Sunday, March 08, 2015

Saudi MOH: 2 New MERS Cases & Weekly Recap Statement


# 9794


In addition to yesterday’s single case from Riyadh, the MOH has announced two more MERS cases today, along with two deaths.





The MOH has also posted this (translated) weekly update:

Health: a weekly statement issued and recorded 19 cases of last week

Rabi 1436

The Ministry of health to inform everyone on the developments of the Middle East respiratory syndrome Corona

The Department of Health announces that from 10 to 16 April 1436, it was recorded 19 confirmed cases infected with coronavirus, aged 30-74 years, including 16 in Riyadh, and two in Jeddah and one in Jeddah and was their nationality as follows (EUR 11, starboard 1, Filipino 2, Indians 1, Sudan 1, Pakistan 1, Taka 2) including 11 male and 8 female.

The Ministry has shown that 8 cases in her community and 3 cases of health practitioners and 3 infections acquired in health facilities and two contacts home recorded one case of infection in the community and two in the first of her community of Qassim and the second health practitioner.

The rapid response teams to combat infection health facilities had about 18 field trip between visits and visits to append last week

Preventive medicine teams also visited 15 homes and been limited to 196 contacts home and followed them until the end of the incubation period of the virus.

The Ministry said that the number of communications that are initiated from the Agriculture Ministry teams (including follow-up to previous cases had direct contact with the camel reached 3 communications in Tabuk and blonde walkhrmh.

The Ministry stressed that the command center which continues its efforts around the clock through the epidemiological surveillance and ensure the commitment of all Government and private health facilities to implement infection control measures and coordination with concerned government sectors and international health organizations, including the World Health Organization and expertise to follow all overtaken on coronavirus


What remains striking after nearly three years, is how little we really know about how MERS spreads in the community.  


A fair number of cases have been linked to hospital spread, and camels have been shown to carry the virus and are presumed to play some part in introduction of the virus to humans, but for most cases the source of infection remains unknown.


Also unexplained are the heavily skewed demographics of infection, as shown in the following graphic from the most recent ECDC Rapid Risk Assessment on MERS



Although nearly half the population of Egypt is under the age of 25 (see CIA FACTBOOK chart below), that age group accounts for less than 10% of the MERS cases to date. 


While comprising only about 20% of the population, those over 50 make up roughly half of the MERS cases reported in Saudi Arabia.  This age skew, along with the 2:1 ratio of male to female cases, has yet to be adequately explained.


The question of `asymptomatic’  transmission of the virus has yet to be answered, although we’ve seen hints that it may be a factor (see Study: Possible Transmission From Asymptomatic MERS-CoV Case). Roughly 20% of known MERS cases are described as being mild (or asymptomatic), and so it isn’t far-fetched to think there are undiagnosed cases in the community, stealthily spreading the virus.


A couple of weeks ago, in Saudi Arabia: WHO MERS Mission Summary, we looked at a brief summary of their findings and recommendations.


Although couched in language diplomatic, the overriding message here is that much more research needs to be done in order to understand how the MERS coronavirus is being transmitted – from animals to humans, within the community, and in the healthcare environment. 


Normally we’d get answers to these questions from a a case-control study, where epidemiologists would compare laboratory-confirmed cases to a large number of controls, matched for age, sex, and by neighborhood. By examining their respective exposures against their outcomes, patterns of risk are often revealed.

While repeated promises have been made regarding this study (see KSA Announces Start To Long-Awaited MERS Case Control Study), for whatever reason, we’ve yet to see the results.

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