#13,917
The Saudi MOH has announced two secondary cases from Khamis Mushait City, which brings the Saudi total to 94 infections since the first of January. Both are listed as female (ages 33 & 42), without camel contact.
Secondary cases are those who are infected as a result of direct contact with a known infected case, usually either a housemate, or at a healthcare facility. By definition, for there to be a secondary case, there needs to be a primary case.
The last primary case reported by the MOH from Khamis Mushait was a month ago during epi week #6.
Whether today's two cases are contacts of the above case is unknown. Four weeks between epidemiologically linked cases is double the maximum expected incubation period, but since onset dates are not provided and we've seen delayed reporting from the Saudis before, it can't be ruled out.
It is also possible there's an as-yet unreported primary case in the region, or one of these cases had contact with a MERS case from outside of the area.Sadly, the recently revised Saudi MOH reporting format - which no longer classifies secondary cases by type (healthcare or household), and no long tells us the status (hospitalized, home isolation) of the patient - gives us far less to go on.
What today's report does tell us is that there's been yet another small cluster of secondary MERS cases in Saudi Arabia. Something we've been seeing more frequently over the past few months.While we haven't seen any indication of sustained or efficient transmission of the MERS virus in the Middle East, this increased activity is a concern - and with the Holy month of Ramadan only two months away - is well worth our continued attention.
