Reducing Respiratory Virus in Preemies Lessens Wheezing: Study

But preventing respiratory synctial virus comes with a hefty price tag

By Serena Gordon

HealthDay Reporter

WEDNESDAY, May 8 (HealthDay News) -- Many pre-term babies suffer recurrent episodes of wheezing. Now, researchers say a common infection is a likely culprit and they may be able to prevent the breathing problems.

Wheezing episodes in late pre-term babies often are caused by infection with the respiratory synctial virus (RSV), the researchers said. And they've found that injections of an expensive RSV medication can prevent the virus -- and the wheezing.

A study of more than 400 babies born late pre-term (between 33 and 35 weeks' gestation) found that days with wheezing dropped by more than 60 percent among those who received injections of palivizumab during RSV season. The effect lasted even after treatment ended.

"In pre-term babies, RSV illnesses seem to be a risk factor for wheezing, and this treatment reduced that risk," said Dr. Robert Lemanske Jr., a professor of pediatrics and medicine at the University of Wisconsin School of Medicine and Public Health, in Madison. Lemanske wrote an editorial accompanying the new study, which was published May 9 in the New England Journal of Medicine.

RSV is a global health threat in the first year of life and the second leading cause of death after malaria, said study lead author Dr. Louis Bont, a pediatric infectious disease specialist at the University Medical Center Utrecht in the Netherlands.

"The risk of hospitalization for RSV bronchiolitis in otherwise healthy late pre-term [babies] is 5 percent," Bont said. "For other pre-terms, it is higher. About half of all otherwise healthy late pre-terms develop wheezing illness."

RSV-related wheezing reduces quality of life, and it has been linked to the development of asthma, Bont said. It's not yet clear if using palivizumab to prevent RSV will lower rates of asthma, he added.

RSV season lasts about four to five months during the fall, winter or spring, but the exact timing in the United States varies by region, according to the U.S. Centers for Disease Control and Prevention. There is no vaccine for the virus, which causes only mild symptoms in adults and older children.

The study was funded by Abbott Laboratories and the Netherlands Organization for Health Research and Development. Abbott markets palivizumab in some foreign countries.

The researchers set out to determine if RSV was the cause of wheezing illness during the first year of life. Studying 429 babies in the Netherlands, they randomly assigned half to receive a monthly injection of palivizumab during RSV season. The other half received a placebo drug.

The babies in the treatment group had 61 percent fewer days of wheezing during the first year of life. This led the researchers to conclude that RSV is a likely contributor to wheezing illness in this group of children.

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Study Reveals How New Respiratory Virus Spreads

Infectious-disease experts went to Middle East to gather information on often deadly MERS virus

By Robert Preidt

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- The new respiratory virus responsible for an ongoing outbreak in the Middle East poses a serious risk to hospitals because it is easily transmitted in health care facilities, according to a new study.

A team of infectious-disease experts traveled to Saudi Arabia to investigate the spread of the Middle East respiratory syndrome coronavirus (MERS-CoV) in four Saudi hospitals in May. They concluded that the new virus was even more deadly than the related SARS (severe acute respiratory syndrome) virus that caused an outbreak in Toronto hospitals in 2003.

Not only is MERS-CoV easily transmitted from patient to patient, but also from hospital to hospital when sick patients are transferred, according to the study, which was published online June 19 in the New England Journal of Medicine.

"Our investigation showed some surprising similarities between MERS and SARS. Both are very deadly viruses and easily transferred between people, and even between health care facilities," team member Dr. Trish Perl, senior hospital epidemiologist for Johns Hopkins Medicine and a professor at the Johns Hopkins University School of Medicine, said in a Johns Hopkins news release.

At the time of the investigation, 23 people in Saudi Arabia had been infected with MERS-CoV and 11 had died of the virus. The death toll in that country now stands at 32, with 49 people infected, according to the most recent report from the U.S. Centers for Disease Control and Prevention.

In Saudi Arabia, swift action by local health officials to monitor the disease -- including rapid detection, isolation and treatment of infected patients -- has largely helped stem the outbreak, Perl said.

In addition, hospitals have ramped up infection control by introducing stronger disinfectants, requiring health care workers to follow strict procedures (such as wearing masks, gowns and gloves), giving infected patients private rooms and providing masks for uninfected patients in the vicinity.

