Today, the Ministry of Health (MOH) officials in the Kingdom of Saudi Arabia (KSA) revised upward the number of Middle East Respiratory Syndrome (MERS) case and MERS-related deaths that have occurred in the KSA (link). As noted by Michael Coston (link), the KSA MOH added a total of 113 cases and 92 deaths to the official cumulative count from that county. The lack of any details for these additional cases or the individuals who died, precludes determining whether all of the unreported deaths are only from the previously unreported cases. In several instances in recent MOH media reports, there have been reported deaths that could not be correlated with previously reported cases because the combination of age/gender of the reported deaths from a specific location could not be associated with previously reported cases (link, link).
Through yesterday, publicly reported cases from the KSA represented about 82% of all MERS cases reported from around the world. Today, with these additional reported cases, the KSA lays claim to about 85% of all cases, not including the 20 infected cases that have been exported to at least 12 different countries. Without doubt, the nexus of worldwide MERS infections is the KSA.
This revelation of previously unreported cases by the KSA MOH ought to be disconcerting. A review of the graph associated with the report indicates that a few of these unreported cases go back as far as May of 2013. There are two possible conclusions about the delay in reporting these case by KSA MOH. The fact that these cases are only now being publicly and officially reported could suggest that the MOH has been purposefully withholding information about these MERS cases since May of 2013.
Or, maybe the KSA MOH has been so overwhelmed by this outbreak, that they have only now been able to go back and sift through their data to find these additional cases. Either way, the announcement today, with no details or explanations, reflects negatively on the KSA MOH and their ability to track the MERS outbreak within their country.