Spain's health ministry today reported the country's first Middle East respiratory syndrome coronavirus (MERS-CoV) case, in a woman who had spent October in Saudi Arabia, a development that raises questions about possible exposure at the recent Hajj pilgrimage.
The woman is a Spanish resident who was born in Morocco and was admitted to a Madrid hospital on Nov 1, where she is in stable condition, according to a health ministry statement posted in Spanish. The virus was confirmed in samples tested at the country's National Microbiology Center.
Spain's health ministry said it considers the infection an imported case that doesn't pose a public health risk to Spain, which is now the fifth European country to report an imported MERS-CoV case, in addition to Britain, France, Germany, and Italy. All of the imported infections occurred in people who had recently traveled to Saudi Arabia or other Middle Eastern countries.
A World Health Organization (WHO) official told the Canadian Press today that the woman with MERS-CoV performed the Hajj pilgrimage, got sick in Saudi Arabia, and flew back to Spain where she was hospitalized and tested. Anthony Mounts, MD, the WHO's technical lead for MERS-CoV, said it's not clear yet if the woman took a commercial flight or came back on a charter plane, according to the story.
Spain's health ministry said it and Madrid health officials are identifying all of the woman's close contacts, based on national and international procedures.
The Hajj pilgrimage, which drew more than 1 million visitors to Saudi Arabia, began Oct 13 and ended on Oct 18. Arabic media sources, citing Saudi health officials, reported no evidence of any MERS cases or other serious infectious diseases related to the event. Some observers, however, noted that, given the disease's incubation period of 10 days or more, infections could surface in pilgrims who return to their home countries.
Health officials in countries welcoming back their Hajj travelers have been on heightened alert for the disease, and there have been a handful of false alarms. For example, a 43-year-old French resident who got sick after returning from Saudi Arabia tested negative for the virus, and it wasn't clear if he or she had attended the Hajj. Egypt also reported negative findings in travelers returning from the Hajj, according to foreign media reports.
Aside from the Spanish woman, only one other MERS-CoV case-patient is known to have a link to religious pilgrimage in Saudi Arabia, a 60-year-old British man who got sick in February after a 5-week stay in Pakistan, followed by an 8-day trip during which he went to Mecca and Medina.
The Spanish woman's infection boosts the global MERS-CoV count to 151 cases, which includes 64 deaths.
CIDRAP project manager Carlos Cruz provided translation assistance for this story.
Nov 6 Spanish health ministry statement (in Spanish)
Nov 6 Canadian Press story
Mar 14, 2013, CIDRAP News story "UK officials detail novel coronavirus cluster findings"