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| Highest MERS Jan-June MERS Acclivity Since 2015 |
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Once a month the WHO's EMRO (Eastern Mediterranean Regional Office) provides a summary of MERS activity in the Middle East - and around the world - based on what is officially reported by individual Ministries of Health to the World Health Organization.
We usually get that report around the 10th of the month, but May's report landed on the 18th, and June's just today.In this summary WHO EMRO reports 7 new MERS Cases - all from Saudi Arabia - in June, half as many as were reported in May (n=14). Despite a marked slowdown in case reports since April, the first half of 2019 has seen the most cases reported (n=168) since 2015.
MERS situation update, June 2019
Read the MERS situation update for June 2019
- At the end of June 2019, a total of 2449 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 845 associated deaths (case–fatality rate: 34.5%) were reported globally; the majority of these cases were reported from Saudi Arabia (2058 cases, including 767 related deaths with a case–fatality rate of 37.2%). During the month of June, a total of 7 laboratory-confirmed cases of MERS were reported globally. All the 7 cases were reported from Saudi Arabia with 1 associated death. In addition, another death from a previously reported case in May was reported this month.
- This month, Saudi Arabia has not reported any new cases related to the Al-Khafji city outbreak. The outbreak has presumed to have stopped due to the effective response measures taken by Saudi Arabia. There were no cluster of cases reported this month apart from one secondary case, a health care worker linked to a case reported in the previous month (May).
- The demographic and epidemiological characteristics of reported cases, when compared during the same corresponding period of 2014 to 2019, do not show any significant difference or change.
- The age group 50–59 years continues to be at the highest risk for acquiring infection of primary cases. The age group 30–39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50–59 years for primary cases and 70–79 years for secondary cases.
Despite the comforting low numbers of cases reported last month, there are known problems in the identification and reporting of MERS cases. Some cases are asymptomatic, while others may present with only mild `cold-like' symptoms. It is assumed that some cases - perhaps many - fly under the surveillance radar.
A 2016 study (see EID Journal: Estimation of Severe MERS Cases in the Middle East, 2012–2016) suggested that as much as 60% of severe Saudi MERS cases go undiagnosed.Because of the difficulties in identifying cases, the WHO continues to advise:
It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis.
Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.For some past blogs on the gaps in our knowledge and concerns over the under-detected MERS infections in the community, you may wish to revisit:
MERS-CoV In Humans: A Systematic Literature Review
J. Korean Med Sci: Atypical Presentation Of A MERS Case In A Returning Traveler From Kuwait
mBio: High Prevalence of MERS-CoV Infection in Camel Workers in Saudi Arabia
AJIC:Intermittent Positive Testing For MERS-CoV
JIDC: Atypical Presentation Of MERS-CoV In A Lebanese Patient
A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia
