The MERS-CoV (Middle East respiratory syndrome coronavirus) siege that began in late March rolled on into May today as Saudi Arabia reported 10 more cases in three cities and Jordan added one.
The new reports came as the World Health Organization (WHO) started an investigation of the MERS outbreak in Jeddah, Saudi Arabia, the epicenter of the country's recent MERS activity. The cause of the increase in cases remains unclear.
In a statement, the Saudi Ministry of Health (MOH) reported 4 cases in Jeddah, 3 in Riyadh, and 3 in Mecca. Two of the patients have no symptoms, 6 are in stable condition, and 2 are being treated in intensive care units. No deaths were reported among the latest patients or previously reported ones.
No healthcare workers
As was true of other new Saudi cases this week, none of the patients were described as healthcare workers (HCWs). Most of the previous reports in the past month have included some patients in that category.
Just two of the new patients, both in Riyadh, are reported to have had contact with other case-patients, and there is no mention of any contact with animals.
The patients range in age from 29 to 75 years. Four are in the 25 to 44 range, 5 are between 45 and 64, and the 75-year-old is the only elderly one.
The 10 new cases boosted the country's MERS tally to 371 cases, of which 107 have been fatal.
In Jordan, the new case was reported by the news agency Petra. It said the patient is an HCW who had contact with a Saudi patient in Jordan who tested positive for the virus last week. That apparently refers to a 25-year-old man who, the WHO said on Apr 23, sought treatment in Jordan after leaving a Saudi hospital against medical advice.
The report gave no other details except to say that the new case is Jordan's seventh confirmed one.
Details on case in Egypt
In other news, the WHO offered some new details on Egypt's first MERS case, involving a 27-year-old man who has been living in Riyadh the past 4 years. The agency said he had contact with two other MERS patients—his uncle, who died of MERS on Apr 19, and his uncle's neighbor, who is still being treated in a Jeddah hospital.
The 27-year-old got sick on Apr 22, returned to Egypt 3 days later, and tested positive on Apr 26, the WHO noted. He is in stable condition.
The WHO also noted that Saudi Arabia has supplied it with information on 138 MERS cases identified between Apr 11 and 26. The agency did not list its count of MERS cases and deaths today but promised to update the tally to reflect the Saudi data as soon as possible.
The WHO's MERS tally recently has lagged far behind counts maintained by others, such as FluTrackers and the European Centre for Disease Protection and Control. The total currently listed by FluTrackers, an infectious disease message board, is 453.
WHO to look at fomites
Also today, the WHO said it began its new investigation of MERS in Saudi Arabia with a visit to healthcare facilities in Jeddah. The agency released on Facebook some photos of its personnel meeting with HCWs there.
More than 100 people in the Jeddah area have tested positive for MERS since mid-March, and 31 have died, the WHO said via Facebook. Most of those cases have occurred in healthcare facilities.
During its investigation, the WHO team will look into whether MERS-CoV can be transmitted by contaminated fomites (physical objects), according to a series of Twitter comments today by WHO spokesman Gregory Hartl.
"We know MERS spreads via droplets. But we need to look both at h2h [human-to-human] spread via droplets, and droplets on fomites," Hartl said. "And for MERS in droplets on fomites, we still have to understand how long the virus can survive."
Elsewhere, the Egyptian government advised vulnerable people not to go on religious pilgrimages to Saudi Arabia this year, given the MERS situation, according to an AhramOnline report yesterday. The advice was for children under age 15, elderly people, pregnant women, and people with chronic diseases.
May 1 MOH statement on 10 cases
Saudi MOH MERS page with case count
May 1 Petra report on case in Jordan
May 1 WHO statement on Egypt's first case
Apr 30 AhramOnline story