Tuesday, July 10, 2018

EMRO MERS-CoV Summary - June 2018

June 2018 Update


It's been just shy of 2 months since the Saudi MOH stopped updating their MERS-CoV surveillance page and removed the last several months worth of data. The entire MOH site appears to be `under construction', although little or no progress is apparent on the MERS portal (see Why No News Isn't Necessarily Good News).

The month of June is statistically the most active month for MERS cases (see The Global Seasonal Occurrence of MERS-CoV), and at the close of May we saw a large family cluster reported in Najran.
But news of any activity in June has been eerily absent, even on Arabic social media.  Saudi media - which is ranked 169th in press freedom - has been equally quiet.
Though publicly silent, the Saudi MOH is required - under the IHR 2005 agreement - to report certain disease outbreaks (including MERS) and public health events to WHO in a timely manner (see Adding Accountability To The IHR).

Mid-June saw our first detailed WHO MERS update since January, but each month WHO EMRO (Eastern Mediterranean Region) also produces a brief summary of the previous month's activity. 
These summaries rarely provide much in the way of individual case or cluster information, and reflect only the number of cases officially reported to WHO during the past month.
As a result, these reports may not reflect all of the MERS cases identified by member nations during the reporting period. With those caveats, the latest EMRO MERS-CoV Summary announces 4 new cases in Saudi Arabia with one fatality.
MERS situation update, June 2018
Update for June 2018
  • At the end of June 2018, a total of 2229 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 791 associated deaths (case–fatality rate: 35.5%) were reported globally; the majority of these cases were reported from Saudi Arabia (1853 cases, including 717 related deaths with a case–fatality rate of 38.7%).
  • During the month of June, a total of 4 laboratory-confirmed cases of MERS were reported in Saudi Arabia including 1 associated death (case-fatality rate: 25%). No healthcare associated transmission or hospital outbreak was reported during this month.
  • The demographic and epidemiological characteristics of reported cases, when compared during the same corresponding period of 2013 to 2018, do not show any significant difference or change. Owing to improved infection prevention and control practices in hospitals, the number of hospital-acquired cases of MERS has dropped significantly since 2015.
  • The age group 50–59 years continues to be at highest risk for acquiring infection of primary cases. The age group 30–39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50–59 years for primary cases and 70–79 years for secondary cases.

Even by EMRO summary standards, this is a pretty spartan report.  But given the paucity of information being released by KSA, any information is better than no information.
the good news is - despite the ongoing frustration over the lack of robust reporting out of KSA -  we've seen no signs of any sustained or efficient transmission of the MERS virus outside of health care facilities, and Saudi health care facilities appear to be getting better at infection control.
With the Hajj now only 5 weeks away, however, it would be comforting if we were getting better, and more timely, information than we've seen released by the Saudis the past couple of months.

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