Middle East respiratory syndrome coronavirus (MERS-CoV): unhappy trails...

An updated map of the countries that have had a visit from, and in 52% of those, had some local transmission of, the MERS-CoV.

South Korea is the first country I have seen that has jumped three colour levels between updates. No mean feat.

So we have 25 countries that have hosted a MERS-CoV infected person, and 13 of those have gone on to have local transmission - new cases from that case on their soil.

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In the meantime, 7,000,000 pilgrims are expected in Saudi Arabia to perform Umrah between mid-May (around the 19th May) and mid-July.[1] Over 2,000,000 had already performed the Umrah pilgrimage to The Holy City of  Makkah in Makkah province, between November 2014 and May 2015.[1,2] We're in the second phase of Umrah now - in the lead-up to the fasting month of Ramadan which begins on the 18th June 2015. 

Remember Saudi Arabia? That's where over 80% of all MERS-CoV cases have originated. That percentage has dropped a little of late thanks to the clusters in South Korea. Given the amazingly, incredibly, ultra-tiny (yes, that small) number of cases that have reportedly arisen during Umrah or Hajj (Septembee 21-26 in 2015)  in previous years, there is absolutely no reason to think 2015 will differ. Even if there have been recent cases in Makkah province. And a hospital cluster in Ash Sharqiyah (eastern province).

Clearly, MERS-CoV is not easy to catch even when so many different people, so many different states of underlying chronic disease, immune compromise, pre-existing infection, height, weight, age all come into contact within the zone of hotness that is Saudi Arabia.  

Which leaves me with one comment after a large batch of 23 cases was announced this morning - bringing the total to 87 from South Korea....look to the infection control South Korea!

References..

1. http://english.alarabiya.net/en/News/middle-east/2015/05/19/7-million-Umrah-pilgrims-expected-in-Saudi-in-next-2-months.html
2. http://english.alarabiya.net/en/News/middle-east/2015/01/28/Over-one-million-Umrah-pilgrims-pass-through-Jeddah.html

MERS-CoV and deaths rise....[UPDATE]

The latest Kingdom of Saudi Arabia (KSA) Ministry of Health (MOH) announcement (Arabic only for now) provides scarce detail on 4 new cases including 2 deaths.

1. 30-year old, Riyadh, health care worker (HCW), in an intensive care unit (ICU)
2. 47-year old, Hafr Al Batin, multiple comorbidities, contact ("Mkhalt") of another case, in an intensive care unit (ICU)
3. 41-year old, Riyadh, HCW, fatal infection
4. 79-year old, [construction worker=Harf al Batin-place name], multiple comorbidities, contact of another case, fatal infection

The last case on that list is particularly interesting* for their role as a contact, who died. Generally, the second "passage" of infection to a new human host has not been as severe as the first. This once again draws attention to the role of underlying disease (comorbidities) in making any infection, even one that has gone through a human host, fatal.

There are no data on the sex of cases, when the fatal cases were admitted to hospital, or any indication at all of a date of disease onset.

After Wednesday's post of the plateau that ceased after umrah, I would be very interested to know how many recent cases has recent travel with a common destination.

The MERS-CoV lab-confirmed case tally now sits at 115 with 54 deaths (proportion fatal 47%)


*It's very sad that there are real people in these numbers who have died from MERS. You may have noticed that I try and stick with the cold number-crunching aspect of these outbreaks. It's not because I'm a heartless b&^$# but because that is not what this blog is about. That and my editorialisation and expositionary writing consume what little time I have spare. But I don't feel that I have enough information to make any other comments about these or any other lives lost to infectious disease. I personally feel that any unexpected and acute loss of life (if I had to scale loss of life) is the worst kind of loss; it's a waste of potential, a source of great sorrow for all involved and it's something we should all strive to prevent, if we can. I know that's not much to convey, but it's all I can offer from my kinda comfy chair in Brisbane.