The investigators also found that the death rate for MERS was much higher than for SARS: 48 percent versus 8 percent, respectively. But the MERS death rate may decrease if more cases -- including patients with mild symptoms -- are identified, the experts said.

The time from MERS exposure to the first signs of infection is about a little more than five days. Symptoms include coughing, shortness of breath, fever and vomiting. It took an average of about eight days for the virus to spread from one person to another, the findings showed.

"The story of how this outbreak occurred and how this virus was transmitted became very clear once we started to lay out the evidence and saw that one infected patient had been in the hospital at the same time as another infected patient, and this patient was transferred to another hospital, where another patient became infected shortly thereafter," Perl said in the news release.

Knowing this information is critical to halting future MERS outbreaks because it reveals how long health officials have to act before a person exposed to the virus begins to show symptoms and when people they infect also start to show symptoms, the researchers said.

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MERS Virus May Never Become Big Threat in U.S., Experts Say

New strain will most likely weaken over time, infection specialists explain

By Steven Reinberg

HealthDay Reporter

THURSDAY, June 6 (HealthDay News) -- Anyone who has watched the movie "Contagion" has seen how fast a virus can spread and how deadly it can be, but is it reality?

Much like the film, a new emerging virus called the Middle East respiratory syndrome coronavirus (MERS-CoV), which kills half the people it infects, has spread from the Middle East to Europe. Since September, there have been 54 reported cases and 30 deaths, making some consider it a worldwide threat.

"Looking at the overall global situation, my greatest concern right now is the novel coronavirus," Dr. Margaret Chan, director-general of the World Health Organization, told delegates at a recent meeting. "The novel coronavirus is a threat to the entire world."

Experts, however, aren't sure the virus is as big a threat as Chan believes.

"Anytime there is a new virus that has the potential to kill people, we ought to take it seriously," said Dr. Marc Siegel, an associate professor of medicine at NYU Langone Medical Center in New York City.

But while Siegel believes the virus's spread should be tracked and studied, he doubts it will ever become a real threat.

"Fear is the biggest virus going," he said. "The amount of concern is already outweighing the risk. People have seen 'Contagion' too many times."

MERS-CoV is one of many viruses that can cause everything from the common cold to severe acute respiratory syndrome (SARS). This virus, however, is new and it's not SARS.

Comparing this virus to the 2003 SARS outbreak is a mistake, Siegel said. "The SARS outbreak, although it was also a coronavirus, was overly hyped. You ended with 8,000 cases around the world and only about 700 deaths."

Every year, the flu kills more than 30,000 people in the United States alone and 500,000 around the world, he said, to put things in perspective.

When a new virus like MERS-CoV comes along, it is often very deadly, but as it spreads it becomes less so, Siegel explained.

"The fact that it has a 50 percent mortality rate means it's a very serious virus, but as viruses get out in the world more, the mortality rate usually goes down," he explained. "With SARS, it started at 50 percent and ended up at 10 percent."

The reason viruses get less deadly is simply that a virus that kills its host can't survive to infect others. "If the virus kills its host, it's much harder to spread," Siegel said.

The key question is how easily does the virus travel from one person to another. "Right now, it does not look that transmissible. Otherwise, it would have spread already more than it has," he said.

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'Cruise Ship Virus' Also Sickens 1 Million U.S. Kids Yearly

Title: 'Cruise Ship Virus' Also Sickens 1 Million U.S. Kids Yearly
Category: Health News
Created: 3/20/2013 6:36:00 PM
Last Editorial Review: 3/21/2013 12:00:00 AM

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'Cruise Ship Virus' Also Sickens 1 Million U.S. Kids Yearly

Norovirus has overtaken rotavirus in causing gastric illness, CDC study finds

By Serena Gordon

HealthDay Reporter

WEDNESDAY, March 20 (HealthDay News) -- Norovirus, the infamous stomach bug that's sickened countless cruise ship passengers, also wreaks havoc on land.

Each year, many children visit their doctor or an emergency room due to severe vomiting and diarrhea caused by norovirus, according to new research from the U.S. Centers for Disease Control and Prevention. The CDC report estimated the cost of those illnesses at more than $273 million annually.

"The main point we found was that the health care burden in children under 5 years old from norovirus was surprisingly great, causing nearly 1 million medical visits per year," said the study's lead author, Daniel Payne, an epidemiologist with the CDC. "The second point was that, for the first time, norovirus health care visits have exceeded those for rotavirus."

Rotavirus is a common gastrointestinal illness for which there is now a vaccine.

