New Saudi MERS illness as WHO profiles recent cases

Saudi Arabia today confirmed one more MERS-CoV case, in a man who is a household contact of an earlier reported patient, and the World Health Organization (WHO) posted an update on 32 Saudi cases over the summer, of which 12 were part of illness clusters.

New Saudi case

In an update for epidemiologic week 40 today, the Saudi Ministry of Health said the latest MERS-CoV (Middle East respiratory syndrome coronavirus) case involves a 22-year-old man from Afif who contracted the virus from a household contact. The man didn't have contact with camels and is currently in home isolation. Afif in in Riyadh region in the central part of Saudi Arabia.

In an epidemiologic report last week, the MOH reported an illness in a 50-year-old man from Afif who died from his illness. He reportedly had no contact with camels, and officials didn't find that he had been exposed to a sick person.

WHO details recent cluster

In an update today, the WHO covered 32 cases reported in Saudi Arabia Jun 1 through Sep 16. Ten of the illnesses were fatal.

Of the 32 cases, 12 were part of five separate clusters: 1 involved a healthcare setting, and the other 4 were based in households. Three featured camel exposure in suspected index cases.

Two of the clusters occurred in Buraydah in Al-Quassim region in the central part of the country, one at a health facility involving two patients, none of them patients or healthcare workers, and the other a household cluster of two patients, including an the suspected index case who had been exposed to camels.

In early June, four more cases were reported in an earlier household cluster in Najran, located in the south. One of the secondary cases was a healthcare worker. In its last update on MERS-CoV in Saudi Arabia, published on Jun 18, the WHO said eight cases had been reported in the Najran cluster, which at the time was still under investigation. The source of the virus was thought to be camels at the initial patient's home.

In mid-July, a household cluster of two cases was reported in Afif, neither of which involved healthcare workers.

The fifth cluster was reported in the middle of September, involving two household cases from the city of Riyadh, one of whom is the suspected index case who had been exposed to camels.

Nine non-cluster patients had camel contact

Of 20 cases that weren't part of clusters, 9 had been exposed to camels, a well-known risk factor for contracting the virus, before they got sick.

All but three were Saudi nationals. People got sick across a wide part of Saudi Arabia, with illnesses reported from nine of the Saudi Arabia's regions. All were adults, including 16 men and 4 women. All were symptomatic, and six died from their infections. None were healthcare workers, and all but four had underlying health conditions.

The latest batch of cases from Saudi Arabia reported over the summer pushes the global number of MERS-CoV cases reported since 2012 to 2,254 cases, at least 800 of them fatal, the WHO said. Saudi Arabia has been the country hardest hit by the virus.

No changes to risk assessment

The WHO said the new cases don't change its overall risk assessment and that it expects more cases to be reported from the Middle East, along with illnesses exported to other countries after exposure to animals, animal products, or sick people, such as those in healthcare settings.

Though the most common route of infection is direct or indirect contact with dromedary camels, MERS-CoV can transmit between humans, mainly through non-sustained transmission that has occurred mainly in healthcare settings.

See also:

Oct 3 MOH report

Oct 3 WHO update

Jun 18 WHO update

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