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Commentary
Abu Dhabi MERS Superspreader Linked To 28
Confirmed
Recombinomics Commentary 05:30
April 29, 2014
A 32 year-old man from Abu Dhabi who was screened, following exposure to a previously laboratory-confirmed case reported on 10 April. He did not become ill and does not have any underlying medical condition. He has no history of recent travel and did not have contact with animals.
A 33 year-old man from Abu Dhabi who was screened following exposure to a previously laboratory-confirmed case reported on 10 April. He did not become ill and is reported to have no underlying medical condition. He has no history of recent travel. He owns two farms and is reported to have contact with camels.
A 30 year-old man from Abu Dhabi. He was screened following exposure with a previously laboratory-confirmed case reported on 10 April. He does not have any underlying medical condition. He has no history of recent travel and did not have contact with animals.
A 42 year-old man from Abu Dhabi. He was screened following exposure to a previously laboratory-confirmed case reported on 10 April. He had mild illness. He is reported to have no underlying medical condition. He has no history of recent travel and had no contact with animals.
A 45 year-old woman from Abu Dhabi who is a daughter of a previously laboratory-confirmed case reported on 22 April. She became ill on 15 April. She is reported to have an underlying medical condition, and has no history of recent travel or contact with animals.
The above comments from the April 26 WHO MERS update describe MERS confirmation in five cases (in red) who were contacts of the Adu Dhabi super-spreader (45M), as well as a tertiary case (in blue). Since the index case may have been infected by an earlier fatal case (68M), the index may be a secondary case, and direct contacts were tertiary cases. The above cases increase those who had contact with the super-spreader to 25, which are in addition to the three cases linked to contacts of the super-spreader.
This transmission chain is being investigated by WHO, as is the explosion of cases in Jeddah. Nearly complete sequences from three Jeddah cases (Jeddah_C7569, Jeddah_C7149, Jeddah_C7770) have been released and all three are closely related to each other, even though they came from two different hospitals. All three sequences contain 8 polymorphisms that have not been reported in any prior sequence.
However, a phylogenetic tree posted by Andrew Rambaut included a Qatar camel sequence (camel_2), which is closely related and has many of the 9 polymorphisms that define this novel sub-clade in Jeddah. Since the earlier fatal case in Abu Dhabi was a camel breeder, the super spreader sequence may be closely related to the novel sub-clade in Jeddah.
Identities between the three published spike gene sequences and partial sequences from 25 additional Jeddah cases raise concerns that the novel sub-clade in Jeddah is large. and may also be causing the super-spreader related cases in the UAE.
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