Saudi MOH: Three MERS Cases In Riyadh (2 Secondary)

#13,904

While the MERS outbreak in Wadi Aldwasir (50 cases) - with nosocomial, household, and community secondary cases reported - has rightfully gotten the bulk of our attention over the past 5 weeks, the nation's capital Riyadh has reported the second highest total (n=16), including several apparent clusters.

• Over epi week 1 & 2, the Saudi MOH reported on a 3 person household cluster in Riyadh (see Saudi MOH: Third Case In Riyadh MERS Cluster). In this case, none of these patients reported recent camel contact. 
• In Epi Week 7 we saw a report of a secondary, household contact case (16, F) in Riyadh. Two other primary cases were reported from Riyadh that week, but we don't know the source of her infection.
• Epi week 9 began with a 24 y.o,. female listed as a secondary, household contact from Riyadh. This came 12 days after the last case reported from Riyadh (see above), and the source of her infection was not stated.

Epi Week 9 ended yesterday with a single case (62, M, Primary with Camel Contact) from Riyadh.

Today, the Saudi MOH has posted the first update for Epi Week 10, and it contains two curiously described secondary cases from Riyadh.

Normally secondary cases are described by the Saudi MOH as either:

• 1) Healthcare-acquired   
• 2) Household Acquired  
• 3) Community Acquired (rarely)
• 4) Under Investigation.

Today's two cases (females aged 39 and 55) are simply listed as secondary, with no camel contact, with no hint as to the source of their infection.  This could simply be an oversight by whoever posted this information, but it is unusual enough to warrant a mention.

Today's announcement brings the Saudi 2019 MERS total to 86 cases, compared to just over 40 cases during the same time period in 2018.

Despite this dramatic uptick in MERS reports - the good news thus far is -  we've seen no signs of any sustained or efficient transmission of the MERS virus in the greater community.

The somewhat less-than-good-news is that each time the MERS virus infects a human, it gets yet another opportunity to acquire host adaptations, and potentially evolve into a bigger threat. 

Which is why we watch the behavior of this coronavirus very carefully, looking for any signs that it is becoming more easily transmissible.  For more on these concerns, you may with to revisit:

A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia