Editor's note: This story was revised on Nov 4 with the correct breakdown by city of the 12 cases reported by the WHO on Nov 3.
Saudi Arabia's Ministry of Health (MOH) confirmed two new MERS-CoV cases today and the death of a previously reported patient yesterday, while the World Health Organization (WHO) confirmed 12 recent Saudi MERS cases and 2 in Qatar.
After 3 days without a MERS-CoV (Middle East syndrome coronavirus) case, the MOH said today that two men in Riyadh contracted the disease. One is a 41-year-old man with no pre-existing disease, animal exposure, or contact with other MERS case-patients. He is hospitalized in a general ward.
The other patient is a 75-year-old man with pre-existing disease who is in an intensive care unit. He had no contact with animals, but officials are investigating possible contact with a suspected or confirmed MERS-CoV, the MOH said. Neither man is a healthcare worker.
Yesterday, the MOH confirmed a MERS-related death in a 60-year-old male MERS patient in Hafar Al-Batin in the northeast. His case was first reported by the MOH On Oct 29, at which point he was listed in stable condition. He had contact with animals before he fell ill, the agency said in the earlier notice.
On Nov 1 the MOH said that a 53-year-old male Riyadh resident has recovered from the disease. He was not a healthcare worker.
The new cases and death bring Saudi Arabia's case totals to 789, including 337 fatal cases.
WHO confirms 12 Saudi cases
In related news, the WHO today confirmed 12 MERS-CoV cases, including 5 fatal ones, that the Saudi MOH reported from Oct 18 through Oct 26. Instead of offering information on each patient, however, the WHO simply reported aggregate data on the cases.
Six of the cases were in Taif, four in Riyadh, and one each in Medina and Sakakah, the WHO noted. They correspond to the cases that the MOH reported during that period.
The 12 cases involved patients ranging in age from 17 to 75 years, with a median of 54. Ten had underlying disease, 10 were Saudi nationals, and 9 were men. Eight of them had contact with lab-confirmed MERS patients, but none had recent contact with animals, although two lived in areas "densely populated with camels."
None of the patients had made an Umrah or Hajj pilgrimage in the 2 weeks before they had symptoms, and only two had traveled out of their city of residence, the WHO said.
The WHO did not specify whether any of the patients were healthcare workers. It listed the global total of MERS cases as 897, including "at least" 325 deaths.
WHO on Qatari cases
Late on Oct 31 the WHO also confirmed Qatar's only two MERS-CoV cases of 2014, which were both reported last month by Qatari officials. In contrast to the Saudi WHO report today, the agency included quite a bit of new information on the cases in Qatar. Both patients are men from Doha.
The first case-patient is a 71-year-old who developed symptoms while driving by car from Qatar to the Al-Ahsa (also spelled Al-Hasa) region of Saudi Arabia on Oct 1. His symptoms worsened on Oct 7, and he visited a health facility in Al-Ahsa that day but was then transferred to Hamad General Hospital in Doha. Tests confirmed his MERS-CoV infection on Oct 11.
The man owns a camel barn and had drunk raw camel milk, the WHO said. He has co-morbidities and is in critical condition.
The second patient is a 43-year-old who first developed symptoms on Oct 14. He sought care at a healthcare facility on both Oct 17 and Oct 18 but was not admitted. His condition deteriorated on Oct 20, and he was then admitted to a hospital. His infection was confirmed that day.
The patient, who had no pre-existing disease, had frequently visited a camel barn in the 2 weeks before he became ill. He had no other exposure to known risk factors and is in stable condition, the WHO said.
The two patients' contact with camels had not been reported last month by Qatari health officials.
Riyadh governor orders MERS efforts
Meanwhile, Riyadh Governor Prince Turki bin Abdullah issued a directive to his senior health officials to bolster efforts to raise MERS awareness in the province, Arab News reported on Nov 1.
In response, regional health director Adnan Al-Abdulkareem said officials have formed 20 teams to bring awareness messages to camel breeders, schools, malls, and King Khaled International Airport. The teams are using print, broadcast, and social media to reach people.
Al-Abdulkareem also said that people with MERS-CoV are being treated at the newly built Prince Mohammed bin Abdulaziz Hospital, designated as the region's MERS center.
Nov 3 MOH update
Nov 2 MOH update
Nov 1 MOH update
Oct 31 WHO update on Qatari cases
Oct 13 CIDRAP News scan on older Qatari patient
Oct 23 CIDRAP News scan on younger Qatari patient
Nov 1 Arab News story