MERS-COV (25): SAUDI ARABIA, QATAR, WHO

Posted on 29TH APR 2017
tagged MERS-CoV, Saudi Arabia; Qatar

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
[2] Qatar, Saudi Arabia - WHO update 27 Apr 2017
[3] Qatar - media report

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[1] Saudi Arabia
Date: Fri 28 Apr 2017
Source: Saudi MOH 26-28 Apr 2017 [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx?PageIndex=1

As of 14:00 [2:00 PM] today [Fri 28 Apr 2017], there have been a total of:
1596 laboratory-confirmed cases of MERS-CoV infection, including
658 deaths [reported case fatality rate 41.3 pe cent],
926 recoveries, and
12 currently active cases

[As previously mentioned, the numbers of deaths, recoveries and currently active cases come from my spreadsheet tallies and differ from those listed on the Saudi MOH website. There was no report on the website for yesterday, Thu 27 Apr 2017 but the tally of number of recoveries increased by 2 since the report on Wed 26 Apr 2017. The below tallies represent information provided on the website taken from the daily reports. - Mod.MPP]

Since the last ProMED-mail update [Tue 25 Apr 2017], there have been a total of:
4 newly confirmed cases, [1 is reported to be asymptomatic]
0 newly reported fatalities, and
0 newly reported recoveries

Information on newly confirmed cases (4 cases)
Date: Fri 28 Apr 2017 (3 cases)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2017-04-28-0...?

26-Apr-17 Riyadh Wadi Aldawasir 26 M expat No stable/asymptomatic N/A No No Yes Secondary household contact

1 - A 65-year-old Saudi male, non-healthcare worker from Hasu [Al Madinah region] currently in stable condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding onset of illness.

2 - An 81-year-old Saudi male, non-healthcare worker from Hafuf (Hafoof) [Ash Sharqīyah region] currently in critical condition. Classified as a primary case with history of possible high risk exposures in the 14 days preceding onset of illness still under investigation..

3 - A 61-year-old Saudi male, non-healthcare worker from Mahayel [`Asīr region] currently in stable condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding onset of illness.

Date: Wed 26 Apr 2017 (1 case)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2017-04-26-0...?

4 - A 26-year-old expat male, non-healthcare worker from Wadi Aldawasir [Riyadh region], currently in stable condition, listed as an asymptomatic case. Classified as a secondary case in a household contact.

--
Communicated by:
ProMED-mail

[Low level continued transmission of the MERS-CoV continues in Saudi Arabia. In the past 3 days there have been 4 newly confirmed cases reported from Saudi Arabia with one being an asymptomatic household contact of one of the Wadi Aldawasir cases. The remaining 3 cases involved 2 individuals with histories of direct contact with camels in the 14 days preceding onset of their illness, and a 3rd individual whose high risk exposure history was still under investigation. Since the beginning of April 2017, there have been a total of 15 newly confirmed cases reported by Saudi Arabia on the MOH MERS-CoV website.

Since [Sun 5 Mar 2017], there have been 15 laboratory confirmed infections with MERS-CoV reported by Saudi Arabia, associated with an outbreak in a renal dialysis unit. Seven of the 15 infections were in individuals who were asymptomatic and were identified through contact screening - 3 were secondary healthcare acquired infections in healthcare workers and 4 were secondary cases in household contacts.
In Moon SY, Son JS. Infectivity of an Asymptomatic Patient With Middle East Respiratory Syndrome Coronavirus Infection. Clin Infect Dis. 2017 Apr 22. doi:10.1093/cid/cix170. [Epub ahead of print], there was one asymptomatic MERS-CoV infected individual with 82 contacts identified, none of whom were found to be MERS-CoV infected leading the authors to conclude that asymptomatic infections with MERS-CoV were not significant players in the continued transmission of the virus.

Maps of Saudi Arabia showing the locations of the newly confirmed cases can be found at the source URLs. - Mod.MPP]

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[2] Qatar, Saudi Arabia - WHO update 27 Apr 2017
Date: Thu 27 Apr 2017
Source: WHO Emergencies preparedness, response, Disease Outbreak News [edited]
http://www.who.int/csr/don/27-april-2017-mers-saudi-arabia-and-qatar/en/

Middle East respiratory syndrome coronavirus (MERS-CoV) - Saudi Arabia and Qatar
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Between [18 Mar and 20 Apr 2017] the national IHR Focal Point of Saudi Arabia reported 13 additional cases of Middle East Respiratory Syndrome (MERS) including 2 fatal cases. [Of note is that during this same period, there were 12 cases of MERS-CoV infection reported on the Saudi MOH MERS-CoV website, with case no. 2 below having been reported as a fatality but not as a newly confirmed case. - Mod.MPP] On [Tue 18 Apr 2017] the national IHR Focal Point of Qatar reported one additional case of MERS.

