beni who became a suspected case of Ebola virus disease [EVD] was intercepted at the Loya checkpoint in Mandima in Ituri;
- The contact is a 43-year-old woman on the 25th day of follow-up with an unknown vaccination status;
- She became symptomatic on the 21st day, 19 Feb 2020, with signs like fever, physical asthenia, and muscle and joint pain;
- She was sent to the Komanda ETC.
Description of probable cases of 22 Feb 2020
1. Province of Ituri
Mandima:
- The 1st case of Mandima in Ituri is a 4-year-old boy, who died on 10 Jun 2019, untreated and unvaccinated, from the Mayuano health area. He was listed as the contact of his co-patient, probable case, who died on 3 Jun 2019 at the Dubai Health Station, where the child was cared for malaria during the period from 31 May-3 Jun 2019; 35 people were listed as contact around this case;
- The 2nd case is a 66-year-old man. He is the grandfather of the previous case. He died on 25 Jun 2019 in the Mayuano health area. He was listed as the contact of his grandson, probable case, who died on 10 Jun 2019 without saliva collection or a dignified and secure burial. This man was untreated and unvaccinated;
- The 3rd case is the son of the previous case. This is a 40-year-old man, who died on 6 Jul 2019 in Mayuano. He was unlisted and unvaccinated;
- The 4th case of Mandima was a 13-year-old girl who died on 17 Aug 2019 at home in the Lwemba health area. The alert was launched the same day, but her family refused to have her brought to the CTE. This girl, not listed as a contact and not vaccinated, was co-patient of her nephew, who died on 5 Jul 2019 in Lwemba, confirmed on 6 Aug 2019 at PS Saint Marc.
Mambasa:
- The case of Mambasa is a 28-year-old woman, who died on 3 Sep 2019 in the Salama health area. The alert was launched on 30 Aug 2019 by the health structure. Not listed as a contact and not vaccinated, she was investigated and validated in the Ebola case, but refused to be transferred to the CTE. Her care was confirmed MVE [EVD (in French, maladie a virus Ebola] on 9 Sep 2019.
2. Province of North Kivu
Alimbongo:
- This is a 2-year-old boy who died on 17 Aug 2019 in Masika health area and listed as contact with his mother, who died on 9 Aug 2019 in Kayna and confirmed on 11 Aug 2019. This child was never seen and not vaccinated. His father, who had accompanied him with 6 other children to avoid the response team, was confirmed as EVD on 20 Aug 2019; 12 people were listed as contact around this child.
Kayna:
- The case is a 40-year-old man, uncle of the previous man, who died on 20 Aug 2019 in the Butsiri health area. He had participated in the funeral of his cousin (mother of the previous case), who died on 9 Aug 2019 in Kayna and was confirmed on 11 Aug 2019. Three other members of his family were confirmed EVD, including his daughter on 20 Aug 2019 and his wife and brother on 25 Aug 2019; 56 people have been listed as high-risk contacts around this case.
Katwa:
- A 21-year-old woman who died on 27 Apr 2019 in the Kambuli health area. She was not listed as a contact and not vaccinated. Before the start of signs [symptoms], this woman was subject to exposure to her deceased mother-in-law and brother-in-law, who were confirmed in Kalunguta on 11 and 17 Apr 2019, respectively; after the start of [her] signs, 2 co-patients at the Vimbao health post died and were confirmed MVE. Three high-risk contacts have been listed around this case.
Manguredjipa:
- This is a 35-year-old woman, not listed as contact and not vaccinated, who died on 3 Jun 2019 in the Akwele health area. Her 6-month-old breastfed infant was confirmed EVD on 8 Jun 2019; 7 people were listed as contacts around this case.
Butembo:
- This is a 6-month-old infant, who died in the Vutetse health area, not listed as a contact and not vaccinated. He was a co-patient of a confirmed case on 16 Nov 2019 hospitalized at the Apostle Paul Pediatric Health Center in Vutetse from 7-14 Nov 2019. The infant was taken care of there from 3-10 Nov [2019]. After the start of signs, his parents were confirmed EVD, including the mother on 22 Nov and father on 24 Nov [2019], as well as 2 other members of his family who had taken care of him during his illness.
Kalunguta:
- This is a 7-month-old infant, untreated and unvaccinated, who died on 19 Feb 2019 in the Mbilinga health area. He was listed as his mother's contact, confirmed and deceased on 9 Feb 2019; 23 people were listed as contacts around this case.
[2] Summary
- Mon 24 Feb 2020. News Scan [CIDRAP (Center for Infectious Disease Research and Policy)]
After additions of what might be retrospective cases, the World Health Organization's (WHO's) online Ebola dashboard shows a case count of 3444 today [24 Feb 2020], which represents 11 more cases than the total reported at the end of last week. The death toll now stands at 2264 in an outbreak that has lasted 18 months in the eastern region of the Democratic Republic of the Congo (DRC).
In a new study published in Vaccine, researchers found that Ebola patients in the DRC who had received rVSV-ZEBOV prior to their infections had lower viral loads and better outcomes than unvaccinated Ebola patients. The study compared 44 patients vaccinated prior to admission to Ebola treatment centers in Butembo and Katwa from January through March of 2019 with 213 unvaccinated patients.
Ten (23%) of 44 vaccinated patients died, compared with 117 (55%) of 213 unvaccinated patients (odds ratio 0.24; 95% confidence interval 0.11 to 0.51, P less than 0.001), the study found. The vaccinated patients were also less likely to suffer kidney damage.
--
Communicated by:
Mary Marshall
<mjm2020@googlemail.com>
******
[3] Vaccine
- Fri 21 Feb 2020 [Vaccine]
Citation: Kasereka MC et al.: Prior vaccination with recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus vaccine is associated with improved survival among patients with Ebolavirus infection. Vaccine. 21 Feb 2020. doi: https://doi.org/10.1016/j.vaccine.2020.02.044.
Abstract.
The 2nd-largest Ebola virus disease (EVD) outbreak ever recorded is currently ongoing in eastern Democratic Republic of the Congo (DRC). This is the 1st outbreak for which the recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus (rVSV-ZEBOV) candidate vaccine has been widely administered, using a ring vaccination strategy. We examined whether prior vaccination with rVSV-ZEBOV impacts viral load, organ impairment, and survival among patients with EVD admitted to Ebola treatment units (ETUs) in the DRC. We conducted a retrospective observational study of patients admitted to the ETUs in Butembo and Katwa, eastern DRC, between 30 Mar and 10 Aug 2019. We included 257 patients, of whom 44 had been vaccinated prior to admission and 213 were unvaccinated. Vaccinated patients were admitted to the hospital sooner than unvaccinated patients (median 2 days (IQR 1.8-4) versus 4 days (IQR 3-6), p less than 0.001). Vaccinated patients had a lower viral load at admission compared to those who were unvaccinated: 6.0 log10 cp/mL (IQR 5.0-7.1) versus 6.9 log10 cp/mL (IQR 5.4-7.6), p = 0.017. In a longitudinal analysis of daily viral load measurements, vaccinated patients had an overall viremia 1.32 log10 cp/mL (95% CI 0.58-2.1) lower than unvaccinated patients over the course of their infection. Acute kidney injury at admission was less common in vaccinated patients: OR 0.44 (95% CI 0.20-0.94), p = 0.027. Mortality in vaccinated patients was 10/44 (23%) compared to 117/213 (55%) unvaccinated patients (OR 0.24, 95% CI 0.11-0.51, p less than 0.001). In conclusion, prior rVSV-ZEBOV vaccination was associated with reduced severity of infection and improved survival among patients with confirmed EVD treated at ETUs in eastern DRC. These findings support the efficacy of the rVSV-ZEBOV vaccine in modulating EVD severity.
関連項目
Ebola update (10): Congo DR (NK, IT) cases, summaries, WHO 20200221.7012106
● ペスト－コンゴ(民)(02) 腺ペスト，肺ペスト 死亡
PRO/AH/EDR> Plague - Congo DR (02): (IT) bubonic, pneumonic, fatal
Archive Number: 20200226.7028683
投稿者 米国・EcoHealth Alliance, Anne Laudisoit 2020年2月26日
[1] Bubonic plague investigation - RFI
On 22 Feb 2020, the Aungba Health Zone chief medical doctor was alerted that suspect bubonic plague cases were reported in the Ugunzu-Makangi village of the Aterlembe health area, Djugu territory, Ituri Province, DR Congo. Murine epizootics were also mentioned in the Makangi village. On 23 Feb 2020, the chief medical doctor of the Aungba health Zone (Lat 2 33' 00'' Long 30 30' 00'') was appointed to visit the health center of Aterlembe for 2 days to investigate suspect bubonic plague cases. The head doctor Dr Delphonse Unen Ali reported on the same day (23 Feb 2020) on the outbreak. The nurse of the Aterlembe health center notified 2 suspected cases of bubonic plague. He reported that the index cases were 2 family members who presented with fever, headache, and painful buboes on 22 Feb 2020 at 2 health centers. After self-medicating for 6 days (16-22 Feb 2020), they consulted as ambulatory patients the Kpese health post and then the Yuku health center, both in the Aru health zone. A 2-year-old boy died on 21 Feb 2020 with symptoms consistent with that of bubonic plague (fever, painful buboes), the 2nd patient -- the 12 year old brother of the co-primary case -- tested positive for plague with the RDT [rapid diagnostic test] and is recovering. He presented with fever, painful buboes, and headaches. So far 16 contacts have been traced and treated with doxycycline, 27 households were dusted.
