MERS-COV (06): SAUDI ARABIA, WHO

Posted on 19TH JAN 2017
tagged MERS-CoV, Saudi Arabia

A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Saudi Arabia, 15-18 Jan 2017
[2] Saudi Arabia WHO update 17 Jan 2017

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[1] Saudi Arabia, 15-18 Jan 2017
Date: 18 Jan 2017
Source: Saudi MoH [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx

As of 13:00 [1:00 pm] today [18 Jan 2017], there have been a total of:
1537 laboratory-confirmed cases of MERS-CoV infection, including
640 deaths [reported case fatality rate 41.6 per cent],
890 recoveries, and
7 currently active cases.

Since the last ProMED-mail update [10 Jan 2016], there have been a total of:
0 newly confirmed cases,
0 newly reported fatalities, and
4 newly reported recoveries.

Information on newly reported recoveries (4 recoveries)
Date: 18 Jan 2017 (1 recovery)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-01-18-0...

1 - An 87 year old Saudi female, non-healthcare worker from Buraidah [Al Qaṣīm region], history of pre-existing co-morbidities [reported as a newly confirmed case on 4 Jan 2017, at which time she was noted to be in a stable condition. At the time of confirmation was classified as a primary case with high risk exposure history still under investigation. - Mod.MPP].

Date: 16 Jan 2017 (3 recoveries)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-01-16-0...

2 - A 58 year old Saudi male, non-healthcare worker from Afeef [Riyadh region], history of pre-existing co-morbidities [reported as a newly confirmed case on 6 Dec 2016, at which time he was noted to be in a stable condition. At the time of confirmation was classified as a primary case with high risk exposure history still under investigation. - Mod.MPP].

3 - A 58 year old Saudi male, non-healthcare worker from Riyadh, history of pre-existing co-morbidities [reported as a newly confirmed case on 4 Jan 2017, at which time he was noted to be asymptomatic. At the time of confirmation was classified as a secondary case in a household contact. - Mod.MPP].

4 - A 56 year old expat male, non-healthcare worker from Riyadh, history of pre-existing co-morbidities [reported as a newly confirmed case on 4 Jan 2017, at which time he was noted to be in a critical condition. At the time of confirmation was classified as a primary case with high risk exposure history still under investigation. - Mod.MPP].

--
communicated by:
ProMED-mail

[In the past 4 days since the last ProMED-mail update, there have been no newly confirmed cases of MERS-CoV infection reported by Saudi Arabia. It is still too early to declare transmission interruption in Buraidah, where there was documented nosocomial transmission, as the most recent case was reported on 10 Jan 2017 (albeit we do not have information on the date of onset of the MERS-CoV illness in this individual). - Mod.MPP]

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[2] Saudi Arabia WHO update 17 Jan 2017
Date: 17 Jan 2017
Source: WHO Emergencies preparedness, response, Disease Outbreak News [edited]
http://www.who.int/csr/don/17-january-2017-mers-saudi-arabia/en/

Middle East respiratory syndrome coronavirus (MERS-CoV) - Saudi Arabia 17 Jan 2017
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Between 16 and 31 Dec 2016, the National IHR Focal Point of Saudi Arabia reported 15 additional cases of Middle East respiratory syndrome (MERS), including 2 fatal cases. Five deaths among previously reported MERS cases were also reported.

Details of the cases
1. A 49 year old male national living in Khurmah city, Taif Region. He developed symptoms on 25 Dec 2016 and was admitted to hospital on 29 Dec 2016. The patient, who has comorbidities, tested positive for MERS-CoV on 30 Dec 2016. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition and admitted to a negative pressure isolation room on a ward. Ministry of Agriculture has been informed, and investigation of camels is ongoing [reported as a newly confirmed case on 31 Dec 2016 at which time he was noted to be in stable condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding onset of illness. - Mod.MPP].

2. A 41 year old female non-national health care worker living in Abha city, Assir Region. She is asymptomatic and was identified through tracing contacts of the 50 year old MERS case reported to WHO on 28 Dec 2016 (See case no. 7 below). She tested positive for MERS-CoV on 28 Dec 2016. She has a history of caring for MERS cases between 25 to 26 Dec 2016. Currently, she is asymptomatic in stable condition at home isolation [reported as a newly confirmed MERS-CoV infection in an asymptomatic contact on 29 Dec 2016. She was reported as a recovery on 7 Jan 2017. - Mod.MPP].

3. A 30 year old female non-national health care worker living in Abha city, Assir Region. She is asymptomatic and was identified through tracing contacts of the 50 year old MERS case reported to WHO on 28 Dec 2016 (See case no. 7 below). She tested positive for MERS-CoV on 28 Dec 2016. She has a history of caring for MERS cases between 25-26 Dec 2016. Currently, she is asymptomatic in stable condition at home isolation [reported as a newly confirmed MERS-CoV infection in an asymptomatic contact on 29 Dec 2016. She was reported as a recovery on 7 Jan 2017. - Mod.MPP].

