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Coronavirus infections
Update on Robert Koch Institute (RKI) risk assessment on disease from the novel coronavirus (HCoV-EMC)

2nd case imported to Germany:

A patient hospitalized in Munich since [19 Mar 2013] was confirmed as having an infection with the novel coronavirus [nCoV] on [23 Mar 2013]. The man had been in a hospital in Abu Dhabi, United Arab Emirates, and was [transferred] to Germany. The patient is being treated in intensive care. The contact investigation is being conducted by the health department in Munich, and all contacts have been informed. This is the 2nd case of disease [caused by the nCoV] imported to Germany. The 1st patient was transferred to Germany on [24 Oct 2012] for treatment and has recovered (see further information of the City of Munich for the 2nd imported case into Germany).

Information on all confirmed cases are summarized in a table (see below)

On the background of a possible human-to-human transmission:
The 1st possible cluster of cases was reported in a family in Saudi Arabia in 2012. In this family, 2 males were infected, there was a short period of unprotected contact involved in the care of the 1st patient which may be considered as a possible source of transmission.

In February 2013 the last 3 reported cases from the UK had been confirmed. This affected a patient ["the index case"] who prior to his illness had visited Saudi Arabia, and 2 family members of the index patient. One of the family members died, the other was diagnosed with milder respiratory symptoms and recovered quickly.

Risk assessment:

There is still no evidence of continuous human-to-human transmission. In Germany, there have been only 2 imported cases of [nCoV associated illness]. There is no increased risk of disease in the general population.

The care of probable cases in the hospital shall continue to include strict measures according to recommendations for diseases caused by the SARS CoV, because of the severe course of these diseases. This recommendation also is for individuals to avoid contact with sick persons with a history of travel to the Arabian Peninsula.

The Robert Koch Institute has differential diagnostic laboratory tests (see case definition of the RKI of [12 Dec 2012]). The specific diagnosis of novel coronavirus has been established at the Robert Koch Institute and the Institute of Virology at the University of Bonn (see also notes the RKI for laboratory diagnostics).

This risk assessment was translated by ProMED and sent by ProMED mail (http://www.promedmail.org).

Date: 26.03.2013