[2] Pneumonic plague - follow up to: 20200225.7026580
Between 19 Feb 2020 and 25 Feb 2020, the health area of Godjoka has experienced an outbreak of suspected pneumonic plague. Symptoms reported were headache, painful cough, dyspnea, hemoptysis, and diarrhea lasting 3 days followed by death. On 25 Feb 2020, the traditional healer's body, positive for plague with the rapid diagnostic test, was transported by relatives to a small locality near Kpandruma (Lat. 2° 03' 15.3" Long. 30° 50' 58.2", alt 2804m) in the Rethy Health Zone, Djugu territory, Ituri Province DR Congo. She was buried there. The transport by relatives increases the risk of plague spread to relatives and mourning villagers. It should be noted that the city of Kpandruma is the major commercial center of the region . On 25 Feb 2020, the intervention team treated over 300 contacts with doxycycline, and disinfected the houses where the bodies were laid prior to burial. Children under 10 years old and pregnant women have received cotrimoxazole [trimethoprim/sulfamethoxazole] on the morning of 26 Feb 2020.
［Mod.LL 注－
The bacterium that causes plague is _Yersinia pestis_. Most cases of plague are due to bubonic plague following the bite of an infected rodent flea causing a swollen and very tender lymph gland. The swollen gland is called a "bubo." Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2-6 days after being bitten. At this point in the illness, there is no risk of person-to-person spread, so if this was indeed a case of bubonic plague, no isolation or quarantine is necessary.
When bubonic plague is left untreated, plague bacteria invade the bloodstream. As the plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition. Infection of the lungs with the plague bacterium causes the pneumonic form of plague, a severe respiratory illness. The infected person may experience high fever, chills, cough, and breathing difficulty and may produce bloody sputum. If plague patients are not given specific antimicrobial therapy, the disease can progress rapidly to death. At this stage, as appears to have happened in this case, person-to-person spread can occur, causing other cases of "primary" plague pneumonia.
Patients with primary pneumonic plague generate large quantities of infectious aerosols that pose a significant risk to close contacts.
CDC (US Centers for Disease Control and Prevention) guidelines identify contacts within 2 meters (6.5 ft) as being at greatest risk and do not consider the organism likely to be carried through air ducts or vents. Persons who have been in contact with pneumonic plague patients or handling potentially infectious body fluids or tissues without appropriate protection should receive preventive antimicrobial therapy. The preferred antimicrobial agents for prophylaxis include tetracyclines and fluoroquinolones. - Mod.LL
関連項目
Plague - Congo DR: (IT) pneumonic, fatal, susp, RFI 20200225.7026580
● COVID-19(18) 中国，イラン，イタリア WHO
PRO/AH/EDR> COVID-19 update (18): China, global, Iran, Italy imported cases, WHO
Archive Number: 20200226.7026481
In this update:
[1] 中国: China National Health Commission 25 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:50 p.m. GMT-5]
[3] イラン: 95 cases, 16 deaths
[4] Countries reporting cases ex Iran: (Kuwait, Bahrain, Oman, Iraq, Afghanistan)
[5] イタリア 322 cases 10 deaths
[6] Countries reporting cases ex Italy: (Romania, Austria, Switzerland, Algeria)
[7] Selected media reports of transmission outside of mainland China
[8] WHO situation report 36 (as of 25 Feb 2020)
[1] 中国
情報源 China National Health Commission [in Chinese, URL なし]
At 04:00 on [25 Feb 2020], 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 406 new confirmed cases, 52 new deaths (52 in Hubei), and 439 new suspected cases.
On the same day, 2422 cases were cured and discharged, 14 573 were close contacts of those under medical observation, and 374 severe cases were reduced.
As of 24:00 on [25 Feb 2020], according to reports from 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps, there were 45 604 confirmed cases (among which, 8552 were severe cases), 29 745 were cured and discharged, and 2715 had died. A total of 78 064 confirmed cases were reported ...
There were * 401 newly confirmed cases in Hubei (370 in Wuhan) ...
［Mod.MPP 注－過去24時間に中国国内で 914 cases の増加があった；* the stated increase of 406 in the past 24 hours の記載については説明できない]
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE [accessed at 9:0 p.m. GMT-5]
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月25日
Confirmed cases
2 Feb 2020 / ... / 23/ 24/ 25 Feb 2020 / Country / Region
17 187 / ... / 76 944 / 77 657 / 77 663 Mainland China
20 / ... / 147 / 159 / 170 / Japan
15 ... / 602 / 833 / 1146 / South Korea
2 / ... / 155 / 229 / 322 / Italy
0 / ... / 43 / 61 / 95 / Iran
0 / 0 ... / 691 / 691 / 691 / Others (Diamond Princess)
Total number of reported deaths: 2708
Iran: 16
South Korea: 10
Italy: 10
Diamond Princess: 3
Japan: 1
Data sources: WHO, CDC, ECDC, NHC, and DXY
［Mod.MPP 注－中国国外で，合計 2928例が確認。過去 24時間に 510例が報告され，韓国は 313例，イタリアは 93例を報告している ... ]
[3] Iran: 95 cases, 16 deaths
情報源 Arab News 2020年2月24日
イラン国内で新たに 2例の感染者が死亡し，合計の死者数が 16人となったと，25日保健省当局者が明らかにした。イランの死者数は，中国を除き最も多い。感染が疑われた症例の中から，35例の感染と 2例の死亡が確認されたと，保健省広報担当者が述べた。イラン全土で 95人の感染が確認されている。保健省は国民に対し，自宅に留まるよう要請している。先週 Qom で初めての死亡例 2例が確認されたが，いまだに何人が隔離措置を受けているかは明らかにされていない。半政府系メディアは 320人が入院中と伝えている。保健副大臣もコロナウイルス検査で陽性となり，現在隔離されている。アラブの 6か国が初の感染例を報告したが，すべてイランと関係していた。クウェートの感染者数は 8例に達している。バーレーン保健省も，イランから Dubai and Sharjah 経由で帰国した，サウジアラビア人女性 6名を含む，新たに 15例が検査で陽性と確認されたと発表した ... イタリアと日本への渡航を控えるよう市民に呼びかけられている。
［Mod.MPP 注－ 24時間に 34例が新たに確認され，イラン国内の感染者は 61例から 95例に増えた。死者の数も，12人から 4人増え，16人となった ... ]
地図； Qom is located to the southwest of Tehran in central Iran.
