Saudi Arabia reports fatal MERS case

Saudi Arabia's health ministry announced yesterday that a 60-year-old man has died at a Riyadh hospital from a Middle East respiratory coronavirus (MERS-CoV) infection, according to media reports citing an Arabic statement from the government.

Few details were available about the patient, other than that he had a chronic medical condition. The new case expands the global MERS-CoV total to 181 cases and bumps the number of deaths to 78. Saudi Arabia's statement about the new case said the country has now recorded 143 cases, Agence-France Presse (AFP) reported today.

Report details MERS link to stillbirth case

In other developments, researchers yesterday reported the clinical details of a stillbirth in a Jordanian woman who was part of an April 2012 MERS-CoV cluster. A team from Jordan and the US Centers for Disease Control and Prevention (CDC) published the findings in the Journal of Infectious Diseases.

Her miscarriage was identified in an epidemiologic investigation of an outbreak in Zarqa, Jordan. The group obtained data and specimens from 37 household members who were connected to the outbreak. The 39-year old woman had a stillbirth at 5 months gestation, and serology tests showed she had been exposed to MERS-CoV.

A review of her history found that she developed acute respiratory illness a day after a close relative died of a lab-confirmed MERS-CoV infection and 7 days after her husband had similar symptoms.

Serology tests on the woman's husband were also positive for MERS-CoV. She refused medical care during her illness, because she was concerned about exposing the fetus to x-rays and medication.

Seven days into her illness she started having vaginal bleeding and abdominal pain and spontaneously delivered the stillborn infant. Fetal specimens weren't available for evaluation. Her other six children tested negative for MERS-CoV antibodies.

The researchers noted that the case provides useful insights on the impact of MERS-CoV and pregnancy, especially given that complications have been known to occur in pregnant women infected with SARS and the 2009 H1N1 influenza virus. They added that more information is needed to assess the risks of the disease during pregnancy, as well as the benefits and risks of possible treatments.

Canadian assessment

Meanwhile, health officials in Canada today updated their MERS-CoV risk assessment, continuing to classify the disease as low risk to Canadians.

The Public Health Agency of Canada (PHAC) continued to recommend no travel restrictions because of the novel virus and recommended that healthcare professionals maintain vigilance for patients with MERS-like symptoms.

The PHAC also observed that most cases have been associated with healthcare settings, which has been noted before. The agency said that at least 9 of the 181 MERS cases have been in children, with a 2-year-old who had underlying lung disease dying from MERS.

See also:

Jan 29 AFP story

Jan 28 J Infect Dis abstract

Jan 29 PHAC risk assessment

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