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Although January is typically one of the slowest months for MERS cases (see The Global Seasonal Occurrence of MERS-CoV), the Saudi MOH has announced their third case of 2020, involving a 64 y.o. male from Buraidah, who is listed as a `primary' case, with no known recent camel contact.
While we await further news on what is appears to be yet another emerging coronavirus - this time in China - it is worth noting that it took nearly a year to scientists to nail down the local host species (camels) for MERS, and that the first big hospital outbreak in humans (April 2012 in Jordan) was completely missed by public health authorities and was only identified via retrospective testing (see Serological Testing Of 2012 Jordanian MERS Outbreak) more than a year later.
Even today, more seven years after MERS-CoV was first identified, we still don't completely understand how it circulates in the community, the role that mild or asymptomatic carriers of the disease play in its transmission, and whether it has the capacity to spark a larger epidemic in the future.
The point being that outbreaks of new diseases are rarely picked up in their infancy, and by the time we do notice them, they often already have a track record. Furthermore, even years after their discovery, many mysteries may remain.Whether that holds true for China's outbreak remains to be seen, but we should be prepared for some twists and turns, and a prolonged learning curve ahead.
