News report says multiple Saudi hospitals treating nCoV cases

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May 7, 2013 (CIDRAP News) – A media report late yesterday suggested that the 13 novel coronavirus (nCoV) cases reported in Saudi Arabia in the past few days are not confined to just one hospital, contrary to a May 5 statement from the Saudi health ministry.

Malek al Moosa, executive director of a small hospital in Hofuf, in the country's Eastern province, said the hospital has treated many of the nCoV patients but that it was not the only hospital treating such patients, the Wall Street Journal reported.

Also, a man who is a cousin of three patients in the current case cluster, including one who died, said his cousins went to three different hospitals in the province, the newspaper said. The story did not name the man.

The 13 cases, with 7 deaths, have all been reported since May 2. On May 5, Ziad A. Memish, MD, deputy minister for public health, reported that transmission of the disease seemed linked to one healthcare facility. He said there had been no transmission in the community.

But Moosa denied that his hospital was the center of the outbreak, according to the Journal. "We have maybe paid the price of being transparent," by testing patients and reporting the results, he said.

The unidentified man whose cousins were infected told the newspaper that the Saudi health ministry "just wants to close the books" by saying the recent cases are limited to one hospital.

Reports of the hospital cluster have stirred concern about possible person-to-person transmission of the virus and have prompted experts to recall how hospital outbreaks spurred the spread of SARS (severe acute respiratory syndrome), another coronavirus infection, a decade ago.

The novel virus is believed to be spreading to humans from some unidentified animal source. But person-to-person transmission has been clearly shown once before, when two family members of an infected UK man caught the virus from him after he returned sick from a trip to Saudi Arabia and Pakistan. Other small case clusters also have occurred, but human transmission has not been proved in those.

In other developments, the Saudi government has invited an international team of experts to help investigate the outbreak, the Journal story said. The team is expected to arrive this week.

Also, the World Health Organization (WHO) released guidance yesterday on infection prevention and control in caring for confirmed or probable nCoV case-patients.

The 9-page document recommends assigning probable or confirmed cases "to be cared for exclusively by a group of skilled [healthcare workers] both for continuity of care and to reduce opportunities for inadvertent infection control breaches that could result in unprotected exposure."

The WHO also advises that relatives and visitors in contact with nCoV patients be limited to those "essential for patient support" and should be trained to use the same infection control precautions as healthcare workers use.

The agency also recommends, among other things, that all staff members and visitors approaching within 1 meter of nCoV patients wear a medical mask, eye protection, gown, and gloves, and perform hand hygiene before and after patient contact.

The WHO previously published recommendations on surveillance and clinical management for nCoV cases.

Also today, the European Centre for Disease Prevention and Control (ECDC) published a brief epidemiologic update on the nCoV cases in Saudi Arabia.

See also:

May 6 Wall Street Journal story

May 6 WHO infection control guidance

May 7 ECDC epidemiologic update

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