Photo Credit NIAID
Today the New England Journal of Medicine published an extensive analysis of the (possibly ongoing) outbreak of MERS-CoV at four hospitals in Eastern Saudi Arabia, between April 1st and May 23rd.
The authors – which included Canadian SARS expert Dr. Allison McGeer - tracked the likely transmission routes, incubation times, and serial intervals (time between onset of symptoms individuals in a chain of infections) of 23 confirmed coronavirus infections.
As Helen Branswell tells us in her article tonight, MERS-CoV appears to transmit in a hospital environment very much in the same as did SARS ten years ago.
Helen Branswell, The Canadian Press Jun 19, 2013 05:00:17 PM
TORONTO – A long-awaited report on a large and possibly still ongoing outbreak of MERS coronavirus in Saudi Arabia reveals the virus spreads easily within hospitals, at one point passing in a person-to-person chain that encompassed at least five generations of spread.
The study, co-written by Toronto SARS expert Dr. Allison McGeer, also hints there may have been a superspreader in this outbreak, with one person infecting at least seven others.
The study lays out what is known about an outbreak of MERS that erupted this spring in four hospitals in the Eastern Province of Saudi Arabia, in an area whose name translated into English can be spelled Al-Ahsa or Al-Hasa (the study uses the second version). It was reported online on Wednesday by the New England Journal of Medicine.
The full NEJM article is available online, and you’ll no doubt want to read it in its entirety, but a few key points (bolding & underlining mine) lifted the discussion include:
- Most of the case patients were men, and the median age was 56 years
- The most common symptoms were fever (87%) and cough (89%), while 35% presented with gastrointestinal symptoms (vomiting or diarrhea)
- Laboratory testing for MERS-CoV remains a challenge. Validated serologic assays are not yet available, and this may have limited the identification of cases.
- Because some patients presented with gastrointestinal symptoms, and transmission appeared to occur between rooms on the ward, the current WHO recommendations for surveillance and control should be regarded as the minimum standards;
- The Case Fatality Ratio was 65%
Abdullah Assiri, M.D., Allison McGeer, M.D., Trish M. Perl, M.D., Connie S. Price, M.D., Abdullah A. Al Rabeeah, M.D., Derek A.T. Cummings, Ph.D., Zaki N. Alabdullatif, M.D., Maher Assad, M.D., Abdulmohsen Almulhim, M.D., Hatem Makhdoom, Ph.D., Hossam Madani, Ph.D., Rafat Alhakeem, M.D., Jaffar A. Al-Tawfiq, M.D., Matthew Cotten, Ph.D., Simon J. Watson, Ph.D., Paul Kellam, Ph.D., Alimuddin I. Zumla, M.D., and Ziad A. Memish, M.D. for the KSA MERS-CoV Investigation Team
June 19, 2013DOI: 10.1056/NEJMoa1306742