Details of the cases:
MERS-CoV cases reported between 18 Mar and 20 Apr 2017:
Case no. / Date report WHO / City of residence / Age / Sex / HCW / Co-morbidities / Camel exposure / Camel milk / Exposure to other cases / Date of onset of symptoms / Date of hospitalization / Date of lab confirmation / Status / Date of outcome

Qatar
1 / 2017-04-18 / Doha / 25 / M / No / No / Yes / NA / NA / 2017-04-11 / NA / 2017-04-17 / Alive

Saudi Arabia
1 / 2017-04-20 / Riyadh / 86 / M / No / Yes / NA / NA / NA / 2017-04-16 / 2017-04-19 / 2017-04-20 / Alive
2 / 2017-04-19 / Wadi Aldwaser / 55 / M / No / Yes / NA / NA / NA / 2017-04-11 / 2017-04-18 / 2017-04-19 / Deceased / 2017-04-20
3 / 2017-04-14 / Taif / 86 / M / No / Yes / Yes / Yes / NA / 2017-04-10 / 2017-04-13 / 2017-04-14 / Alive
4 / 2017-04-14 / Turbah / 61 / F / No / Yes / NA / NA / NA / 2017-04-08 / 2017-04-12 / 2017-04-13 / Alive [recovered 24 Apr 2017]
5 / 2017-04-11 / Taif / 60 / M / No / Yes / Yes / Yes / NA / 2017-04-01 / 2017-04-09 / 2017-04-10 / Alive [died 21 Apr 2017]
6 / 2017-04-11 / Riyadh / 72 / M / No / Yes / NA / NA / NA / 2017-04-03 / 2017-04-08 / 2017-04-10 / Alive [recovered 23 Apr 2017]
7 / 2017-04-06 / Riyadh / 62 / M / No / Yes / Yes / NA / NA / 2017-03-26 / 2017-04-04 / 2017-04-05 / Alive
8 / 2017-04-02 / Dammam / 31 / M / No / No / No / No / Yes* / NA / NA / 2017-04-02 / Alive [recovered 14 Apr 2017]
9 / 2017-04-01 / Dammam / 58 / M / No / Yes / NA / NA / NA / 2017-03-27 / 2017-03-30 / 2017-04-01 / Alive [recovered 13 Apr 2017]
10 / 2017-03-30 / Beqiq / 63 / M / No / Yes / Yes / Yes / NA / 2017-03-28 / 2017-03-29 / 2017-03-30 / Alive [recovered 14 Apr 2017]
11 / 2017-03-27 / Alkharj / 54 / M / No / Yes / Yes / Yes / NA / 2017-03-23 / 2017-03-26 / 2017-03-27 / Alive [recovered 15 Apr 2017]
12 / 2017-03-22 / Hafer Albatin / 40 / M / No / No / No / No / Yes* / NA / NA / 2017-03-21 / Alive [recovered 7 Apr 2017]
13 / 2017-03-18 / Hafer Albatin / 20 / M / No / No / Yes / Yes / NA / 2017-03-09 / 2017-03-15 / 2017-03-17 / Deceased / 2017-03-17
* Case was detected through contact tracing of a previous MERS-CoV case.

Between [18 Mar and 20 Apr 2017], 13 cases of MERS were reported in Saudi Arabia. Six of these cases had exposure to infected dromedary camels or consumed their raw milk, which is the most likely source of their infection and 2 cases were detected through contact tracing of previously reported MERS-CoV cases. Investigation into the history of exposure to the known risk factors in the 14 days prior to onset of symptoms is ongoing for the remaining cases. Contact tracing of household and healthcare contacts is ongoing for all 13 cases.

On [Tue 18 Apr 2017], one case of MERS was reported in Qatar. The 25-year-old case has a history of frequent contact with dromedary camels and no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He is currently in stable condition admitted to a negative pressure isolation room on a ward. The department of health protection and communicable disease control in the Ministry of Public Health has carried out case investigation and contact tracing. All contacts have tested negative but will continue to be monitored until the end of the monitoring period of 14 days of last exposure to the case.

