MERS-COV (34): SAUDI ARABIA, UNITED ARAB EMIRATES, QATAR, WHO

Posted on 07TH JUN 2017
tagged MERS-CoV, Saudi Arabia; United Arab Emirates; 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, 3 new cases/infections - MOH 6 Jun 2017
[2] Saudi Arabia, UAE, Qatar - WHO update 6 Jun 2017

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[1] Saudi Arabia, 3 new cases/infections - MOH 6 Jun 2017
Date: 6 Jun 2017
Source: Saudi MOH [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2017-06-06-0...

As of 14:00 [2:00 PM] today [Tue 6 Jun 2017], there have been a total of:
1632 laboratory-confirmed cases of MERS-CoV infection, including
668 deaths [reported case fatality rate 40.9 per cent],
942 recoveries, and
19 currently active cases/infections.

[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; my spreadsheet counts asymptomatic infections. - Mod.MPP]

Since the last ProMED-mail update yesterday [5 Jun 2017], there have been a total of:
3 newly confirmed cases/infections
0 newly reported fatalities, and
0 newly reported recoveries.

Information on newly confirmed cases (3 cases/infections)
1 - A 45-year-old expat male, non-healthcare worker from Hufoof [Ash Sharqīyah 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 84-year-old Saudi male, non-healthcare worker from Riyadh [Riyadh region] currently in stable condition, having been identified as an asymptomatic contact of a confirmed MERS-CoV infected individual. Classified as a secondary hospital acquired case in a patient.

3 - A 48-year-old Saudi male, healthcare worker from Riyadh [Riyadh region] currently listed in stable condition, having been identified as an asymptomatic contact of a confirmed MERS-CoV infected individual. Classified as a secondary healthcare acquired case in a healthcare worker.

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Communicated by:
ProMED-mail

[A map showing the locations of these cases can be seen at the source URL. - Mod.MPP]

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[2] Saudi Arabia, UAE, Qatar - WHO update 6 Jun 2017
Date: 6 Jun 2017
Source: WHO Emergencies preparedness, response [edited]
http://www.who.int/csr/don/06-june-2017-mers-saudi-arabia-united-arab-em...

Between 21 Apr and 29 May 2017, the National IHR Focal Point of Saudi Arabia reported 25 additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection including 6 fatal cases. On 16 May 2017, the IHR NFP of the United Arab Emirates reported 2 additional cases of MERS-CoV. On 23 May 2017, the National IHR Focal Point of Qatar reported one additional case of MERS-CoV.

Details of the cases
MERS-CoV cases reported between 21 Apr and 29 May 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 / 2017-05-23 / Doha / 29 / M / No / No / Yes / NA / NA / 2017-05-14 / 2017-05-22 / 2017-05-23 / Alive

United Arab Emirates
1 / 2017-05-16 / Al Ain / 69 / M / No / Yes / Yes / NA / NA / 2017-05-03 / 2017-05-05 / 2017-05-11 / Alive
2 / 2017-05-16 / Al Ain / 45 / M / No / Yes / Yes / NA / Yes* / NA / NA / 2017-05-15 / Alive
*Case was detected through contact tracing of a previous MERS-CoV case.