It's important to note that the rate of norovirus hasn't been increasing in young children, Payne said. The reason norovirus is now responsible for more health care visits than rotavirus is that the incidence of rotavirus infection is dropping because the rotavirus vaccine is working well.

Results of the study are published in the March 21 issue of the New England Journal of Medicine.

Norovirus is a viral illness that can affect anyone, according to the CDC. It commonly causes nausea, diarrhea, vomiting and stomach cramps. Most people recover from a norovirus infection in a day or two, but the very young and the very old -- as well as those with underlying medical conditions -- have a greater risk of becoming dehydrated when they're sick with norovirus.

The virus is very contagious. Payne said it takes as few as 18 norovirus particles to infect someone. By comparison, a flu virus may take between 100 and 1,000 virus particles to cause infection. Payne said people who have been infected can also keep spreading the virus even after they feel better.

Norovirus is difficult to diagnose definitively. The test that can confirm the virus is costly and time consuming, Payne said, so there have not been good data on how many children are affected by it each year.

To get a better idea of how prevalent this infection really is, the researchers collected samples from hospitals, emergency departments and outpatient clinics from children under 5 years old who had acute gastrointestinal symptoms. The children were from three U.S. counties: Monroe County, N.Y.; Davidson County, Tenn.; and Hamilton County, Ohio. The samples were collected in 2009 and 2010, and were tested for both norovirus and rotavirus.

Norovirus was detected in 21 percent of children under 5 in 2009 and 2010. Rotavirus was found in 12 percent of children in the same age group. Norovirus was also found in 4 percent of healthy children tested in 2009 .

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2 Health Care Workers Made Ill by SARS-Like Virus

An emerging, SARS-like virus that has sickened 40 people in the Middle East and Europe since September has now caused illness in two health care workers who were caring for infected patients, health officials report.

Two health care staffers caring for a patient in Saudi Arabia have been sickened with the coronavirus, the first such recorded case of transmission from patient to health care worker, the Associated Press reported. Person-to-person transmission has been suspected before, the news agency said.

Coronaviruses include SARS, the infection that caused a widespread global outbreak in 2003. The new coronavirus appears to have a high fatality rate, with 20 deaths recorded among the 40 known cases.

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Homegrown Strain of Dengue Fever Virus Pinpointed in Florida

Some 2009-2010 cases originated in Key West mosquitoes, not from travelers, CDC says

By Alan Mozes

HealthDay Reporter

THURSDAY, March 14 (HealthDay News) -- Some people who fell prey to a 2009-2010 outbreak of dengue fever in Florida carried a particular viral strain that they did not bring into the country from a recent trip abroad, according to a fresh genetic analysis conducted by the U.S. Centers for Disease Control and Prevention.

To date, most cases of dengue fever on American soil have typically involved travelers who "import" the painful mosquito-borne disease after having been bitten elsewhere. But though the disease cannot move from person to person, mosquitoes are able to pick up dengue from infected patients and, in turn, spread the disease among a local populace.

The CDC's viral fingerprinting of Key West, Fla., dengue patients therefore raises the specter that a disease more commonly found in parts of Africa, the Caribbean, South America and Asia might be gaining traction among North American mosquito populations.

"Florida has the mosquitoes that transmit dengue and the climate to sustain these mosquitoes all year around," cautioned study lead author Jorge Munoz-Jordan. "So, there is potential for the dengue virus to be transmitted locally, and cause dengue outbreaks like the ones we saw in Key West in 2009 and 2010," he said.

"Every year more countries add another one of the dengue virus subtypes to their lists of locally transmitted viruses, and this could be the case with Florida," said Munoz-Jordan, chief of CDC's molecular diagnostics activity in the dengue branch of the division of vector-borne disease.

He and his colleagues report their findings in the April issue of CDC's Emerging Infectious Diseases.

Dengue fever is the most widespread mosquito-borne viral disease in the world, now found in roughly 100 countries, the study authors noted.

That said, until the 2009-2010 southern Florida outbreak, the United States had remained basically dengue-free for more than half a century.

Ultimately, 93 patients in the Key West area alone were diagnosed with the disease during the outbreak, which seemingly ended in 2010, with no new cases reported in 2011.

But the lack of later cases does not give experts much comfort. The reason: 75 percent of infected patients show no symptoms, and the large "house mosquito" population in the region remains a disease-transmitting disaster waiting to happen.

