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Commentary
MERS
Outbreak In Riyadh Military Hospital
Recombinomics
Commentary 01:00
September 12, 2013
The above translation describes a suspected MERS-CoV at the Prince Sultan Medical Center in Riyadh (see map). Reconciling the above numbers with confirmed cases is a challenge because the Kingdom of Saudi Arabia Ministry of Health (KSA-MoH) updates cite health care workers, but do not name hospitals. Moreover, the updates do not give dates, which compromises cluster analysis.
The number of recently reported confirmed cases has spiked higher in recent days. Five updates were released between September 5-11 and all five cited four confirmed cases in Medina, Riyadh, or Batin. WHO updates frequently include dates, but the most recent update was on September 7 and covered the cases cited in the September 5 update. Thus, the 16 most recently reported cases have not been described by WHO.
The 20 confirmed cases in the three areas above have raised concerns that recently concluded Ramadan activities have exacerbated the MERS situation. Qatar has recently reported 3 confirmed cases and the first case (59M) had traveled to Saudi Arabia prior to disease onset. Although the trip to KSA was not to perform Umrah during Ramadan, he did travel to Medina and was apparently infected in a local clinic. Moreover, he is the likely source for the two additional cases in Qatar, both of which were fatal. The report of additional cases in Medina, including health care workers has raised concerns for pilgrims traveling to Mecca and Medina for the Hajj.
The cases in Riyadh may also be linked to the five suspect cases in Turkey, which also include a fatality. If confirmed, the Turkey cluster would represent more exports of MERS-CoV from KSA.
In addition to the clusters in Medina and Riyadh, large clusters have been reported in Batin, where family members have been treated in two local hospitals, including a military hospital.
The clusters in military hospitals in Riyadh and Batin increase concerns that the number of cases being treated in KSA exceeds the explosion of cases reported by the KSA-MoH in the last week. Media reports in other cities cite additional hospital outbreaks.
More detail on the cases, as well as WHO updates on the 16 cases recently reported by the KSA-MoH would be useful. The increased activity raises serious concerns of additional spread due to Hajj activities and travel in and out of the KSA.
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