MERS-COV (58): SAUDI ARABIA (RIYADH, ASH SHARQIYAH), WHO

Posted on 09TH SEP 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

In this update:
[1] Saudi Arabia, 3 new cases - Saudi MOH, 3-7 Sep 2017
[2] Saudi Arabia WHO update 6 Sep 2017

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[1] Saudi Arabia, 3 new cases - Saudi MOH, 3-7 Sep 2017
Date: Thu 7 Sep 2017
Source: Saudi MOH 3 - 7 Sep 2017 [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx?PageIndex=1

As of [Thu 7 Sep 2017], there have been a total of:
1715 laboratory-confirmed cases of MERS-CoV infection, including
690 deaths [reported case fatality rate 40.2 percent],
1003 recoveries, and
22 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. One complication is the reporting of cases as either recoveries or deaths that cannot be confirmed as previously reported newly confirmed cases. - Mod.MPP]

Since the last ProMED-mail update [Sat 2 Sep 2017], there have been a total of:
3 newly confirmed cases
0 newly reported fatalities, and
2 newly reported recoveries.

Information on newly reported cases (3 cases):
Date: 7 Sep 2017 (1 case)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-07-0...

1 - A 48-year-old expat male, non-healthcare worker from Riyadh [Riyadh region] noted to be in critical condition. Classified as a primary case with high risk exposure history still under investigation.

Date: 6 Sep 2017 (1 case)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-06-0...

2 - A 78-year-old Saudi male, non-healthcare worker from Riyadh [Riyadh region] noted to be 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: 5 Sep 2017 (1 case)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-05-0...

3 - A 37-year-old Saudi male, non-healthcare worker from Hufoof [Ash Sharqīyah region] noted to be in critical condition. Classified as a primary case with high risk exposure history still under investigation.

Information on newly reported recoveries (2 recoveries)
Date: 6 Sep 2017 (2 recoveries)
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-06-0...

1 - A 21-year-old Saudi female, non-healthcare worker from Dawmat Aljandal [Al Jawd region] with no history of co-morbidities. [reported as a newly confirmed case on [1 Sep 2017] at which time she was noted to be in stable condition, having been identified as an asymptomatic contact of a previously confirmed case. Classified as a secondary case in a household contact. - Mod.MPP]

2 - A 48-year-old Saudi male, non-healthcare worker from Alaflaj [Riyadh region] with a history of pre-existing co-morbidities. [reported as a newly confirmed case on [21 Aug 2017] at which time he was noted to be in stable condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding onset of illness.. - Mod.MPP]

--
Communicated by:
ProMED-mail

[From the above summary report from Saudi Arabia, with the absence of new cases reported from Dawmat Aljandal (Al Jawf region), the epidemiologic picture has returned to sporadic cases reported, with a mix of history of contact with camels in the 14 days preceding onset of illness, and those where high risk exposure histories have not been fully investigated by the time of the report of the case.

Maps showing the geographic location of all reports mentioned above can be found at the source URLs. - Mod.MPP]

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[2] Saudi Arabia WHO update 6 Sep 2017
Date: 6 Sep 2017
Source: WHO, Emergencies preparedness, response, Disease Outbreak News [edited]
http://www.who.int/csr/don/6-september-2017-mers-saudi-arabia/en/

Middle East respiratory syndrome coronavirus (MERS-CoV) - Saudi Arabia 6 Sep 2017

Between [13 and 30 Aug 2017], the National IHR Focal Point of Saudi Arabia reported 12 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV), including one death and, and one death from a previously reported case.

Details of the cases
MERS-CoV cases reported between [15 Aug 2017 and 30 Aug 2017]

* Data subject to change due to ongoing investigations. Fields related to the final status of the case are updated as information is available.

NA = Not available

Case no. / Date of notification to WHO (yyyy/mm/dd) / City of residence / Age / Sex / Health care worker / Comorbidities / Exposure to camels / Camel milk consumption / Exposure to MERS-CoV cases / Date of symptoms onset (yyyy/mm/dd) / Date of 1st hospitalization (yyyy/mm/dd) / Date of laboratory confirmation (yyyy/mm/dd) / Status / Date of outcome (yyyy/mm/dd)

1 / 2017-08-15 / Madinah / 67 / M / No / Yes / Yes / NA / No / 2017-08-12 / 2017-08-14 / 2017-08-14 / Deceased / 8/27/2017
2 / 2017-08-16 / Jeddah / 69 / M / No / Yes / NA / NA / NA / 2017-08-13 / 2017-08-15 / 2017-08-15 / Alive
3 / 2017-08-18 / Jeddah / 51 / M / No / Yes / NA / NA / NA / 2017-08-11 / 2017-08-17 / 2017-08-17 / Alive
4 / 2017-08-21 / Riyadh / 48 / M / No / Yes / Yes / Yes / NA / 2017-08-18 / 2017-08-20 / 2017-08-20 / Alive
5 / 2017-08-24 / Dawmet Aljandal / 40 / F / No / Yes / NA / NA / NA / 2017-08-17 / 2017-08-21 / 2017-08-22 / Alive
6 / 2017-08-24 / Hail / 46 / M / No / No / Yes / NA / NA / 2017-08-21 / 2017-08-23 / 2017-08-24 / Alive
7 / 2017-08-26 / Dawmet Aljandal / 10 / F / No / NR / NA / NA / Yes† / NA / NA / 2017-08-26 / Alive
8 / 2017-08-26 / Dawmet Aljandal / 14 / F / No / NR / NA / NA / Yes† / NA / NA / 2017-08-26 / Alive
9 / 2017-08-26 / Dawmet Aljandal / 50 / M / No / Yes / NA / NA / Yes† / 2017-08-24 / 2017-08-25 / 2017-08-26 / Alive
10 / 2017-08-27 / Dawmet Aljandal / 33 / F / No / Yes / NA / NA / NA / 2017-08-23 / 2017-08-24 / 2017-08-26 / Alive
11 / 2017-08-30 / Dawmet Aljandal / 22 / F / No / NR / NA / NA / Yes† / NA / NA / 2017-08-29 / Alive
12 / 2017-08-30 / Dawmet Aljandal / 18 / F / No / NR / NA / NA / Yes† / NA / NA / 2017-08-29 / Alive

†Case was detected through contact tracing of a previous MERS-CoV case.
**Hospitalized for other unrelated condition prior to symptom onset.

Among the 12 newly reported cases, 6 were associated with a MERS cluster in Dawmet Aljandal City Al Jawf region, Saudi Arabia. This cluster is not linked to the cluster of MERS that was previously reported in Al Jawf in the Disease Outbreak News posted on [Thu 17 Aug 2017]. In this new cluster, the 6 cases are among 17 household contacts who were being followed up by the Saudi Arabian Ministry of Health.

Globally, 2079 laboratory-confirmed cases with MERS-CoV, including at least 722 related deaths have been reported to WHO.

Public health response
The source of infection of this cluster is under investigation by the Ministry of Health and Ministry of Agriculture in Saudi Arabia. The Saudi Arabian Ministry of Health has identified and is following up health care workers and household contacts of known MERS patients. As per Saudi Arabian policy, listed contacts are not allowed to attend Hajj.

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Communicated by:
ProMED-mail Rapporteur Marianne Hopp

[As per the above update, there have now been 2079 laboratory confirmed cases/infection with MERS-CoV reported to the WHO including at least 722 related deaths (reported case fatality rate: 34.7 percent).

Additional outcome information available for some of the above mentioned cases includes: case No.2 reported as a fatality on [Thu 31 Aug 2017], and cases Nos. 4, 6, 7 and 9 were reported as recoveries on 6 Sep 2017, 31 Aug 2017, 1 Sep 2017 and 1 Sep 2017 respectively.

The above report also confirms a 2nd cluster of cases in Dawmat Aljandal (Al Jawf region) all associated with household contacts. It does appear that since Saudi Arabia changed its contact tracing/testing policy to include all individuals with known contact with a laboratory confirmed case of MERS-CoV infection,, irrespective of clinical status/illness (including asymptomatic individuals) there have been more and larger clusters of cases identified. So, either the virus is changing and now producing more asymptomatic infections, or, there have always been many more asymptomatic infections that were missed because they did not meet the clinical criteria for testing. (seek and you shall find).

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

See Also

MERS-CoV (57): Saudi Arabia (HA, JF) 20170902.5291366
MERS-CoV (56): UAE, Saudi Arabia (JF, HA, RI), WHO 20170829.5280997
MERS-CoV (55): Saudi Arabia (MK, MD, BA), WHO 20170819.5260102
MERS-CoV (54): Saudi Arabia (JF) nosocomial transmission 20170811.5244266
MERS-CoV (53): Saudi Arabia (JF), nosocomial transmission 20170810.5242142
MERS-CoV (52): Saudi Arabia (JF,AS,MD) nosocomial transmission 20170808.5235847
MERS-CoV (51): Saudi Arabia (HA, JF) 20170808.5234663
MERS-CoV (50): Saudi Arabia 20170806.5232071
MERS-CoV (40): animal reservoir, camels, review, FAO 20170619.5115999
MERS-CoV (30): Saudi Arabia (RI,MD,MK) 20170602.5077920
MERS-CoV (20): Qatar, Saudi Arabia, WHO 20170404.4947466
MERS-CoV (10): Saudi Arabia (SH, MK) 20170202.4811346
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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