Iran's health ministry has reported the country's fourth Middle East respiratory syndrome coronavirus (MERS-CoV) infection, in a 44-year-old male healthcare worker, and Saudi Arabia has had another death from the disease, according to official reports today.
The Iranian is a resident of Kerman province in the southeastern part of the country, according to a statement today from the World Health Organization (WHO). So far all four of Iran's lab-confirmed MERS-CoV cases are from Kerman. The three earlier cases were linked.
So far it's not clear if the latest case in Iran is part of the earlier cluster. The WHO said the man came down with mild symptoms on Jun 6 and was admitted to a hospital on Jun 17 after his condition worsened. His samples were initially negative for the virus, but specimens collected 2 days later were positive. He is hospitalized in stable condition.
The man didn't have contact with a lab-confirmed MERS case-patient, but did have close contact on May 26 at the hospital where he worked with a patient who had a severe acute respiratory infection. That patient had traveled to Saudi Arabia to perform Umrah in early May and was hospitalized on May 17 with a severe respiratory infection.
The WHO said that specimens of the close contact were negative for influenza and MERS-CoV. He was transferred to an intensive care unit on May 26 and was intubated. He died 4 days later. Provincial health officials are investigating the illnesses and following the man's close contacts, who include healthcare workers and family members.
Earlier cases reported in Iran involved two sisters, ages 52 and 50, who got sick in the middle of May and a 35-year-old female nursing assistant who became ill after having contact with the one of the sisters.
Exposures a mystery in recent Saudi cases
The WHO also filled in more details about three of four cases reported by Saudi Arabia on Jun 25 and Jun 27.
All the patients are men. None had contact with other confirmed MERS patients or animals, and none had consumed camel products, sought recent healthcare, or performed Umrah in the 14 days before getting sick. Two are in stable condition, while one is listed in critical condition and is on extracorporeal membrane oxygenation (ECMO).
Two of the patients are foreign workers, one a 46-year-old who worked in construction in Riyadh and one a 58-year-old farmer who worked in the city of Bisha at a facility that does not have animals. The third patient is a 57-year-old retired Saudi citizen from Jeddah who has underlying medical conditions.
The WHO said so far it has received reports of 824 lab-confirmed MERS cases, of which at least 286 were fatal.
In other developments, Saudi Arabia today reported no new illnesses but said that an 85-year-old Jeddah man whose illness was reported earlier has died from his MERS-CoV infection. In a press statement the health ministry said the man had an underlying medical condition.
The man's death lifts the country's MERS death toll to 293, while the overall number of illnesses remained at 714.
Outbreak activity continues decline
The European Centre for Disease Prevention and Control (ECDC) today posted an epidemiologic update on MERS-CoV, which highlighted an overall decline in activity in recent weeks.
Most of the cases reported over the past month were reported from Saudi Arabia. Between Jun 4 and Jul 2 the country reported 25 cases, the United Arab Emirates reported 1, and Iran reported 1.
According to the ECDC, the global MERS total as of today has reached 842 cases, 322 of them fatal. All but 21 cases were reported in the Middle East, and all cases so far have links to that region, the group said.
Jul 2 WHO statement
Jul 2 MOH statement
Jul 2 ECDC epidemiological update