[4] Countries reporting cases ex Iran: (クウェート，バーレーン，オマーン，イラク)
A Kuwait 4 new cases
情報源 Anadolu Agency 2020年2月25日
25日，クウェートで新たに 4例の感染が確認され，合計患者数は 9人となった。すでに隔離措置されている，イランからの渡航者の間で感染が確認された，と保健省が明らかにした。
B Bahrain 9 new cases
情報源 Khaleej Times 2020年2月25日
保健省は，Dubai and Sharjah 経由でバーレーン国際空港に到着したバーレーンおよびサウジアラビア国民の，新たな 9例の感染を確認し，国内の感染者数は 17例となった。必要なすべての検査が行われ，空港の隔離ゾーンに留め置いた後，the Ebrahim Khalil Kanoo Community Health Center in Al Salmaniya に移して治療していると述べ，具体的には，4 female Bahraini nationals arriving from Iran, via Sharjah, and 3 male Bahraini nationals arriving from Iran (2 arriving via Sharjah and 1 arriving via Dubai), and 2 female Saudi nationals arriving from Iran, via Sharjah と説明されている。
C. Oman - 2 new cases
情報源 Times of Oman and Mod. EP 2020年2月25日
新たに 2例が確認されたと，保健省が明らかにした。イランへの旅行者と説明されている。国内の感染者数は 4例となった。
D. Iraq 4 new cases
情報源 BBC 2020年2月25日
隣国イランを訪問後イラクに帰国した 4人家族が，コロナウイルス検査で陽性になったと報じられている。Kirkuk において検疫下にある ... 24日，イラク初の感染例が報告されており，an Iranian theology student in the city of Najaf だった。
地図 A good map of the region showing the countries and their locations with respect to Iran
[5] Italy 322 cases 10 deaths
情報源 Italian Government Health Ministry 2020年2月25日
イタリア国内で 322人が the new SARS-CoV-2 coronavirus に感染し，うち 10人が死亡，1人が治癒回復した。2月25日18時に開かれた防災庁官 the Commissioner for the emergency of civil protection, Angelo Borrelli の会見で，公式の数字として示された。114人に症状がみられ入院中; 35人は集中治療室に収容された, 一方 162人が自宅待機となっている。これまでに 8600件を超える検体スワブが行われた。
各地域の発生状況は，以下のとおり:
- Lombardy Region: 240
- Veneto Region: 43
- Emilia Romagna Region: 26
- Piedmont Region: 3
- Lazio: 3 (the 2 Chinese tourists and the resigned researcher)
- Tuscany: 2
- Sicily: 3
- Liguria: 1
- Autonomous Province of Bolzano: 1
［Mod.MPP 注－感染者数の総計は現在 322人で，うち 10人が死亡。昨日 24日は，220例と死者 7例だった。発生地域リストでは，新たに南部シチリア島が加わった。アウトブレイクの中心地であるロンバルディア Lombardy を観光で訪れていた。8600件以上の検体が採取されたというのは衝撃的で，多くは接触者追跡調査のためである。検体の検査が進めば，さらに陽性例が増えるだろう。イタリアは，他の欧州諸国から人気の旅行先で，ロンバルディは商業ハブでもある。加えて，イタリア人は身が軽く，欧州中を旅行している。[6] がその証左である]
[6] Countries reporting cases ex Italy: (クロアチア，オーストリア，スイス，アルジェリア，スペイン，ブラジル)
A. Croatia
情報源 BBC 2020年2月25日
- The 1st case of coronavirus infection in Croatia が報告された。
- 2月19日から 20日までミラノに滞在した若年男性で，軽い症状で Zagreb に入院している。
［Mod.MPP 注－ちなみに，この患者がクロアチアを訪れる前にルーマニアにも滞在していたとして，ルーマニアも警戒態勢にあるとのレポートがある。ルーマニア滞在中，この男性は妻の親類と過ごしており，いくつかの会議にも出席していた]
B. Austria
情報源 BBC 2020年2月25日
オーストリアアルプスのホテルは，レセプションで勤務していたイタリア人のウイルス感染が判明し，閉鎖されている。ホテル名は明らかにされていないが，インスブルック The Alpine city of Innsbruck 市とされている。内務相は "ホテル内に他の感染者がいないか確かめるため，誰もホテルから出たり入ったりしていない" と説明している... Innsbruck は州都 the capital of the state of Tyrol でイタリアと国境で接している ... 感染のあったこの女性の自宅も検疫下にある。先週，いずれも 24歳の女性とパートナーはともに，イタリア/ロンバルディ州の自宅から車で Innsbruck を訪れていた [* travelled to Innsbruck by car from their home in Lombardy, Italy last week.; 自宅と旅行先が逆では ?] 。イタリアでは欧州最悪の被害が発生している。
C. Switzerland
情報源 Swiss Info 2020年2月25日
スイス初のコロナウイルス感染例が，25日にイタリアとの国境にある南部 canton Ticino で確認された ... 保健当局The Federal Office of Public Health によると，70歳代男性で 2月15日にミラノ the Milan region of Italy のイベントに参加した際に感染し 2日後に発症した。その後は家族とともに過ごし，現在は a clinic in Lugano, canton Ticino に隔離されているものの，健康とされている ... スイス国内ではこれまでに約 300例の疑い症例 suspected cases of COVID-19 に対し検査が行われているが，感染が確認された症例はない。cantons Bern and Basel の複数の患者を含め，全国の疑い例が検査されているが，canton Ticinon で検査されている症例はごく少数で，数時間以内に検査結果が判明すると，当局者が説明した ...
D. Algeria
情報源 Morocco World News 2020年2月25日
政府系メディアによると，アルジェリア国内初となる，2月17日にアルジェリアに到着したイタリア人男性 1名の，the 1st case in Algeria of the novel coronavirus "Covid-19" が確認された。保健相は，イタリア人男性 2名のうち，症状のあるのは 1名のみと説明している。
E. Spain
情報源 El Diario [in Spanish] 2020年2月25日
保健当局 The Government Department of Health は 25日，初めての感染例 the 1st positive sample for coronavirus が Catalunya で確認されたと明らかにした。バルセロナ Barcelona 在住のイタリア人女性で，the Clinic Hospital, reference center for contagious diseases 病院に入院中である。2月12日から 22日までの間，母国であるイタリア北部 the Lombardy Region を旅行していた。24日夜に自ら the Clinic を受診し，疫学情報と微生物検査が行われた。the Canary and Balearic Islands で 4例が確認されているが，イベリア半島で検査陽性となった初めての症例である。第 1例目は 1月に La Gomera で確認されすでに退院しており，2例目は Mallorca 在住の英国人だった。す火円で報告された最新の陽性例はイタリア人医師とその妻で，現在 the National Microbiology Center での二次検査の結果を待っている。これらの患者が確認され，滞在先ホテルの宿泊客らも管理されている。
F. Brazil (Sao Paolo)
情報源 O Globo [in Portuguese] 2020年2月25日
サンパウロ Sao Paulo で感染が疑われる患者の保健省による調査が行われている。二次確認検査の結果が待たれており，26日朝判明の予定である。この the capital of Sao Paolo 在住の 61歳男性は，2月9日から 21日までイタリアを旅行していた。the Albert Einstein Hospital での一次検査が陽性であったため，a 2nd confirmation by the Adolfo Lutz Institute が行われた。咳などの軽い症状が認められている。2週間，呼吸器隔離室に収容される予定で，すべての接触者の追跡が行われる。
［Mod.MPP 注－Brazil, and especially Sao Paulo (and Rio de Janeiro) と欧州各国との間の頻繁な往来があるとすれば，注意が必要。今回の症例が除外されたとしても，(ブラジル国内で) 確定診断例が出るのは時間の問題である ... ]
[7] Selected media reports of transmission outside of mainland China
A. Japanese cruise ship: Australia
投稿者 豪・Allen Cheng １，2 2020年2月24日
... there have now been 7 cases among the 164 repatriated Australians from the Diamond Princess.
B. South Korea: 977 total cases, 10 deaths，Official report from KCDC
情報源 Ministry of Health and Welfare, Korean CDC [in Korean] 2020年2月25日
Data taken from a table on the website of the Korean MOHW (Ministry of Health and Welfare).
24 Feb 2020 9:00 AM KT 893 confirmed cases, 8 deaths
24 Feb 2020 16:00 (4:00 PM) KT 977 confirmed cases, 10 deaths
24日以降，新たに 84例の感染と，2例(既知の症例，1951年生女性と1962年生男性)の死亡。
新たな 84例に関する情報(No information on association with the Sincheon Earth Church)
Seoul (4): Busan (5), Dae-gu (44), Ulsan (1), Gyeonggi (2), Gyeongbuk (23), Chungbuk (2), Chungnam (1)
[8] WHO Situation Report 36 (as of 25 Feb 2020*)
情報源 World Health Organization 2020年2月25日
Highlights
- Four new Member States (Afghanistan, Bahrain, Iraq, and Oman) reported cases of COVID-19 in the past 24 hours.
関連項目
COVID-19 update (17): China, animal reservoir, wildlife trade & consumption ban 20200225.7024245
● COVID-19(19) 中国，イタリア，イラン WHO
PRO/AH/EDR> COVID-19 update (19): China, global, Italy & Iran. imported cases, WHO
Archive Number: 20200226.7029842
In this update:
[1] 中国: China National Health Commission 26 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:20 p.m. GMT-5]
[3] イラン: 139 cases, 19 deaths
[4] Countries reporting cases ex Iran: (Pakistan, Georgia, Kuwait, Bahrain)
[5] イタリア 400 cases 12 deaths
[6] Countries reporting cases ex Italy: (Romania, Brazil, Greece, Sweden, Norway, Finland)
[7] Selected media reports of transmission outside of mainland China
[8] WHO situation report 37 (as of 26 Feb 2020)
[1] 中国: China National Health Commission 26 Feb 2020
情報源 China National Health Commission [in Chinese] 2020年2月26日
At 04:00 on [26 Feb 2020], 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps reported 433 new confirmed cases and 29 new deaths (26 in Hubei and 1 in Beijing, Heilongjiang, and Henan). 508 new suspected cases were added.
On the same day, 2750 new cases were cured and discharged, ...
As of 24:00 on [26 Feb 2020], according to reports from 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps, there were 43 258 confirmed cases (among which, 8346 were severe cases), 32 495 were cured and discharged, and 2744 died. A total of 78 497 confirmed cases ... 湖北省の感染発生状況など。
［Mod.MPP 注－24時間に 433例の増加があり，中国国内で報告された患者数は a total of 78 497 cases of confirmed COVID-19 となった。死者 29人の報告のうち，26 (89.7%) が湖北省から報告されている]
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE [accessed at 9:20 p.m. GMT-5]
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月26日
Confirmed cases
2 Feb 2020 / ... / 24 Feb 2020 / 25 Feb 2020 / 26 Feb 2020/ Country / Region
17 187 / ... / 77 657 / 77 663 / 78,486 / Mainland China
20 / ... / 159 / 170 / 189 / Japan
15 / ... / 833 / 1146 / 1595 / South Korea
2 / ... / 229 / 322 / 453 / Italy
0 / ... / 61 / 95 / 139 / Iran
0 / ... / 691 / 691 / 705 / Others (Diamond Princess)
Total number of reported deaths: 2800
（中国以外）
Iran: 19
South Korea: 12
Hong Kong: 2
Italy: 12
Diamond Princess: 4
France: 2
Japan: 3
Philippines: 1
Taiwan: 1
Data sources: WHO, CDC, ECDC, NHC, and DXY
［Mod.MPP 注－中国国外の感染者は合計 3666例となり，24時間で 738例の増加があり，うち 449例を韓国が，131例をイタリアが，44例をイランが報告している]
[3] Iran: 139 cases, 19 deaths
情報源 BBC 2020年2月26日
全国にコロナウイルス感染が拡大する中，イランはどの市にも隔離措置を行う予定はないと，大統領が発言した。個人の隔離のみを行うと述べた。当局は Qom, the centre of the outbreak への渡航を控えるよう呼びかけているが，多数のシーア派巡礼者が訪れる寺院は閉じていない。139例の感染と19例の死者が報告され，隣国に対しても多数の患者の感染源になっている。26日にイラン保健省はイラン全国で COVID-19 が確認されていると発表した。しかし，入院または感染疑い患者のうち，24時間ごとに少なくとも 10％ が退院している，と楽観的な見方を示した ...
