MERS-COV (09): SAUDI ARABIA (MAKKAH) WHO
Posted on 28TH JAN 2017
tagged MERS-CoV, Saudi Arabia
In this update:
 Saudi Arabia, 2 new cases - MOH 26-27 Jan 2017
 Saudi Arabia - WHO 26 Jan 2017 (covers 1-13 Jan 2017)
 Saudi Arabia, 2 new cases - MOH 26-27 Jan 2017
Date: Fri 27 Jan 2017
Source: Saudi MoH 26-27 Jan 2017 [edited]
As of 14:00 [2:00 pm] today [Fri 27 Jan 2017], there have been a total of:
1544 laboratory-confirmed cases of MERS-CoV infection, including 641 deaths [reported case fatality rate 41.5 percent], 894 recoveries, and 9 currently active cases.
Since the last ProMED-mail update [Wed 25 Jan 2017], there have been a total of:
2 newly confirmed cases, 0 newly reported fatality, and 0 newly reported recoveries.
Information on newly reported cases (2 cases)
Date: Fri 27 Jan 2017 (1 case)
1- A 59-year-old Saudi male, non-healthcare worker from Turaba [Makkah region], currently in critical condition. Classified as a primary case with history of direct contact with camels in the 14 days preceding onset of illness.
Date: Thu 26 Jan 2017 (1 case)
2- A 30-year-old Saudi male, healthcare worker from Jeddah [Makkah region], currently in stable condition. Classified as a secondary healthcare acquired case in a healthcare worker.
[In the 2 days since the last ProMED-mail update on MERS-CoV in KSA, there have been 2 newly confirmed cases reported. Both from Makkah region (one from Jeddah and one from Turaba). This now brings the total number of MERS-CoV cases reported by Saudi Arabia since [Sun1 Jan 2017] to 22, and represents the 7th consecutive day with a new case being reported each day. Notable is the case reported today [Fri 27 Jan 2017] in a healthcare worker in Jeddah. Hopefully this will be a single case in a healthcare worker with a lapse in infection control procedures and is not the debut of a nosocomial outbreak.
Returning to the 22 cases reported since the beginning of the year, the geographic breakdown includes 6 cases from Al Qaṣīm region (all 6 from Buraidah), 5 cases from Riyadh region (4 from Riyadh and one from Al Qararah), 5 cases from Makkah region (3 from Jeddah, 1 from Taif and 1 from Turaba), 4 cases from Ash Sharqīyah (Eastern) region (3 from Hufoof and 1 from Jubail), and 1 each from Al Madinah and Najran regions.
Five of the 6 cases from Buraidah (Al Qasim region) were definitively confirmed to be part of a nosocomial outbreak involving 2 healthcare centers (see discussion in WHO update below).
Maps of the locations of the newly confirmed cases can be found at the source URL. The HealthMap/ProMED map of Saudi Arabia can be found at http://www.healthmap.org/promed/p/131. - Mod.MPP]
 Saudi Arabia - WHO 26 Jan 2017 (covers 2-7 Jan 2017)
Date: Thu 26 Jan 2017
Source: WHO Emergency, Preparedness, Response - DON 26 Jan 2017 [edited]
Middle East respiratory syndrome coronavirus (MERS-CoV) - Saudi Arabia 26 Jan 2017
Between [Mon 2 and Sun 7 Jan 2017] the National IHR Focal Point of Saudi Arabia reported nine (9) additional cases of Middle East Respiratory Syndrome (MERS) including two (2) fatal cases. Two (2) deaths among previously reported MERS cases (cases no. 7 and 8 in DON published on [Tue17 Jan 2017]) were also reported.
Detailed information concerning these cases can be found in a separate document [see link to MERS-CoV cases reported between [Mon 2 and Sun 7 Jan 2017], an excel spreadsheet available for download at source URL]. The 5 cases from Buridah reported are part of a small health care setting outbreak involving 2 hospitals. A Ministry of Health rapid response team has been dispatched and measures to prevent further cases including contact tracing, and strengthening of infection, prevention and control have been put in place. None of the cases reported are health care workers.
(Chart from WHO data)
Case no. Date report WHO/ City of residence/ Age /Sex / HCW/ Comorbidities/ Camel Exposure / Camel milk / Exposure other cases/ Date of onset symptoms/ Date of hospitalization / Date of lab confirm / Status / Date of outcome
1 2017-01-07 Hofouf 57 M No No NA NA NA 2016-12-26 2017-01-05 2017-01-06 Alive
2 2017-01-06 Buridah 73 F No Yes NA NA NA 2017-01-03 2016-12-24** 2017-01-05 Alive
3 2017-01-05 Buridah 70 F No Yes NA NA NA 2016-12-23 2017-01-03 2017-01-05 Alive
4 2017-01-04 Buridah 88 F No Yes NA NA NA 2016-12-19 2017-01-01 2017-01-03 Deceased 2017-01-03
5 2017-01-04 Buridah 87 F No Yes NA NA NA 2016-12-29 2017-01-02 2017-01-04 Alive
6 2017-01-04 Riyadh 56 M No Yes NA NA NA 2016-12-28 2017-01-02 2017-01-04 Alive
7 2017-01-04 Riyadh 59 M No NA No No Yes NA NA 2017-01-02 Alive
8 2017-01-02 Madinah 70 M No Yes Yes Yes NA 2016-12-25 2017-01-01 2017-01-02 Alive
9 2017-01-02 Buridah 63 F No Yes NA NA NA 2016-12-29 2016-12-31 2017-01-01 Deceased 2017-01-02
Globally, since September 2012, 1888 laboratory-confirmed cases of infection with MERS-CoV including at least 670 related deaths have been reported to WHO.
WHO risk assessment
MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.
The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.
ProMED-mail Rapporteur Marianne Hopp
[The WHO report confirms the existence of a small, limited nosocomial outbreak in Buraidah (Al Qasim region) in the beginning of this month [January 2017] involving 5 cases. In the original reports from the Saudi MOH, only 2 of the 5 cases were identified as having had contact in the healthcare environment (case No. 2 above, and another case reported on [Tue 10 Jan 2017] not included in the above outbreak).
As I've said before, it is safe to say that MERS-CoV is endemic in Saudi Arabia with cases occurring associated with contact with camels, and the occasional healthcare associated transmission, now hopefully limited and small numbers. What remains to be defined are the high risk exposures that have resulted in "primary" cases where there is no clear history of exposure to camels, nor is there a clear history of contact with other known MERS-CoV infected individuals. - Mod.MPP
A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/131.]
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