Saudi Arabia cites one MERS case; Iranian patient dies

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Flag of Iran, where a MERS patient has died., Stockbyte

Just one new MERS-CoV (Middle East respiratory syndrome coronavirus) case was reported in Saudi Arabia today, while a media report said one of the first two MERS patients in Iran has died.

And in other developments, US health officials said this week that in the next phase of their contact investigations sparked by the first two US MERS cases, they hope to conduct blood tests on several hundred people to look for evidence of past infection.

New case in Qunfudhah

The latest Saudi case involves a 36-year-old man who is in critical condition in a government hospital's intensive care unit in Jeddah, the Saudi Ministry of Health said in today's update. The man, who has diabetes and hypertension, fell ill on May 26 and was first hospitalized in Qunfudhah (also spelled Gonfodah) on May 28, before being transferred to Jeddah.

The MOH gave no information about the man's possible exposures to the virus. His case was preceded by 5 others reported in Qunfudhah in the past week, including 1 on May 22 and 4 on May 24 and 25.

With just one case today, the general slowdown in Saudi Arabian cases seems to be gradually solidifying, after weeks of high daily case counts during April and early May. The country's MERS count has now reached 569 cases, with 187 deaths.

The MOH also reported that five other MERS patients were released from hospitals in Mecca, Jeddah, and Medina yesterday.

In Iran, meanwhile, one of two sisters identified as the country's first MERS case-patients has died, while the other has been released from a hospital, according to a story from the Azerbaijan-based Trend News Agency. The two cases were reported May 26.

Iran's Tasnim news agency said the patient who died, a 53-year-old, had been treated for several days in the southeastern city of Kerman, according to the Trend story.

Her sister was released from the hospital after "a few days" of treatment, the story said, citing Mohammad Mehdi Gouya, head of Iran's Centre for Disease Control, as the information source.

Another official, Ali Akbar Haghdoust, head of Kerman Medical University, said nine other people have suspected MERS-CoV infections and are being tested, according to the story. The two sisters were among four suspected case-patients in one family.

CDC contact investigation

In the United States, Centers for Disease Control and Prevention (CDC) officials said they hope to extend their investigation of the first two US MERS cases by doing a serologic (antibody) survey of up to several hundred people who were on airline flights with the two patients.

The two cases were identified early this month in health professionals who work in Saudi Arabia and traveled to the United States.

Marty Cetron, MD, director of the CDC's Division of Global Migration and Quarantine, talked about the plan during a conference call for clinicians on May 28.

"We're now entering the second phase of this vigilant testing in order to inform our response and understand transmission and that is beginning a sero survey where there'll be I hope several hundred participants on a voluntary basis providing a convalescent blood sample in order to give us any indication whether an apparent infection had occurred potentially associated with this airline travel," Cetron said, according to the call transcript.

He said the investigation will span more than 30 US states and six countries. "We think that the information gleaned from this first of its kind full airline based contact investigation could be informative in looking at, one, the ease of transmission, and two, whether or not there's a necessity to continue these types of conveyance investigations as cases are exported," he added.

Serologic tests don't detect active disease but suggest whether a person has been infected in the recent past. They can indicate whether mild or asymptomatic infections occurred but went undetected.

Initial serologic tests of a business associate of the first US MERS patients indicated that he had been infected, a finding that was announced by the CDC May 17. But this week the agency reported that a subsequent, more definitive serologic test showed he had not been infected.

In other comments, Cetron said more than 500 airline passengers were associated with the two US cases. "We've notified more than 98% of them and none so far has had evidence of an acute infection compatible with MERS," he said.

Also during the teleconference, the CDC's Susan Gerber, MD, said that apart from the two patients, 245 people in the United States have been tested and found to be free of MERS-CoV. Gerber is the team lead for respiratory viruses in the CDC Division of Viral Diseases.

CDC spokesman Jason McDonald said 245 is the total number of people tested for MERS-CoV in the United States so far. Just under 200 of them were tested before the first two cases cropped up, he told CIDRAP News today.

See also:

May 30 Saudi MOH statement

May 30 Trend News Agency story on Iranian death

Transcript of May 28 CDC teleconference for clinicians

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