［Mod.MPP 注－ この 24時間に 44例が増加し，イランで確認されている症例は 95例から 139例となった。また死者数も 16例から 19例に 3例増加している]
[4] Countries reporting cases ex Iran: (パキスタン，ジョージア，クウェート，バーレーン)
A. Pakistan (Islamabad, Karachi)
情報源 Dawn 2020年2月26日
保健当局者 Special Assistant to Prime Minister on Health が，パキスタン国内初の 2例の感染例が確認されたと，26日ツイッターに投稿した。1例は Sindh, 2例目は "federal areas" で確認されたと述べ，過去 2週間以内にイランへの渡航歴があるとしたが，詳細は明らかにされていない ... イランへの渡航歴のある 22歳男性 ... 20日，イランからカラチ Karachi へ空路で到着し，イラン滞在時から症状のあった男性とその家族は隔離され，26日に検査で陽性と確認された。2例目の症例についての情報は明らかにされていない。
B. Georgia
情報源 GHN news [Georgian News Agency) [in Georgian] 2020年2月26日
ジョージア初のコロナウイルス感染例が報告されたと，保健相 Georgia's Health Minister が明らかにした。イランからアゼルバイジャンを経由してジョージアに帰国した，50歳のジョージア人男性で，感染症病院で感染が確認された。状態は落ち着いている。症状が認められていたため，病院に直行したと説明されている。
C. Kuwait 25 cases
情報源 Gulf News 2020年2月26日
26日に新たに 13例の感染が確認され，クウェート国内の感染者数は 25人となった。新たに確認された患者はすべてイランを訪れていた，と保健省が明らかにした。患者らの状態は安定しているとされている ...
D Bahrain 33 total cases
情報源 Arab Times 2020年2月26日
バーレーン保健省は 26日，新たに 7例の患者を報告し，国内の患者数は合計 33例となった。7人はいずれも最近イランから到着していた。イランからの入国・帰国者はウイルスを保有し家族などへの感染源となる疑いがあるので，ただちに定められた番号に電話するよう呼びかけた。
地図 A good map of the region showing the countries and their locations with respect to Iran
[5] Italy 400 cases 12 deaths
情報源 Italian Government Health Ministry 2020年2月26日
イタリアの the new SARS-CoV-2 coronavirus 感染者は 400人となり，3人が治癒している。26日18時現在の公式の数字である。128人は症状があり入院中で，うち 36人が集中治療を受けており，一方 221人は自宅待機となっている。これまでに 8600検体以上の検査を行った。
地域別の発生状況
- Lombardy Region: 258
- Veneto Region: 71
- Emilia Romagna Region: 47
- Piedmont Region: 3
- Lazio: 3 (the 2 Chinese tourists and the researcher repatriated from Wuhan)
- Tuscany: 2
- Sicily: 3
- Liguria: 11
- Marche: 1
- Autonomous Province of Bolzano: 1
［Mod.MPP 注－25日の感染 322例と死者 10例から，現在は 400例と 12例となった。新たにマルケ Le Marche 州でも確認されている]
[6] Countries reporting cases ex Italy: (Romania, Brazil, Norway, Greece)
A. Romania
情報源 Antena 3 2020年2月26日
ルーマニア初の感染例が発表された。ルーマニア国内でイタリア人と接触のあった，Gorj 出身者だった。the Matei Bals Institute におけるウイルス診断検査で陽性が確認された，the Gorj group の患者である，と the Secretary of State in the Ministry of Health から説明されている。このイタリア人は 4日間ルーマニアを旅行し，コロナウイルスに感染しており，Rimini [Italy] の病院に入院した。(ルーマニア人の）71歳のこの患者に発熱は認められていない。認められていない。
［Mod.MPP 注－20200226.7026481 に記載があった，ルーマニアで妻の親類と過ごした後，クロアチアで感染が確認されたイタリア人とは別のようだ]
B. Brazil Sao Paulo confirmed
情報源 B news [in Portuguese] 2020年2月26日
州知事 the governor of Sao Paulo state が the 1st case of coronavirus in Sao Paulo でかつブラジル初の感染例について述べた。 the Albert Einstein Hospital と確認のための the reference lab at the Adolfo Lutz Institute での検査で確定された。2月9日から21日までイタリア北部を旅行したブラジル人男性で，咳などの軽い症状のため，自宅で隔離されている
［Mod.MPP 注－イタリアおよび他の欧州諸国から頻繁な渡航がある国はアルゼンチンで，イタリア系子孫が多く住んでいる］
C. Greece
情報源 CNN Greece [in Greek] 2020年2月26日
26日，専門医 the infectious disease specialist が，ウイルス肺炎を発症した 38-year-old woman from Thessaloniki について明らかにした。イタリア北部を旅行していたが，現在は in good health で他の健康上の問題はない。AHEPA Hospital in Thessaloniki 病院特別病棟で治療中の女性自身に加え，他の家族らは自宅隔離を行っている ...
D. North Macedonia
情報源 Novinite Sofia News Agency 2020年2月26日
北マケドニア初の感染例 The 1st case of a coronavirus in northern Macedonia が確認された。1970年 Skopje で生まれたこの人物はイタリアに 1か月間滞在していた。the Infectious Diseases Clinic の隔離病棟に入院中で，2週間症状が続いており，イタリアの医療施設で検査を受けていた。北マケドニアに帰国後そのまま the Infectious Diseases Clinic in Skopje を受診している
E. Croatia
情報源 Vecernji [in Croatian] 2020年2月26日
クロアチアで 3人がコロナウイルスに感染した；2 in Zagreb and one in Rijeka 。1例目はミラノで the Champions League match 観戦した若年男性。21日は就業し，23日に発病し the Infectious Diseases Clinic "Dr. Fran Mihaljevic."に入院中。双子の兄弟も観戦していた。2人の健康状態は良好。26日，Rijeka で入院中の 3例目の感染が確定した。
F. Sweden
情報源 Goteborgs-Posten [in Swedish] 2020年2月26日
新型コロナウイルス検査が陽性となり，30歳の男性が the Eastern Hospital, Sahlgrenska University Hospital, in Gothenburg で治療を受けている。男性はイタリア北部を旅行し，先週 Gothenburg に戻っていた。スウェーデンに帰国して 3日後に発熱と呼吸器の症状を発症した。25日に感染症クリニックを受診し検査が行われ，26日に陽性であることが判明した。イタリアで感染したものとみられている。
G. Finland
情報源 Ilta Sanomat [in Finnish] 2020年2月26日
HUS, the hospital district of Helsinki and Uusimaa 保健当局によると，フィンランド初の感染例が 26日確認された。イタリア北部のミラノで感染した。フィンランド人の就労世代の女性で，入院して治療を受けており，発熱はみられるが状態は良好とされている。
[7] Selected media reports of transmission outside of mainland China
A. South Korea: 1261 total cases, 12 deaths
Official report from KCDC
情報源 Ministry of Health and Welfare, Korean CDC [in Korean] 2020年2月26日
25 Feb 2020 16:00 (4:00 PM) KT 977 confirmed cases, 10 deaths
26 Feb 2020 9:00 AM KT 1146 confirmed cases, 11 deaths
26 Feb 2020 16:00 (4:00 PM) KT 1261 confirmed cases, 12 deaths
Change: 115 newly confirmed infections; 2 new deaths from 25 Feb 2020 reported cases, among previously confirmed case
地域別の発生状況
Seoul 49
Busan 58
Dae-gu 710
Gyeonggi 51
Gyeongbuk 317 ...
Total: 1261
［Mod.MPP 注－ ... Dae-gu province and Gyeongbuk provinces が the highest number of cases, 710 and 317 respectively を報告している。Dae-gu は周りを Gyeongbuk province に囲まれた，中東部の都市で the epicenter of this ongoing outbreak となっている]
B. Korea USA and Korean military
情報源 AP news 2020年2月26日
韓国軍内で新たな感染が発表され，20 cases on its bases and some 9570 people in isolation となっている ...
