Riyadh MERS outbreak shows no signs of slowing

Saudi Arabia today reported seven more MERS-CoV cases, five of them from the Riyadh hot spot, and the World Health Organization (WHO) filled in more details about 15 recent cases in the country, including 11 that are part of a growing hospital outbreak.

Also, the WHO announced that its MERS-CoV (Middle East respiratory syndrome coronavirus) emergency committee is meeting today for the 10th time since the virus was first detected in 2012.

The committee's meeting comes just weeks before the annual Hajj, which attracts large international crowds of pilgrims to Saudi Arabia and its holy sites.

Saudi update hints at Najran cluster

Of the seven new MERS-CoV cases in Saudi Arabia, two are from Najran in the southern part of the country, which has now reported six cases since early August. One of those six involves a foreign healthcare worker, a 64-year-old man who didn't have any known contact with a suspected or confirmed case, according to an Aug 16 MOH update.

Saudi Arabia's Ministry of Health (MOH) said both of the patients in Najran reported today had contact with a confirmed or suspected MERS case in the community or hospital. The patients are Saudi women ages 50 and 32, and neither are reported to be healthcare workers. Both are hospitalized in stable condition.

Meanwhile, the five new cases in Riyadh are likely linked to a hospital outbreak that has been under way at King Abdulaziz Medical City since at least the middle of July. Four had contact with a confirmed or suspected case, and the exposure is still under review for one of the patients.

Three of the latest Riyadh cases involve male foreign healthcare workers, ages 27, 40, and 53. The three are listed in stable condition, and all had contact with a suspected or confirmed MERS-CoV case.

The other patients, both in critical condition, are a 30-year-old Saudi woman and a 16-year-old Saudi boy.

Sixty people are still being treated for their infections, and another 12 are in home isolation. The new cases lift Saudi Arabia's total from the disease to 1,195, with the death total remaining at 510.

WHO details hospital exposures

The WHO today provided additional details on 15 MERS cases reported by Saudi Arabia on Aug 24 and 25, noting that 11 are linked to a hospital outbreak in Riyadh.

It's not known how many cases overall have been linked to the hospital outbreak, but so far the WHO has noted 62 in its updates since Aug 21. It has acknowledged 1 additional case at a different hospital. Saudi Arabia's MOH has reported 137 cases in Riyadh since Jul 21.

Two of the 15 patients described today are foreign healthcare workers from a hospital experiencing an outbreak. One is a 30-year-old woman in stable condition, and the other is a 51-year-old man listed as critical.

Several of the patients appeared to have contracted MERS-CoV while hospitalized for the treatment of other conditions, and another had visited the hospital's emergency department within 2 weeks of symptom onset.

The four patients that aren't apparently part of the hospital outbreak include a 67-year-old woman from Al Zulfi, a 72-year-old woman from Ad Dilam, and two Saudi men from Riyadh, ages 42 and 82. The younger man had contact with two earlier announced patients.

Illness onsets for the patients range from Aug 5 through Aug 23. All are adults, ranging in age from 30 to 82 years old. Nine are men and six are women.

Two patients died from their infections, both of them seniors who had underlying health conditions. Nine are hospitalized in stable condition, and four are listed as critical.

The WHO also said Saudi health officials reported nine deaths from the virus in earlier reported cases.

New cases reported to the WHO boost its overall MERS totals to 1,493 confirmed cases, with the number of deaths now at least 527.

MERS emergency committee convenes

In a related development, the WHO announced today that its MERS-CoV emergency committee is meeting today for the 10th time to discuss recent developments.

In an e-mail to the media, the agency said the group is meeting by teleconference and will be apprised of technical developments and the latest epidemiologic findings. Committee members will assess if the events meet the definition of a public health emergency of international concern as defined by the International Health Regulations.

In its last meeting, held on Jun 16 during South Korea's hospital outbreak, the group said though the arrival of the virus in South Korea took the world by surprise, there didn't appear to be any sustained spread in the community. It advised close monitoring but said the spread of the virus still fell short of a public health emergency.

Emergency committees typically meet every 3 months, or as events warrant. The WHO said it would release a statement about the committee's conclusions.

See also:

Sep 2 Saudi MOH update

Aug 16 Saudi MOH update

Sep 2 WHO update

Jun 17 CIDRAP News story "WHO panel rules no MERS emergency as Korea notes more cases"

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