Saudi Arabia
1 / 2017-05-29 / Madinah / 60 / M / No / Yes / NA / NA / NA / 2017-05-26 / 2017-05-28 / 2017-05-29 / Alive
2 / 2017-05-25 / Jeddah / 52 / M / No / Yes / Yes / Yes / NA / 2017-05-15 / 2017-05-23 / 2017-05-24 / Alive
3 / 2017-05-21 / Hail / 64 / M / No / Yes / NA / NA / NA / 2017-05-14 / 2017-05-19 / 2017-05-20 / Alive
4 / 2017-05-19 / Almithnab / 43 / M / No / Yes / Yes / Yes / NA / 2017-05-13 / 2017-05-16 / 2017-05-18 / Alive
5 / 2017-05-19 / Riyadh / 63 / M / No / Yes / NA / NA / NA / 2017-05-12 / 2017-05-17 / 2017-05-18 / Alive
6 / 2017-05-17 / Riyadh / 38 / M / No / NA / NA / NA / Yes* / 2017-05-14 / 2017-05-24** / 2017-05-15 / Alive
7 / 2017-05-17 / Bishah / 57 / M / Yes / NA / NA / NA / Yes* / NA / NA / 2017-05-16 / Alive
8 / 2017-05-16 / Riyadh / 25 / F / Yes / NA / NA / NA / Yes* / NA / NA / 2017-05-15 / Alive
9 / 2017-05-15 / Riyadh / 30 / F / Yes / NA / NA / NA / Yes* / NA / NA / 2017-05-14 / Alive
10 / 2017-05-15 / Riyadh / 33 / M / Yes / NA / NA / NA / Yes* / NA / NA / 2017-05-14 / Alive
11 / 2017-05-14 / Riyadh / 55 / M / No / Yes / NA / NA / NA / 2017-05-08 / 2017-05-11 / 2017-05-13 / Deceased / 2017-05-24
12 / 2017-05-13 / Bisha / 54 / M / No / Yes / NA / NA / Yes* / 2017-05-01 / 2017-05-01** / 2017-05-10 / Deceased / 2017-05-16
13 / 2017-05-09 / Bisha / 71 / M / No / Yes / NA / NA / NA / 2017-05-03 / 2017-05-06 / 2017-05-08 / Deceased / 2017-05-24
14 / 2017-05-08 / Hofouf / 40 / F / No / No / NA / NA / NA / 2017-05-02 / 2017-05-07 / 2017-05-08 / Alive
15 / 2017-05-08 / Alnemas / 75 / M / No / Yes / NA / NA / NA / 2017-05-02 / 2017-05-05 / 2017-05-07 / Deceased / 2017-05-08
16 / 2017-05-06 / Riyadh / 46 / M / No / No / NA / NA / NA / 2017-04-24 / 2017-05-05 / 2017-05-06 / Deceased / [2017-05-14]
17 / 2017-05-03 / Albukiriah / 74 / M / No / Yes / Yes / Yes / NA / 2017-04-24 / 2017-04-30 / 2017-05-02 / Alive
18 / 2017-04-29 / Buridah / 68 / M / No / Yes / Yes / Yes / NA / 2017-04-25 / 2017-04-28 / 2017-04-29 / Alive
19 / 2017-04-28 / Mahayl Assir / 61 / M / No / Yes / Yes / Yes / NA / 2017-04-20 / 2017-04-26 / 2017-04-28 / Alive
20 / 2017-04-28 / Hofouf / 81 / M / No / Yes / NA / NA / NA / 2017-04-20 / 2017-04-26 / 2017-04-28 / Deceased / 2017-05-04
21 / 2017-04-28 / Alhaisu / 65 / M / No / Yes / Yes / Yes / NA / 2017-04-25 / 2017-04-26 / 2017-04-28 / Alive
22 / 2017-04-26 / Wadi Aldwaser / 26 / M / No / NA / NA / NA / Yes* / NA / NA / 2017-03-26 / Alive
23 / 2017-04-21 / Wadi Aldwaser / 31 / M / No / NA / NA / NA / Yes* / NA / NA / 2017-03-21 / Alive
24 / 2017-04-21 / Wadi Aldwaser / 58 / M / No / NA / NA / NA / Yes* / NA / NA / 2017-03-21 / Alive
25 / 2017-04-21 / Wadi Aldwaser / 50 / M / No / NA / NA / NA / Yes* / NA / NA / 2017-03-21 / Alive
*Case was detected through contact tracing of a previous MERS-CoV case.
**Hospitalized for other unrelated condition prior to symptom onset.

Saudi Arabia
Between [21 Apr 2017] and 29 May 2017, 25 cases of MERS-CoV infection were reported in Saudi Arabia including 6 fatal cases. Twelve of the 25 reported cases during this period were associated with 3 simultaneous yet unrelated clusters of MERS cases. The Ministry of Health is evaluating each case and their contacts and implementing measures to limit further human-to-human transmission. A description of the 3 clusters is below.

Cluster 1
A cluster of cases has been identified at a hospital in Bisha city, Assir Region. Cases associated with this cluster are:

1st identified fatal case: A 71-year-old male reported on 9 May 2017.
Secondary case - Healthcare contact: A 54-year-old male reported to WHO on 13 May 2017.
Secondary case - Healthcare contact: A 57-year-old male reported to WHO on 17 May 2017.

Cluster 2
A cluster of cases has been identified in a hospital in Riyadh city, Riyadh Region. Cases associated with this cluster are:

1st identified fatal case: A 55-year-old male reported to WHO on 14 May 2017.
Secondary case - Healthcare contact: A 33-year-old male reported to WHO on 15 May 2017.
Secondary case - Healthcare contact: A 30-year-old female reported to WHO on 15 May 2017.
Secondary case - Healthcare contact: A 25-year-old female reported to WHO on 16 May 2017.
Secondary case - Healthcare contact: A 38-year-old male reported to WHO on 17 May 2017.