4. A 66 year old male national living in Madinah city, Madinah Region. He developed symptoms on 21 Dec 2016 and was admitted to hospital on 26 Dec 2016. The patient who has comorbidities tested positive for MERS-CoV on 28 Dec 2016. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition and admitted to a negative pressure isolation room on a ward. Ministry of Agriculture has been informed, and investigation of camels is ongoing. [I am unable to find a report of this case during the specified period of this update (16-31 Dec 2016). - Mod.MPP]

5. A 46 year old female national living in Riyadh city, Riyadh Region. She developed symptoms on 21 Dec 2016 and was admitted to hospital on 26 Dec 2016. The patient, who has comorbidities, tested positive for MERS-CoV on 27 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward [this is most likely the individual reported as a 42 year old Saudi female, newly confirmed case on 27 Dec 2016 and reported as a recovery on 7 Jan 2017. - Mod.MPP].

6. An 82 year old male national living in Najran city, Najran Region. He developed symptoms on 21 Dec 2016 and was admitted to hospital on 24 Dec 2016. The patient, who has comorbidities, tested positive for MERS-CoV on 26 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in critical condition and admitted to the intensive care unit on mechanical ventilation [reported as a newly confirmed case on 27 Dec 2016 at which time he was noted to be in critical condition. Reported as a fatality on 8 Jan 2017. - Mod.MPP].

7. A 50 year old male national living in Abha city, Assir Region. He developed symptoms on 21 Dec 2016 and was admitted to hospital on 25 Dec 2016. The patient who has comorbidities tested positive for MERS-CoV on 26 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in a critical condition and admitted to the intensive care unit on mechanical ventilation [reported as a newly confirmed case from Khamis Mushayet on 27 Dec 2017 at which time he was noted to be in a critical condition. Reported as a fatality on 2 Jan 2017. - Mod.MPP].

8. A 44 year old male national living in Riyadh city, Riyadh Region. He developed symptoms on 20 Dec 2016 and was admitted to hospital on 24 Dec 2016. The patient, who has no comorbidities tested positive for MERS-CoV on 25 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward [reported as a newly confirmed case on 26 Dec 2016 at which time he was noted to be in a stable condition. Reported as a fatality on 1 Jan 2017. - Mod.MPP].

9. A 64 year old female national living in Najran city, Najran Region. She developed symptoms on 17 Dec 2016 and was admitted to hospital on 21 Dec 2016. The patient, who had comorbidities, tested positive for MERS-CoV on 23 Dec 2016. She was admitted to a negative pressure isolation room on a ward. However, her condition deteriorated, and she passed away on 30 Dec 2016 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing [reported as a newly confirmed case in a 63 year old Saudi female on 25 Dec 2016 at which time she was noted to be in a stable condition. Classified as a primary case with a history of indirect contact with camels in the 14 days preceding onset of illness. She was reported as a fatality on 30 Dec 2016. - Mod.MPP].

10. A 78 year old male national living in Riyadh city, Riyadh Region. He developed symptoms on 18 Dec 2016 and was admitted to hospital on 19 Dec 2016. The patient, who has comorbidities, tested positive for MERS-CoV on 21 Dec 2016. He has a history of contact with camels in the 14 days prior to the onset of symptoms. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward. Ministry of Agriculture has been informed and investigation of camels is ongoing [reported as a newly confirmed case on 22 Dec 2016 at which he was noted to be in a stable condition. Reported as a recovery on 9 Jan 2016. - Mod.MPP].

11. A 24 year old male national living in Makkah city, Makkah Region. He was asymptomatic and identified through tracing of household contacts of the 47 year old MERS case reported to WHO on 20 Dec 2016 (See case no. 12 below). The case tested positive for MERS-CoV on 21 Dec 2016. He has no comorbidities and no history of exposure to the other known risk factors in the 14 days prior to detection. Currently, he is asymptomatic in a stable condition at home isolation [reported as a newly confirmed MERS-CoV infection in an asymptomatic household contact on 21 Dec 2016 and as a recovery on 5 Jan 2017. - Mod.MPP].

12. A 47 year old male national living in Makkah city, Makkah Region. He developed symptoms on 17 Dec 2016 and was admitted to hospital on 18 Dec 2016. The patient, who has comorbidities, tested positive on 19 Dec 2016. He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward [reported as a newly confirmed case on 20 Dec 2016 at which time he was noted to be in a stable condition. Reported as a recovery on 30 Dec 2016. - Mod.MPP].

13. A 57 year old male national living in Riyadh city, Riyadh Region. He developed symptoms on 13 Dec 2016 and was admitted to hospital on 18 Dec 2016. The patient who has no comorbidities tested positive for MERS-CoV on 19 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward [reported as a newly confirmed case in a 58 year old Saudi male on 19 Dec 2016 at which time he was noted to be in a stable condition. Reported as a recovery on 31 Dec 2016. - Mod.MPP].

14. A 22 year old female national living in in Taif city, Taif Region. She developed symptoms on 14 Dec 2016 and was admitted to hospital on 16 Dec 2016. The patient, who has comorbidities, tested positive for MERS-CoV on 18 Dec 2016. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in a stable condition and admitted to a negative pressure isolation room on a ward [reported as a newly confirmed case on 19 Dec 2016, at which time she was noted to be in a stable condition. Reported as a recovery on 24 Dec 2016. - Mod.MPP].