C. Japan total 186 cases
情報源 Taro Kono [in Japanese] 2020年2月26日
２月26日、新型コロナウイルス感染症の20名及び無症状病原体保有者２名が報告されました。国内感染者は186名（うち無症状病原体保有者19名）となりました。
D. Norway ex China
情報源 VG 2020年2月26日
26日夕，the Public Health Institute (FHI) によると，ノルウェー北部在住の感染者は健康で症状は現れていない。弱い陽性反応で，感染リスクはきわめて低いと考えられている。中国のアウトブレイク発生地域に滞在し，今週末に帰国した。
E. USA (CA) no known exposure
情報源 5KPIX, CBS SF Bay Area 2020年2月26日
This would be the 1st case in the state not associated with the Diamond Princess cruise ship or with someone who had returned to Northern California from visiting China ...
Solano County において 26日，感染源不明の新型コロナウイルス感染例が診断され，現在 Sacramento County で治療を受けている ...
[8] WHO Situation Report 37 (as of 26 Feb 2020*)
情報源 World Health Organization 2020年2月26日
Highlights
- Four new Member States (Algeria, Austria, Croatia, and Switzerland) reported cases of COVID-19 in the past 24 hours. Algeria is the 1st Member State of the AFRO Region to report a case of COVID-19.
- 初めて，中国国外からの報告数が中国国内を上回った。 ...
関連項目
COVID-19 update (18): China, global, Iran, Italy imported cases, WHO 20200226.7026481
● エボラ(11) コンゴ(民)
PRO/AH/EDR> Ebola update (11): Congo DR (NK, IT) cases, summary, vaccine
Archive Number: 20200226.7028853
In this update:
[1] Case updates
- CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) update 25 Feb 2020，24 Feb 2020
[2] Summaries
- CIDRAP (Center for Infectious Disease Research and Policy) News Scan for 24 Feb 2020
[3] Vaccine
[1] Case updates
- Tue 25 Feb 2020. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) [in French]
The epidemiological situation of the Ebola virus disease in the provinces of North Kivu and Ituri dated 24 Feb 2020:
Since the start of the epidemic, the cumulative number of cases has been 3444, of which 3310 have been confirmed and 134 are probable. In total, there were 2264 deaths (2130 confirmed and 134 probable) and 1167 winners (people healed, or survivors);
- No new confirmed cases ...
[WHO AFRO dashboard]
- Mon 24 Feb 2020. CMRE (Comite Multisectoriel de la Riposte a la maladie a virus Ebola) [in French]
News
Interception of a suspect contact from Beni at the Loya checkpoint in Komanda
- A contact from Beni who became a suspected case of Ebola virus disease [EVD] was intercepted at the Loya checkpoint in Mandima in Ituri;
- The contact is a 43-year-old woman on the 25th day of follow-up with an unknown vaccination status;
- She became symptomatic on the 21st day, 19 Feb 2020, with signs like fever, physical asthenia, and muscle and joint pain;
- She was sent to the Komanda ETC.
Description of probable cases of 22 Feb 2020
1. Province of Ituri
Mandima:
- The 1st case of Mandima in Ituri is a 4-year-old boy, who died on 10 Jun 2019, untreated and unvaccinated, from the Mayuano health area. He was listed as the contact of his co-patient, probable case, who died on 3 Jun 2019 at the Dubai Health Station, where the child was cared for malaria during the period from 31 May-3 Jun 2019; 35 people were listed as contact around this case;
- The 2nd case is a 66-year-old man. He is the grandfather of the previous case. He died on 25 Jun 2019 in the Mayuano health area. He was listed as the contact of his grandson, probable case, who died on 10 Jun 2019 without saliva collection or a dignified and secure burial. This man was untreated and unvaccinated;
- The 3rd case is the son of the previous case. This is a 40-year-old man, who died on 6 Jul 2019 in Mayuano. He was unlisted and unvaccinated;
- The 4th case of Mandima was a 13-year-old girl who died on 17 Aug 2019 at home in the Lwemba health area. The alert was launched the same day, but her family refused to have her brought to the CTE. This girl, not listed as a contact and not vaccinated, was co-patient of her nephew, who died on 5 Jul 2019 in Lwemba, confirmed on 6 Aug 2019 at PS Saint Marc.
Mambasa:
- The case of Mambasa is a 28-year-old woman, who died on 3 Sep 2019 in the Salama health area. The alert was launched on 30 Aug 2019 by the health structure. Not listed as a contact and not vaccinated, she was investigated and validated in the Ebola case, but refused to be transferred to the CTE. Her care was confirmed MVE [EVD (in French, maladie a virus Ebola] on 9 Sep 2019.
2. Province of North Kivu
Alimbongo:
- This is a 2-year-old boy who died on 17 Aug 2019 in Masika health area and listed as contact with his mother, who died on 9 Aug 2019 in Kayna and confirmed on 11 Aug 2019. This child was never seen and not vaccinated. His father, who had accompanied him with 6 other children to avoid the response team, was confirmed as EVD on 20 Aug 2019; 12 people were listed as contact around this child.
Kayna:
- The case is a 40-year-old man, uncle of the previous man, who died on 20 Aug 2019 in the Butsiri health area. He had participated in the funeral of his cousin (mother of the previous case), who died on 9 Aug 2019 in Kayna and was confirmed on 11 Aug 2019. Three other members of his family were confirmed EVD, including his daughter on 20 Aug 2019 and his wife and brother on 25 Aug 2019; 56 people have been listed as high-risk contacts around this case.
Katwa:
- A 21-year-old woman who died on 27 Apr 2019 in the Kambuli health area. She was not listed as a contact and not vaccinated. Before the start of signs [symptoms], this woman was subject to exposure to her deceased mother-in-law and brother-in-law, who were confirmed in Kalunguta on 11 and 17 Apr 2019, respectively; after the start of [her] signs, 2 co-patients at the Vimbao health post died and were confirmed MVE. Three high-risk contacts have been listed around this case.
Manguredjipa:
- This is a 35-year-old woman, not listed as contact and not vaccinated, who died on 3 Jun 2019 in the Akwele health area. Her 6-month-old breastfed infant was confirmed EVD on 8 Jun 2019; 7 people were listed as contacts around this case.
Butembo:
- This is a 6-month-old infant, who died in the Vutetse health area, not listed as a contact and not vaccinated. He was a co-patient of a confirmed case on 16 Nov 2019 hospitalized at the Apostle Paul Pediatric Health Center in Vutetse from 7-14 Nov 2019. The infant was taken care of there from 3-10 Nov [2019]. After the start of signs, his parents were confirmed EVD, including the mother on 22 Nov and father on 24 Nov [2019], as well as 2 other members of his family who had taken care of him during his illness.
Kalunguta:
- This is a 7-month-old infant, untreated and unvaccinated, who died on 19 Feb 2019 in the Mbilinga health area. He was listed as his mother's contact, confirmed and deceased on 9 Feb 2019; 23 people were listed as contacts around this case.
[2] Summary
- Mon 24 Feb 2020. News Scan [CIDRAP (Center for Infectious Disease Research and Policy)]
After additions of what might be retrospective cases, the World Health Organization's (WHO's) online Ebola dashboard shows a case count of 3444 today [24 Feb 2020], which represents 11 more cases than the total reported at the end of last week. The death toll now stands at 2264 in an outbreak that has lasted 18 months in the eastern region of the Democratic Republic of the Congo (DRC).
In a new study published in Vaccine, researchers found that Ebola patients in the DRC who had received rVSV-ZEBOV prior to their infections had lower viral loads and better outcomes than unvaccinated Ebola patients. The study compared 44 patients vaccinated prior to admission to Ebola treatment centers in Butembo and Katwa from January through March of 2019 with 213 unvaccinated patients.
Ten (23%) of 44 vaccinated patients died, compared with 117 (55%) of 213 unvaccinated patients (odds ratio 0.24; 95% confidence interval 0.11 to 0.51, P less than 0.001), the study found. The vaccinated patients were also less likely to suffer kidney damage.
--
Communicated by:
Mary Marshall
<mjm2020@googlemail.com>
******
[3] Vaccine
- Fri 21 Feb 2020 [Vaccine]
Citation: Kasereka MC et al.: Prior vaccination with recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus vaccine is associated with improved survival among patients with Ebolavirus infection. Vaccine. 21 Feb 2020. doi: https://doi.org/10.1016/j.vaccine.2020.02.044.
Abstract.
The 2nd-largest Ebola virus disease (EVD) outbreak ever recorded is currently ongoing in eastern Democratic Republic of the Congo (DRC). This is the 1st outbreak for which the recombinant Vesicular Stomatitis Virus - Zaire Ebolavirus (rVSV-ZEBOV) candidate vaccine has been widely administered, using a ring vaccination strategy. We examined whether prior vaccination with rVSV-ZEBOV impacts viral load, organ impairment, and survival among patients with EVD admitted to Ebola treatment units (ETUs) in the DRC. We conducted a retrospective observational study of patients admitted to the ETUs in Butembo and Katwa, eastern DRC, between 30 Mar and 10 Aug 2019. We included 257 patients, of whom 44 had been vaccinated prior to admission and 213 were unvaccinated. Vaccinated patients were admitted to the hospital sooner than unvaccinated patients (median 2 days (IQR 1.8-4) versus 4 days (IQR 3-6), p less than 0.001). Vaccinated patients had a lower viral load at admission compared to those who were unvaccinated: 6.0 log10 cp/mL (IQR 5.0-7.1) versus 6.9 log10 cp/mL (IQR 5.4-7.6), p = 0.017. In a longitudinal analysis of daily viral load measurements, vaccinated patients had an overall viremia 1.32 log10 cp/mL (95% CI 0.58-2.1) lower than unvaccinated patients over the course of their infection. Acute kidney injury at admission was less common in vaccinated patients: OR 0.44 (95% CI 0.20-0.94), p = 0.027. Mortality in vaccinated patients was 10/44 (23%) compared to 117/213 (55%) unvaccinated patients (OR 0.24, 95% CI 0.11-0.51, p less than 0.001). In conclusion, prior rVSV-ZEBOV vaccination was associated with reduced severity of infection and improved survival among patients with confirmed EVD treated at ETUs in eastern DRC. These findings support the efficacy of the rVSV-ZEBOV vaccine in modulating EVD severity.
