# 9829
After a week where Riyadh has dominated the Saudi MERS reports, we get two cases that hail from outside the capital region, one of whom reportedly had recent animal contact while the other has no known risk exposure.
Despite the fact that MERS-CoV came to light more than 30 months ago, there are still major gaps in our understanding of how the virus is transmitting among humans.
Although roughly 40% of recent cases have been linked to hospital exposures – and a small percentage are thought due to animal (camel) exposure - for the majority of cases, no exposure risks have been identified.
We continue to see many cases arise in the community without any history of exposure to known risk factors (hospital or community exposure to known cases, animal exposure), begging the question – How were they infected?
Questions normally answered by conducting a thorough case-control study, which has been long promised (see KSA Announces Start To Long-Awaited MERS Case Control Study), but has yet to be delivered by the Saudis.