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WHO: Saudi Arabia Reports 9 New MERS-CoV Cases
Photo Credit NIAID
#18,714
Two months ago, in WHO DON: Middle East Respiratory Syndrome Coronavirus - Kingdom of Saudi Arabia, we looked at the most recent bi-annual update on MERS-CoV from Saudi Arabia, which described 4 cases (2 fatal) from the previous 6 months.
All cases involved males aged between 27 and 78 years, and all presented with comorbidities. None were health workers, and from investigations only one was found to have indirect contact with dromedary camels (hosts of MERS-CoV) and their raw products (milk).
Reporting on MERS-CoV from Saudi Arabia (and neighboring countries) has plummeted over the past 6 years (see chart below), although the reasons why are a bit vague; The `fog' of the COVID pandemic, social distancing, and even some partial immunity from COVID vaccination has been suggested.
Overnight the WHO published a new DON report which adds 9 more cases, including a cluster of 7 from a Riyadh hospital, 6 of which were hospital employees. Interestingly, 4 of the 6 HCWs were asymptomatic, while 2 had mild symptoms.
Many mild and asymptomatic MERS infections are believed to have gone unreported over the years.
KSA routinely excluded them from their reports until 2015, that is, until the WHO issued a particularly strong rebuke (without singling out the Saudis) on the handling of asymptomatic cases in their 2015 WHO Statement On The 10th Meeting Of the IHR Emergency Committee On MERS.
Today's update adds 9 more cases (see epi chart below), all reported since January. Only one is listed as having had `indirect' contact with camels or camel products. Of the 4 sick enough to hospitalized, 2 died.
First, a link and some excerpts from today's WHO report. After which I'll have a bit more.
Disease Outbreak News
Middle East respiratory syndrome coronavirus - Kingdom of Saudi Arabia
12 May 2025
Situation at a glance
Between 1 March and 21 April 2025, the Ministry of Health (MoH) of the Kingdom of Saudi Arabia (KSA) reported nine cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Two of these cases died. Among the nine cases, a cluster of seven cases were identified in Riyadh, including six health and care workers who acquired the infection from caring for a single infected patient. The cluster was identified through contact tracing and subsequent testing of all contacts, with four of the six health and care workers being asymptomatic and two showing only mild, nonspecific signs.
The notification of these cases does not change the overall risk assessment, which remains moderate at both the global and regional levels. These cases show that the virus continues to pose a threat in countries where it is circulating in dromedary camels and spilling over into the human population. WHO recommends implementation of targeted infection prevention and control (IPC) measures to prevent the spread of health-care-associated infections of MERS-CoV and onward human transmission
Description of the situation
Between 1 March and 21 April 2025, the Ministry of Health (MoH) of the Kingdom of Saudi Arabia (KSA) reported nine cases of MERS-CoV infection. The cases were reported from the Hail (1) and Riyadh (8) regions of Saudi Arabia (Figure 1). Of the reported cases, five were male and four were female.
Among these cases, a cluster of seven was identified in Riyadh, including six health and care workers who acquired a nosocomial infection from one single infected patient they had cared for. Of the six health and care workers, four remained asymptomatic, while two developed mild, nonspecific symptoms including myalgia, fatigue, nausea and vomiting (Table 1). Laboratory confirmation of the cases was performed by real-time polymerase chain reaction (RT-PCR) between 1 March 2025 and 16 April 2025.
Of the cases, only one had indirect contact with camels and is not a part of the reported cluster. The rest of the patients had no known history of contact with camels or camel products.
Since the first report of MERS-CoV in KSA in 2012, a total 2627 laboratory-confirmed cases of MERS-CoV infection, with 946 associated deaths (Case Fatality Rate or CFR of 36%), have been reported to WHO from 27 countries, across all six WHO regions. The majority of cases (2218; 84%), have been reported from KSA, including these newly reported cases (Figure 2). Since 2019, no human MERS-CoV infections have been reported from countries outside the Middle East.
(Continue . . . )
Although dromedary camels are the primary animal reservoir for MERS - and direct or indirect contact are viewed as a major risk factor for infection - sporadic cases continue to show up in the community without any known exposures (camels, camel products, or known MERS cases).
A 2020 Perspective published in the EID Journal (see Middle East Respiratory Syndrome Coronavirus Transmission) reported that `. . . among 1,125 laboratory-confirmed MERS-CoV cases reported to WHO during January 1, 2015–April 13, 2018, a total of 157 (14%) had unknown exposure.'
Prior to the emergence of SARS-CoV-2 in late 2019, MERS-CoV was the coronavirus with the most pandemic potential (see 2017's A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia), and while COVID beat it to the punch, it remains very much a threat.
The MERS-CoV virus continues to mutate and evolve, and some researchers even worry it could recombine with SARS-CoV-2 (see Nature: CoV Recombination Potential & The Need For the Development of Pan-CoV Vaccines) and produce a more easily transmissible hybrid.
How likely that is to happen is a subject of considerable debate, but it appears to be at least theoretically possible.
Compared to the hundreds of cases reported each year in KSA during the last decade, 9 cases are hardly earthshaking, but they do represent a noticeable uptick.
For more on the Hajj, and MERS-CoV you may wish to revisit 2022's The Upcoming Hajj & The UKHSA MERS-CoV Risk Assessment.
https://afludiary.blogspot.com/2025/...-mers-cov.html
Photo Credit NIAID
#18,714
Two months ago, in WHO DON: Middle East Respiratory Syndrome Coronavirus - Kingdom of Saudi Arabia, we looked at the most recent bi-annual update on MERS-CoV from Saudi Arabia, which described 4 cases (2 fatal) from the previous 6 months.
