Friday, August 28, 2015

Case Details from the Current MERS Outbreak in Riyadh Saudi Arabia, August 2015

The current outbreak in Riyadh started mid-July when a 56-year-old man became infected with Middle East Respiratory Syndrome coronavirus (MERS). This individual had frequent contacts with camels and consumed raw camel milk. This man infected his 52-year-old wife, his 53-year-old brother, and 30-year old son. The index case and his wife are reported to have died.

Almost 120 cases have been confirmed during this MERS outbreak in Riyadh through August 28, 2015.  As in other MERS outbreaks, more males then females are infected, about 61%. The males range in age from 2-109 years old with a median age of 61. The females range in age from 25 to 98 with a median age of 58.

The fatality rate for this outbreak is about 25%, with similar death percentages for both males and females. However the fatality statistics could change because the Saudi Arabia Ministry of Health is reporting that there are at least 50 cases still under treatment.

In this outbreak, most of the infections had been contracted by either visiting or being treated in a hospital with current MERS patients. A few cases are reported to have contact with confirmed MERS patients possibly outside of a healthcare setting. Information on family clusters is not available. It is difficult to assess the extent of family clusters, since that information is not generally available. 

Besides the initial family cluster in this outbreak, one other possible family cluster can be proposed from the data. A 56-year-old female experienced symptom onset on August 7, with her death reported on August 17. The World Health Organization reports that a 28-year-old female had contact with this woman and became symptomatic on August 12. A third individual, a two-year-old boy, also had contact with this woman and became symptomatic on August 12 as well. The boy is reported by the Saudi Arabia Ministry of Health to have recovered. Speculating, this cluster would seem to be a result of a daughter and a grandson interacting with the 56-year-old grandparent.

Healthcare workers represent about 11% of all infected individuals in this current outbreak.  This is similar to the overall percentage of healthcare workers infected with MERS in Riyadh since 2012. About 10% of all of MERS cases reported from Riyadh since 2012 were healthcare workers.

The epidemiological similarities among various MERS outbreaks should begin to provide a framework for understanding and controlling this disease in the future.

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