Saudi Arabia reports 7 more MERS cases, 1 fatal

Saudi Arabia today reported seven new Middle East respiratory syndrome coronavirus (MERS-CoV) cases, one of them fatal, as details emerged that Filipinos are among the recent deaths.

Six of the new Saudi cases are from areas that have reported several recent infections, such as Jeddah (4), Medina (1), and Riyadh (1). But one of the patients is from Gonfothah, on the southwestern coast of the country, according to a statement from Saudi Arabia's health ministry (MOH).

One of the patients is in critical condition, three are listed as stable, and two are asymptomatic. The patient who died is a 74-year-old man who had lymphoma and started having respiratory symptoms on May 18. He was hospitalized the next day and died on May 20.

All of the patients are adults and range in age from 33 to 75. Four are men. Aside from the man who died, only one other patient has an underlying medical condition, a 75-year-old man who has hypertension.

Only one patient—a 65-year-old man from Gonfothah who is asymptomatic and visited a government hospital for health reasons—was reported to have contact with a confirmed case. Otherwise, no healthcare, camel, or animal environment exposure was listed for the other patients.

Illness onsets range from May 10 to May 20, and hospital admission dates range from May 12 to May 22.

The new cases boost Saudi Arabia's MERS total to 551, including 177 deaths.

Filipinos among recent MERS deaths

In a related development, government officials from the Philippines said they have been notified that two of Saudi Arabia's recent MERS deaths involved Filipinos, ABS-CBNnews.com reported today. The officials did not specify the genders or occupations of the two people, but did say that the patients died on May 12 and May 18.

On May 19, Saudi Arabia's health ministry listed a May 18th death of a 28-year-old woman in Jeddah and on May 13 listed four May 12th deaths from Jeddah, but it's unclear if any of them involve the patients from the Philippines, because the MOH hasn't been listing nationalities in any of its recent updates.

They are the fifth Filipinos to die from MERS in the Middle East, according to the report. At least two of the earlier deaths were in health workers, a paramedic working in the United Arab Emirates and a nurse working at a Riyadh hospital.

WHO weighs in on US secondary transmission

In US developments, the World Health Organization (WHO) provided some new details about an Illinois man who was recently found to have been infected with MERS, based on serology testing after he was exposed in a business setting to the first imported US case-patient, a doctor whose illness was detected in Indiana after he returned from working in a Saudi hospital.

The report said the man—the third US MERS patient— is in his 70s and has underlying health conditions. He has no history of travel outside of the United States.

Polymerase chain reaction (PCR) tests on respiratory samples taken 10 days after he had contact with the doctor were negative for active infection. A blood sample taken 14 days after contact, however, was positive for MERS antibodies.

The WHO said that although the test suggests the man was infected, he is not listed as a case, because the WHO currently defines a lab-confirmed case as testing positive on PCR analysis.

On May 17 the US Centers for Disease Control and Prevention (CDC) announced the man's likely infection after two close-contact meetings in a face-to-face business setting in which the two men shook hands. The Illinois man had mild coldlike symptoms but did not seek medical care.

His serology tests results make his the first secondary transmission case found in the investigation of two imported MERS cases, both of whom had returned to the United States after working in Saudi hospitals.

So far the WHO has received reports of 632 lab-confirmed cases, including 193 deaths. It said the total includes all cases reported so far, plus 17 more reported from Saudi Arabia from May 16 to May 18. The agency said it is working with Saudi Arabia to get more information on the cases and will provide a further update as soon as possible.

CDC travel notice tweaks

Yesterday the CDC updated its travel alert for the Arabian Peninsula, noting that the MERS virus has been found in some camels and that some patients had contact with camels. It said, though, that it's still not known how people become infected with MERS.

The agency urged travelers to take WHO-recommended precautions around animals or animal environments and to avoid consuming raw or undercooked animal products.

The CDC also urged people who are traveling with the aim of providing healthcare services to review its guidance for infection control regarding confirmed or suspected MERS patients. It also said most instances of person-to-person spread have occurred in healthcare workers and other close contacts.

The CDC's travel advisory is at the yellow alert level, which recommends practicing enhanced precautions. The CDC has not recommended that travelers change their plans because of MERS.

See also:

May 22 Saudi MOH statement

Saudi MOH MERS-CoV media statements with case count

ABS-CBNnews.com story

May 22 WHO statement

May 21 CDC Arabian Peninsula MERS travel alert update

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