#14,516
Although there is no indication that they are connected, today the Saudi MOH announced the 4th primary MERS case from the Capital City of Riyadh (see here, here, and here) since November 1st.
Like yesterday's announced case (M, 33), today's case is a male (age 38), but with the unfortunate distinction of already being deceased at the time of this announcement.
Since we aren't provided an onset date, or date of diagnosis, it is possible that this case is being belatedly reported. Delays of several days are not uncommon.
The more worrisome scenario would be that this patient went undiagnosed prior to death, and was not promptly isolated and may have exposed others (household contacts, HCWs, or other patients) to the virus.
Since the initial signs of MERS infection are often similar to a cold or the flu, differentiating who is - and who isn't - infected can be a extremely difficult, even for doctors accustomed to seeing cases (see Evaluation of a Visual Triage for the Screening of MERS-CoV Patients).Although cases remain widely scattered and seemingly unconnected, over the past two months we've seen a steady increase in the number of MERS infections reported from Saudi Arabia, with 20 new cases recorded since October 1st.
Stay tuned.
