The World Health Organization (WHO) today confirmed two fatal Middle East respiratory syndrome coronavirus (MERS-CoV) cases involving men from Saudi Arabia and Jordan.
The cases are the first to be officially confirmed since Jan 9.
Saudi Arabia reported to the WHO that its case is in a 54-year-old healthcare worker from Riyadh who started having respiratory symptoms on Dec 29, was hospitalized on Jan 4, and died on Jan 14.
An illness closely matching the description was first noted in a media report citing unnamed health personnel on Jan 17. It said the man was a Bangladeshi surgeon working at Prince Salman Hospital in Riyadh.
WHO spokesman Gregory Hartl confirmed that the man in the media report is the same patient from Saudi Arabia described in the WHO report today.
Today's WHO statement said the man was treated in the intensive care unit and that samples tested after his death were positive for MERS-CoV. The man had a history of chronic disease but had not been in contact with animals or people with known MERS-CoV infections. An investigation into the source of his infection is ongoing.
The other patient is a 48-year-old man who got sick on Dec 31, with symptoms that included fever, dry cough, difficulty breathing, abdominal pain, and vomiting, according to a Jan 23 report that the WHO received from Jordan's health ministry. The man was hospitalized on Jan 9 and placed on a ventilator on Jan 16 after his condition worsened.
He died on Jan 23, and a sample taken 2 days earlier tested positive for MERS-CoV, according to the WHO statement.
The man had traveled to the United Kingdom from Nov 12 to Dec 25 for treatment of underlying health conditions. He had no history of animal contact and isn't known to have attended any large social events in the past 30 days. However, he received two guests from Kuwait between Dec 25 and Dec 31.
Jordanian health officials are monitoring the man's family contacts, medical staff, and health workers, and further investigations are under way in Jordan and the United Kingdom, the WHO said.
The latest cases raise the global number of MERS-CoV infections to 180, including 77 deaths, according to the WHO.
Measures in healthcare settings
The WHO said MERS-CoV infections acquired in healthcare settings underscore the need to continue strengthening infection prevention and control measures. Facilities that care for suspected or confirmed MERS-CoV patients should take steps to decrease the risk of transmission to patients, workers, and visitors and that all health workers should be regularly trained on preventing and controlling the disease, it added.
In a related development, the WHO published a protocol for investigating MERS-CoV transmission in healthcare setting. It describes the epidemiologic, virologic, and serologic methods to assess health workers who are exposed to patients infected with MERS-CoV.
The study outline is adapted from a protocol developed by the Consortium for the Standardization for Influenza Seroepidemiology (CONSISE), a global partnership that develops influenza investigation methods and standardized seroepidemiology methods for assessing pandemic, zoonotic, and seasonal flu threats.
The protocol for MERS-CoV walks facilities through ethical considerations, study subject selection, sample size considerations, laboratory evaluation, serologic testing, and data analysis. It includes other resources, such as sample questionnaires for infection control staff and roster sheets for health workers who were potentially exposed.
Jan 27 WHO statement
Jan 17 CIDRAP News scan "Report: Bangladeshi doctor died of MERS-CoV in Saudi Arabia"