The uptick in Saudi MERS cases continues today with 3 new cases; 2 primary cases with camel contact and the second household contact in Riyadh to be announced in the last two days
We've not seen a WHO GAR update in nearly a month, and these daily reports don't provide a lot of detail, but the index case of this cluster may be the 24 y.o. expat male reported on Feb. 17th who was simply listed as a `primary case'.
`Primary cases’ are those that occur in the community when there is no known exposure to a health care facility or to a known human case. Over the past 3 years, roughly 40% of Saudi cases are listed as either `primary’ or as from an undetermined origin.
The Saudi MOH has announced 20 new MERS cases in the month of February, 7 of which are described as either direct or indirect contacts of camels.
Not unexpected, as last November in EID Journal: Risk Factors For Primary MERS-CoV Infection, Saudi Arabia, we saw a small case-control study that found 33% of their subjects reported camel contact in the 14 days prior to falling ill vs. 15% in the control group.
So far in 2016 we haven't seen any significant nosocomial outbreaks (only 1 asymptomatic HCW in Al Kharj), suggesting that so far at least, Saudi hospitals may be doing a better job identifying and isolating suspected cases than they have in the past (see MMWR: A Large Nosocomial Outbreak Of MERS In Riyadh - Summer 2015).