# 7269
Early last evening (EDT) FluTrackers picked up a KSA MOH report indicating they had confirmed four more cases of nCoV (novel coronavirus or MERS) infection – although details were sparse.
Overnight Crof picked up a Reuters report - Saudi Arabia confirms four new MERS cases - confirming the story. Below you’ll find AFP’s version – which only tells us that one case has recovered, while three others remain hospitalized.
4 more cases of deadly coronavirus in Saudi
By AFP
Published Tuesday, May 14, 2013
Four more cases of the deadly coronavirus have been detected in Saudi Arabia, the health ministry said, raising the number of people infected from the SARS-like virus in the kingdom to 28, including 15 fatalities.
The four cases were registered in Eastern Province, which has been gripped by panic after it was shown to be home to most of the infection cases in the kingdom, the ministry said on its website late Monday.
Although the lack of details on recent cases has made it increasingly difficult, Sharon Sanders at FluTrackers has endeavored to keep a line listing of nCoV cases, which you’ll find on this this thread.
Somewhat reassuringly, we’ve not seen the kind of exponential rise in cases that would signal efficient and sustained human-to-human transmission of this virus.
But there are still a lot of unknowns here.
So far, very little epidemiological data on these recent Saudi cases has surfaced, and the source of this virus has yet to be identified. Also unknown is whether there are mild (or even asymptomatic) cases going undiagnosed in the community.
The concern is that the more opportunities this virus has to infect humans, the more likely it is to adapt to our physiology.
And when a chain or series of human infections occurs, adaptation becomes more likely.
This adaptation to humans could eventually permit the virus to spread more efficiently - a concern voiced yesterday by Dr. Ali Mohamed Zaki – the Egyptian virologist who alerted ProMed Mail of the first identified case in Saudi Arabia (see Sometimes They Come Back) last summer.
Coronavirus is mutating, says expert
May 14 2013 at 09:20am
By Alexander Dziadosz
Cairo - The doctor who discovered a new SARS-like virus says it will probably trigger an epidemic at some point, but not necessarily in its current virulent form.
<SNIP>
Zaki, now working at Ain Shams university in Cairo, said the virus was probably mutating. “From what is going on, it seems it is going step-by-step to become more easily transmitted,” he told Reuters.
But he said doctors and authorities were in a better position to deal with an outbreak than they had been with SARS because the new virus had been identified relatively early:
“Now we have the virus before the epidemic happened - and I think it will happen - and we have tools to diagnose it.”
The novel coronavirus – like other single stranded RNA viruses – is prone to making copying errors when it replicates within a host, which can result in rapid mutation.
Most mutations are evolutionary dead-ends. They do nothing to enhance the virus’s biological fitness to replicate or spread, and quite often reduce it.
But with the virus replicating millions of times within each host, the virus has numerous opportunities to eventually produce a favorable mutation; one that increases its biological fitness to replicate and spread.
Whether (or when) that will happen . . . well, that’s impossible to know.
And we certainly don’t know whether this virus would retain its current level of virulence – which appears high - if it were to become more transmissible.
What we do know is that viruses like this can change very quickly, which means that what we observe about it today may not hold true tomorrow, next week, or next year.
Which today makes the novel coronavirus an uncertain - but plausible - global health threat.
