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Commentary
Iran MERS Kerman Cluster Grows To Six
Recombinomics Commentary 12:45
May 28, 2014
The above headline summarizes multiple media reports indicating six suspect / confirmed MERS patients have been hospitalized, including two sisters who have been lab confirmed. Two of the suspect cases appear to be sisters of the two confirmed cases and now two male patients have been hospitalized, who may also be family members.
Although detail is still lacking with regard to disease onset dates and location of exposures, reports suggest that exposure may have been in the Kingdom of Saudi Arabia (KSA) while performing Umrah or linked to a pilgrim returning from KSA..
The confirmation of MERS in two pilgrims / contacts matches the number confirmed in the Netherlands, and any additional confirmations in Kerman would represent the largest cluster of pilgrims / contacts reported to date.
The two cases in the Netherlands appear to be linked to exposure in Medina and partial sequences from the two cases match each other and the case in Munster, Indiana (Indiana/USA-1_Saudi Arabia_2014), who was from Riyadh. Antibody testing of a casual contact in Cook County (almost certainly in Chicago, Illinois) confirmed MERS, raising concerns of more efficient human transmission.
An earlier pilgrim from Malaysia was lab confirmed, but no sequences have been reported. Similarly, pilgrims from Turkey and Indonesia have been confirmed in KSA, but sequences from cases in Riyadh and Medina have been withheld.
The cluster in Iran highlights the need for release of the sequences from a record number of confirmed cases in Riyadh, Medina, and Mecca, which may be linked to the Riyadh/Medina sub-clade identified in the Indiana and Netherlands cases.
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