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Published Date: 2019-02-15 00:04:57
Subject: PRO/AH/EDR> MERS-CoV (17): Saudi Arabia (RI) Oman, RFI
Archive Number: 20190215.6317274
MERS-COV (17): SAUDI ARABIA (RIYADH) OMAN, REQUEST FOR INFORMATION
******************************************************************
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International Society for Infectious Diseases
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In this update:
[1] Saudi Arabia: 2 newly confirmed cases, 2 fatalities - Saudi MOH
[2] Oman: 1 newly confirmed case - Media report
[3] Oman, 4 additional confirmed cases and 2 deaths - Omani MOH tweet

******
[1] Saudi Arabia: 2 newly confirmed cases, 2 fatalities - Saudi MOH
Date: Thu 14 Feb 2019
Source: Saudi MOH 13-14 Feb 2019 [edited]
https://www.moh.gov.sa/en/CCC/events/national/Pages/2019.aspx


In the past 2 days since the last update [12 Feb 2019], there have been a total of 2 newly confirmed cases, 2 fatalities, and 2 recoveries reported by Saudi Arabia. In addition, there have been 5 cases previously listed as on home isolation that were changed to hospitalized, and 6 additional cases whose transmission classification was changed from the initial report.

Information on newly confirmed cases:
https://www.moh.gov.sa/en/CCC/events/national/Documents/Epiwk7-19.pdf

[1]
Date of confirmation report: 13 Feb 2019
Case no.: 19-1836
MERS in Wadi Aldwasir city: 50-year-old male in Wadi Aldwasir city, Riyadh region
Contact with camels: no
Case classification: secondary, healthcare acquired
Current status: home isolation

[2]
Date of confirmation report: 14 Feb 2019
Case no.: 19-1837
MERS in Wadi Aldwasir city: 60-year-old male in Wadi Aldwasir city, Riyadh region
Contact with camels: no
Case classification: secondary, healthcare acquired
Current status: deceased
Date of outcome report: 14 Feb 2019 [at time of initial confirmation report]

Information on newly reported outcomes:

Fatalities
[1]
See newly confirmed case [2] above [case no.: 19-1837]

[2]
https://www.moh.gov.sa/en/CCC/events/national/Documents/Epiwk6-19.pdf
Date of confirmation report: 8 Feb 2019
Case no.: 19-1813
MERS in Wadi Aldwasir city: 84-year-old male in Wadi Aldwasir city, Riyadh region
Contact with camels: no
Case classification: secondary, healthcare acquired
Date of outcome report: 14 Feb 2019
Outcome: deceased

Recoveries:

[1]
https://www.moh.gov.sa/en/CCC/events/national/Documents/Epiwk5-19.pdf
Date of confirmation report: 1 Feb 2019
Case no.: 19-1791
MERS in AlKharj city: 31-year-old male in AlKharj city, Riyadh region
Contact with camels: yes
Case classification: secondary, healthcare acquired
Date of outcome report: 14 Feb 2019
Outcome: recovered

[2]
https://www.moh.gov.sa/en/CCC/events/national/Documents/Epiwk6-19.pdf
Date of confirmation report: 3 Feb 2019
Case no.: 19-1794
MERS in Wadi Aldwasir city: 55-year-old male in Wadi Aldwasir city, Riyadh region
Contact with camels: yes
Case classification: secondary, healthcare acquired
Current status: recovered

Information on status changes (from home isolation to hospitalized):

[1] Case no.: 19-1815, confirmation report: 8 Feb 2019; 41-year-old male from Wadi Aldawasir, Riyadh region. Date of reported change from home isolation to hospitalized: 14 Feb 2019. Classified as a secondary healthcare-acquired case.

[2] Case no.: 19-1820, confirmation report: 11 Feb 2019; 71-year-old male from Wadi Aldawasir, Riyadh region. Date of reported change from home isolation to hospitalized: 13 Feb 2019. Classified as a secondary healthcare-acquired case.

[3] Case no.: 19-1825, confirmation report: 11 Feb 2019; 37-year-old female from Wadi Aldawasir, Riyadh region. Date of reported change from home isolation to hospitalized: 14 Feb 2019. Classified as a primary community-acquired case (no history of camel contact).

