Tuesday, August 23, 2016

Saudi MOH Announce 1 Secondary (Household) MERS Case


It's been a quiet August for MERS reports in Saudi Arabia - a sharp contrast to last year when they were dealing with a very Large Nosocomial Outbreak Of MERS In Riyadh - Summer 2015.

Today's case is only the 5th this month, and is a household contact of a 36 y.o. male reported infected on the 8th; a primary case with no known risk exposure. 

 Both cases have been listed as being in stable condition. 

With the start of the Hajj now just over 2 weeks away, this recent downturn in cases has to be welcome news for the Kingdom, although how long it will last is anyone's guess.  

While MERS has become a perennial concern for the Hajj, the most likely infectious disease outbreak scenarios involve less exotic threats; mosquito borne illnesses (like Dengue & Chikungunya, and now Zika), tuberculosis, mumps, measles, chickenpox, norovirus and respiratory viruses like seasonal influenza & Rhinovirus.

In EID Journal: Respiratory Viruses & Bacteria Among Pilgrims During The 2013 Hajj, we saw a study that examined a small group of French pilgrims (n=129) both before and after attending the Hajj, and compared nasal swabs.  They found:
. . .  that performing the Hajj pilgrimage is associated with an increased occurrence of respiratory symptoms in most pilgrims; 8 of 10 pilgrims showed nasal or throat acquisition of respiratory pathogens.

Another study we looked at in 2012 – before MERS emerged - in  Clinical Infectious Diseases (co-authored by former Saudi Deputy Minister of Health, Ziad Memish) called - Unmasking Masks in Makkah: Preventing Influenza at Hajj  found:.  
Each year more than 2 million people from all over the world attend the Hajj pilgrimage to Saudi Arabia. At least 60% of them develop respiratory symptoms there or during outward or homebound transit [1, 2]

The CDC has published an extensive list of health precautions and advice for travelers to this year's Hajj, which may be read at Hajj and Umrah in Saudi Arabia Alert - Level 2, Practice Enhanced Precautions.

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