MERS by month of Onset – Credit ECDC
The ECDC has published an updated Epidemiological Update on MERS cases, which includes the 1st four Jordanian cases of 2015, along with Saudi cases reported through September 2nd. As always, they pack a lot of information, and some excellent graphics, into their updates.
As the chart above illustrates, while our history of tracking MERS is pretty short, we do seem to be seeing more MERS activity the past few months than we have during previous summers. These numbers, however, are largely being propelled by three major nosocomial outbreaks (Hofuf, South Korea, Riyadh).
I’ve only included the outbreak summaries, so follow the link for the entire update:
02 Sep 2015
According to WHO the four cases reported from Jordan between 26 and 28 August 2015 seem to be part of a MERS-CoV outbreak at a hospital in Amman.
The first case reported was a 60-year-old man who lived in Jeddah, Saudi Arabia, but had travelled to Amman on 28 July 2015. The onset of symptoms began on 31 July and he was hospitalised for the first time from 10 to 18 August. However, he was readmitted to another hospital on 20 August. It is not known how this case became infected.
The second case is a 38-year-old man from Kuwait City who travelled to Amman on 7 August 2015. He developed symptoms on 12 August. He was hospitalised on 17 August in the same hospital where the first case was treated. One possible exposure is that he frequently visited a family member who was being treated at the same hospital as the first case.
The third case is a 76-year-old man from Amman who was hospitalised for treatment of a chronic health condition on three different occasions at the same hospital as the two previous cases. According to WHO he was hospitalised twice for an underlying condition and then admitted on 20 August 2015 after he was diagnosed with MERS-CoV.
The fourth case is a 47-year-old woman from Kuwait City who travelled to Amman on 15 July 2015. She is a contact of the second case and tested positive for MERS-CoV on screening tests. She is asymptomatic and is in home isolation. Her only known exposure is that she visited family members at the hospital where the first patient was being treated.
In addition to the four cases mentioned, Jordan has announced two extra cases, a 56-year-old Jordanian man who was diagnosed with MERS-CoV after undergoing surgery and a 74-year-old woman who has pre-existing medical conditions.
Since the beginning of 2015, Saudi Arabia has reported 367 cases, of which 30 were reported after ECDC’s risk assessment of 27 August 2015. Twenty-eight of the cases occurred in Riyadh (Figure 4) and two in Najran.
Figure 3. Number of cases (n=131) reported by Saudi Arabia in Riyadh, 3 August 2015 – 2 September 2015, by date of reporting
For four of the 30 cases it was clearly indicated that they did not have any contact with a previously identified or suspected case. The remaining 26 cases had either had contact, or were under review for having had contact, with suspected or confirmed cases in the community or hospital. This may indicate that there might be a low-level community transmission but the majority of the cases are clearly related to nosocomial transmission of MERS-CoV in Saudi Arabia. Six of the 30 cases are healthcare workers.