With the very strong caveat that all we have right now are multiple media reports – and I find nothing on the Turkish MOH site – the Turkish press is lit up this morning with reports of three suspected MERS cases isolated in the Province of Van after returning from doing Umrah in Saudi Arabia.
First, an English language report from an Azerbaijani news source, which unlike the other reports, doesn’t call these `suspected cases’. Caveat lector.
7 March 2015, 12:27 (GMT+04:00)
Three cases of infection with a coronavirus were revealed in the Turkish province of Van, the Sabah newspaper reported March 7.
Reportedly, two of the infected are women. The infected are the Turkish citizens and have previously come from pilgrimage in Saudi Arabia. No further details were disclosed.
From the Turkish language press we get a couple of somewhat more detailed, but less definitive, reports.
2 female 3 people indicated that they returned from Umrah in Van, taken on suspicion of MERS disease quarantine at the hospital in the city.
Saturday, March 7, 2015 09:11
According to the information received, returned from a visit to Umrah 71 years old Gift Aydin name a couple that can not be learned, headaches since a week, cough, nausea, vomiting, shortness of breath and fever increases, on Dursun Centenary College with a private hospital in the city, was admitted to Odabaş Medical Center.
A 'also according to the news, and then tests the chest in the interviews conducted with experts and infection specialists, it was decided that one of the referral to the suspicion of MERS disease Van Regional Training and Research Hospital.
Future releases will be made regarding the patients quarantined in hospital health status learned, after referral to the couple's Van Regional Training and Research Hospital, a private hospital patients, relatives and staff of the mask he wore, and the cleaning staff hospital of the inner and outer parts of the start washing was observed.
Saturday March 7, 2015 12:01
pilgrimage return Mers virus was found in the van. 3 people returning from a pilgrimage to the Mers were quarantined virus cases. Cough and was taken to hospital due to high fever. Out that it is the Mers were immediately quarantined and began to treat the virus. 1 week finds headache, evil 3 people at home who was hospitalized with fever and cough cause with the help of neighbors.
While MERS may be suspected – understandable, given their recent travel history – influenza and other respiratory illnesses are rife this time of year, and so the diagnosis will have to wait for laboratory confirmation. Still, if MERS is confirmed in one or more of these pilgrims, it wouldn’t be the first time for Turkey.
Last October we learned of Turkey’s first imported MERS case (see Turkey Announces MERS Fatality – ex KSA).
Native to the Arabian peninsula, MERS has managed to travel well beyond the region via international travel, with 13 countries outside of the Middle East seeing imported cases over the past two years. With an incubation period of up to 15 days, it is all to easy for someone to become exposed in the region and travel – asymptomatically for a week or longer – before falling ill.
Credit - ECDC risk assessment on MERS-CoV
While the yearly Hajj pilgrimage, which sees in excess of 2 million visitors to Saudi Arabia over a few short weeks, is viewed as the biggest mass gathering MERS risk, millions of other religious pilgrims travel to the Holy cities throughout the year.
All able bodied Muslims are required to make at least one major pilgrimage to Mecca during their lifetime, at the time of the hajj. This is known as the fifth pillar of Islam, and is one of the duties incumbent upon all Muslims.
The faithful may also make `lesser pilgrimages’, called omra (or Umrah), at other times of the year. These minor pilgrimages don’t absolve the faithful of making the hajj journey unless they take place during Ramadan (this year: June 17h-July 17th).
As a result, the Kingdom of Saudi Arabia (KSA) receives more than 6 million visitors each year. Most will arrive during the month of Ramadan and during the Hajj ( which begins the last week of September this year), but Umrah pilgrims come and go by the tens of thousands each month.
With the expected spring surge in MERS cases – particularly in Saudi Arabia - the next few months will probably hold the greatest prospects for seeing additional exported MERS cases from the region.