Thursday, September 10, 2015

Saudi MOH Reports 3 Additional MERS Cases

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# 10,509

 

The Saudi MOH reports 2 new cases in Riyadh, one of which is listed as having had contact with a confirmed or suspected case, and a second case in less than a week from Al Medinah;  a health care worker with (like the one announced on Monday)  `contact’ with a confirmed or suspected case.


The initial source of the Medinah cluster remains a bit of a mystery, since both cases from that city are listed as `contacts’ of a confirmed or suspected case.

 

This makes the 38th day running with MERS cases reported in Saudi Arabia. 

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Over the past two days the World Health Organization has released details on 40 MERS cases reported from Saudi Arabia between August 26th and September 5th.

  • 9 September 2015
    Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia
  • 8 September 2015
    Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Saudi Arabia


Of these 40 cases, 11 are listed as Health Care Workers.  Of those, only 3 are listed as having provided direct care to a laboratory-confirmed MERS case.   For the rest, the following mantra applies:

 

Investigation of possible epidemiological links with MERS-CoV cases in the hospital or with shared health care workers is ongoing. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.


For the majority of the remaining non-HCW cases, a slightly reworded mantra is offered:

 

Investigation of possible epidemiological links with MERS-CoV cases in the hospital or with shared health care workers is ongoing. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.


The bottom line is that for the vast majority of cases, the only link has been either working in, visiting, or being admitted to a hospital where MERS cases are being treated. 

 

The exact mechanism of nosocomial transmission for most of these cases – be it via fomites, asymptomatic carriers, or some other route – is far from clear.


Why, after three years, dozens of hospital outbreaks,  and hundreds of deaths that should still be the case is the source of a good deal of frustration in the international medical and public health community.   Something that Dr. Ian Mackay  addresses in his morning blog:

 

 Ignore mild and asymptomatic cases at your peril...

 

 

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