Sunday, January 24, 2016

Saudi MOH: Two Asymptomatic MERS Cases With Camel Contact


Two days ago the Saudi MOH reported a symptomatic MERS case in Jeddah, a primary case linked to camel contact.   Today they report two asymptomatic cases - also linked to camel exposure - in Alkhumra (which appears to be Al-Khumra, a sub district of Jeddah). 

These two cases were detected due to the enhanced surveillance conducted in the wake of yesterday's announcement that Camels Test Positive For MERS-CoV In Jeddah Market. 

Today they've also added a new graphic (camel contact) to their daily report. 

While asymptomatic MERS cases have been documented for several years - usually discovered during the process of contact tracing - the Saudis haven't been particularly aggressive in testing anyone without severe symptoms, and so many have gone undetected.

Last September, we saw the WHO Statement On The 10th Meeting Of the IHR Emergency Committee On MERS  chastise the Saudi Response to MERS in unusually blunt terms, specifically mentioning their handling (or lack thereof) of asymptomatic cases:
The Committee further noted that its advice has not been completely followed. Asymptomatic cases that have tested positive for the virus are not always being reported as required.

Timely sharing of detailed information of public health importance, including from research studies conducted in the affected countries, and virological surveillance, remains limited and has fallen short of expectations. 

The role (and incidence) of `mild’ or asymptomatic carriage and transmission of the virus remains unresolved, although the lack of identifiable exposures among many primary cases at least suggests that they may play a part in the spreading of the virus. 

In  WHO Guidance On The Management Of Asymptomatic MERS Cases, the World Health Organization strongly urges that asymptomatic PCR-positive MERS cases be isolated, and their contacts be monitored as well.

Today's announcement may be a sign the Saudi MOH is taking the WHO's advice to heart. 

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