Thursday, October 22, 2015

WHO Update On Riyadh Household MERS Cluster

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# 10,648

 

We’ve the first World Health Organization DON update on the recent cluster of MERS cases among young expat female workers, reportedly living together in a very crowded apartment in Eastern Riyadh.   This update covers only the first four cases (there were 7 as of yesterday), and quite frankly, leaves us with more questions than answers.

 

There is no clue offered as to the likely source of exposure for the `index case’ of this cluster, a 26-y.o. non-national who reportedly employed by a private cleaning crew that worked for Princess Nora University in the nation’s capital.  She developed `symptoms’ on October 1st, was hospitalized on the 8th, and tested positive on the 9th. 


The second case, listed here as a `household contact’ of the first, supposedly became symptomatic on the same day as the `index case’ (October 1st), but wasn’t hospitalized until the 10th.

 

The third case, also listed as `household contact’ of the first two cases, fell ill a week after the first two cases. 


The details become a bit murkier for case #4, who was initially listed by the Saudis as a `household contact’, but here is somewhat vaguely referred to as living `in the same area’  as the first three cases. 

 

Exactly what that means, isn’t clear. 

 

There is no mention of any direct contact with the first three cases.  In the Saudi MOH Statement On Riyadh MERS Cluster Among University Workers, released a week ago, they stated `all cases live in one house in eastern Riyadh.’   Whether that still stands, is an open question.

 

Cases 5, 6 & 7 – which are not covered here – have been listed in the Saudi MOH daily report as `secondary household contacts’ - a distinction without a precise definition - and one that becomes even more curious in light of the details provided on case #4.  

 

As I say, more questions than answers. Hopefully we’ll get some of this sorted out in the next WHO update.

 

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

Disease outbreak news
22 October 2015

Between 10 and 13 October 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The four cases are from the same compound in Riyadh city.

Details of the cases
  • A 26-year-old, non-national female developed symptoms on 1 October and, on 8 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 9 October. Currently, she 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.
  • A 27-year-old, non-national female developed symptoms on 1 October and, on 10 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 11 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient is a household contact of a laboratory-confirmed MERS-CoV case (see above – case no. 1). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
  • A 26-year-old, non-national female developed symptoms on 7 October and, on 11 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 12 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient is a household contact of two laboratory-confirmed MERS-CoV cases (see above – case no. 1, 2). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
  • A 26-year-old, non-national female developed symptoms on 10 October and, on 11 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 12 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient lives in the same area as three laboratory-confirmed MERS-CoV cases (see above – case no. 1, 2, 3). She has 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.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 3 MERS-CoV cases that were reported in previous DONs on 27 September (case no. 13), on 17 September (case no. 9) and on 2 September (case no. 1).

Globally, since September 2012, WHO has been notified of 1,599 laboratory-confirmed cases of infection with MERS-CoV, including at least 574 related deaths.

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