After a three-day respite without reporting any MERS cases, the MOH is back with a primary case involving a 50 y.o. female in Afif, who is listed in critical condition. Afif is a small town of about 40,000 people located roughly halfway between Riyadh and Mecca.
There is no indication of a source of exposure, something which often goes unexplained in these primary `community’ cases.
While some may be the result of camel contact, that explanation is unlikely to apply to all of these community acquired `mystery’ cases. The role (and incidence) of `mild’ or asymptomatic carriage and transmission of the virus – while plausible - remains unresolved (see WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps).