Thursday, October 29, 2015

WHO MERS Update : Saudi Arabia – Oct 29th

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# 10,676

 

The World Health Organization has published a MERS update listing 12 cases reported by the Saudi MOH between October 17th – October 24th.  Of these, four are members of a household/compound where expat employees live together, and a MERS outbreak has been ongoing for a couple of weeks. 

 

Their exposures are pretty straight forward, although we never learned how the `index’ case in this cluster was exposed.


Two others acquired the virus via nosocomial transmission, one as a HCW caring for a MERS patient and the other simply unlucky to be hospitalized in a facility where MERS is being treated.

 

The remaining 6 are less well defined.  One is noted to raise sheep, and had camel contact prior to falling ill, but the other five appear to fall into that nebulous category of `primary’ cases from the community, without an obvious exposure.

 

Our understanding of community transmission of the MERS virus continues to be hampered by the lack of a well-mounted case-control study out of Saudi Arabia (see  WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps).

 

 

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news
29 October 2015

Between 17 and 24 October 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death.

Details of the cases
  1. A 45-year-old, non-national male from Alkharj city developed symptoms on 13 October and, on 22 October, was admitted to hospital. The patient, who had comorbidities, tested positive for MERS-CoV on 23 October and, on the same day, passed away. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  2. A 60-year-old female from Riyadh city developed symptoms on 13 October and, on 22 October, was admitted to a hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 23 October. Currently, she is in critical condition in ICU. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  3. A 47-year-old, non-national, female health care worker from Riyadh city developed symptoms on 15 October and, on 19 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 21 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient ‬‬provided care to a laboratory-confirmed MERS-CoV case (see DON published on 22 October – case no. 1). She has no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms.
  4. A 28-year-old, non-national female from Riyadh city developed symptoms on 15 October and, on 16 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 21 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient lives in a housing compound that has been experiencing a MERS-CoV outbreak. She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Investigation of possible epidemiological links with previous cases detected in the compound is ongoing.
  5. A 75-year-old male from Hofuf city developed symptoms on 20 October, while admitted to hospital due to chronic conditions since 8 October. The patient tested positive for MERS-CoV on 21 October. Currently, he is in critical condition in ICU. The patient was admitted to the same ward as a laboratory-confirmed MERS-CoV case (see below – case no. 10). He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Investigation of possible epidemiological links with the case and with shared health care workers is ongoing.
  6. A 52-year-old, non-national female from Riyadh city was identified through contact tracing while asymptomatic. The patient, who has comorbidities, tested positive for MERS-CoV on 21 October and, on the same day, was admitted to hospital. Currently, she is still asymptomatic and in stable condition in a negative pressure isolation room on a ward. The patient lives in a housing compound that has been experiencing a MERS-CoV outbreak; furthermore, she has a history of contact with a MERS-CoV case (see DON published on 22 October – case no. 4). The patient has no history of exposure to other known risk factors in the 14 days prior to being detected.
  7. A 37-year-old male from Hofuf city developed symptoms on 8 October and, on 11 October, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 17 October. Currently, he is in critical condition in ICU. The patient owns sheep and has frequent contact with them; furthermore, he has a history of contact with camels in the 14 days prior to the onset of symptoms. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
  8. A 29-year-old, non-national female from Riyadh city was identified through contact tracing. She developed symptoms on 15 October and, on 16 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 18 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient lives in a housing compound that has been experiencing a MERS-CoV outbreak; furthermore, she has a history of contact with a MERS-CoV case (see DON published on 22 October – case no. 4). The patient has no history of exposure to other known risk factors in the 14 days prior to being detected.
  9. A 61-year-old female from Riyadh city developed symptoms on 14 October and, on 16 October, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 18 October. Currently, she is in critical condition in ICU. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  10. A 76-year-old male from Hofuf city developed symptoms on 3 October and, on 14 October, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 16 October. Currently, he is in stable condition in a negative pressure isolation room on a ward. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  11. A 65-year-old male from Aldawadmi city developed symptoms on 11 October and, on 16 October, was admitted to hospital. The patient, who has comorbidities, tested positive for MERS-CoV on 17 October. Currently, he is in stable condition in a negative pressure isolation room on a ward. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  12. A 29-year-old, non-national female from Riyadh city was identified through contact tracing. She developed symptoms on 13 October and, on 14 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 17 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient lives in a housing compound that has been experiencing a MERS-CoV outbreak; furthermore, she has a history of contact with a MERS-CoV case (see DON published on 22 October – case no. 4). The patient has no history of exposure to other known risk factors in the 14 days prior to being detected.

Contact tracing of household and healthcare contacts is ongoing for these cases.

Globally, since September 2012, WHO has been notified of 1,611 laboratory-confirmed cases of infection with MERS-CoV, including at least 575 related deaths.

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