The World Health Organization (WHO) yesterday provided new details about three unrelated hospital MERS-CoV outbreaks that as of May 29 had infected 12 people, and Saudi Arabia's Ministry of Health (MOH) today announced five more cases, including at least four tied to the hospital cluster in Riyadh.
In its overview of MERS-CoV (Middle East respiratory syndrome coronavirus) cases, the WHO also noted what appear to be three new cases in the United Arab Emirates (UAE) and Qatar, all of which involved direct links to camels.
Hospital cluster details
The 12 cases linked to the three hospital outbreaks are part of 25 MERS cases that Saudi Arabia reported to the WHO between Apr 21 and May 29. Four patients are healthcare workers, one from Bisha and three from Riyadh. Six of the 25 illnesses were fatal.
The hospital events have occurred simultaneously and aren't related to each other, and the WHO added that Saudi Arabia's MOH is probing each cases and taking steps to curb further human-to-human transmission.
The first hospital cluster involves a facility in Bisha, a city in southwestern Saudi Arabia. The index patient was a 71-year-old man who died from his infection in early May. Following the case, two secondary healthcare contacts were reported, two men ages 54 and 57.
A hospital in the city of Riyadh is the setting for the second cluster, where the first known patient is a 55-year-old man who was ill during the first half of May and died. Four secondary cases were identified in the middle of May, two men ages 33 and 38 and two women ages 30 and 25.
In April, a MERS-CoV cluster at a hospital in the city of Wadi ad-Dawasir, located in south central Saudi Arabia. The WHO said the outbreak is thought to be over, based on the follow-up period of the contacts. Five illnesses are linked to the cluster; the first case—involving a 55-year-old man—was already reported by the WHO on Apr 27. Today's statement adds four secondary cases: two household contacts (men ages 50 and 58) and two healthcare contacts (men ages 31 and 26).
Five new Saudi cases
In a related development, the Saudi MOH today reported five new MERS cases, all from Riyadh, at least four of them likely linked to the hospital outbreak.
One of the cases is listed as a 35-year-old Saudi woman who is an asymptomatic household contact of a patient infected with MERS-CoV.
The other four were infected in a heathcare setting; three as healthcare workers and one as a patient. All of the healthcare workers are expats, and only one of them has symptoms, a 42-year-old woman who is listed in stable condition. The others are a 45-year-old woman and a 39-year-old man.
The patient who contracted MERS-CoV in the hospital is a 57-year-old Saudi woman who has an asymptomatic infection.
The latest cases raise Saudi Arabia's overall MERS-CoV total to 1,627, including 671 deaths. Nine people are still being treated for their infections.
UAE and Qatar cases
Both the UAE and Qatar reported MERS-CoV cases over the past several weeks, but the cases reported by the WHO today appear to be new ones.
A pair of infections reported by the UAE involve men from the city of Al Ain who had direct links with camels. One is a 69-year-old farmer who is hospitalized in critical condition, and the other is a 45-year-old butcher whose asymptomatic illness was found during contact tracing following the first case.
The WHO said more contact tracing and investigations in dromedary camels are under way.
Meanwhile, Qatar's case-patient is a 29-year-old man from Doha who has had frequent contact with camels. According to the WHO, the country's health ministry and animal health officials are conducting investigations.
Since September 2012, when the virus was first detected in humans, the WHO has received reports of 1,980 cases and at least 699 deaths.
Jun 6 WHO statement on MERS-CoV in Saudi Arabia, UAE, and Qatar
Jun 6 WHO Excel case-detail spreadsheet
Jun 7 Saudi MOH statement