[4] Case no.: 19-1827, confirmation report: 12 Feb 2019; 37-year-old female from Wadi Aldawasir, Riyadh region. Date of reported change from home isolation to hospitalized: 14 Feb 2019. Classified as a primary community-acquired case (with a history of contact with camels).

[5] Case no.: 19-1832, confirmation report: 12 Feb 201919; 52-year-old male from Wadi Aldawasir, Riyadh region. Date of reported change from home isolation to hospitalized: 14 Feb 2019. Classified as a primary community-acquired case (with a history of contact with camels).

Information on changes in transmission classification:

[1] Case no.: 19-1809 originally classified as a secondary healthcare-acquired case on 7 Feb 2019, reclassified as a primary community-acquired case (no contact with camels) on 14 Feb 2019 (Wadi Aldawasir, Riyadh region).

[2] Case no.: 19-1819 originally classified as a secondary healthcare-acquired case on 10 Feb 2019, reclassified as a primary community-acquired case (with contact with camels) on 14 Feb 2019 (Wadi Aldawasir, Riyadh region).

[3] Case no.: 19-1830, originally classified as a primary community-acquired case on 12 Feb 2019, reclassified as a secondary healthcare-acquired case on 13 Feb 2019 (Wadi Aldawasir, Riyadh region).

[4] Case no.: 19-1833, originally classified as under investigation on 12 Feb 2019, reclassified as a primary community-acquired case (no history of contact with camels) on 13 Feb 2019 (Wadi Aldawasir, Riyadh region).

[5] Case no.: 19-1835, originally classified as under investigation on 12 Feb 2019, reclassified as a secondary healthcare-acquired case on 13 Feb 2019 (Wadi Aldawasir, Riyadh region).

[6] Case no.: 19-1836, originally classified as under investigation on 13 Feb 2019, reclassified as a secondary healthcare-acquired case on 14 Feb 2019 (Wadi Aldawasir, Riyadh region).

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[In the past 2 days since the last update (12 Feb 2019), there have been 2 newly confirmed cases of MERS-CoV infection reported by Saudi Arabia. Both were males in Wadi Aldawasir, where there has been ongoing transmission both in the community as well as in one or more healthcare facilities. Both newly confirmed cases were classified as secondary healthcare-acquired cases, one of which was reported as a fatality at the time of initial confirmation report. There was a 2nd fatality reported in a previously confirmed case, also in a secondary healthcare-acquired case with an initial confirmation report on 8 Feb 2019.

Noteworthy is the number of previously confirmed cases (5) that had been listed as on home isolation and were changed to hospitalized, suggesting the asymptomatic or mild infection at the time of confirmation developed into more serious disease requiring hospitalization. In my memory over the years reporting on MERS-CoV cases, this is the 1st time we are seeing in real time reported mild or asymptomatic cases progressing to more serious disease.

Also noteworthy is the number of cases whose initial classification by transmission type was changed after further investigation (6 cases): 3 cases reclassified as secondary healthcare-acquired infections and 3 reclassified as primary community-acquired infections.

The total of laboratory-confirmed infections reported since 1 Jan 2019 is now 61, with 38 cases reported from Wadi Aldawasir since 29 Jan 2019.

The HealthMap/ProMED-mail map of Saudi Arabia can be found at http://healthmap.org/promed/p/131. - Mod.MPP]

******
[2] Oman: one newly confirmed case - media report
Date: Tue 12 Feb 2019
Source: Times of Oman [edited]
https://timesofoman.com/article/829762


A new case of the Middle-East respiratory syndrome coronavirus (MERS-CoV) has been detected in Oman, the Ministry of Health confirmed. According to a statement by the ministry, the new case brings the total number of cases recorded this year [2019] to 6.

"The [person in this] case is receiving all the necessary medical care in one of the hospitals," the ministry revealed in a statement online.

The ministry affirmed its continued efforts to monitor and control the disease through the effective Epidemiological Surveillance System, adding that hospitals are capable and equipped to deal with such cases.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[The above media report mentions a 6th case confirmed in Oman in the past 2 weeks. The previous 5 cases were all female residents of a household that was associated with a camel farm, although none of the infected individuals gave a history of direct contact with camels. The current ministry report (https://www.moh.gov.om/en/-/---973) does not mention if this newly reported case is associated with the previous cluster. No further epidemiologic information was available. If any of our subscribers have more information to share, it would be greatly appreciated.

