Saudis cite 2 more MERS cases; Italian cluster profiled

Saudi Arabia today reported two more Middle East respiratory syndrome coronavirus (MERS-CoV) cases, plus the death of a previously reported case-patient, according to a machine-translated statement provided by FluTrackers, an online infectious-disease message board.

One case involves a 50-year-old Saudi citizen who has cancer and other chronic diseases and is in a hospital intensive care unit, said the statement from the Saudi Ministry of Health (MOH). The other involves a 70-year-old resident who also has chronic diseases and is in intensive care. No other details on the cases were provided.

Both new cases and the death occurred in the Riyadh region, the statement said. The patient who died was a 54-year-old man who also suffered from chronic diseases.

The MOH's English language MERS-CoV media page currently shows that Saudi Arabia has had 79 cases with 40 deaths.

Following the new report, the US Centers for Disease Control and Prevention (CDC) updated its MERS-CoV page to show a global count of 99 cases, with 48 deaths.

The World Health Organization (WHO) has not yet noted the two new Saudi cases, nor has it recognized three other cases reported earlier this week: two in Saudi Arabia on Aug 19 and one in Qatar on Aug 20.

In other MERS developments, Italian officials published a report today on their investigation of the three cases that occurred in Italy in late May and early June, offering a few new details. The report appears in Eurosurveillance.

The cases started with a previously healthy 45-year-old man from Florence who got sick at the end of a 40-day stay in Jordan and who, after returning to Italy, passed the virus to an 18-month-old relative (identified in press reports as a niece) and a co-worker who was in her early 40s.

The 18-month-old girl had close contact with the index case-patient on May 26, when he spent the day with her and her family, the report says. The co-worker and the case-patient shared an office where both worked on May 27.

MERS-CoV was suspected early and led to prompt testing for the virus in all three cases, according to the report. The man was hospitalized with pneumonia, whereas the little girl had only a mild febrile illness and the woman had a mild influenza-like illness. All three patients were previously healthy, and all recovered fully in less than 2 weeks.

Health officials identified and monitored 144 contacts of the three patients, including 115 for the index patient, 5 for the little girl, and 24 for the woman, the report says. None of them experienced a fever or other suggestive symptoms within 10 days. Also, 70 of the contacts were tested for the virus, and all results were negative.

In general, the findings seem to fit a pattern noted previously by the WHO and others: that secondary cases tend to be milder than sporadic or index cases and that the illness can be mild in young, otherwise healthy people.

Also today, an English-language version of an Aug 20 statement by Qatar's Supreme Council of Health said the MERS-CoV patient whose case was reported in Qatar this week was out of the country when he got sick. The patient, age 59, was diagnosed after returning to Qatar and hospitalized and is now in stable condition, the statement said.

The statement gave no other details about the case, but press reports have described the patient as a man.

See also:

Aug 22 FluTrackers item


Aug 21 Eurosurveillance report

Jul 9 CIDRAP News story on changing pattern in MERS cases

English translation of Aug 20 Qatar statement

Saudi MOH's media statements page on MERS


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