MERS-COV (35): SAUDI ARABIA (RIYADH), NOSOCOMIAL AND HOUSEHOLD TRANSMISSION

Posted on 09TH JUN 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

Date: Thu 8 Jun 2017
Source: Saudi MOH 7-8 Jun 2017 [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx?PageIndex=1

As of 14:00 [2:00 PM] today [Thu 8 Jun 2017], there have been a total of:
1642 laboratory-confirmed cases of MERS-CoV infection, including
668 deaths [reported case fatality rate 40.7 per cent],
942 recoveries, and
32 currently active cases/infections.

[Please note that the prior post dated 6 Jun 2017 (MERS-CoV (34): Saudi Arabia, UAE, Qatar, WHO 20170606.5087888) erroneously had 19 currently active cases/infections when it should have been 22. My apologies for missing that error in the preparation and editing of the post. - Mod.MPP]

[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 [6 Jun 2017], there have been a total of:
10 newly confirmed cases/infections [8 asymptomatic contacts]
0 newly reported fatalities, and
0 newly reported recoveries.

Information on newly confirmed cases (10 cases/infections - All from Riaydh [Riyadh Region])
Date: 8 Jun 2017 (5 cases - 4 asymptomatic)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2017-06-08-0...

1 - A 30-year-old expat female, healthcare worker currently 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.

2 - A 31-year-old expat female, healthcare worker currently 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.

3 - A 25-year-old Saudi male, healthcare worker currently in stable condition. Classified as a secondary healthcare acquired case in a healthcare worker.

4- A 58-year-old expat male, non-healthcare worker 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.

5- A 48-year-old expat male, non-healthcare worker 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.

Date: 7 Jun 2017 (5 cases/infections)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2017-06-07-0...

6- A 35-year-old Saudi female, non-healthcare worker currently in stable condition having been identified as an asymptomatic contact of a confirmed MERS-CoV infected individual. Classified as a secondary case in a household contact.

7 - A 42-year-old expat female, healthcare worker currently in stable condition. Classified as a secondary healthcare acquired case in a healthcare worker.

8 - A 45-year-old expat female, healthcare worker currently 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.

9- A 57-year-old Saudi female, non-healthcare worker 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.

10 - A 39-year-old expat male, healthcare worker currently 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.

--
Communicated by:
ProMED-mail

[In the past 2 days since the last ProMED-mail update on [6 Jun 2017], there has been an additional 10 cases/infections identified in Riyadh associated with either household (1 individual) or healthcare (9 individuals - 6 healthcare workers and 3 patients) contact. A total of 8 of these 10 individuals were listed as asymptomatic, most likely identified through know or potential contact tracing activities. The other 2 were symptomatic (cases 3 and 7) and currently listed as in stable condition.

Re-assessing reports of laboratory confirmed cases/infections in Riyadh, there were 2 fatal cases, 1 each reported on [6 May and 14 May 2017], followed by 30 additional reports during the period [15 May] through today [8 Jun 2017]. Of note, in the [6 Jun 2017] WHO update (posted in the ProMED-mail update of 6 Jun 2017); the case reported on [14 May 2017] was identified as the index case in the ongoing outbreak. Of these 30 additional laboratory confirmations, 15 involve healthcare workers, 9 involve patients, 2 are household contacts, 3 are still under investigation and 1 case (a fatal case) was listed as a primary case with direct contact with camels.

So what is going on in Riyadh? How many healthcare facilities are implicated in this current outbreak (presumably an independent outbreak from the one reported in Wadi Aldawasir back in April 2017 (see prior ProMED-mail posts)? Has there been a change in laboratory techniques for testing of asymptomatic contacts? Has the "net" been widened with more individuals being identified for contact testing than previously? Or, has the virus changed with increased transmissibility for secondary (and possibly tertiary or more) transmission chains involving asymptomatic individuals?

More information from knowledgeable individuals would be greatly appreciated.

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

See Also

MERS-CoV (34): Saudi Arabia, UAE, Qatar, WHO 20170606.5087888
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
----
MERS-CoV (123): Saudi Arabia (MK, AS) new cases 20161231.4734758
MERS-COV (01): Oman, Saudi Arabia 20160105.3911188
2015
----
MERS-COV (167): acute management and long-term survival 20151231.3904300
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
2014
----
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
----
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
----
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
.................................................mpp/ao/mpp