On Saturday (see Jordan: 3rd MERS Fatality Of 2015) we saw a media report of a third fatality and a reference to a 7th patient in Jordan’s recent MERS cluster, but without details. The first 4 cases were described last week in WHO Update On Jordanian MERS Cluster, while today we have descriptions of cases #5 and #6.
Both of these cases had the ill fortune to be seeking medical care at a facility already treating a MERS case. While the exact route of exposure is unknown, the update states:
`Investigation of possible epidemiological links with the MERS-CoV cases admitted to their hospital or with shared health care workers is ongoing.’
To date, at least 26 countries have dealt with MERS cases, yet only 4 nations (Saudi Arabia, South Korea, UAE, & Jordan) account for 97% of the world’s known cases, and all have reported extended nosocomial outbreaks. The remaining 22 affected countries been able to identify, isolate, and treat MERS cases with either minimal or no secondary transmission to patients or hospital staff.
Whether - or how long - that luck will hold is an open question. But the experience so far suggests that a combination of vigilance and good infection protocols can prevent the spread of this virus.
After their spectacular failure to contain MERS earlier this summer, last week Korea Announced Major Changes In Wake Of MERS Outbreak they hope will prevent a reoccurrence. Unless and until a similar commitment is forthcoming from hospitals and Health Ministries across the Arabian Peninsula, healthcare facilities there are likely to continue to amplify outbreaks of the virus.
Disease outbreak news
6 September 2015
Between 30 and 31 August 2015, the National IHR Focal Point of Jordan notified WHO of 2 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. Both cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city.
Details of the cases
- A 73-year-old female from Amman city was admitted to hospital due to her chronic conditions on 21 August and, on 24 August, was discharged. This hospital has been experiencing a MERS-CoV outbreak. On 28 August, the patient developed symptoms and, on the same day, was admitted to the same hospital. She was treated symptomatically and discharged from hospital on 29 August. As her symptoms worsened, the patient visited a different hospital and was admitted on the same day. She tested positive for MERS-CoV on 31 August. Currently, the patient is in stable condition in a negative pressure isolation room on a ward. Investigation of possible epidemiological links with the MERS-CoV cases admitted to her 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.
- A 56-year-old male from Amman city was admitted to hospital for a medical procedure on 18 August. This hospital has been experiencing a MERS-CoV outbreak. While hospitalized, on 28 August, the patient developed symptoms and, on 30 August, tested positive for MERS-CoV. The patient, who had comorbidities, passed away on 1 September. Investigation of possible epidemiological links with the MERS-CoV cases admitted to her hospital or with shared health care workers is ongoing. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
Contact tracing of household and healthcare contacts is ongoing for these cases.
Globally, the WHO has been notified of 1,495 laboratory-confirmed cases of infection with MERS-CoV, including at least 528 related deaths.