Recombinomics Commentary 05:45
November 24, 2012
WHO reported a cluster of four cases in
October in a family living in the same household in Saudi Arabia, in
which a father and son both fell ill with symptoms including pneumonia,
fever and respiratory problems. The father, 70, died after developing
renal failure. His son was hospitalized shortly afterward and died four
days later after multiorgan failure. The son was confirmed with the
coronavirus while the father's results are pending.
The above comments
provide additional detail on the Riyadh
fatal cluster, which support human
to human transmission. The detail includes the time gap
between disease onset / hospitalization dates, which supports infection
of the son by his father. Moreover the report of renal failure in
both cases further support novel betacoronavirus infection, even though
lab confirmation in the father has not been reported.
The first two confirmed cases
also had renal
failure. The case in Saudi Arabia died, while the Qatar case
was placed on an ECMO machine to assist breathing after both lungs were
severely damaged. Reports of renal failure in all three fatal
cases, as well as severe
confirmed cases bear striking similarities to the 2002/2003 SARS
cases. Renal failure was reported in 5-6% of the cases and the
vast majority of such cases were fatal.
Thus, the report of renal
failure in at least 4 of the 8 confirmed / suspect cases strongly
suggests that a much larger number of cases have not been reported /
detected. The failure to confirm the novel coronavirus in one of
the symptomatic family members raises additional testing concerns.
Although media reports
continue to emphasize the lack of confirmed human transmission, the
delayed onset dates and renal failure in the two fatal cases in the
familial cluster support human transmission in cases other than the 8
confirmed / suspect cases reported to date.