Four more MERS cases cited in UAE, 2 in Saudi Arabia

Six more MERS-CoV (Middle East respiratory syndrome coronavirus) cases were reported today, including four in relatively young healthcare workers in the United Arab Emirates (UAE) who took care of another MERS patient. The other two cases are in Saudi Arabia.

The report comes a day after a panel of experts assembled by the World Health Organization (WHO) concluded that the MERS situation is a serious concern but does not yet constitute an international public health emergency.

The WHO reported the four UAE cases in a statement in which it also recognized two other cases that the Saudi Ministry of Health (MOH) reported yesterday. The UAE cases involve healthcare workers from two Abu Dhabi hospitals who helped care for an earlier MERS patient, the agency said.

Two of the four, a 28-year-old man and a 30-year-old woman, had no symptoms of illness, the WHO said. The other two, both women, aged 30 and 40, had only mild upper respiratory symptoms and are in stable condition.

The Saudi patients are a 41-year-old man in Riyadh and a 59-year-old woman in the eastern governorate of Al-Ahsa, the Saudi Ministry of Health (MOH) said in a brief online statement. It said both patients are in hospital intensive care units, but it gave no information about their occupations or possible exposures to the virus.

The WHO statement added no new information about the two Saudi cases reported by the MOH yesterday. They involve a 26-year-old man who is a close contact of a previous MERS patient, and a 42-year-old female healthcare worker. Both live in the southwestern province of Asir. Neither patient was hospitalized, the MOH said yesterday.

The six new cases raise the unofficial global count of MERS cases to 90, including 45 deaths. The WHO count, which does not yet include the two new Saudi cases, is 88 cases with 45 deaths. Saudi Arabia's posted tally is now 70 cases and 38 deaths.

The four UAE cases apparently bring that country's case count to six, which includes an 82-year-old man whose illness was reported last week and a UAE man who was flown to Germany for treatment and died there in March. In addition, a 65-year-old man from France fell ill with MERS in May after traveling in the UAE.

The eight cases reported in the past 2 days are in keeping with a recent trend noted by the WHO last week: younger patients, less severe illness, and more women. In particular, eight other asymptomatic cases were reported in late June, including four in female healthcare workers and four in children, all in Saudi Arabia.

The new unofficial tally of 90 cases and 45 deaths represents a case-fatality ratio of 50%—lower than the 56% cited by the WHO in its MERS situation summary on Jul 9.

In that report, the WHO also observed that cases resulting from person-to-person transmission seem to be milder than those apparently involving transmission from non-human sources. The agency said it was unclear whether that phenomenon was an artifact of surveillance and case-finding efforts or signaled that infections acquired from non-human sources are more virulent.

See also:

Jul 18 Saudi MOH statement

Jul 18 WHO statement

Jul 15 CIDRAP News story on previous UAE case

Jul 9 CIDRAP News story on trend toward younger patients, more women

Saudi MOH MERS overview page with case count

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