15. A 60 year old male national living in Mahd Aldhahab city, Madinah Region. He developed symptoms on 1 Dec 2016 and was admitted to hospital on 6 Dec 2016. The patient, who had comorbidities, tested negative for MERS-CoV on 11 Dec 2016. Another nasopharyngeal swab was collected on 14 Dec 2016 and tested positive for MERS-CoV on 15 Dec 2016. The patient was admitted to a negative pressure isolation room on a ward. However, his condition deteriorated, and he passed away on 24 Dec 2016. He had a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms. Ministry of Agriculture has been informed, and investigation of camels is ongoing [reported as a newly confirmed case on 16 Dec 2016 at which time he was noted to be in a stable condition. Reported as a fatality on 24 Dec 2016. - Mod.MPP].

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 5 MERS-CoV cases that were reported in previous editions of Disease Outbreak News published on 28 Nov 2016 (case no. 2), 19 Dec 2016 (1) (case no. 6), and 19 Dec 2016 (2) (case no. 1, 2, and 9).

Contact tracing of household and healthcare contacts is ongoing for these cases.

Globally, since September 2012, 1879 laboratory-confirmed cases of infection with MERS-CoV including at least 666 related deaths have been reported to WHO.

--
communicated by:
ProMED-mail rapporteur Marianne Hope

[As of 31 Dec 2016, the global tally of MERS-CoV infected individuals reported to WHO is 1879 cases including at least 666 related deaths. Of note is that the above WHO update contains information on a newly reported case that had not previously been reported on the Saudi MoH MERS-CoV website (case no.4 above). This case may well be the individual reported as a recovery on 6 Jan 2017, reported then as a 60 year old Saudi male from Madinah. If so, this would increase the official number of MERS-CoV infected individuals reported by Saudi Arabia since September 2012 to 1538 cases.

The HealthMap/ProMED map of Saudi Arabia can be found at http://healthmap.org/promed/p/131. - Mod.MPP]

See Also
MERS-CoV (05): Saudi Arabia (NJ, SH, RI), RFI 20170114.4766221
MERS-CoV (04): Saudi Arabia (MK, QS), nosocomial outbreak, RFI 20170110.4754928
MERS-CoV (03): Saudi Arabia (SH) & clarification 20170108.4750515
MERS-CoV (02): Saudi Arabia (QS) nosocomial transmission 20170107.4748974
MERS-CoV (01): Saudi Arabia (QS,RI,MD), RFI 20170105.4744802
2016
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MERS-CoV (123): Saudi Arabia (MK, AS) new cases 20161231.4734758
MERS-CoV (122): Saudi Arabia 20161228.4728747
MERS-CoV (121): Saudi Arabia, new cases 20161223.4720359
MERS-CoV (120): Saudi Arabia, new cases, WHO 20161219.4709903
MERS-CoV (110): Saudi Arabia (NJ,MK) new cases 20161108.4614294
MERS-CoV (100): Saudi Arabia (JF) new case, WHO 20160922.4508259
MERS-CoV (90): Saudi Arabia (RI), camel association, UAE 20160808.4402381
MERS-CoV (80): Saudi Arabia (MK), WHO 20160707.4331372
MERS-CoV (70): Saudi Arabia (MK), UAE, WHO, RFI 20160621.4300452
MERS-CoV (60): Saudi Arabia (TB) 20160610.4276126
MERS-CoV (50): Saudi Arabia (RI, NJ) 20160406.4143365
MERS-CoV (40): Egypt, animal reservoir, camel, ex Sudan, susp. 20160316.4097730
MERS-CoV (30): Saudi Arabia (QS) WHO 20160303.4066494
MERS-CoV (20): Saudi Arabia (NJ, RI) 20160212.4016509
MERS-CoV (10): Saudi Arabia (MK), Thailand ex Oman, RFI 20160125.3964309
MERS-COV (01): Oman, Saudi Arabia 20160105.3911188
2015
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MERS-COV (167): acute management and long-term survival 20151231.3904300
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
2014
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MERS-CoV (69): Saudi Arabia, new case, RFI 20141230.306305
MERS-CoV (01): Bangladesh, KSA, Algeria, UAE, Iran, WHO, RFI 20140616.2541707
MERS-CoV - Eastern Mediterranean (82): anim res, camel, seroepidemiology 20140613.2537848
MERS-CoV - Eastern Mediterranean (01): Saudi Arabia, UAE, Oman, WHO 20140103.2150717
2013
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MERS-CoV - Eastern Mediterranean (106): animal reservoir, camel, Qatar, OIE 20131231.2145606
MERS-CoV - Eastern Mediterranean: Saudi Arabia, new case, RFI 20130518.1721601
Novel coronavirus - Eastern Mediterranean (29): MERS-CoV, ICTV nomenclature 20130516.1717833
Novel coronavirus - Eastern Mediterranean: bat reservoir 20130122.1508656
2012
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Novel coronavirus - Eastern Mediterranean (06): comments 20121225.1468821
Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI 20121130.1432498
Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664
Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733
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