We’ve two new MERS cases reported today, one from Riyadh and one from Al-Kharj, for which no indication of how they were exposed is provided. One is already listed as having already died, and the other is in critical condition.
Given the lack of epidemiological information provided, and the Saudi MOH’s record of sometimes not reporting cases immediately upon their discovery, it makes it difficult to comment on the advanced stage of illness of these two patients.
Late detection, however, could indicate a greater risk of exposure to others. Hopefully we’ll learn more when the WHO posts an update.
The designation as a `Primary’ case only tells us these cases had no known exposure to an indentified MERS case. Nearly 40% of all known Saudi cases fall into this `primary’ category.
While some percentage of these `primary’ cases may have had contact with camels - or camel products – for most their source of exposure is unknown. The possibility that mild or asymptomatic cases are facilitating the community spread of MERS remains an intriguing, but largely unproven theory.
Until the source of these sporadic primary’ MERS infections from the community can be identified and eliminated, the odds of seeing additional, large nosocomial outbreaks – locally, and internationally – continue.