WHO details recent Saudi hospital MERS cluster

The World Health Organization (WHO) today fleshed out details of a MERS-CoV outbreak at a hospital in Hofuf, a cluster that included four cases plus an ambulance driver who took the index patient to the hospital.

The data on the hospital outbreak is part of a report on 13 Middle East respiratory syndrome coronavirus (MERS-CoV) cases, 4 of them fatal, reported from the country between Oct 15 and Oct 29.

MERS-CoV is known to spread easily in hospital settings, where the virus has been responsible for several outbreaks, some of them large.

Health worker, patients among hospital cluster

The index patient is thought to be a 73-year-old Saudi man from Hofuf who started having symptoms on Oct 10 and was admitted to the hospital in stable condition 3 days later. He had a history of contact with camels and he consumed raw camel milk. His condition deteriorated and he died on Oct 18.

His ambulance driver, who had driven the patient to the hospital before the man's MERS-CoV infection was detected, is a 40-year-old man who got sick on Oct 19 and was hospitalized the following day. He is currently in stable condition in home isolation.

The other three patients in the hospital cluster are a 33-year-old female health worker who took care of the index patient and two patients who were already hospitalized for unrelated conditions. The healthcare worker's asymptomatic infection was identified during contact tracing, and she is in stable condition in home isolation.

One of the patients infected during their hospital stays is a 61-year-old Saudi man who was admitted to the hospital for catheterization the same day as the index patient and came down with symptoms 6 days later. An investigation into the epidemiological links with other MERS-CoV cases is underway, and the man is listed in stable condition.

The other patient who contacted the virus in the hospital is a 55-year-old foreign man who was admitted to the outbreak hospital on Oct 2 after having a heart attack. He started having MERS-CoV symptoms on Oct 20 while still hospitalized. He had been in critical condition when he died on Oct 22. Officials are still probing the links he had to other MERS-CoV cases.

Other cases include pair of household contacts

Of the other eight cases detailed in the WHO report, two involved contact with camels or consumption of raw camel milk, while exposure to the virus is still under investigation for five. For all the cases with a camel connection, health officials notified the agriculture ministry, and investigations in the animals are underway.

Two of the cases are a household cluster, involving a 58-year-old foreign man who got sick while working in Arar and his 65-year-old male household contact whose symptomatic MERS-CoV infection was found during contact tracing. The younger man had underlying health conditions and died of his infection, and his household contact is hospitalized in stable condition.

The other six patients include a 41-year-old man from Buraidah who is in critical condition, a 46-year-old man from Hofuf who is in stable condition, a 72-year-old woman from Najran who is in stable condition, a 53-year-old man from Abha who died, a 47-year-old man from Buraidah who is in stable condition, and a 72-year-old man from Riyadh who is in critical condition and on a ventilator.

Since September 2012, when the virus was first detected in humans, the WHO has received 1,826 reports of MERS-CoV cases, including at least 649 deaths. Most of the cases are from Saudi Arabia, where a small but steady stream of infections is still occurring.

See also:

Nov 11 WHO statement

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