関連項目
Ebola update (10): Congo DR (NK, IT) cases, summaries, WHO 20200221.7012106
● ペスト－コンゴ(民)(02) 腺ペスト，肺ペスト 死亡
PRO/AH/EDR> Plague - Congo DR (02): (IT) bubonic, pneumonic, fatal
Archive Number: 20200226.7028683
投稿者 米国・EcoHealth Alliance, Anne Laudisoit 2020年2月26日
[1] Bubonic plague investigation - RFI
On 22 Feb 2020, the Aungba Health Zone chief medical doctor was alerted that suspect bubonic plague cases were reported in the Ugunzu-Makangi village of the Aterlembe health area, Djugu territory, Ituri Province, DR Congo. Murine epizootics were also mentioned in the Makangi village. On 23 Feb 2020, the chief medical doctor of the Aungba health Zone (Lat 2 33' 00'' Long 30 30' 00'') was appointed to visit the health center of Aterlembe for 2 days to investigate suspect bubonic plague cases. The head doctor Dr Delphonse Unen Ali reported on the same day (23 Feb 2020) on the outbreak. The nurse of the Aterlembe health center notified 2 suspected cases of bubonic plague. He reported that the index cases were 2 family members who presented with fever, headache, and painful buboes on 22 Feb 2020 at 2 health centers. After self-medicating for 6 days (16-22 Feb 2020), they consulted as ambulatory patients the Kpese health post and then the Yuku health center, both in the Aru health zone. A 2-year-old boy died on 21 Feb 2020 with symptoms consistent with that of bubonic plague (fever, painful buboes), the 2nd patient -- the 12 year old brother of the co-primary case -- tested positive for plague with the RDT [rapid diagnostic test] and is recovering. He presented with fever, painful buboes, and headaches. So far 16 contacts have been traced and treated with doxycycline, 27 households were dusted.
[2] Pneumonic plague - follow up to: 20200225.7026580
Between 19 Feb 2020 and 25 Feb 2020, the health area of Godjoka has experienced an outbreak of suspected pneumonic plague. Symptoms reported were headache, painful cough, dyspnea, hemoptysis, and diarrhea lasting 3 days followed by death. On 25 Feb 2020, the traditional healer's body, positive for plague with the rapid diagnostic test, was transported by relatives to a small locality near Kpandruma (Lat. 2° 03' 15.3" Long. 30° 50' 58.2", alt 2804m) in the Rethy Health Zone, Djugu territory, Ituri Province DR Congo. She was buried there. The transport by relatives increases the risk of plague spread to relatives and mourning villagers. It should be noted that the city of Kpandruma is the major commercial center of the region . On 25 Feb 2020, the intervention team treated over 300 contacts with doxycycline, and disinfected the houses where the bodies were laid prior to burial. Children under 10 years old and pregnant women have received cotrimoxazole [trimethoprim/sulfamethoxazole] on the morning of 26 Feb 2020.
［Mod.LL 注－
The bacterium that causes plague is _Yersinia pestis_. Most cases of plague are due to bubonic plague following the bite of an infected rodent flea causing a swollen and very tender lymph gland. The swollen gland is called a "bubo." Bubonic plague should be suspected when a person develops a swollen gland, fever, chills, headache, and extreme exhaustion, and has a history of possible exposure to infected rodents, rabbits, or fleas. A person usually becomes ill with bubonic plague 2-6 days after being bitten. At this point in the illness, there is no risk of person-to-person spread, so if this was indeed a case of bubonic plague, no isolation or quarantine is necessary.
When bubonic plague is left untreated, plague bacteria invade the bloodstream. As the plague bacteria multiply in the bloodstream, they spread rapidly throughout the body and cause a severe and often fatal condition. Infection of the lungs with the plague bacterium causes the pneumonic form of plague, a severe respiratory illness. The infected person may experience high fever, chills, cough, and breathing difficulty and may produce bloody sputum. If plague patients are not given specific antimicrobial therapy, the disease can progress rapidly to death. At this stage, as appears to have happened in this case, person-to-person spread can occur, causing other cases of "primary" plague pneumonia.
Patients with primary pneumonic plague generate large quantities of infectious aerosols that pose a significant risk to close contacts.
CDC (US Centers for Disease Control and Prevention) guidelines identify contacts within 2 meters (6.5 ft) as being at greatest risk and do not consider the organism likely to be carried through air ducts or vents. Persons who have been in contact with pneumonic plague patients or handling potentially infectious body fluids or tissues without appropriate protection should receive preventive antimicrobial therapy. The preferred antimicrobial agents for prophylaxis include tetracyclines and fluoroquinolones. - Mod.LL
関連項目
Plague - Congo DR: (IT) pneumonic, fatal, susp, RFI 20200225.7026580
● 髄膜炎菌性髄膜炎－コスタリカ 第3世代セファロスポリン耐性
PRO/EDR> Meningitis, meningococcal - Costa Rica: 3rd-gen. cephalosporin resistance, RFI
Archive Number: 20200226.7028303
情報源 Q Costa Rica News 2020年2月23日
50歳の男性と高齢者が，コスタリカおよび南北アメリカで初めてとなる，2例の感染例と確認された。通常の髄膜炎菌性髄膜炎と敗血症の治療に用いられる抗生物質に耐性のある菌の感染が確認された。
found to be infected with the bacteria most resistant to antibiotics used in the treatment of meningitis and meningococcal septicemia that cause serious brain damage and even death.
The Centro Nacional de Referencia en Bacteriología (CNRB) -- National Center of Reference in Bacteriology, of the Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (Inciensa) -- Costa Rican Institute for Research and Education in Nutrition and Health (Incense), issued an alert, in early February [2020], after documenting the circulation of _Neisseria meningitidis_ (_N. meningitidis_) serogroup Y, resistant to penicillin and not sensitive to cefotaxime [and ceftriaxone?], two 3rd generation antibiotics, reports La Nación.
[Invasive meningococcal disease (meningococcemia and meningitis) is a life-threatening infection caused by _Neisseria meningitidis_ that evolves rapidly, often even when appropriate treatment has been started promptly. Because antimicrobial treatment for invasive meningococcal disease with a 3rd-generation cephalosporin (cefotaxime and ceftriaxone) is the widely accepted standard recommendation (https://academic.oup.com/cid/article/39/9/1267/402080), resistance of _N. meningitidis_ to cefotaxime and ceftriaxone is very worrisome.
The news report above says that 2 patients in Costa Rica were infected with _N. meningitidis_ serogroup Y resistant to penicillin and 2 3rd generation cephalosporins, one of which was cefotaxime. The other 3rd generation cephalosporin is not specified, but is perhaps ceftriaxone, the other 3rd generation cephalosporin usually used to treat this disease. We are also not told in the news report above if the 2 patients were epidemiologically linked, nor are we told the extent (that is, MICs [minimum inhibitory concentration] of penicillin or cefotaxime), the mechanisms of resistance, or resistance to any of the other antimicrobial drugs used to prevent or treat this disease. More information would be appreciated from knowledgeable sources.
Reduced susceptibility of _N. meningitidis_ to penicillin has been reported in the past in many countries, including the US (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169190/), usually due to decreased affinity of target penicillin-binding proteins for penicillin and less commonly to beta-lactamase production (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC89938/, https://pubmed.ncbi.nlm.nih.gov/3134848-relative-penicillin-g-resistance-in-neisseria-meningitidis-and-reduced-affinity-of-penicillin-binding-protein-3/, and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC162989/pdf/392577.pdf). Meningococcal isolates with reduced susceptibility to penicillin G usually were reported susceptible to 3rd-generation cephalosporins (cefotaxime and ceftriaxone). For example, despite the decrease in susceptibility to penicillin G in 33% of 2888 isolates of _N. meningitidis_, all isolates were susceptible to ceftriaxone in Brazil from 2009 to 2016 (https://pubmed.ncbi.nlm.nih.gov/29717974-surveillance-of-antimicrobial-resistance-in-neisseria-meningitidis-strains-isolated-from-invasive-cases-in-brazil-from-2009-to-2016/). Similar data have been reported for the US (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169190/). However, one previous study reported 8 clinical isolates _N. meningitidis_ in Delhi, India in 2006 that were resistant to ceftriaxone and cefotaxime, with most also resistant to penicillin, ciprofloxacin, and chloramphenicol (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1698303/). All of the isolates were identified as serogroup A _N. meningitidis_, but no further details concerning these isolates were given in this report (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865813/).
