The World Health Organization (WHO) today filled in many of the blanks on 113 MERS-CoV cases that were belatedly reported by Saudi Arabia on Jun 3, revealing that 34 of those cases were fatal, not 92, as indicated by the original Saudi announcement.
The WHO reported that most of the cases occurred since the beginning of March and that more than a third involved healthcare workers (HCWs). The agency also said the new details do not change the general pattern of the MERS-CoV (Middle East respiratory syndrome coronavirus) outbreak.
"The characteristics of the 113 cases are similar to those previously reported," the agency said. "The pattern and dynamic of the epidemic and the risk assessment remain unchanged."
The original Saudi announcement on Jun 3 caused considerable surprise and puzzlement. The Ministry of Health (MOH) said at the time that the cases were revealed through a rigorous examination of all the agency's MERS data. At that point, the new numbers increased the country's case count by almost 20% and its death toll by 48%. The agency gave no details at the time about the case locations, ages, symptoms, or nature of exposure.
Subsequently, MOH officials told news services that the cases had not been reported in a more timely way because some hospitals and labs didn't pass their test results to the ministry.
76 patients recovered
Of the 113 cases, 76 patients recovered, 3 are still hospitalized, and 34 died, the WHO statement said.
As for the discrepancy between the 34 deaths cited by the WHO and the 92 deaths reported by the MOH on Jun 3, WHO spokesman Glenn Thomas explained today that many of the 92 deaths occurred in previously reported cases. "Only a part of the 92 deaths were among the 113," he told CIDRAP News.
The WHO said 84 of the 113 cases occurred after Mar 1 and the rest surfaced between May 5, 2013, and Feb 28, 2014. They were scattered among seven regions of the country, but many were in the Mecca (49) and Riyadh (47) regions. Cases in the Mecca region included 44 in Jeddah, a major MERS hotspot in April and May.
The median age of the patients is 41 years (range, 3 months to 89 years), and 57% (64) are males, the WHO reported. As for nationality, 69 are Saudis and 44 are from other countries.
Information on symptoms was available for 111 cases. Thirty-two patients had no symptoms, while 79 reported symptoms. Of those 79, 70 were hospitalized. No information was provided on patients' underlying medical conditions.
Forty-two (37%) of the 113 patients were HCWs, the WHO said. Of the 42, 39 recovered, 1 died, and 2 remain hospitalized.
Eighteen sporadic cases
Information on the source of infection was provided in 72 of the 113 cases, the agency said. Eighteen of these (25%) fall in the sporadic category, in that they "acquired infection from a non-human source at the community level." The statement did not say if any of those patients had contact with camels or other animals.
The other 54 patients acquired their infection from another person, the statement said. Transmission occurred in healthcare settings in 41 of those cases, and the other 13 cases involved household transmission.
The new Saudi data raised the WHO's global MERS count to 820 confirmed cases, including "at least" 286 deaths.
Details on four recent cases
Also today, the WHO confirmed and supplied new details on four recent MERS cases reported by the MOH. The patients (who are included in the new count of 820 cases) are:
- A 38-year-old Riyadh woman who was hospitalized for another condition in April and experienced respiratory symptoms on Jun 11. She tested positive for the virus on the 18th and is in stable condition. An investigation on the source of her infection is continuing.
- A 45-year-old Riyadh man who got sick on Jun 6, was hospitalized Jun 19, and is in stable condition. He has no history of contact with other MERS patients, recent travel, or contact with animals.
- A 57-year-old man from a village in the Tabuk region who has a history of daily exposure to camels. He was hospitalized Jun 16 and then air-ambulanced to Jeddah Jun 24 and is in critical condition.
- An 85-year-old man from Jeddah who became ill on Jun 15 and was hospitalized on Jun 21. He is currently in stable condition. He is reported to have no history of contact with animals.
Jun 26 statement on 113 late-reported cases
Jun 26 WHO statement on recent cases
Jun 3 CIDRAP News story on original Saudi announcement