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Commentary

More MERS Clusters In KSA Raise Concerns
Recombinomics Commentary 23:45
December 10, 2013

The first case is for a 73-year-old female citizen in Riyadh, who had been suffering from various chronic diseases. She passed away….
The second case is for a 65-year-old male citizen in Al-Jouf, who has been suffering from various chronic diseases. Recently, he has been transferred to the IC unit in Riyadh region; to carry on his treatment
 
The first case is for a 26-year-old female citizen, working in the health sector in Riyadh, who was in contact with a confirmed case of the virus, and the disease symptoms were not shown in her cases.
The second case is for a 51-year-old female citizen in Al-Jouf, who has been suffering from various chronic diseases. Recently, she has been transferred to the IC unit in Riyadh region; to carry on her treatment.

The above comments from the Kingdom of Saudi Arabia Ministry of Health (KSA-MoH) MERS website describe two MERS clusters.  The November 19 announcement (in red) describes a fatal case (73F) in Riyadh, as well as the first confirmed case (65M) in Al-Jouf.  The December 6 announcement (in blue) describes a second Riyadh case (26F) who is an asymptomatic health care worker who is a contact of a confirmed case.  The announcement also cites a second case (51F) in Al-Jouf, raising concerns that the second case is part of a cluster, even though the announcement is silent on the relationship between the two Al- Jouf cases.

The wording, other than age and gender, is identical for both cases, citing underlying disease as well as transfer to an ICU in Riyadh.  The transfers raise concerns that the hospital(s) in Al-Jouf do not have the resources to properly care for the two confirmed cases.

However, recent local media reports raise concerns that there are several additional suspect or confirmed cases which include relative(s) of the confirmed case(s) and hospital employees in Sakaka (see map).  Additional reports cite a 40 year old expatriate from India, as well as another case (37M) who has been in a coma for 12 days and has been MERS confirmed.

More information on the confirmed and suspect cases in Sakaka, Al-Jouf, including relationships and disease onset dates, would be useful.

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