To try and get a handle on just how serious that risk might be, the CDC team looked at blood samples from 16 of Florida's 67 counties, collected from dengue patients by the Florida Department of Health.

Rigorous genetic testing revealed what researchers feared: the identification of a local Key West strain among dengue patients who had not recently traveled outside the United States.

The team was able to trace the new Key West strain back to its original imported source: a Central American viral strain initially brought into Florida by patients infected in that region. But they stressed that as the local mosquito population acquired the virus from this first round of patients, it developed into a distinct strain of its own. In turn, the new strain was passed on to local residents who had not recently visited Central America.

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Threat to U.S. from new “bird flu” virus: possible but unknown

Posted May 17, 2013, 2:23 pm

Beginning in March, 2013, reports started to come out of Eastern China that a new “bird flu” virus was loose and causing infections in humans. The new virus is called H7N9. Should we in the U.S. be worried?

Neither I nor anyone I know can give a confident answer to that question. What makes flu viruses so unpredictable is that they are constantly changing or mutating their genes. They also are constantly swapping their genes with the genes of other flu viruses. When they change or swap their genes, they change their character.

When I hear about a new flu virus, I want to know two things about it: how easily is it spread from one person to another, and how sick does it make the people it infects?

A report from the U.S. Centers for Disease Control and Prevention (CDC), and another from a team from China in this week’s New England Journal of Medicine, indicate that so far the new H7N9 virus has not clearly spread from one person to another, and has not spread outside of Eastern China. But things can change quickly with flu viruses.

H7N9 has made people very sick, however. Indeed, all three of the people infected with virus described in the New England Journal of Medicine died.

As of the end of April, the CDC said that China had reported 126 human cases of the new flu. The people tend to be older (average age in their 60s) and many have had chronic illnesses. Fewer children and young adults have been infected, so far.

The world is full of different flu viruses. Most of them infect just animals, often just one type of animal. Sometimes a flu virus “jumps” from one animal to another. Sometimes, it is even able to jump from animals to humans. That’s what has happened with H7N9. It has jumped from chickens and ducks to humans.

So far, none of the health care workers caring for people stricken with the new virus have contracted the virus. No travelers from China to the U.S. have been found carrying the virus.

In other words, as I write this article, there does not appear to be a clear threat to people outside of Eastern China. But every public health agency around the world is keeping a close eye on China. That’s because a virus that cannot spread easily from one person to another can change or swap genes—and suddenly be capable of spreading easily. We know of no reason why this could not happen with H7N9. And we know that it can produce severe, even fatal, illness.

How bad can a flu virus be? The worst flu outbreak for which we have good records occurred in 1918. A new virus emerged that spread easily between people and made people very sick.

How easily, and how sick? In the course of a few months, 30% of the people in the world caught the virus, and at least 20 million people died. That’s more than were killed in World War I.

Here in Boston, at the height of the pandemic, 200 dead people every day were carried through the streets in horse-drawn wagons, and often buried in mass graves. As in many other cities around the world, overnight there were hundreds and thousands of orphans. The grandmother of one of my colleagues on the faculty here was one of those orphans. I am not being melodramatic: the worse influenza pandemics can be truly awful.

The CDC and scientists at the National Institutes of Health (NIH) are working overtime to protect our health. But these two critically important federal agencies have just had their budgets slashed by the “sequester.”

Regardless of what you think about federal spending in general, if you share my view that we should not be cutting funding for health research and public health, you could do what I have done. Write your representatives in Congress to restore cuts in the CDC and NIH budgets.

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Secrets of New SARS-Like Virus Uncovered

Finding shows how it enters cells, could lead to vaccine, researchers report

By Barbara Bronson Gray

HealthDay Reporter

WEDNESDAY, March 13 (HealthDay News) -- A discovery that shows how a novel -- and often fatal -- virus infects cells may help fight a health threat that has recently emerged on the world stage, researchers report.

A unique coronavirus was identified as the cause of severe respiratory illness in 14 people from Jordan, Qatar, Saudi Arabia and the United Kingdom between April 2012 and February 2013, according to the U.S. Centers for Disease Control and Prevention. Eight people have died after contracting the virus.

Coronaviruses -- named for their crown-like projections visible under a microscope -- are causes of the common cold but also are associated with more severe illness, such as SARS (Severe Acute Respiratory Syndrome), which killed hundreds of people worldwide in 2003.

