WHO MERS Update – Saudi Arabia

Coronavirus – Credit CDC PHIL

 

# 9921

 

 

The World Health Organization has posted an update on 12 recently reported MERS cases (between March 24th-31st) from Saudi Arabia.  While the epidemiological investigation continues on some of these cases, from the synopsis we learn that:

 

• 5 Cases have no known Risk Exposure
• 4 Cases had some camel and/or sheep contact but their actual source of infection is not known
• 2 Cases had direct contact with previously diagnosed cases
• 1 Case was a HCW who treated a MERS positive case

 

Although three of these cases had a direct epidemiological link to a known case, the rest have either no known link - or at best - a potential zoonotic exposure from camels, camel products, or sheep.

 

As we’ve discussed previously (see The Community Transmission Mystery), after nearly three years, for the vast majority of cases we still don’t know how these patients were exposed. 

 

A question that might be answered by a well-mounted case-control study, but which we have yet to see published (see last summer’s  KSA Announces Start To Long-Awaited MERS Case Control Study). 

 

Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news
9 April 2015

Between 24 and 31 March 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 2 deaths. Cases are listed by date of reporting, with the most recent case listed first.

Details of the cases are as follows:

• A 65-year-old, non-national female from Riyadh city developed symptoms on 28 March and was admitted to hospital on 30 March. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
• A 60-year-old male from Jeddah city developed symptoms on 14 March and was admitted to hospital on 28 March. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in critical condition in ICU.
• A 63-year-old, non-national, male health worker from Jeddah city. He developed symptoms on 26 March and was admitted to hospital on 29 March. The patient has comorbidities. He provided care to a laboratory-confirmed MERS-CoV case (case n. 10 – see below). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
• An 80-year-old male from Taima city, Tabuk Region developed symptoms on 9 March and was admitted to hospital on 12 March. The patient had comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. The patient passed away on 27 March.
• A 39-year-old male from Alkhafji city developed symptoms on 23 March and was admitted to hospital on 26 March. The patient has no comorbidities. He has history of frequent contact with camels and consumption of raw camel milk. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in ICU.
• A 54-year-old male from a small village near Hofuf city developed symptoms on 20 March and was admitted to hospital on 27 March. The patient had comorbidities. He had history of frequent contact with camels and consumption of raw camel milk. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He passed away on 28 March.
• A 30-year-old male from Riyadh city developed symptoms on 2 March and was admitted to hospital on 9 March. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is on home isolation after being discharged from hospital on 25 March.
• A 65-year-old male from Dholem city developed symptoms on 21 March and was admitted to hospital on 24 March. The patient has comorbidities. He has history of contact with camels and sheep, and consumption of raw camel milk. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in stable condition in a negative pressure isolation room on a ward.
• A 48-year-old, non-national male from Riyadh city developed symptoms on 21 March and was admitted to hospital on 23 March. He is a contact of a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 26 March (case n. 12). The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in ICU.
• A 20-year-old, non-national male from Jeddah city developed symptoms on 22 March and was admitted to hospital on 23 March. The patient is a contact of a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 26 March (case n. 3). He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
• A 42-year-old, non-national male from Makkah city developed symptoms on 18 March and was admitted to hospital on 23 March. The patient has history of contact with camels and consumption of raw camel milk in Makkah. He also has a history of travelling to Riyadh in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.
• A 55-year-old female from Arar city developed symptoms on 6 March and was admitted to hospital on 20 March. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 2 previously reported MERS-CoV cases. The cases were reported in a previous DON on 26 March (cases n. 2, 7).

Contact tracing of household contacts and healthcare contacts is ongoing for these cases.