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Concept: United Arab Emirates

198

A novel coronavirus (MERS-CoV) causing severe, life-threatening respiratory disease has emerged in the Middle East at a time when two international mass gatherings in Saudi Arabia are imminent. While MERS-CoV has already spread to and within other countries, these mass gatherings could further amplify and/or accelerate its international dissemination, especially since the origins and geographic source of the virus remain poorly understood.

Concepts: Saudi Arabia, Arabian Peninsula, Riyadh, United Arab Emirates, Middle East, Qatar, Jordan, Arabic language

197

A human coronavirus, called the Middle East respiratory syndrome coronavirus (MERS-CoV), was first identified in September 2012 in samples obtained from a Saudi Arabian businessman who died from acute respiratory failure. Since then, 49 cases of infections caused by MERS-CoV (previously called a novel coronavirus) with 26 deaths have been reported to date. In this report, we describe a family case cluster of MERS-CoV infection, including the clinical presentation, treatment outcomes, and household relationships of three young men who became ill with MERS-CoV infection after the hospitalization of an elderly male relative, who died of the disease. Twenty-four other family members living in the same household and 124 attending staff members at the hospitals did not become ill. MERS-CoV infection may cause a spectrum of clinical illness. Although an animal reservoir is suspected, none has been discovered. Meanwhile, global concern rests on the ability of MERS-CoV to cause major illness in close contacts of patients.

Concepts: Disease, Severe acute respiratory syndrome, Saudi Arabia, Arabian Peninsula, Riyadh, United Arab Emirates, Middle East, Arabic language

175

Accurate information about the prevalence and types of tobacco use is essential to deliver effective public health policy. We aimed to study the prevalence and modes of tobacco consumption in the United Arab Emirates (UAE), particularly focusing on the use of Midwakh (Arabic traditional pipe).

Concepts: Tobacco, Saudi Arabia, United Arab Emirates, Middle East, Iran, Arab people

171

BACKGROUND: Although vitamin D deficiency has been studied in various adult populations, there are few data on the prevalence of this nutritional deficiency among healthy adolescents in the United Arab Emirates (UAE). This study was conducted to determine the prevalence of vitamin D deficiency and to examine its correlates in adolescents aged 15 to 18 years. METHODS: This was a cross-sectional study in urban schools. Healthy adolescents (N=315) from a sample of 8 schools were randomly selected from the 142 schools in Al Ain, Abu Dhabi Emirate. Outcomes measured included serum concentrations of 25-hydroxy vitamin D (25OHD), plasma lipids, blood sugar, blood pressure and anthropometric data, nutrition and lifestyle variables. RESULTS: Fourty-one participants (19.7%) were vitamin D deficient (serum 25OHD level <=15 ng/mL [<=37.5 nmol/L]. Using a cutoff level of 25(OH)D of <=20 ng/ml [<=50 nmol/l] 143 participants (45.4%) were vitamin D insufficient. Overall 65.1% of study participants were either vitamin D deficient or insufficient. The prevalence of vitamin D deficiency varied between boys (10%) and girls (28%). In a final multivariate model, serum 25(OH)D concentrations were inversely correlated with female gender, consumption of fast food per week, and body mass index and positively correlated with physical activity scores after adjustment for age. CONCLUSIONS: Vitamin D deficiency and insufficiency were highly prevalent in adolescents, and more common in girls.

Concepts: Nutrition, United Arab Emirates, Abu Dhabi, Dubai, Khalifa bin Zayed Al Nahyan, Zayed bin Sultan Al Nahyan, Al Ain

167

This study estimates the potential health gains achievable in the United Arab Emirates (UAE) with improved controls on environmental pollution. The UAE is an emerging economy in which population health risks have shifted rapidly from infectious diseases to chronic conditions observed in developed nations. The UAE government commissioned this work as part of an environmental health strategic planning project intended to address this shift in the nature of the country’s disease burden.