Although no deaths have been reported in the United States, the fact that there were clusters of people infected in the United Kingdom shows the new virus can be transmitted between humans, according to the CDC.

Now there's a possible clue on how to stop the virus, which was first identified last September. Dutch researchers said they've identified the receptor that is used by the coronavirus to invade cells.

Approaches to preventing the virus from binding to the receptor and gaining entry to cells may help combat infection, said study author Bart Haagmans, a virologist at the Erasmus Medical Center, in Rotterdam. "These findings provide further insight into how the virus causes severe pneumonia, as the receptor is present in the lower respiratory tract [trachea, airways or lungs]," he explained.

The research was published in the March 14 issue of the journal Nature.

The severity of the disease appears to vary, mirroring minor flu-like infections in some people and becoming life-threatening in others. Those with the most serious infections seem to have had other viral or bacterial infections at the same time, which may help explain the more severe cases, experts said.

The virus doesn't seem as contagious as seasonal flu, and Haagmans said this appears to confirm the role of the receptor he identified. "This may be due to the fact that the receptor is minimally expressed in cells of the upper respiratory tract," he said. "Therefore, it is also unlikely that the virus can become much more capable of spreading more universally."

The discovery of the receptor could potentially help researchers inhibit the spread of the virus, said Haagmans. One approach would be to develop a vaccine that securely locked the cell door to the coronavirus receptor, preventing the virus from being able to storm the cell.

Haagmans said he doesn't know why the virus seems to be deadly. He said it's possible that scores of people with a less harmful form of the disease have not been identified, due to limited testing in the Arabian Peninsula, where the disease seems to have originated.

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Emerging SARS-Like Virus Well-Suited to Attack Humans: Study

By Mary Elizabeth Dallas

HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- The new SARS-like "coronavirus" that first emerged in the Middle East can invade the lungs and immune system as easily as the common cold, according to a new study.

But in the event of a large-scale outbreak, researchers in Switzerland found the virus -- known as HCoV-EMC -- may be treatable with components of the immune system, known as interferons. This immunotherapy has shown promise in the treatment of the respiratory disease SARS and hepatitis C, the study authors said.

"Surprisingly, this coronavirus grows very efficiently on human epithelial cells," said study co-author Volker Thiel of the Institute of Immunobiology at Kantonal Hospital in St. Gallen, in a news release from the American Society for Microbiology. Epithelial cells line hollow organs and glands.

"The other thing we found is that the viruses [HCoV-EMC, SARS, and the common cold virus] are all similar in terms of host responses: they don't provoke a huge innate immune response," he said.

The study was published online Feb. 19 in mBio.

HCoV-EMC, which may have jumped from animal to human very recently, was first isolated in June after a man in Saudi Arabia died from a severe respiratory infection and kidney failure. Following his death, health officials identified 11 more people infected with the virus, the latest in Great Britain. So far, six of the 12 people with known infections have died. Nearly all patients have lived or traveled in the Middle East.

Concerns have been raised that the new strain could trigger a pandemic similar to the SARS outbreak of 2002-03, which infected more than 8,000 people and killed 774.

"We don't know whether the cases we observed are the tip of the iceberg, or whether many more people are infected without showing severe symptoms," noted Thiel.

The World Health Organization on Saturday said that doctors should test patients for the new coronavirus if they have unexplained pneumonia or unexplained complicated respiratory illness not responding to treatment.

So far, no cases of the coronavirus have been reported in the United States, according to the U.S. Centers for Disease Control and Prevention.

To test the new virus, the researchers used cultured bronchial cells to mimic the lining of the human airway. Although this lining is a key barrier against respiratory viruses, the study revealed these cells didn't mount a big defense against HCoV-EMC. Instead, they found human lungs are highly susceptible to the virus, which can multiply at a faster initial rate than SARS.

The study authors noted, however, that pre-treating the airway with proteins that play a critical role in immune response to infections -- known as lambda-type interferons -- significantly reduced the number of infected cells.

Although their findings suggest there is promise for an effective treatment against HCoV-EMC, the researchers added ongoing cooperation between scientists and health agencies around the world is needed to prevent outbreaks of this virus and other diseases.

More information

The World Health Organization provides more information on coronavirus infections.