Resistance to other antimicrobial agents that may be used for therapy of meningococcal infections or for prophylaxis of case contacts has been reported in several countries. This includes resistance to chloramphenicol, fluoroquinolones, and rifampin.
Horizontal exchange of genes that encode resistance for penicillin, rifampin, and the fluoroquinolones from other _Neisseria_ species that share a common ecological niche with _N. meningitidis_ in the nasopharynx has been proposed as one possible mechanism of acquisition of meningococcal antibiotic resistance (http://jac.oxfordjournals.org/cgi/content/full/49/3/545). - Mod.ML
PRO/EDR> Meningitis, meningococcal - Costa Rica: 3rd-gen. cephalosporin resistance, RFI
Archive Number: 20200226.7028303
情報源 Q Costa Rica News 2020年2月23日
50歳の男性と高齢者が，コスタリカおよび南北アメリカで初めてとなる，2例の感染例と確認された。通常の髄膜炎菌性髄膜炎と敗血症の治療に用いられる抗生物質に耐性のある菌の感染が確認された。
found to be infected with the bacteria most resistant to antibiotics used in the treatment of meningitis and meningococcal septicemia that cause serious brain damage and even death.
The Centro Nacional de Referencia en Bacteriología (CNRB) -- National Center of Reference in Bacteriology, of the Instituto Costarricense de Investigación y Enseñanza en Nutrición y Salud (Inciensa) -- Costa Rican Institute for Research and Education in Nutrition and Health (Incense), issued an alert, in early February [2020], after documenting the circulation of _Neisseria meningitidis_ (_N. meningitidis_) serogroup Y, resistant to penicillin and not sensitive to cefotaxime [and ceftriaxone?], two 3rd generation antibiotics, reports La Nación.
[Invasive meningococcal disease (meningococcemia and meningitis) is a life-threatening infection caused by _Neisseria meningitidis_ that evolves rapidly, often even when appropriate treatment has been started promptly. Because antimicrobial treatment for invasive meningococcal disease with a 3rd-generation cephalosporin (cefotaxime and ceftriaxone) is the widely accepted standard recommendation (https://academic.oup.com/cid/article/39/9/1267/402080), resistance of _N. meningitidis_ to cefotaxime and ceftriaxone is very worrisome.
The news report above says that 2 patients in Costa Rica were infected with _N. meningitidis_ serogroup Y resistant to penicillin and 2 3rd generation cephalosporins, one of which was cefotaxime. The other 3rd generation cephalosporin is not specified, but is perhaps ceftriaxone, the other 3rd generation cephalosporin usually used to treat this disease. We are also not told in the news report above if the 2 patients were epidemiologically linked, nor are we told the extent (that is, MICs [minimum inhibitory concentration] of penicillin or cefotaxime), the mechanisms of resistance, or resistance to any of the other antimicrobial drugs used to prevent or treat this disease. More information would be appreciated from knowledgeable sources.
Reduced susceptibility of _N. meningitidis_ to penicillin has been reported in the past in many countries, including the US (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169190/), usually due to decreased affinity of target penicillin-binding proteins for penicillin and less commonly to beta-lactamase production (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC89938/, https://pubmed.ncbi.nlm.nih.gov/3134848-relative-penicillin-g-resistance-in-neisseria-meningitidis-and-reduced-affinity-of-penicillin-binding-protein-3/, and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC162989/pdf/392577.pdf). Meningococcal isolates with reduced susceptibility to penicillin G usually were reported susceptible to 3rd-generation cephalosporins (cefotaxime and ceftriaxone). For example, despite the decrease in susceptibility to penicillin G in 33% of 2888 isolates of _N. meningitidis_, all isolates were susceptible to ceftriaxone in Brazil from 2009 to 2016 (https://pubmed.ncbi.nlm.nih.gov/29717974-surveillance-of-antimicrobial-resistance-in-neisseria-meningitidis-strains-isolated-from-invasive-cases-in-brazil-from-2009-to-2016/). Similar data have been reported for the US (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1169190/). However, one previous study reported 8 clinical isolates _N. meningitidis_ in Delhi, India in 2006 that were resistant to ceftriaxone and cefotaxime, with most also resistant to penicillin, ciprofloxacin, and chloramphenicol (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1698303/). All of the isolates were identified as serogroup A _N. meningitidis_, but no further details concerning these isolates were given in this report (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1865813/).
Resistance to other antimicrobial agents that may be used for therapy of meningococcal infections or for prophylaxis of case contacts has been reported in several countries. This includes resistance to chloramphenicol, fluoroquinolones, and rifampin.
Horizontal exchange of genes that encode resistance for penicillin, rifampin, and the fluoroquinolones from other _Neisseria_ species that share a common ecological niche with _N. meningitidis_ in the nasopharynx has been proposed as one possible mechanism of acquisition of meningococcal antibiotic resistance (http://jac.oxfordjournals.org/cgi/content/full/49/3/545). - Mod.ML
PRO/AH/EDR> COVID-19 update (18): China, global, Iran, Italy imported cases, WHO
Archive Number: 20200226.7026481
In this update:
[1] 中国: China National Health Commission 25 Feb 2020
[2] Global update: Johns Hopkins CSSE [accessed at 9:50 p.m. GMT-5]
[3] イラン: 95 cases, 16 deaths
[4] Countries reporting cases ex Iran: (Kuwait, Bahrain, Oman, Iraq, Afghanistan)
[5] イタリア 322 cases 10 deaths
[6] Countries reporting cases ex Italy: (Romania, Austria, Switzerland, Algeria)
[7] Selected media reports of transmission outside of mainland China
[8] WHO situation report 36 (as of 25 Feb 2020)
[1] 中国
情報源 China National Health Commission [in Chinese, URL なし]
At 04:00 on [25 Feb 2020], 31 provinces (autonomous regions, municipalities) and the Xinjiang Production and Construction Corps reported 406 new confirmed cases, 52 new deaths (52 in Hubei), and 439 new suspected cases.
On the same day, 2422 cases were cured and discharged, 14 573 were close contacts of those under medical observation, and 374 severe cases were reduced.
As of 24:00 on [25 Feb 2020], according to reports from 31 provinces (autonomous regions and municipalities) and the Xinjiang Production and Construction Corps, there were 45 604 confirmed cases (among which, 8552 were severe cases), 29 745 were cured and discharged, and 2715 had died. A total of 78 064 confirmed cases were reported ...
There were * 401 newly confirmed cases in Hubei (370 in Wuhan) ...
［Mod.MPP 注－過去24時間に中国国内で 914 cases の増加があった；* the stated increase of 406 in the past 24 hours の記載については説明できない]
地図 A good map of China showing provinces
[2] Global update: Johns Hopkins CSSE [accessed at 9:0 p.m. GMT-5]
情報源 Johns Hopkins CSSE (Center for Systems Science and Engineering) 2020年2月25日
Confirmed cases
2 Feb 2020 / ... / 23/ 24/ 25 Feb 2020 / Country / Region
17 187 / ... / 76 944 / 77 657 / 77 663 Mainland China
20 / ... / 147 / 159 / 170 / Japan
15 ... / 602 / 833 / 1146 / South Korea
2 / ... / 155 / 229 / 322 / Italy
0 / ... / 43 / 61 / 95 / Iran
0 / 0 ... / 691 / 691 / 691 / Others (Diamond Princess)
Total number of reported deaths: 2708
Iran: 16
South Korea: 10
Italy: 10
Diamond Princess: 3
Japan: 1
Data sources: WHO, CDC, ECDC, NHC, and DXY
［Mod.MPP 注－中国国外で，合計 2928例が確認。過去 24時間に 510例が報告され，韓国は 313例，イタリアは 93例を報告している ... ]
[3] Iran: 95 cases, 16 deaths
情報源 Arab News 2020年2月24日
イラン国内で新たに 2例の感染者が死亡し，合計の死者数が 16人となったと，25日保健省当局者が明らかにした。イランの死者数は，中国を除き最も多い。感染が疑われた症例の中から，35例の感染と 2例の死亡が確認されたと，保健省広報担当者が述べた。イラン全土で 95人の感染が確認されている。保健省は国民に対し，自宅に留まるよう要請している。先週 Qom で初めての死亡例 2例が確認されたが，いまだに何人が隔離措置を受けているかは明らかにされていない。半政府系メディアは 320人が入院中と伝えている。保健副大臣もコロナウイルス検査で陽性となり，現在隔離されている。アラブの 6か国が初の感染例を報告したが，すべてイランと関係していた。クウェートの感染者数は 8例に達している。バーレーン保健省も，イランから Dubai and Sharjah 経由で帰国した，サウジアラビア人女性 6名を含む，新たに 15例が検査で陽性と確認されたと発表した ... イタリアと日本への渡航を控えるよう市民に呼びかけられている。
［Mod.MPP 注－ 24時間に 34例が新たに確認され，イラン国内の感染者は 61例から 95例に増えた。死者の数も，12人から 4人増え，16人となった ... ]
地図； Qom is located to the southwest of Tehran in central Iran.