Concepts: Medicine, Saudi Arabia, United Arab Emirates, United Nations, Abu Dhabi, Dubai, Arab people, Ras al-Khaimah

152

Data on the occurrence of whale sharks, Rhincodon typus, in the Arabian Gulf and Gulf of Oman were collected by dedicated boat surveys and via a public-sightings scheme during the period from 2011 to 2014. A total of 422 individual whale sharks were photo-identified from the Arabian Gulf and the northern Gulf of Oman during that period. The majority of sharks (81%, n = 341) were encountered at the Al Shaheen area of Qatar, 90 km off the coast, with the Musandam region of Oman a secondary area of interest. At Al Shaheen, there were significantly more male sharks (n = 171) than females (n = 78; X2 = 17.52, P < 0.05). Mean estimated total length (TL) for sharks was 6.90 m ± 1.24 (median = 7 m; n = 296). Males (7.25 m ± 1.34; median = 8 m, n = 171) were larger than females (6.44 m ±1.09; median = 7 m, n = 78; Mann-Whitney U test, p < 0.01). Of the male sharks assessed for maturity 63% were mature (n = 81), with 50% attaining maturity by 7.29 m and 100% by 9.00 m. Two female sharks of >9 m individuals were visually assessed as pregnant. Connectivity among sharks sighted in Qatari, Omani and UAE waters was confirmed by individual spot pattern matches. A total of 13 identified sharks were re-sighted at locations other than that at which they were first sighted, including movements into and out of the Arabian Gulf through the Strait of Hormuz. Maximum likelihood techniques were used to model an estimated combined population for the Arabian Gulf and Gulf of Oman of 2837 sharks ± 1243.91 S.E. (95% C.I. 1720-6295). The Al Shaheen aggregation is thus the first site described as being dominated by mature males while the free-swimming pregnant females are the first reported from the Indian Ocean.

Concepts: Arabian Peninsula, United Arab Emirates, Qatar, Persian Gulf, Shark, Gulf of Oman, Oman, Strait of Hormuz

151

130

To the Editor: A majority of the 94 cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection that have been reported to date have occurred in Saudi Arabia. Patients with this infection have presented with serious respiratory disease and have required hospitalization.(1),(2) However, there have been case reports of less severe disease within family(3),(4) and hospital(2) clusters, and the clinical spectrum of MERS-CoV infections may extend to asymptomatic and subclinical cases. Therefore, the epidemiologic and clinical characteristics of this infection need further definition. The patterns of the spread of MERs-CoV among family(3),(4) or hospital(2) clusters suggest that . . .

Concepts: Health care, Health, Saudi Arabia, Arabian Peninsula, Riyadh, United Arab Emirates, Middle East, Arabic language

129

The Middle East respiratory syndrome (MERS) coronavirus has caused recurrent outbreaks in the Arabian Peninsula since 2012. Although MERS has low overall human-to-human transmission potential, there is occasional amplification in the healthcare setting, a pattern reminiscent of the dynamics of the severe acute respiratory syndrome (SARS) outbreaks in 2003. Here we provide a head-to-head comparison of exposure patterns and transmission dynamics of large hospital clusters of MERS and SARS, including the most recent South Korean outbreak of MERS in 2015.

Concepts: Severe acute respiratory syndrome, Saudi Arabia, Arabian Peninsula, United Arab Emirates, Middle East, Jordan

93

The United Nations (UN) recently released population projections based on data until 2012 and a Bayesian probabilistic methodology. Analysis of these data reveals that, contrary to previous literature, the world population is unlikely to stop growing this century. There is an 80% probability that world population, now 7.2 billion people, will increase to between 9.6 billion and 12.3 billion in 2100. This uncertainty is much smaller than the range from the traditional UN high and low variants. Much of the increase is expected to happen in Africa, in part due to higher fertility rates and a recent slowdown in the pace of fertility decline. Also, the ratio of working-age people to older people is likely to decline substantially in all countries, even those that currently have young populations.

Concepts: Africa, Demography, Population, United Arab Emirates, Decision theory, United Nations, World population, Population growth