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New SARS-Like Virus May Have Spread Between People

Title: New SARS-Like Virus May Have Spread Between People
Category: Health News
Created: 2/14/2013 11:00:00 AM
Last Editorial Review: 2/14/2013 12:00:00 AM

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Little-Known Virus Sends Many Kids to Hospital

By Serena Gordon

HealthDay Reporter

WEDNESDAY, Feb. 13 (HealthDay News) -- Chances are you've never heard of human metapneumovirus. But, it's quite possible that you've been sick with this respiratory germ at some point in your life.

Discovered only 12 years ago, human metapneumovirus (HMPV) shares many symptoms with the flu. And, like the flu, most people who get it are miserable for a short time and then get better with no complications.

But the virus can cause serious illness, and in a recent study in U.S. children, researchers found that 6 percent of children who were hospitalized had HPMV, while 7 percent of pediatric emergency room visits were due to the virus.

"It turns out that human metapneumovirus is one of the most common causes of acute respiratory infections," said study senior author Dr. John Williams, an associate professor of pediatrics at the Vanderbilt University School of Medicine in Nashville, Tenn.

"Everyone knows about flu and RSV [respiratory syncytial virus], but it's just in the last couple of years that HPMV is making it into the medical school textbooks. For otherwise healthy children and adults, it tends to be a minor illness, like a cold, but populations that are vulnerable to one of these viruses are vulnerable to all of them," said Williams, who added that this generally includes the very young, the very old and people with underlying health problems, such as asthma or chronic heart disease.

"Now, that we've discovered this leading cause of respiratory infections in kids, it gives us a target for a vaccine," he noted.

The study was supported by a grant from the New Vaccine Surveillance Network of the U.S. Centers for Disease Control and Prevention. It was published in the Feb. 14 issue of the New England Journal of Medicine.

Human metapneumovirus was only discovered in 2001, though it was likely causing disease for many years before it was identified, according to background information in the study. And, although it's been a dozen years since the disease was discovered, it was still unclear how often people were infected, and how severe the illness could be.

To track down these answers, Williams and his Vanderbilt colleague Dr. Kathryn Edwards, along with other researchers, collected data on the virus from hospitals in three U.S. counties from 2003 through 2009.

They found the virus in 200 of 3,490 children (6 percent) hospitalized during that time period. Of 3,257 outpatient clinic visits, they found 7 percent of children had HPMV. And, of 3,001 children seen in emergency rooms, 7 percent had the virus. The researchers also tested 770 children who weren't having any symptoms, and found the virus in 1 percent.

Annually, one out of every 1,000 hospitalizations in children less than 5 years old was due to human metapneumovirus. In those less than 6 months of age, the rate of hospitalization due to HPMV was three per 1,000. In children aged 6 months to 1 year, that number was two per 1,000, according to the study.

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New SARS-Like Virus May Have Spread Between People

Feb. 13, 2013 -- A new illness similar to the deadly SARS virus has probably spread from person to person in the U.K.

Previous cases of this new virus, a coronavirus, have been seen in people who've returned from visits abroad. The latest case is in a person who hasn’t been abroad recently and is thought to have caught it from a relative, British officials say.

However, officials say the threat of the infection spreading remains very low.

Many coronaviruses are not a cause for concern. Some strains cause the common cold but also include SARS, or severe acute respiratory syndrome.

The new coronavirus was identified in September 2012 in a person who died from a severe infection of the lungs. The virus caused fever, cough, shortness of breath, and breathing problems.

British officials  say 11 confirmed cases have been seen worldwide, including three deaths in Saudi Arabia and two deaths in Jordan. None have been reported in the U.S., according to the CDC.

Previous U.K. cases have been seen in people who travelled to Qatar, Pakistan, and Saudi Arabia.

Officials say two new cases were found in a U.K. resident who had recently been to the Middle East and Pakistan and a family member who had not traveled recently. They are in intensive care at the Queen Elizabeth Hospital in Birmingham. The family member has an existing medical condition that makes them more susceptible to infections of the lungs, officials say.

In a statement, Professor John Watson, head of the respiratory diseases department at Britain’s Health Protection Agency (HPA),  says, "Confirmed novel coronavirus infection in a person without travel history to the Middle East suggests that person-to-person transmission has occurred, and that it occurred in the U.K.

"Although this case provides strong evidence for person-to-person transmission, the risk of infection in most circumstances is still considered to be very low. If novel coronavirus were more infectious, we would have expected to have seen a larger number of cases than we have seen since the first case was reported three months ago."

The HPA says special measures have been put in place to stop the infection from spreading.

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