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Commentary Spain Confirms MERS In Hajj Pilgrim The above comments confirm that the MERS case in Spain (see map) was infected while on a Hajj pilgrimage, as suggested by statements in the Spain Ministry of Health press release, which noted that she (61F) flew to the Kingdom of Saudi Arabia (KSA) on October 1 and returned on November 1. Shortly thereafter MERS was confirmed. However, media reports noted that she had been hospitalized in KSA on October 15 and diagnosed as having pneumonia. However, the etiological agent was not identified. Disease onset on or about October 15 raises the strong possibility that she contracted MERS somewhere along the Hajj route but KSA failed to identify MERS in the above case or the source of her infection. Moreover, travel after the KSA hospitalization increased the potential for transmission to other travelers and significant spread. KSA has maintained that no Hajj pilgrim was diagnosed with MERS, although cases in Riyadh and the Eastern Region (Jubail) were confirmed, with disease onset dates similar to the above case. The confirmation of a Hajj pilgrim in Spain raises serious surveillance and transparency concerns. Recombinomics
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