Sixteen days ago the Saudi MOH posthumously announced a MERS case in Abha - the capital of Asir province - which they listed as a primary case. Today, the MOH announces a second case from Abha - reportedly a `household contact' - who is listed in critical condition.
The `gap' of at least 16 days between the first patient's death and this report, combined with the advanced progression of patient #2's illness, suggests this reported may be somewhat belated.
Since March 8th we've seen 54 MERS cases reported by the Saudi MOH, of which 11 had already expired at the time they were reported, while 16 others were listed in critical condition.
Last year I managed to audit a small number of cases and found the average delay between testing positive and being reported by the MOH was close to 3 days, with a maximum of 7. And that is the most likely explanation of why half of the cases over the past 6 weeks have either been in critical condition, or already dead, when announced.
But another possibility - for some of these cases, at least - is that their MERS infections aren't being recognized early.
And if that turns out to be the case, it increases the odds that others might be exposed either in the community, or in hospital settings.