In 2014 a stepwise increase in Middle East respiratory syndrome coronavirus (MERS-CoV) cases preceded the largest healthcare facility outbreak of MERS to date.
If you look at the most recent daily Kingdom of Saudi Arabia (KSA) Ministry of Health report below,[1] you could be forgiven for thinking that there is currently a threatening rise in cases which could easily spiral out of control once again unless it is quickly stepped on.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEjLp6t9LvscqHm1VoH-JiJRX1jiHdpJKtE1vKvJMv0hBIlKVpUpbWlRrt_ObZleJTh0e_HArEj1jfV-xQD2Eqj4LI0UoIiU7M2NOOXsdnLAxVFf7LrQjMNAPjbrCwxBBcdYAPqDOb26LQk/s320/KSA.jpg)
When these fires are let smoulder in this way, they can quickly spread embers across the region and then cases fly out to other ports.
A week ago there were 8 cases reported in a day. That's far from the biggest reporting day we've seen in 3 MERS years (around 31 cases in a day n April '14), but it's still high. There have been 11 consecutive days with 2 -8 cases reported each day. The region in the map above has been the hotspot, but in the 12-March report there were 4 cases, each in a different city.
![](https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh71nvk9j1gArRmEzBEGEvVi4l0vNEV99w-haySB0xQgh-hK9P1duIVbIaIbelaETbADETHSH0dCDwyJIQsOMUXVFnnAnb7cYZivpUkGEjsgghi8l4mWD1kM0lFf7MN0VwTudiDAD1Cb1g/s320/TanintheLedger.jpg)
There have been no viral gene or genome sequences from 2016 arriving on the interwebs yet, so we are left with a few of the old questions...again
- is this all normal or is something different this time around?
- has this season's MERS-CoV undergone a significant genetic change(s), affecting stability, tropism or transmission?
- has infection control and prevention slipped again?
- is there more contact with infected camels this year?
- are increased camel descriptions an indication of better surveillance and questioning about camel contact?
Time to start watching and plotting MERS-CoV again.
References...
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