To date, Qatar has reported 20 laboratory-confirmed cases of MERS. The last case was reported on [Tue 21 Mar 2017] (see Disease Outbreak News published on [Tue 4 Apr 2017]).

Globally, since September 2012, WHO has been notified of 1952 laboratory-confirmed cases of infection with MERS-CoV including at least 693 related deaths have been reported.

--
Communicated by:
ProMED-mail rapporteur Marianne Hopp

[As mentioned above, there have been a total of 20 cases of MERS-CoV reported by Qatar since the identification of the virus in 2012. This newly confirmed case represents the 2nd case reported by Qatar this year (2017).

With respect to Saudi Arabia, the above WHO report provides more details on a fatality reported in Wadi Aldawasir on [Wed 19 Apr 2017] for whom an initial laboratory confirmation report was not available on the Saudi MOH MERS-CoV website. In addition, case no 12 was not reported as a newly confirmed case on the Saudi MOH MERS website, but was reported as a recovery on [Fri 7 Apr 2017]. Of the 13 cases contained in the above report, 3 resulted in fatalities (cases no. 2, 5 and 13). There was an additional newly confirmed infection reported by the MOH that is not on the above list - a report on [Wed 29 Mar 2017] of a 93-year-old Saudi female who was reported as a recovery on [Mon 3 Apr 2017]. Cases from the above line listing that were reported as official recoveries include cases 4,6,8,9,10,11, and 12.

The HealthMap/ProMED map of Saudi Arabia can be found at: http://healthmap.org/promed/p/131 and of Qatar at http://healthmap.org/promed/p/130. - Mod.MPP]

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[3] Qatar - media report
Date: Tue 25 Apr 2016 11:21
Source: The Peninsula Qatar [edited]
https://www.thepeninsulaqatar.com/article/25/04/2017/Immunisation-campai...

......Separately, speaking about the prevalence of MERS-CoV -- Middle East Respiratory Syndrome Corona Virus Dr Al Rumaihi said that the 2nd confirmed case of the virus also has been discharged from the hospital.

"This year [2017] we had 2 cases and both have been discharged from the hospital. Due to proper management of the cases we have prevented any outbreak. But we are still working closely with research institutes to understand the situation in Qatar," said Al Thani.

--
Communicated by:
ProMED-mail

[Additional information contained in this media report excerpt is the recovery outcome of both cases from Qatar. - Mod.MPP

A HealthMap/ProMED-mail map can be accessed at: http://healthmap.org/promed/p/130.]

See Also

MERS-CoV (24): UAE (AZ), Saudi Arabia (RI), WHO 20170425.4993929
MERS-CoV (23): Saudi Arabia (AS) animal reservoir, human contact, OIE, RFI 20170421.4986081
MERS-CoV (22): UAE (AZ), Saudi Arabia (RI,MK) Qatar, RFI 20170415.4971825
MERS-CoV (21): Egypt, animal reservoir, camel, ex Sudan, control, RFI 20170405.4948727
MERS-CoV (20): Qatar, Saudi Arabia, WHO 20170404.4947466
MERS-CoV (19): Saudi Arabia (SH, QS) 20170402.4942800
MERS-CoV (18): Africa, animal reservoir, camels, 2015, research 20170331.4939980
MERS-CoV (17): Saudi Arabia (RI) 20170327.4929414
MERS-CoV (16): Qatar, Saudi Arabia (SH, MD, RI) 20170322.4918921
MERS-CoV (15): Saudi Arabia (RI, MK) nosocomial outbreak, WHO, RFI 20170312.4894950
MERS-CoV (14): Saudi Arabia 20170306.4875743
MERS-CoV (13): Saudi Arabia (MK, RI) 20170219.4850389
MERS-CoV (12): Saudi Arabia (BA, MD, QS) 20170213.4836328
MERS-CoV (11): Saudi Arabia (NJ, MD, MK), WHO 20170211.4832839
MERS-CoV (10): Saudi Arabia (SH, MK) 20170202.4811346
MERS-CoV (09): Saudi Arabia (MK) WHO 20170127.4797694
MERS-CoV (08): Saudi Arabia (MK, RI) 20170125.4792072
MERS-CoV (06): Saudi Arabia, WHO 20170119.4775249
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 (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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