Five Saudi MERS cases, 1 fatal, involve family cluster

Saudi Arabia has identified five new cases of Middle East respiratory syndrome coronavirus (MERS-CoV), including one death, with at least three of the illnesses in one family, according to government and media reports today.

An Associated Press (AP) report said a 19-year-old man from Al Kharj, southeast of Riyadh, died of his infection and that he had two sisters who were hospitalized with suspected cases.

Within hours of the AP story's publication, the Saudi Arabian Ministry of Health (MOH) announced five cases, including that of the 19-year-old. A translation of the Arabic-language MOH statement was posted on the infectious disease blog Avian Flu Diary.

All patients from Riyadh

The MOH said the other patients, all from Riyadh, included an 83-year-old man with chronic conditions who is in a hospital intensive care unit, a 22-year-old woman with mild symptoms, an 18-year-old woman with mild symptoms, and a 53-year-old with no symptoms. All were described as Saudi citizens.

The statement said the man who died had chronic conditions. It also indicated that the 83-year-old was the first person to get sick, but it gave no information on how he might have been exposed to the virus and no timeline.

The two young women and the 53-year-old all had contact with other case-patients, the MOH said. It indicated that the man who died was the second person to get sick, but it didn't specify whether he had contact with the 83-year-old man.

The absence of symptoms in the 53-year-old implies that he or she was tested because of exposure to the other patients, suggesting the possibility that he or she is a relative of the others. The MOH statement gave no information about monitoring of contacts.

With the new cases, the MOH raised its posted MERS count to 156 cases and 63 deaths.

Previous clusters, healthcare outbreaks

A few family clusters of MERS cases have been seen since the disease emerged in 2012, and outbreaks have occurred in healthcare facilities, but the general perception is that the virus does not spread very easily from person to person. The outbreaks in healthcare facilities have not lasted long and have not spread into communities, according to World Health Organization (WHO) reports.

At 19, the man who died was far below the median age of MERS case-patients, which is 52, according to the WHO. But, like him, most patients have been described as having chronic health problems. About 62% of MERS patients have been male, the WHO has said.

The WHO's official global MERS count stands at 189 cases, 82 of them fatal. In addition to today's cases, the agency has not yet noted a case announced by the MOH on Mar 6 that involved an 86-year-old Riyadh man who had no symptoms.

See also:

Mar 14 AP story

Mar 14 Avian Flu Diary post

Mar 14 ProMED post on new cases

WHO summary updates on MERS-CoV

Most recent (Mar 12) WHO MERS case update

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