Thursday, October 31, 2019

Saudi MOH Announces 3rd & 4th MERS Case of Epi Week 44


The recent uptick in MERS cases continues with 2 more cases announced today by the Saudi MOH - bringing October's total to 13 cases - which exceeds the combined total for August and September.  
Today's 1st case hails from Wadi Aldwasir, which you'll recall was the site of a large community & Healthcare acquired outbreak (60+ cases & 8 deaths) last spring (see WHO Update & Saudi Epidemiological Investigation Of The Wadi Aldwasir MERS Cluster).
Since that outbreak ended we've seen a smattering of MERS cases from that area - including two others this month (Epi Week 40 and Epi Week 42), all of which have been reported as `primary' cases with no stated epidemiological links.

These barebones daily updates from the Saudi MOH are always subject to  revision, but for now none of these cases is reported as `secondary',  which would indicate a cluster.

Today's second case adds to yet another recent hot spot - Khamis Mushait - which I highlighted in yesterday's blog.  Today's case - a 55 y.o. male listed as `primary' - is either the 4th or 5th case  (see below) from the area this month.

  • The third case - reported yesterday - is a 94 y.o. male, reportedly with recent camel contact. 
Community acquisition of the MERS virus outside of hospitals and healthcare facilities - and among those without recent camel contact - remains poorly understood, although environmental exposures and potential spread by mildly symptomatic or asymptomatic carriers are considered likely.
So far - despite some regional clustering of primary cases - we've not seen MERS transmit in the community the way that SARS did 16 years ago.
MERS does, however, transmit from person-to-person quite readily in close quarters - such as in hospitals and households - and we've seen studies (see A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia) suggesting the virus doesn't have all that far to evolve before it could pose a genuine global threat.

So we watch these reports closely, for any signs that the status quo has changed.