Nine Saudi MERS cases add to Jeddah outbreak; Yemen has first case

Saudi Arabia announced nine new Middle East respiratory syndrome coronavirus (MERS-CoV) cases today and over the weekend, further expanding an outbreak in the Red Sea city of Jeddah, while Yemen reported its first MERS case yesterday.

The latest Saudi cases involved four healthcare workers, three of whom had no symptoms. The reports raised the tally of cases reported in Jeddah since Mar 28 to 27, with 4 deaths, according to a case list maintained by FluTrackers, an infectious disease message board.

Also today, the World Health Organization (WHO) confirmed 15 recent MERS cases in Saudi Arabia and 1 in the United Arab Emirates (UAE), on the basis of national health ministry reports received between Apr 6 and 11. The UAE case, a fatal one in a 45-year-old, appeared to be previously unreported.

Latest Saudi cases

The Saudi Ministry of Health (MOH) announced four cases, all in Jeddah, in an Apr 12 statement. Those involved are:

  • A 26-year-old woman who was aymptomatic
  • A 58-year-old male healthcare worker listed in stable condition
  • A 39-year-old male healthcare workers with no symptoms
  • A 71-year-old man in stable condition

Those four people were the only ones who were positive for the virus among 200 who were tested, the MOH said. It did not give any details about how those infected were exposed to the virus. The ministry also said the MERS case-fatality rate in the country had dropped to 35.9% from 42% but did not specify the time frame involved.

Five more cases in Jeddah were reported today in a machine translation of another MOH statement, posted by Avian Flu Diary, an infectious disease blog. Two of those infected were healthcare workers. The cases involve:

  • A 70-year-old man who died
  • A 51-year-old who is in an intensive care unit
  • A 28-year-old healthcare worker who has no symptoms
  • A 45-year-old healthcare worker with no symptoms
  • A 56-year-old man in stable condition

The MOH's posted MERS count has reached 194 cases, included 69 deaths.

Among the 27 cases listed by FluTrackers for the Jeddah outbreak, at least 13 work in the health sector. The outbreak appears to rival a hospital-related outbreak that occurred in eastern Saudi Arabia's Al-Ahsa governorate in April and May of last year. That one involved 23 confirmed and 11 probable cases, according to a report in the New England Journal of Medicine in June 2013.

Yemen's first case

Yemen's first MERS case was reported yesterday by the semi-official newspaper al-Thawra, which quoted Health Minister Almed al-Ansi, according to a Reuters report.

It said the patient is a Yemeni who works as an aeronautical engineer, but it gave no details about his age, whereabouts, condition, or exposure to the virus.

Yemen is the latest country on or near the Arabian Peninsula to be affected by MERS-CoV. Besides Saudi Arabia, others are Qatar, Kuwait, Jordan, the UAE, and Oman. Cases have also been reported in Tunisia, the United Kingdom, France, Germany, and Italy, but all had direct or indirect links to the Middle East.

WHO case confirmations

Of the 16 MERS cases confirmed by the WHO today, most appear to have been reported previously by health ministries or the media. But the fatal case in a 45-year-old man from Abu Dhabi, UAE, appeared to be new.

The WHO said the man fell ill on Apr 6, was hospitalized on Apr 7, and died on Apr 10. He was not known to have any chronic diseases or any recent travel or contact with other MERS patients or animals, the agency said.

The other 15 cases were all in Saudi Arabia. Of those, 8 were in Jeddah, 3 were in Riyadh, and the location of the other 3, all healthcare workers with no symptoms, was not listed. The three healthcare workers are 26, 26, and 33 years old. One other healthcare worker, a 32-year-old woman from Jeddah, is also listed as asymptomatic.

Two of the cases were fatal. A 70-year-old Jeddah man with underlying medical conditions died Apr 5, and a 57-year-old Riyadh man died Mar 30, the WHO said.

A 28-year-old man from Jeddah who has no symptoms is a household contact of the 70-year-old man who died, the WHO said. The statement did not list exposure information for any of the other cases.

With the 16 cases, the WHO raised its MERS count to 228 cases with 92 deaths.

See also:

Apr 12 Saudi MOH statement

Apr 14 Avian Flu Diary post on five Jeddah cases announced today

Saudi Arabia MOH MERS page with case count

Apr 13 Reuters story on case in Yemen

FluTrackers case list

Apr 14 WHO statement

Jun 19, 2013, CIDRAP News story on NEJM report on al-Ahsa hospital outbreak

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