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Commentary

Abu Dhabi MERS Superspreader Raises SARS Concerns
Recombinomics Commentary 20:00
April 17, 2014

A cluster of four health-care workers were identified through screening of contacts of a previously laboratory-confirmed case from Abu Dhabi who died on 10 April 2014. These include:
A 44 year-old man from Abu Dhabi who was screened on 13 April. He had no illness and is reported to have no underlying medical condition.
A 30 year-old man from Abu Dhabi who was screened on 13 April. He had no illness and is reported to have no underlying medical condition.
A 34 year-old man from the Philippines who resides in Abu Dhabi. He was screened on 13 April without any illness and is reported not to have any underlying medical condition.
A 28 year-old man from Abu Dhabi who became ill on 14 April 2014. He is reported to have no underlying medical condition.

The above comments from today’s WHO MERS update raise concerns that MERS is beginning to behave like the SARS-CoV that circulated in China in the spring of 2003 and exploded geographically due to a superspreader who traveled to Hong Kong and infected dozens at the Metropole Hotel, who then transported the virus and created serious nosocomial outbreaks in Hong Kong, Singapore, Hanoi, and Toronto.
 
The above 4 confirmed health care workers (HCWs) are in addition to the 10 HCWs announced by WHO yesterday.  All 14 of the HCWs had contact with the same MERS case (45M) who died on April 10.  As noted above, one of the MERS confirmed HCWs returned home to the Philippines, raising concerns of international spread.

Although MERS, like SARS appears to spread most effectively in the spring, the cluster in Abu Dhabi, as well as the clusters in Jeddah in the Kingdom of Saudi Arabia (KSA), has generated record numbers of MERS cases in HCWs, similar to levels seen in 2003 associated with the spread of SARS.

These cases have been mild or asymptomatic, raising concerns that MERS can now more effectively grow in the human upper respiratory tract, leading to an increased detection rate, as well as more efficient human transmission.

Sequences from the spike gene in the clusters in Abu Dhabi and Jeddah would be useful.

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