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Commentary
Fatal Novel
Beta Coronavirus HCW Cluster In Jordan
Recombinomics
Commentary 10:00
December 3, 2012
He said he then instructed in the month of April transfer, a university student from Blue State Hospital to Prince Hamzah Hospital as he was complaining of heart inflammation of the membranes and suspicion of tuberculosis disease and encountered his hospitalization in conjunction with the pandemic.
The above translation of a media report on the Jordan Health Minister (Abdul Latif Wrekat) December 2 press release on the April novel betacornavirus outbreak linked to the ICU department of the public hospital in Zarpa provides detail that was absent from the WHO update on the two lab confirmed (by NAMRU-3) fatal health care workers (HCWs).
Media coverage in April was largely local, although ECDC filed several updates, which noted that the cluster was linked to the ICU and included 7 nurses, 1 doctor, and 3 additional cases. The ECDC report also noted that one of the nurses died.
Local April media reports noted the April 19 fatality (40F). At that time several of the other HCWs had been discharged, and agencies indicated the nurse was the exception for severity, which may have been linked to her natural immunity. However, the death of a second HCW (intern, Amjad Akram Rizk, who had been at the same public hospital, but transferred to a private hospital on April 15), raised significant concerns. The heart problem and a suspicion of tuberculosis were cited in the denial that the second fatality (25M) was linked to the earlier cases.
Initial testing was negative for all of the cases, but re-testing by NAMRU-3 identified the novel coronavirus in the two fatal cases. The failure to identify the coronavius in the milder cases, which includes the son of the fatal case, raises serious concern that the current assay lacks the sensitivity to detect milder cases.
The cluster at an ICU bears striking similarities with multiple outbreaks that affected HCWs associated with confirmed SARS CoV cases in 2003, as well as the close medical contacts of the first case from Qatar (49M). 13 of the contacts were symptomatic but tests on 10 of these contacts were negative for the recent novel betacornavirus.
Thus, although WHO continues to claim that the clusters linked to the confirmed cases fail to demonstrate sustained transmission, symptomatic clusters of contacts raise concerns that the WHO assessment is linked to false negatives generated by recent PCR testing..
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