Posted on 12TH SEP 2018
tagged MERS-CoV, Saudi Arabia; South Korea

A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases

In this update:
[1] Saudi Arabia, 1 new case (Riyadh)
[2] Global update WHO
[3] South Korea - looking for case contacts

[1] Saudi Arabia, 1 new case (Riyadh)
Date: 11 Sep 2018
Source: Saudi MOH 11 Sep 2018 [edited]

10 Sep 2018
Newly confirmed case
Case No. 18-1747
MERS in Riyadh city: 44-year-old male in Riyadh city,
Riyadh Region
Contact with camels: Yes
Case classification: Primary, community acquired
Outcome: Hospitalized

Communicated by:

[After 6 days with no newly confirmed cases, this current case in Riyadh is now the 5th case of MERS-CoV infection confirmed in Saudi Arabia since the beginning of September 2018. The other 4 cases were reported from Al Qasim region, one of whom was reported to have had contact in a renal dialysis unit, and one other had a history of contact with a camel.

The HealthMap/ProMED map of Saudi Arabia can be accessed at: - Mod.MPP

[2] Global update WHO
Date: 11 Sep 2018
Source: WHO/EMRO Situation update [edited]

MERS situation update, August 2018
At the end of August 2018, a total of 2248 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 798 associated deaths (case-fatality rate: 35.5 percent) were reported globally; 83 percent of these cases were reported from Saudi Arabia (1871 cases, including 724 related deaths with a case-fatality rate of 38.7 percent).

During the month of August [2018], a total of 9 laboratory-confirmed cases of MERS were reported globally; 8 cases were reported in Saudi Arabia, including 4 associated deaths, and one case was reported in the United Kingdom. The cases from Saudi Arabia included one symptomatic case that acquired infection in a dialysis unit. The case reported from the United Kingdom has a history of travelling to the Arabian Peninsula. The contact-tracing of all patients' contacts showed negative laboratory results for MERS by PCR.

The demographic and epidemiological characteristics of reported cases, when compared with the same corresponding period of 2013 to 2018, do not show any significant difference or change. Owing to improved infection prevention and control practices in hospitals, the number of hospital-acquired cases of MERS has dropped significantly since 2015.

The age group 50-59 years continues to be at highest risk for acquiring infection of primary cases. The age group 30-39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50-59 years for primary cases and 70-79 years for secondary cases.

Communicated by:
ProMED-mail Rapporteur Mary Marshall

[As stated in the above highlights from the August 2018 Situation Update, there have been a total of 2248 case-fatality rate cases of laboratory confirmed infection with MERS-CoV, including at least 798 associated deaths, bringing the global reported case-fatality rate to 35.5 percent. Of note is that Saudi Arabia accounts for 83 percent of the reported cases and 90.7 percent of the reported fatalities.

Of note is that information available on the newly launched Saudi MOH MERS-CoV site reported only 6 newly confirmed cases during the month of August 2018. That being said, Epidemiologic week No. 34 is not included on the website, and I suspect the "missing" cases may have been confirmed during that week. I miss the links to the WHO line listing of newly confirmed cases that used to accompany the monthly updates. They helped to validate information at the end of each month.

Maps showing the geographical distribution of reported cases can be found at: Rapid risk assessment: Severe respiratory disease associated with Middle East respiratory syndrome coronavirus (MERS-CoV), 22nd update, available at:

Additional graphics and tables presenting epidemiologic data can be found at this monthly update URL. - Mod.MPP]

[3] South Korea - looking for case contacts
Date: 10 Sep 2018
Source: UPI [edited]

South Korean health authorities are struggling to track foreign passengers who were on the same plane with a sick traveler who was diagnosed with MERS, as the government seeks to contain the spread of the infectious respiratory disease.

A 61-year-old man was diagnosed with Middle East respiratory syndrome on Saturday [8 Sep 2018] after he returned from his business trip to Kuwait. The patient traveled with a colleague on Emirates flights from Kuwait via Dubai to Incheon.

Health authorities said they were unable to reach some 50 foreign passengers among a total 115 on the same plane with the MERS patient, according to Yonhap.

A 24-year-old British woman on the flight showed symptoms of MERS but has tested negative and was released from the hospital.

Health authorities have traced those who came into contact with the sick traveler, including his South Korean co-workers in Kuwait.

As of Monday [10 Sep 2018], South Korean authorities had confirmed 21 people who came into close contact with the patient and 417 who were in the same places.

The MERS patient stayed in Kuwait from [16 Aug 2018 to 6 Sep 2018] and experienced stomachache and diarrhea, according to the Korea Centers for Disease Control and Prevention.

MERS, also known as a camel flu, is an infectious respiratory disease that originated in Saudi Arabia in 2012 and has potential to cause large outbreaks, according to the World Health Organization. Patients experience fever, cough, and shortness of breath.

Travelers from the Middle East are requested to report any symptoms of MERS when entering South Korea.

In 2015, South Korea saw 38 people die in a MERS outbreak. A total of 116 MERS patients have been reported this year [2018], including 114 in Saudi Arabia, one in the United Arab Emirates, and one in Oman.

[Byline: Wooyoung Lee]

Communicated by:

[As we are still in the incubation period for MERS-CoV disease following exposure, it is too early to confirm whether there are no secondary cases associated with this case. Clearly, the South Korean MOH is taking major steps to prevent a repeat of their last experience with MERS-CoV, having been "brought" to South Korea by a businessman returning from the Middle East in 2015.

The HealthMap/ProMED map of South Korea can be accessed at: - Mod.MPP]

See Also
MERS-CoV (35): South Korea ex Kuwait 20180908.6016517
MERS-CoV (34): Saudi Arabia (QS) clarification 20180906.6012360
MERS-CoV (33): Saudi Arabia: (QS) RFI 20180904.6006491
MERS-CoV (32): Saudi Arabia (QS) 20180903.6004712
MERS-CoV (31): Saudi Arabia (RI, QS), UK (England) ex Saudi Arabia, WHO 20180901.6002235
MERS-CoV (30): Saudi Arabia (RI) new case 20180830.5998414
MERS-CoV (20): Saudi Arabia (NJ) susp. family cluster 20180602.5835120
MERS-CoV (10): Oman, Saudi Arabia, WHO 20180315.5690014
MERS-CoV (01): Malaysia (ex KSA), Saudi Arabia, UAE (ex Oman) 20180102.5532148
MERS-CoV (77): Saudi Arabia, camels, human, epidemiology, assessment 20171222.5520561
MERS-CoV (01): Saudi Arabia (QS, RI, MD) RFI 20170105.4744802
MERS-CoV (123): Saudi Arabia (MK, AS) new cases 20161231.4734758
MERS-COV (01): Oman, Saudi Arabia 20160105.3911188
MERS-COV (167): acute management and long-term survival 20151231.3904300
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
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
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
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