For the 8th day running KSA is reporting new MERS cases, with today's report focused on two patients - both in critical condition - and both with a history of (direct or indirect) camel contact. `Direct camel contact' is fairly self-explanatory, while indirect camel exposure has been defined as:
Having visited settings where animals were kept but without having direct contact; or exposure to household members who themselves had direct animal exposure.
Although there is no overriding `season' for MERS, late winter and spring are viewed as times of heightened concern, primarily because of so many young - virologically naive - camels born over the winter. Since the first of the year 24 MERS cases have been reported by KSA, 8 of which either had direct or indirect camel contact.
In the face of mounting evidence (see EID Journal: MERS Coronaviruses in Dromedary Camels, Egypt & The Lancet: Identification Of MERS Virus In Camels), in May of 2014 the Saudi Ministry Of Agriculture Issued Warnings On Camels, urging breeders and owners to limit their contact with camels, and to use PPEs (masks, gloves, protective clothing) when in close contact with their animals.
Compliance, however, has been spotty and camel products continue to be used by the public.
While camel contact no doubt contributes to the continual `reseeding' of the virus into the human population, most people appear to be infected by contact with infected individuals, often in hospital or health care settings.
For the majority of `primary' cases (those that occur in the community when there is no known exposure to a health care facility or to a known human case), the risk exposure remains unknown.