The Saudi MOH is reporting their 6th MERS case in the past three days, adding a 45 y.o. expat male, who is listed in critical condition in the nation's capital city, Riyadh.
The patient is listed as a `primary' case, with no known risk exposure.
This late November-early December uptick in cases have been widely scattered across the country, with just 3 of the last 12 cases linked to camel exposure. One was listed as a household contact of a known case, while the remaining 8 are listed as `primary' cases with no known risk exposure.
Exactly how these primary cases are becoming infected remains a mystery. A recent study (see EID Journal: Estimation of Severe MERS Cases in the Middle East, 2012–2016), suggests that public health surveillance probably only picks up 40% of the severe cases in the Middle East.
Meaning there could be some number of undetected MERS cases in the community who play some role in its transmission.
The MOH also announces 1 fatal outcome, in Kharj.