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Commentary
26th MERS-CoV
Fatality In KSA Raises Concerns
Recombinomics
Commentary 23:00
June 10, 2013
The above translation describes the 26th MERS-CoV death in the Kingdom of Saudi Arabia (KSA). This death increases the case fatality rate (CFR) for the confirmed cases in KSA to 65% (see map). However, only seven of the confirmed cases that are alive have been discharged. The other seven remain hospitalized and most are in critical condition. The case fatality rate for the confirmed cases with outcomes is 78%.
Both of these rates are dramatically different than the CFR for onward transmission cases in Europe or Africa, raising concerns that KSA detection is largely limited to hospitalized cases with severe pneumonia where the vast majority die. Milder cases are largely missed, either because viral RNA levels in the upper respiratory tract are low or samples from the lower respiratory tract are not collected because milder cases do not produce sputum.
The above case was from the large cluster of cases in Hofuf, Al Hasa who were infected while being treated for underlying conditions like renal failure of diabetes complications. Many of these patients were already dead when confirmed, while most that were alive a month ago have since died, as described above for the latest confirmed death.
The high case fatality rate for the cases in KSA raises concerns that the number of mild cases is orders of magnitude higher than the fatal cases, and the upcoming Ramadan and Hajj events will lead to infections of pilgrims, followed by dramatic spread worldwide.
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