Cluster 3
A 3rd cluster was detected at a hospital in Wadi Aldwaser city, Riyadh region. This outbreak is believed to be over based on the follow-up period of all contacts. The 4 newly identified cases associated with this outbreak are listed below. In total, 5 cases were associated with this outbreak:

1st identified case: A 55-year-old male previously reported to WHO on 19 Apr 2017 (see Disease Outbreak News published on 27 Apr 2017).

Secondary case - Household contact: A 50-year-old male reported to WHO on 21 Apr 2017.
Secondary case - Household contact: A 58-year-old male reported to WHO on 21 Apr 2017.
Secondary case - Healthcare contact: A 31-year-old male reported to WHO on 21 Apr 2017.
Secondary case - Household contact: A 26-year-old male reported to WHO on 26 Apr 2017.

United Arab Emirates
On 16 May 2017, 2 cases of MERS-CoV infection were reported in the United Arab Emirates. Both cases were reported from Al Ain city and both have reported direct links to dromedary camels. The 1st case that was identified, a 69-year-old male farmer, is in critical condition in hospital, and the 2nd case, a 45-year-old male butcher, is asymptomatic and identified during contact tracing of the 1st case. Contact tracing and dromedary investigations are ongoing.

Qatar
On 23 May 2017, one case of MERS-CoV infection was reported in Qatar. The case, a 29-year-old male from Doha, has reported frequent contact with dromedary camels. The Department of Health Protection and Communicable Disease Control in the Ministry of Public Health and animal health resources are currently carrying out case investigation and contact tracing.

Globally, since September 2012, WHO has been notified of 1980 laboratory-confirmed cases of infection with MERS-CoV, including at least 699 related deaths reported.

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Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[According to the above WHO update, as of 29 May 2017, there had been a total of 1980 laboratory confirmed cases of infection with the MERS-CoV reported to WHO, including 699 related deaths (reported case fatality rate of 35.3 percent). During the same period (2012 through 29 May 2017) there were a total of 1614 laboratory confirmed cases of MERS-CoV infection including 665 deaths reported by Saudi Arabia. Hence, Saudi Arabia represents 81.5 percent of the total number of cases of MERS-CoV infection and 95.1 percent of the total number of deaths attributable to MERS-CoV infection reported to WHO during this period.

All of the cases reported in the above WHO report (including those from Saudi Arabia, Qatar, and the UAE), have been reported previously in ProMED-mail posts (see references below).

Since 29 May 2017, there have been an additional 18 laboratory confirmed cases and 3 deaths reported by Saudi Arabia, with no additional cases reported by other countries during this same period.

Additional information on the cases listed in the above WHO report include official outcome information from the Saudi MOH website with recoveries reported on cases 3, 7, 10 reported on 30 May 2017, case 4 on 29 May 2017, case 6 on 28 May 2019, case 8 on 24 May 2017, case 9 on 27 May 2017, case 14 on 15 May 2017, cases 17, 22 on 12 May 2017, case 18 on 11 May 2017. case 19 on 19 May 2017, case 21 on 2 May 2017, and case 24 on 9 May 2017.

In addition, case 5 was reported on 5 Jun 2017 as having died.

Additional official outcome information is still pending on cases 1, 2, 24, 25.

While transmission of the MERS-CoV documented in Bisha and Wadi Aldawasir appear to have been interrupted, nosocomial transmission is still continuing in Riyadh as seen in section [1] above. With today's [6 Jun 2017] addition of 2 more nosocomial infections, the tally of cases/infections related to the nosocomial transmission in Riyadh is now up to 16 cases (11 of whom are identified as asymptomatic contacts), with an additional 3 cases identified in Riyadh still under investigation for possible high risk exposures.

HealthMap/ProMED maps can be found at:
Saudi Arabia: http://healthmap.org/promed/p/131
United Arab Emirates: http://healthmap.org/promed/p/132
Qatar: http://healthmap.org/promed/p/130.
- Mod.MPP]

See Also
MERS-CoV (33): Saudi Arabia (RI), nosocomial transmission 20170605.5085681
MERS-CoV (32): Saudi Arabia (RI,MD) 20170604.5083353
MERS-CoV (31): Saudi Arabia (MK,RI) nosocomial transmission 20170604.5082194
MERS-CoV (30): Saudi Arabia (RI,MD,MK) 20170602.5077920
MERS-CoV (27): Saudi Arabia (RI,AS,QS) nosocomial transmission 20170519.5049088
MERS-COV (26): Saudi Arabia, EMRO update, RFI 20170514.5032286
MERS-CoV (25): Saudi Arabia, Qatar, WHO 20170428.5002073
MERS-CoV (24): UAE (AZ), Saudi Arabia (RI), WHO 20170425.4993929
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 (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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