Friday, September 20, 2013

Middle East respiratory syndrome coronavirus (MERS-CoV) summary and literature update – as of 20 September 2013

[red bolding below is mine]

Since April 2012, 130 laboratory-confirmed and 17 probable cases of human infection with Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported to WHO. Affected countries in the Middle East include Jordan, Kingdom of Saudi Arabia (KSA), the United Arab Emirates (UAE), and Qatar; in Europe countries affected include: France, Germany, the United Kingdom (UK) and Italy; and in North Africa: Tunisia. Infections presumably acquired through exposure to non-human sources have all occurred in the Middle East; limited transmission in the countries of Europe and North Africa has occurred in close contacts of recent travellers from the Middle East. No new countries have reported MERS-CoV cases since the last update; the last exported case to a country outside the Middle East was in June 2013.
Since the last update, 37 new laboratory-confirmed cases of MERS-CoV have been reported; these include 34 cases from KSA and three cases from Qatar. In addition, one previously reported probable case in Tunisia has now been confirmed as a result of additional laboratory testing. Two cases previously counted as confirmed have been reclassified as probable on the basis of further clarifications of the case definition. Of the 130 confirmed cases, 58 (45%) have died. Seventy-seven of 124 confirmed cases (63%) for which sex is known were male and the median age of the 125 confirmed cases with known age is 50 years (range, 14 months to 94 years).
Nine new cases were reported to be sporadic, i.e. cases that were reported to have no prior contact with another known case and including cases that were the first case within a cluster. Of these, 56% were female; the median age was 53 years; and 89% had at least one underlying condition reported. Eighty-nine percent were severely ill or died. Eight of these cases were probably exposed to the virus in KSA (six in Riyadh, one in Medina, one in Hafr Al Batin) and one in Qatar. The median age and gender balance of these nine new cases represents a shift compared with earlier cases. Up until mid-July 2013, the median age of sporadic cases was 59.5 years and 83% were male.
Three recent outbreaks are described below:
  • Five cases were reported in Medina. The first Saudi case reported was a 55-year-old male who had probable contact with a 59-year-old Qatari male, who was in Medina at the time of onset of illness. The remaining cases were contacts of confirmed cases and included two asymptomatic health care workers identified through contact tracing. One additional health care worker, who died in the course of his illness, was reported without information about contact with other confirmed cases. None of the cases was reported to have performed pilgrimage while in Medina.
  • Two clusters were reported in Riyadh. In a cluster of six cases, one male index case aged 53 years is thought to have infected five other cases, including two health care workers. Both health care workers experienced mild illness. In the second cluster, all three cases were health care workers. A 41 year old Filipino healthcare worker who did not have any contact to confirmed cases of MERS-CoV infections acquired the disease from an unknown source and is thought to have transmitted it to two more healthcare workers. During this same period of time, an additional four sporadic cases were reported (mentioned above) with no contact with known cases, and five with no information on exposure.
  • The first case of the cluster in Hafr Al Batin was a 38-year-old male with onset of illness in early August. Five family members ranging in age from 7 to 79 years subsequently became infected. Two children aged 3 and 18 years and one 74 year-old female were also reported as contacts of a known case but their connection with this family was not reported.
For further details regarding the cases please refer to:

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