Wednesday, October 28, 2015

Saudi MOH Statement On Hofuf MERS Cluster


Saudi MOH – No New MERS Cases Today





We’ve been following a  MERS outbreak in Hofuf, Al-Ahsa region, for about two weeks and as of yesterday we had noted 7 cases; two primary and 5 nosocomial (see Saudi MOH Announces 4 MERS Cases (Riyadh & Hofuf)). 


This is one of two hospital outbreaks ongoing in Saudi Arabia (the other being in Riyadh), and the second major outbreak in Hofuf this year. Between April and July Hofuf reported 40+ cases, most being hospital acquired (see June 15th EMRO MERS report).


While the MOH is reporting no new cases today, overnight they posted a statement on the Hofuf/Al-Ahsa cluster. What follows is a machine translation from the Arabic.


Health announces limited cases coronavirus in almana General Hospital in Al-Ahsa

15 Muharram 1437

The Health Ministry said that in the framework of epidemiological investigation and under continuous monitoring of coronavirus in Saudi Arabia.

The Ministry would like to announce the registration of a limited number of cases of corona virus in almana General Hospital auth seven cases. So began the initial state of emergency then infection in two sections put patients. It logged 5 additional cases as a result of infection in the hospital and one other preliminary is not linked to any of the cases. One of the cases was that of a nurse.

The Ministry immediately apply many precautionary measures followed in these cases, all cases were transferred to the King Fahad hospital-alhafoof, stop the entry of scheduled cases simply enter critical cases only with the full implementation of infection control requirements. As well as an inventory of all contacts either at home or health practitioners also includes discharged from hospital since the first case. It was also examining all close contacts of patients and health practitioners, and inform all hospitals in Al-Ahsa and outbreak preparedness.


Among the things we don’t learn from this statement are the source(s) of community exposure that started this cluster, and the events that led to the transmission of the virus to 4 patients and 1 nurse inside the hospital.


When South Korea was blindsided by their first imported MERS case last May, they failed to identify and isolate the index case, and as a result  saw a massive multi-facility outbreak (n=186 cases).


Yet, through aggressive quarantine and infection control policies, they managed to halt the transmission relatively quickly.  While they have continued to treat PCR positive patients, they’ve not seen the transmission of the virus in roughly 4 months.

Many other hospitals around the world have managed to isolate and treat MERS cases without secondary transmission (see Eurosurveillance: Estimating The Odds Of Secondary/Tertiary Cases From An Imported MERS Case). 


Credit Eurosurveillance

As the chart above illustrates, out of 23 MERS importations around the world through July 1st, 2015, 19 managed to isolate and treat cases without seeing secondary/nosocomial cases.  


Exactly why – after three years of dealing with the virus -  Saudi (and other Middle Eastern) hospitals continue to struggle so with containment remains a mystery.

No comments: