MERS-COV (61): SAUDI ARABIA

Posted on 02ND OCT 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, 5 new cases - MOH 21 Sep 2017 - 1 Oct 2017
[2] WHO/FAO/OIE meeting on MERS - media report

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[1] Saudi Arabia, 5 new cases - MOH 21 Sep 2017 - 1 Oct 2017
Date: Sun 1 Oct 2017
Source: Saudi MOH 21 Sep 2017 - 1 Oct 2017 [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/default.aspx?PageIndex=1

As of Sun 1 Oct 2017, there have been a total of:
1721 laboratory-confirmed cases of MERS-CoV infection, including
696 deaths [reported case fatality rate 40.5 percent],
1008 recoveries, and
17 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. Note that during this period since the last update, reporting on the MOH website has been significantly delayed on the English language page. In addition, a revision of the 21 Sep 2017 reporting was made with the addition of 2 newly confirmed cases being reported. - Mod.MPP]

Since the last ProMED-mail update [current through 20 Sep 2017], there have been a total of:
5 newly confirmed cases,
2 newly reported fatalities, and
2 newly reported recoveries.

Information on newly confirmed cases (5 cases):
Date: 30 Sep 2017 (1 case)
https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-30-...

1- A 31-year-old Saudi male, non-healthcare worker from Bisha [Asīr region] noted to be in critical condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding onset of illness.

Date: 27 Sep 2017 (1 case)
https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-27-...

2- A 76-year-old Saudi male, non-healthcare worker from Nafi [Riyadh region] noted to be in stable condition. Classified as a primary case with high risk exposures during the 14 days preceding onset of illness still under investigation.

Date: 26 Sep 2017 (1 case)
https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-26-...

3- A 52-year-old Saudi male, non-healthcare worker from Taif [Makkah region] noted to be in critical condition. Classified as a primary case with a history of direct contact with camels in the 14 days preceding the onset of illness.

Date: 21 Sep 2017 (2 cases)
https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-21-...

4- A 48-year-old Saudi male, non-healthcare worker from Hufoof [Ash Sharqīyah 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. Reported as a recovery on 27 Sep 2017.

5- A 72-year-old Saudi female, non-healthcare worker from Hufoof [Ash Sharqīyah region] with a history of pre-existing co-morbidities, reported as having died at the time of the initial confirmation report. Classified as a primary case with high risk exposure history still under investigation.

Information on reported fatalities (2)
In addition to case no. 5 in the above information on newly reported cases, on 22 Sep 2017, there was a 51-year-old expat male, non-healthcare worker from Jeddah [Makkah region] with a history of pre-existing co-morbidities reported as a fatality [reported as a newly confirmed case on 18 Aug 2017 at which time he was noted to be in critical condition. Classified as a primary case with high risk exposure history still under investigation; see https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-22-... for official report. - Mod.MPP].

Information on reported recoveries (2)
In addition to case no.4 in the above information on newly reported cases, on 28 Sep 2017, there was a 48-year-old expat male non-healthcare worker from Riyadh [Riyadh region] with a history of pre-existing co-morbidities reported as a recovery. [He was reported as a newly confirmed case on 7 Sep 2017 at which time he was noted to be in critical condition. He was classified as a primary case with high risk exposure history still under investigation; see https://www.moh.gov.sa/en/CCC/PressReleases/Pages/statistics-2017-09-28-... for official report. - Mod.MPP]

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Communicated by:
ProMED-mail

[During the month of September 2017, there were a total of 11 newly confirmed cases, 7 fatalities and 9 recoveries of MERS-CoV infection reported on the Saudi MOH website. The 11 newly confirmed cases were reported from Riyadh, (Riyadh - 2 cases, Alzulfi 1 case, Nafi 1 case), Ash Sharqīyah (Hufoof - 3 cases), and 1 case each from Al Jawf (Dawmat Aljandal), Hail (Hail), Makkah (Taif) and Asīr (Bisha). Outcomes on 7 of the 11 cases were known: 4 died, and 3 recovered. Only one of the 11 cases was identified as an asymptomatic household contact of a previously confirmed case, the case from Dawmat Aljandal in Al Jawf region. The other 10 cases were classified as primary cases, 4 with a history of direct contact with camels, one with a history of indirect contact with camels, and the remaining 5 were listed as high risk exposures still under investigation. Hence, September 2017 was a month without nosocomial transmission with a background picture of sporadic cases occurring in different locations in the country.

Maps showing the locations within Saudi Arabia of the 5 newly confirmed cases, 2 fatalities, and 2 recoveries reported above can be found at the source URLs.

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

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[2] WHO/FAO/OIE meeting on MERS - media report
Date: 27 Sep 2017
Source: Infection Control Today [edited]
http://www.infectioncontroltoday.com/news/2017/09/experts-agree-on-next-...

Critical next steps to accelerate the response to the global public health threat posed by Middle-East respiratory syndrome coronavirus (MERS-CoV) have been agreed to by representatives from the Ministries of Health and Ministries of Agriculture of affected and at risk countries, and experts. The virus, which circulates in dromedary camels without causing visible disease, can be fatal for humans.

At a meeting hosted by the World Health Organization (WHO), the Food and Agriculture Organization (FAO), and the World Organisation for Animal Health (OIE) in Geneva this week, more than 130 experts from 33 countries, organizations and research institutions met to share what is known about the virus, identify priority research needs, improve cross-collaboration between animal and human health sectors, and agree on a plan to address crucial gaps.

"MERS is not only a regional threat. While the majority of human cases have been reported from the Middle East, the outbreak in the Republic of Korea in 2015 showed MERS' global reach and capacity to have significant public health and economic consequences," said Dr. Maria Van Kerkhove, MERS-CoV technical lead in WHO's Health Emergencies program. "We are at the stage where we have to confront the challenges in our ability to detect and respond to MERS outbreaks and improve our knowledge about this virus through collaborative research," she said.

Since 2012, when the virus was 1st identified in Saudi Arabia, there have been 2081 laboratory-confirmed cases of MERS-CoV infection reported to WHO from 27 countries, with at least 722 deaths, a fatality rate of 35 percent. While progress has been made in research and surveillance, significant gaps remain in understanding the virus, including how it circulates in dromedary camels, the natural reservoir hosts, or how it spills over into the human population.

"MERS-CoV is a disease with a significant impact on public health, which requires further investigations in animal sources to better understand its epidemiology and improve its control in humans. OIE Member Countries are requested to notify any occurrences of MERS-CoV in animals. This crucial information will contribute to escalating a coordinated response from the animal and human health sectors," said Dr. Gounalan Pavade, Chargé de mission, OIE.

More than 80 percent of MERS cases have been reported from Saudi Arabia. While many of these people were infected in healthcare facilities, with improved data collection on MERS patients since 2015, a significant proportion of recently reported human cases are believed to have been exposed through direct or indirect contact with infected camels. Frequent international travel has allowed sporadic cases to be exported to every region of the world by individuals who are unknowingly infected before they travel.

"It is in our common interest to address the disease in the human-animal interface, work across sectors and disciplines, together for the sake of our shared goals, healthy people and healthy animals," said Dr. Ahmed El Idrissi, senior animal health officer, FAO. "In doing so, we recognize the importance of a One Health approach to health threats of animal origin."

Human-to-human transmission remains limited, but healthcare-associated outbreaks have occurred in several countries in the Middle East and in the Republic of Korea. Infection prevention and control measures are vital to prevent the possible spread of the disease in hospitals and clinics and to protect health-care workers, visitors and other patients. No vaccine or specific treatment is currently available, and treatment is supportive and based on the patient's clinical condition.

MERS-CoV is one of the high threat pathogens included in the WHO's Research & Development Blue Print, which provides a road map for research and development of diagnostic, preventive and therapeutic products for prevention, early detection and response to these threats caused by a list of 11 high prioritized pathogens.

The MERS research priorities and activities being guided by WHO, FAO and OIE build on a series of regional and global meetings organized by the 3 organizations over the past 5 years. While tremendous progress has been made, particularly at addressing some key unknowns about the behavior of this virus in animals and humans, some fundamental gaps about MERS-CoV remain. The global community remains within the grip of this emerging infectious disease.

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Communicated by:
ProMED-mail

[We are looking forward to seeing technical briefs discussed at this meeting. There are still major gaps in knowledge on the epidemiology and transmission of the MERS-CoV. In reviewing the cases classified as primary cases in the past year, slightly more than half of these cases did not have a history of known contact -- neither direct nor indirect -- with camels in the 14 days preceding the onset of their illness. And given the high prevalence of MERS-CoV antibodies in camels from the region, why are 80 percent of the reported cases being reported from Saudi Arabia? Why not other countries? - Mod.MPP]

See Also
MERS-CoV (60): UAE, Saudi Arabia, WHO 20170922.5334852
MERS-CoV (59): Oman, Saudi Arabia, WHO 20170913.5313874
MERS-CoV (58): Saudi Arabia (RI, SH), WHO 20170907.5302261
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 (116): Oman, additional information 20161201.4669008
MERS-CoV (115): Oman, RFI 20161130.4664043
MERS-CoV (14): Thailand ex Oman, WHO 20160129.3976802
MERS-CoV (12): UAE, Oman, Saudi Arabia, WHO 20160126.3967808
MERS-CoV (10): Saudi Arabia (MK), Thailand ex Oman, RFI 20160125.3964309
MERS-COV (08): Thailand ex Oman, Saudi Arabia corr 20160124.3962172
MERS-COV (02): Oman, WHO 20160107.3918976
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 (74): South Korea, Saudi Arabia, Thailand ex Oman 20150621.3454450
MERS-CoV (70) - Thailand ex Oman, 1st report, RFI 20150618.3447631
MERS-CoV (71): Thailand ex Oman, South Korea, Saudi Arabia, UAE 20150618.3447481
MERS-CoV (56): South Korea, China, Saudi Arabia, Oman, WHO 20150605.3413986
MERS-CoV (52): Oman, Saudi Arabia, South Korea, WHO, RFI 20150531.3399248
MERS-CoV (14): Saudi Arabia, Oman, WHO 20150124.3114951
MERS-CoV (08): Oman, Saudi Arabia, WHO 20150117.3097488
MERS-CoV (06): Oman, new case, RFI 20150111.3085228
MERS-CoV (04): Oman, Saudi Arabia, RFI 20150108.3079584
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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