HealthMap/ProMED-mail map of Oman can be found at http://healthmap.org/promed/p/124 - Mod.MPP]

******
[3] Oman, 4 additional confirmed cases and 2 deaths - Omani MOH tweet
Date: 14 Feb 2019
Source: Omani MOH tweet, Avian Flu Diary
http://afludiary.blogspot.com/
https://twitter.com/OmaniMOH/status/1096062392281247744


According to a translation found on the Avian Flu Diary, the following was a tweet from the Omani MOH:

The Ministry of Health issued a statement No. (4) on strengthening precautionary measures to control the Middle East respiratory syndrome "Corona" in the Sultanate.

According to Atheer, the statement reads as follows:

"The Ministry of Health in the latest update of the data on the Middle East respiratory syndrome (Corona) in the Sultanate, the number of cases recorded this year [2019] has reached 10 cases and resulted in 4 deaths from different provinces of the Sultanate.

With the increase in the number of cases, the ministry will strengthen precautionary measures and prevention at the level of hospitals and health centers in order to promote the early detection of infected and reduce the spread of infection within the founder

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[There are now 10 cases of MERS-CoV including 4 deaths reported from Oman since 1 Jan 2019 involving different geographic locations in the Sultanate. More information from knowledgeable sources on the epidemiology of these cases including gender, age, geographic location and high risk exposures preceding onset of illness would be greatly appreciated. - Mod.MPP]

See Also

MERS-CoV (16): Saudi Arabia (RI, NJ) 20190212.6312350
MERS-CoV (15): Saudi Arabia (RI,QS), WHO EMRO 20190211.6310266
MERS-CoV (14): Saudi Arabia (RI) 20190210.6307667
MERS-CoV (13): Saudi Arabia (RI, QS, JF), Oman 20190208.6306743
MERS-CoV (12): Saudi Arabia (RI, AS) secondary transmission 20190206.6303349
MERS-CoV (11): Saudi Arabia (RI) 20190203.6292857
MERS-CoV (10): Saudi Arabia (RI), secondary cases 20190131.6288132
MERS-CoV (01): Saudi Arabia (RI) 20190104.6241859
2018
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MERS-CoV (52): Saudi Arabia (RI) WHO 20181228.6226691
MERS-CoV (01): Malaysia (ex KSA), Saudi Arabia, UAE (ex Oman) 20180102.5532148
2017
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MERS-CoV (77): Saudi Arabia, camels, human, epidemiology, assessment 20171222.5520561
MERS-CoV (01): Saudi Arabia (QS, RI, MD) RFI 20170105.4744802
2016
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MERS-CoV (123): Saudi Arabia (MK, AS) new cases 20161231.4734758
MERS-COV (01): Oman, Saudi Arabia 20160105.3911188
2015
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MERS-COV (167): acute management and long-term survival 20151231.3904300
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
2014
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MERS-CoV (69): Saudi Arabia, new case, RFI 20141230.306305
MERS-CoV (01): Bangladesh, KSA, Algeria, UAE, Iran, WHO, RFI 20140616.2541707
MERS-CoV - Eastern Mediterranean (82): anim. res., camel, seroepidemiology 20140613.2537848
MERS-CoV - Eastern Mediterranean (01): Saudi Arabia, UAE, Oman, WHO 20140103.2150717
2013
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MERS-CoV - Eastern Mediterranean (106): animal reservoir, camel, Qatar, OIE 20131231.2145606
MERS-CoV - Eastern Mediterranean: Saudi Arabia, new case, RFI 20130518.1721601
Novel coronavirus - Eastern Mediterranean (29): MERS-CoV, ICTV nomenclature 20130516.1717833
Novel coronavirus - Eastern Mediterranean: bat reservoir 20130122.1508656
2012
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Novel coronavirus - Eastern Mediterranean (06): comments 20121225.1468821
Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI 20121130.1432498
Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664
Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733
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