All cases involved males aged between 27 and 78 years, and all presented with comorbidities. None were health workers, and from investigations only one was found to have indirect contact with dromedary camels (hosts of MERS-CoV) and their raw products (milk).
Reporting on MERS-CoV from Saudi Arabia (and neighboring countries) has plummeted over the past 6 years (see chart below), although the reasons why are a bit vague; The `fog' of the COVID pandemic, social distancing, and even some partial immunity from COVID vaccination has been suggested.
Overnight the WHO published a new DON report which adds 9 more cases, including a cluster of 7 from a Riyadh hospital, 6 of which were hospital employees. Interestingly, 4 of the 6 HCWs were asymptomatic, while 2 had mild symptoms.
Many mild and asymptomatic MERS infections are believed to have gone unreported over the years.
KSA routinely excluded them from their reports until 2015, that is, until the WHO issued a particularly strong rebuke (without singling out the Saudis) on the handling of asymptomatic cases in their 2015 WHO Statement On The 10th Meeting Of the IHR Emergency Committee On MERS.
- Seroprevalence studies have also hinted mild infection may be common (see Presence of Middle East respiratory syndrome coronavirus antibodies in Saudi Arabia: a nationwide, cross-sectional, serological study by Drosten & Memish et al.,)
- and a 2016 study (see EID Journal: Estimation of Severe MERS Cases in the Middle East, 2012–2016) suggested that as much as 60% of severe Saudi MERS cases go undiagnosed.
Today's update adds 9 more cases (see epi chart below), all reported since January. Only one is listed as having had `indirect' contact with camels or camel products. Of the 4 sick enough to hospitalized, 2 died.
First, a link and some excerpts from today's WHO report. After which I'll have a bit more.
Disease Outbreak News
Middle East respiratory syndrome coronavirus - Kingdom of Saudi Arabia
12 May 2025
Situation at a glance
Between 1 March and 21 April 2025, the Ministry of Health (MoH) of the Kingdom of Saudi Arabia (KSA) reported nine cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Two of these cases died. Among the nine cases, a cluster of seven cases were identified in Riyadh, including six health and care workers who acquired the infection from caring for a single infected patient. The cluster was identified through contact tracing and subsequent testing of all contacts, with four of the six health and care workers being asymptomatic and two showing only mild, nonspecific signs.
The notification of these cases does not change the overall risk assessment, which remains moderate at both the global and regional levels. These cases show that the virus continues to pose a threat in countries where it is circulating in dromedary camels and spilling over into the human population. WHO recommends implementation of targeted infection prevention and control (IPC) measures to prevent the spread of health-care-associated infections of MERS-CoV and onward human transmission
Description of the situation
Between 1 March and 21 April 2025, the Ministry of Health (MoH) of the Kingdom of Saudi Arabia (KSA) reported nine cases of MERS-CoV infection. The cases were reported from the Hail (1) and Riyadh (8) regions of Saudi Arabia (Figure 1). Of the reported cases, five were male and four were female.
Among these cases, a cluster of seven was identified in Riyadh, including six health and care workers who acquired a nosocomial infection from one single infected patient they had cared for. Of the six health and care workers, four remained asymptomatic, while two developed mild, nonspecific symptoms including myalgia, fatigue, nausea and vomiting (Table 1). Laboratory confirmation of the cases was performed by real-time polymerase chain reaction (RT-PCR) between 1 March 2025 and 16 April 2025.
Of the cases, only one had indirect contact with camels and is not a part of the reported cluster. The rest of the patients had no known history of contact with camels or camel products.
Since the first report of MERS-CoV in KSA in 2012, a total 2627 laboratory-confirmed cases of MERS-CoV infection, with 946 associated deaths (Case Fatality Rate or CFR of 36%), have been reported to WHO from 27 countries, across all six WHO regions. The majority of cases (2218; 84%), have been reported from KSA, including these newly reported cases (Figure 2). Since 2019, no human MERS-CoV infections have been reported from countries outside the Middle East.
(Continue . . . )
Although dromedary camels are the primary animal reservoir for MERS - and direct or indirect contact are viewed as a major risk factor for infection - sporadic cases continue to show up in the community without any known exposures (camels, camel products, or known MERS cases).
A 2020 Perspective published in the EID Journal (see Middle East Respiratory Syndrome Coronavirus Transmission) reported that `. . . among 1,125 laboratory-confirmed MERS-CoV cases reported to WHO during January 1, 2015–April 13, 2018, a total of 157 (14%) had unknown exposure.'
Prior to the emergence of SARS-CoV-2 in late 2019, MERS-CoV was the coronavirus with the most pandemic potential (see 2017's A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia), and while COVID beat it to the punch, it remains very much a threat.
The MERS-CoV virus continues to mutate and evolve, and some researchers even worry it could recombine with SARS-CoV-2 (see Nature: CoV Recombination Potential & The Need For the Development of Pan-CoV Vaccines) and produce a more easily transmissible hybrid.
How likely that is to happen is a subject of considerable debate, but it appears to be at least theoretically possible.
Compared to the hundreds of cases reported each year in KSA during the last decade, 9 cases are hardly earthshaking, but they do represent a noticeable uptick.
With the Hajj less than a month away (June 4th to the 9th) - and KSA expected to host 2 million religious pilgrims from around the globe - these recent cases generate a bit more concern.
For more on the Hajj, and MERS-CoV you may wish to revisit 2022's The Upcoming Hajj & The UKHSA MERS-CoV Risk Assessment.
https://afludiary.blogspot.com/2025/...-mers-cov.html