[4] Countries reporting cases ex Iran: (クウェート，バーレーン，オマーン，イラク)
A Kuwait 4 new cases
情報源 Anadolu Agency 2020年2月25日
25日，クウェートで新たに 4例の感染が確認され，合計患者数は 9人となった。すでに隔離措置されている，イランからの渡航者の間で感染が確認された，と保健省が明らかにした。
B Bahrain 9 new cases
情報源 Khaleej Times 2020年2月25日
保健省は，Dubai and Sharjah 経由でバーレーン国際空港に到着したバーレーンおよびサウジアラビア国民の，新たな 9例の感染を確認し，国内の感染者数は 17例となった。必要なすべての検査が行われ，空港の隔離ゾーンに留め置いた後，the Ebrahim Khalil Kanoo Community Health Center in Al Salmaniya に移して治療していると述べ，具体的には，4 female Bahraini nationals arriving from Iran, via Sharjah, and 3 male Bahraini nationals arriving from Iran (2 arriving via Sharjah and 1 arriving via Dubai), and 2 female Saudi nationals arriving from Iran, via Sharjah と説明されている。
C. Oman - 2 new cases
情報源 Times of Oman and Mod. EP 2020年2月25日
新たに 2例が確認されたと，保健省が明らかにした。イランへの旅行者と説明されている。国内の感染者数は 4例となった。
D. Iraq 4 new cases
情報源 BBC 2020年2月25日
隣国イランを訪問後イラクに帰国した 4人家族が，コロナウイルス検査で陽性になったと報じられている。Kirkuk において検疫下にある ... 24日，イラク初の感染例が報告されており，an Iranian theology student in the city of Najaf だった。
地図 A good map of the region showing the countries and their locations with respect to Iran
[5] Italy 322 cases 10 deaths
情報源 Italian Government Health Ministry 2020年2月25日
イタリア国内で 322人が the new SARS-CoV-2 coronavirus に感染し，うち 10人が死亡，1人が治癒回復した。2月25日18時に開かれた防災庁官 the Commissioner for the emergency of civil protection, Angelo Borrelli の会見で，公式の数字として示された。114人に症状がみられ入院中; 35人は集中治療室に収容された, 一方 162人が自宅待機となっている。これまでに 8600件を超える検体スワブが行われた。
各地域の発生状況は，以下のとおり:
- Lombardy Region: 240
- Veneto Region: 43
- Emilia Romagna Region: 26
- Piedmont Region: 3
- Lazio: 3 (the 2 Chinese tourists and the resigned researcher)
- Tuscany: 2
- Sicily: 3
- Liguria: 1
- Autonomous Province of Bolzano: 1
［Mod.MPP 注－感染者数の総計は現在 322人で，うち 10人が死亡。昨日 24日は，220例と死者 7例だった。発生地域リストでは，新たに南部シチリア島が加わった。アウトブレイクの中心地であるロンバルディア Lombardy を観光で訪れていた。8600件以上の検体が採取されたというのは衝撃的で，多くは接触者追跡調査のためである。検体の検査が進めば，さらに陽性例が増えるだろう。イタリアは，他の欧州諸国から人気の旅行先で，ロンバルディは商業ハブでもある。加えて，イタリア人は身が軽く，欧州中を旅行している。[6] がその証左である]
[6] Countries reporting cases ex Italy: (クロアチア，オーストリア，スイス，アルジェリア，スペイン，ブラジル)
A. Croatia
情報源 BBC 2020年2月25日
- The 1st case of coronavirus infection in Croatia が報告された。
- 2月19日から 20日までミラノに滞在した若年男性で，軽い症状で Zagreb に入院している。
［Mod.MPP 注－ちなみに，この患者がクロアチアを訪れる前にルーマニアにも滞在していたとして，ルーマニアも警戒態勢にあるとのレポートがある。ルーマニア滞在中，この男性は妻の親類と過ごしており，いくつかの会議にも出席していた]
B. Austria
情報源 BBC 2020年2月25日
オーストリアアルプスのホテルは，レセプションで勤務していたイタリア人のウイルス感染が判明し，閉鎖されている。ホテル名は明らかにされていないが，インスブルック The Alpine city of Innsbruck 市とされている。内務相は "ホテル内に他の感染者がいないか確かめるため，誰もホテルから出たり入ったりしていない" と説明している... Innsbruck は州都 the capital of the state of Tyrol でイタリアと国境で接している ... 感染のあったこの女性の自宅も検疫下にある。先週，いずれも 24歳の女性とパートナーはともに，イタリア/ロンバルディ州の自宅から車で Innsbruck を訪れていた [* travelled to Innsbruck by car from their home in Lombardy, Italy last week.; 自宅と旅行先が逆では ?] 。イタリアでは欧州最悪の被害が発生している。
C. Switzerland
情報源 Swiss Info 2020年2月25日
スイス初のコロナウイルス感染例が，25日にイタリアとの国境にある南部 canton Ticino で確認された ... 保健当局The Federal Office of Public Health によると，70歳代男性で 2月15日にミラノ the Milan region of Italy のイベントに参加した際に感染し 2日後に発症した。その後は家族とともに過ごし，現在は a clinic in Lugano, canton Ticino に隔離されているものの，健康とされている ... スイス国内ではこれまでに約 300例の疑い症例 suspected cases of COVID-19 に対し検査が行われているが，感染が確認された症例はない。cantons Bern and Basel の複数の患者を含め，全国の疑い例が検査されているが，canton Ticinon で検査されている症例はごく少数で，数時間以内に検査結果が判明すると，当局者が説明した ...
D. Algeria
情報源 Morocco World News 2020年2月25日
政府系メディアによると，アルジェリア国内初となる，2月17日にアルジェリアに到着したイタリア人男性 1名の，the 1st case in Algeria of the novel coronavirus "Covid-19" が確認された。保健相は，イタリア人男性 2名のうち，症状のあるのは 1名のみと説明している。
E. Spain
情報源 El Diario [in Spanish] 2020年2月25日
保健当局 The Government Department of Health は 25日，初めての感染例 the 1st positive sample for coronavirus が Catalunya で確認されたと明らかにした。バルセロナ Barcelona 在住のイタリア人女性で，the Clinic Hospital, reference center for contagious diseases 病院に入院中である。2月12日から 22日までの間，母国であるイタリア北部 the Lombardy Region を旅行していた。24日夜に自ら the Clinic を受診し，疫学情報と微生物検査が行われた。the Canary and Balearic Islands で 4例が確認されているが，イベリア半島で検査陽性となった初めての症例である。第 1例目は 1月に La Gomera で確認されすでに退院しており，2例目は Mallorca 在住の英国人だった。す火円で報告された最新の陽性例はイタリア人医師とその妻で，現在 the National Microbiology Center での二次検査の結果を待っている。これらの患者が確認され，滞在先ホテルの宿泊客らも管理されている。
F. Brazil (Sao Paolo)
情報源 O Globo [in Portuguese] 2020年2月25日
サンパウロ Sao Paulo で感染が疑われる患者の保健省による調査が行われている。二次確認検査の結果が待たれており，26日朝判明の予定である。この the capital of Sao Paolo 在住の 61歳男性は，2月9日から 21日までイタリアを旅行していた。the Albert Einstein Hospital での一次検査が陽性であったため，a 2nd confirmation by the Adolfo Lutz Institute が行われた。咳などの軽い症状が認められている。2週間，呼吸器隔離室に収容される予定で，すべての接触者の追跡が行われる。
［Mod.MPP 注－Brazil, and especially Sao Paulo (and Rio de Janeiro) と欧州各国との間の頻繁な往来があるとすれば，注意が必要。今回の症例が除外されたとしても，(ブラジル国内で) 確定診断例が出るのは時間の問題である ... ]
[7] Selected media reports of transmission outside of mainland China
A. Japanese cruise ship: Australia
投稿者 豪・Allen Cheng １，2 2020年2月24日
... there have now been 7 cases among the 164 repatriated Australians from the Diamond Princess.
B. South Korea: 977 total cases, 10 deaths，Official report from KCDC
情報源 Ministry of Health and Welfare, Korean CDC [in Korean] 2020年2月25日
Data taken from a table on the website of the Korean MOHW (Ministry of Health and Welfare).
24 Feb 2020 9:00 AM KT 893 confirmed cases, 8 deaths
24 Feb 2020 16:00 (4:00 PM) KT 977 confirmed cases, 10 deaths
24日以降，新たに 84例の感染と，2例(既知の症例，1951年生女性と1962年生男性)の死亡。
新たな 84例に関する情報(No information on association with the Sincheon Earth Church)
Seoul (4): Busan (5), Dae-gu (44), Ulsan (1), Gyeonggi (2), Gyeongbuk (23), Chungbuk (2), Chungnam (1)
[8] WHO Situation Report 36 (as of 25 Feb 2020*)
情報源 World Health Organization 2020年2月25日
Highlights
- Four new Member States (Afghanistan, Bahrain, Iraq, and Oman) reported cases of COVID-19 in the past 24 hours.
関連項目
COVID-19 update (17): China, animal reservoir, wildlife trade & consumption ban 20200225.7024245