South Korea today reported two more MERS-CoV infections, lifting the nation’s total to seven, and it revealed that a high-risk contact flew to China, prompting the man’s hospitalization and tracing of airline passengers and other contacts.
Meanwhile, the virus has sickened one more person in Saudi Arabia and killed two more, according to reports over the past 2 days from Saudi Arabia’s Ministry of Health (MOH).
Hospital exposures in South Korea
The two newly announced South Korean MERS-CoV (Middle East respiratory syndrome coronavirus) cases involve a 28-year-old female healthcare worker and a 71-year-old man who is a patient in the same hospital as the index patient, The Korea Herald reported today.
Yang Byung-guk, MD, PhD, MPH, director of the Korea Centers for Disease Control and Prevention (Korea CDC), said the high-risk contact was not on the monitoring list, because he did not share a room with the first patient and their rooms were at last 10 meters apart, according to the report. The Korea CDC defines “close contact” as being within about 2 meters in a room or care area with a lab-confirmed MERS-CoV patient for a prolonged period.
South Korea’s first case was announced on May 20, involving a 68-year-old man who had traveled to the Middle East. Subsequent infections were detected in the man’s wife, his hospital roommate, his hospital roommate’s daughter, and another healthcare worker.
Officials said the man who traveled to China is the son of the index patient’s roommate and had apparently visited his two sick family members in the hospital, the Herald reported, citing South Korea’s health ministry. It added that the man had a fever on May 19 and left for China on May 26, despite advice from doctors that he shouldn’t leave the country.
According to the report, the Korea CDC wasn’t aware the man had visited his sick father and sister in the hospital and the man did not initially tell his doctor that his family members had MERS when he sought care for his symptoms on May 22.
South Korea asked China to quarantine the man and will share a list with China of 166 people who were on the man’s flight, 28 of whom sat close to him, according to the Herald report.
Chinese officials placed the man under observation and isolation in Guangdong province yesterday and notified the World Health Organization (WHO), Xinhua, China’s state news agency, reported today. It said the 44-year-old business traveler arrived in Hong Kong on May 26 and traveled through the mainland city of Shenzhen to his destination in Huizhou, both in Guangdong province.
No other illnesses have been found in 35 of the man’s known close contacts, according to Xinhua.
Saudi case, deaths
In separate statements yesterday and today Saudi Arabia’s MOH confirmed another MERS-CoV infection and said two previously announced patients have died from their illnesses.
The latest case-patient is a 26-year-old woman who is a healthcare worker in Hofuf, the MOH said today. It added that she is symptomatic, is in stable condition, and had contact with a suspected or confirmed MERS case in the community or hospital.
Several MERS-CoV cases have been reported from Hofuf in recent weeks, including four reported earlier this month that are thought to be part of a family cluster.
The two deaths in earlier cases involve a 48-year-old Saudi man from Taif and Hofuf, according to MOH reports today and yesterday. It also said a 71-year-old foreign man who got sick in Hofuf has recovered from his illness.
So far the MOH has reported 1,007 MERS-CoV cases, 442 of them fatal. They agency said 560 people have recovered, 4 patients are still being treated, and 1 is on home isolation.
South Korea has had two more MERS-CoV cases among contacts with its first MERS case—now five cases total—and Saudi Arabia reported four new infections in as many days.
Meanwhile, the World Health Organization (WHO) issued statements recently on the first three Korean MERS-CoV (Middle East respiratory syndrome coronavirus) cases, recent cases in Qatar and the United Arab Emirates (UAE), and 16 recent Saudi cases.
Korean health worker infected
The two new cases in South Korea involve the daughter of the third Korean MERS patient and a healthcare worker (HCW) involved in MERS care, according to separate reports today from the Korea Herald.
The daughter, however, likely did not contract the disease from her 76-year-old father, who shared a hospital room with South Korea’s first MERS-CoV case-patient, a 68-year-old who had traveled to the Middle East, the Herald reported. Officials believe she contracted MERS from the 68-year-old man while visiting her father in the hospital.
She was quarantined as one of the 64 contacts of the first patient, the story said. She tested positive for MERS-CoV at a state-designated hospital after she developed a fever higher than 100°F. She is in stable condition, according to officials.
A separate Korea Herald story, translated and posted today by the infectious disease blog Avian Flu Diary, said that one of two HCWs with suspected MERS has tested positive for the disease, while the other HCW appears to have tested negative.
South Korea’s first MERS case was reported May 20, while the second case—involving the man’s wife—and the third were reported the next day.
Four new Saudi cases
Saudi Arabia’s Ministry of Health (MOH) confirmed four MERS-CoV cases in 4 days, all in those 65 years and older. Three are in Hofuf in the eastern part of the country near Qatar. The MOH also reported four MERS-related deaths in that span.
The Hofuf cases were reported on May 23, May 24, and yesterday. They involve 77- and 68-year-old Saudi women in critical condition in intensive care units (ICUs) and a 71-year-old male expatriate in stable condition. None are HCWs, but all had contact with a confirmed MERS case-patient.
Hofuf has had a number of cases in the past few weeks, including four that reported on May 9 that appear to represent a family cluster.
The Saudi case reported today by the MOH involves a 65-year-old Saudi man in Taif, which is near Mecca. He is listed in critical condition in an ICU. He is not an HCW, and his potential contact with MERS-CoV patients is under investigation.
The deaths were reported on the same days as the Hofuf cases. They involve a 71-year-old man in Riyadh, a 75-year-old man in Begig, and two women, 68 and 77, in Hofuf. None were HCWs, all had pre-existing disease, and all were Saudi citizens.
Saudi Arabia’s MOH also posted a weekly update on May 24 containing no new information. These updates have been sporadic at best.
WHO updates flesh out exposures
The WHO, meanwhile, posted details on May 24 about South Korea’s first three MERS-CoV cases. It noted that the index patient traveled extensively in the Middle East: to Bahrain, the UAE, Saudi Arabia, and Qatar. It added that all three patients are in stable condition.
Other WHO updates highlighted contact with camels and other MERS cases before symptom onset. The recent case-patient from the UAE, for example, “has a history of contact with MERS-CoV infected camels imported from Oman,” the agency said on May 24. The UAE reported this case, which involves a 33-year-old man, to the WHO on May 18.
The Qatari patient, a 29-year-old man, had frequent contact with camels, the WHO said in a separate May 24 statement.
And, in updates involving 16 Saudi MERS-CoV patients posted Mar 24 and yesterday, the WHO said 2 patients had contact with camels and 8 had possible exposure to other MERS patients. Two of the 16 patients are in critical condition, and 2 died.
May 26 Korea Herald story on fourth MERS patient
May 26 Avian Flu Diary post
May 23 Saudi MOH update
May 24 Saudi MOH update
May 25 Saudi MOH update
May 26 Saudi MOH update
May 24 Saudi MOH weekly update
May 24 WHO statement on South Korean cases
May 24 WHO statement on UAE case
May 24 WHO statement on Qatari case
May 24 WHO statement on Saudi cases
May 25 WHO statement on Saudi cases
Source: CIDRAP – Center for Infectious Disease Research and Policy