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It has been more than 2 years since the country of Qatar has reported a human MERS infection (see Qatar MOH: Statement On Their 3rd MERS Case Of 2017), but today we are learning about a small cluster that began in November via a DON (Disease Outbreak News) update from the World Health Organization.
The source of the exposure for the index case (F, 67), who subsequently died, is under investigation. The two asymptomatic family members who tested positive by RT-PCR on Nov. 29th are reportedly still in an isolation ward as of Dec. 23rd.
While Saudi Arabia has provided the lion's share of MERS cases (2100+) recorded on the Arabian peninsula since 2012, at least 175 other cases have been reported from neighboring countries, including the UAE (92), Jordan (35), and Oman (24).
This update, published late yesterday, from the WHO.
Middle East respiratory syndrome coronavirus (MERS-CoV) – Qatar
Disease Outbreak News
26 December 2019
On 5 December 2019, the National IHR Focal Point for Qatar reported three laboratory-confirmed cases of Middle East respiratory syndrome (MERS-CoV) infection to WHO.
The first case-patient (case #1) is a 67-year-old female from Doha, Qatar. She developed fever, cough, shortness of breath and headache on 23 November 2019, and presented to a hospital on 25 November. On 27 November, she went to the same hospital for follow up. However, on 28 November, her condition worsened and she was admitted to the hospital. A nasopharyngeal swab was collected on 28 November and tested positive for MERS-CoV by reverse-transcriptase polymerase chain reaction (RT-PCR) on 29 November. The patient had underlying medical conditions, and passed away on 12 December 2019. The source of her infection is under investigation.
The patient had neither a history of contact with dromedary camels nor recent travel. Follow up and screening of seven household contacts and 40 healthcare worker contacts is ongoing and two asymptomatic secondary cases have been identified so far.
The two contacts are a 50-year-old (case # 2) and a 32-year-old (case # 3), living in Doha. Both were identified through contact tracing and are asymptomatic. Case #2 is the son of case #1 and has an underlying medical condition . Case #3 was involved in direct contact with case #1 and has no underlying medical conditions. A nasopharyngeal swab was collected on 29 November for both case #2 and case #3 and tested positive for MERS-CoV by RT-PCR on 29 November. As of 23 December, both are in a stable condition in an isolation ward where protocols for infection prevention and control have been implemented.
Public health response
Upon identification of case #1, the case was isolated, the infection prevention and control protocols were implemented as per WHO guidelines; investigation and contact tracing were initiated.
All 47 identified contacts of the patient have been monitored daily for the appearance of respiratory or gastrointestinal symptoms for a period of 14 days following their last exposure to the patient.
All contacts were tested for MERS-CoV and test results were positive for two asymptomatic contacts (Case #2 and #3 mentioned above).
WHO risk assessment
Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels. MERS-CoV has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.
The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to dromedary camels, animal products (for example, consumption of camel’s raw milk), or humans (for example, in a health care setting or household contacts).
WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.
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