Thursday, November 08, 2018

Saudi MOA Reports 3 MERS Cases Including 1 Secondary Household Contact


Halfway through epi week 45 the Saudi MOH reports 3 MERS cases, 1 of which from Riyadh City is described as a `secondary, household contact', although it isn't clear to whom he was exposed.
Over the past 10 days we've seen 2 other cases reported from Riyadh City (1 wk 44, 1 wk 45) - both described as males in their 50's.
While the sources of many community acquired cases are never identified, among those cases that are defined as clusters, nearly all have occurred in households or healthcare facilities.

Below you'll find the current report from KSA's MOH. I'll return with a postscript after the break.

Although the official numbers remain reassuringly low, there are legitimate concerns over just how well surveillance is picking up mild to moderate infections.    
In recent weeks we've looked at a report (see mBio: High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia) once again hinting at mild and/or asymptomatic spread of the virus, and two studies on the limitations of testing and screening (see AJIC:Intermittent Positive Testing For MERS-CoV & Evaluation of a Visual Triage for the Screening of MERS-CoV Patients).
Because of the difficulties in identifying cases, the WHO continues to advise:
It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis.
Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

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