Coronavirus cases, deaths reported in Tunisia, Saudi Arabia

May 20, 2013 (CIDRAP News) – A media report today said the Middle East respiratory syndrome coronavirus (MERS-CoV) has reached Tunisia, killing one man and infecting two of his relatives, while Saudi Arabia has reported another death and a new case since May 17.

The Kuwait News Agency (KUNA) said today that a 66-year-old man with diabetes died of a MERS-CoV infection after returning from a trip to Saudi Arabia and Qatar and that two relatives tested positive for the virus. The relatives were improving with treatment, the story said.

The man who died was hospitalized with an "acute respiratory condition" in the coastal city of Monastir after he returned home, according to KUNA. The story gave no other details, and the cases have not yet been recognized by the World Health Organization (WHO).

If the KUNA report is accurate, Tunisia is the eighth country to be affected by MERS-CoV, along with Jordan, Saudi Arabia, Qatar, the United Kingdom, France, Germany, and the United Arab Emirates. All of the European cases have had direct or indirect links to the Middle East.

Meanwhile, the WHO reported on May 18 a new MERS-CoV case in Saudi Arabia, involving an 81-year-old woman who is part of a hospital-centered case cluster in the Al-Ahsa region of Eastern province. Her illness increases the cluster to 22 cases, of which 9 have been fatal. Press reports have listed the Al-Moosa General Hospital in Hofuf as the site of the cluster.

The 81-year-old was a patient in the facility from Apr 8 to 28 and was identified in the investigation of the outbreak there, the WHO said. She has "multiple coexisting medical conditions" and is in critical but stable condition. The statement gave no details on how she became infected or on her connections to other patients in the cluster.

In more developments today, Saudi Arabia's Ministry of Health (MOH) reported that a man with "chronic heart diseases, diabetes and high blood pressure, in addition to kidney failure," has died of MERS-CoV. The statement did not say whether his case had been reported previously or list other details such as his age or whether he was part of the hospital case cluster.

An Arab News story today, however, said the man had been a patient at the hospital in Al-Ahsa. His death raised the MERS-CoV death toll in Saudi Arabia to 16, the MOH said.

The Saudi MOH statement also said one healthcare worker who had been sick with the virus has recovered and been released from a hospital. Last week the WHO reported that two healthcare workers, a 45-year-old man and a 43-year-old woman, were part of the healthcare-related case cluster after catching the virus from patients. The MOH statement gave no other information on the worker who recovered.

The WHO's May 18 statement put the global MERS-CoV count at that point at 41 cases with 20 deaths. The Tunisian cases and death and the Saudi Arabia death reported today apparently increase the count to 44 cases and 22 deaths (assuming the deceased Saudi Arabian's illness was reported previously).

The novel virus has spread from person to person in healthcare facilities and in families but has not achieved sustained community transmission. Investigators have not been able to identify the virus's animal origin or exactly how it spreads.

Also today, Saudi Arabian health officials asked the Arab Health Ministers Council to discuss MERS-CoV during its upcoming meeting, according to the Saudi Gazette. The council will meet during the World Health Assembly, the annual meeting of WHO member countries, which began today.

And in other related news, officials at Canada's National Microbiology Laboratory in Winnipeg said they can't provide samples of MERS-CoV to other labs, according to a CBC News story. The report said a material transfer agreement the national lab signed when it obtained the virus from a lab in the Netherlands forbids sending samples to other facilities.

See also:

May 20 KUNA story about cases in Tunisia

May 18 WHO statement

May 20 Saudi Arabian MOH statement on death of patient

May 20 Arab News story

May 20 Saudi Gazette story

May 20 CBC News story on Canadian lab

Related May 17 CIDRAP News story

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