http://china.org.cn/world/Off_the_Wire/2015-08/16/content_36321552.htm

There is an outbreak of MERS in Saudia Arabia and it is getting more serious by the day. There is not a lot out there and so you read it here at AFT -  stay tuned for I am tracking this and it could become a real problem.

The Saudi Health Ministry registered 21 Middle East Respiratory Syndrome (MERS) corona virus cases in the week ending on Aug. 15, Saudi Press Agency reported on Sunday.

MERS, also known as Coronavirus, causes symptoms similar to colds in individuals it infects.

The ministry said the number includes 20 cases in Riyadh, and one in Abha.

The total number of confirmed MERS cases since its appearance is 1,072, 588 of whom were cured, with 25 cases still undergoing treatment, in addition to four domestically quarantined cases.

The announcement was issued as Saudi Arabia plans a nationwide campaign to prevent the virus from spreading amongst pilgrims who have started arriving from all over the world to perform the Hajj (major Islamic pilgrimage).

The ministry recently announced a free-of-contagious-diseases season, including MERS corona, amongst pilgrims who performed the Omra (minor Islamic pilgrimage) in the summer.

Medclinician

The number of cases has doubled since my last post.

http://www.cidrap.umn.edu/news-perspective/2015/08/four-more-sickened-riyadh-mers-outbreak

The number of MERS-CoV infections in an outbreak centered in Saudi Arabia's capital continued a brisk rise today, with four new cases reported, three of them in individuals who had contact with a suspected or confirmed case.

In announcing the cases today, Saudi Arabia's Ministry of Health (MOH) has reported 32 infections from Riyadh since Aug 1 in an outbreak that appears to be mostly linked to the hospital setting.

None of the patients listed in today's update are healthcare workers, though several of them have been sickened in the Riyadh outbreak, a pattern also common in other hospital-linked outbreaks, such as the recent Middle East respiratory coronavirus (MERS-CoV) event in South Korea.

One of the patients is a 2-year-old boy who is hospitalized in stable condition. The MOH said an investigation revealed he had contact with a suspected or confirmed MERS-CoV. Few children have been reported in recent outbreaks.

The three other patients are all adults, a 28-year-old Saudi woman, a 47-year-old foreign woman, and a 57-year-old Saudi man. All have symptoms and are hospitalized in stable condition. The man is the only one of the four patients announced today whose source of infection remains unclear.

Medclinician

I posted this on the MERS forum but thought It should be here also!

Thirteen new MERS cases confirmed in Riyadh outbreak

Saudi Arabia reported 14 new MERS-CoV illnesses, along with 4 more deaths, over the past 3 days, with all but 1 of the infections linked to an ongoing hospital-related outbreak in Riyadh.

Today alone 9 new MERS-CoV (Middle East respiratory syndrome coronavirus) cases were reported in the country's capital, vaulting the nation's overall total from the disease above the 1,100 mark, to 1,105.

The only case confirmed over the past few days outside of Riyadh involves a 64-year-old foreign man in the southern city of Najran who works in a health setting, Saudi Arabia's Ministry of Health (MOH) said when it announced four cases yesterday. He is listed in stable condition. The investigation into his case so far has found no history of contact with a suspected or confirmed MERS case.

The 14 new cases in Riyadh, many of them with hospital-related links, bring the number of Saudi MERS illnesses since Aug 1 to 46.

New case details

On Aug 15 the MOH reported one new Riyadh case, that of a 63-year-old Saudi woman who is hospitalized in stable condition. The woman is not a health worker, and authorities are still reviewing any contact she may have had with a suspected or confirmed case in the community or hospital.

The following day, heath officials reported the sick healthcare worker from Najran, along with three more cases in Riyadh, one of them fatal. Investigators are still reviewing the contact status for all those Riyadh cases. The patients, all of them Saudi citizens, include a 60-year-old man who died from his infection and a 41-year-old man and 31-year-old woman who are hospitalized in stable condition.

All 9 cases reported today involve Saudi citizens, and all had contact with a MERS case-patient. One patient is healthcare worker, a 39-year-old man who is hospitalized in critical condition.

The others eight are all adults who range in age from 55 to 98. Six are men and two are women. Five are listed in stable condition, and three are listed as critical.

As of today, 33 people in Saudi Arabia are being treated for MERS-CoV infections, and 3 are in home isolation.

Latest fatalities

One of the four deaths reported in the past 3 days involved a newly reported case-patient, a 60-year-old Saudi man whose illnesses was detailed in yesterday's MOH statement.

The other three fatalities occurred in previously announced cases, two of them from Riyadh. The deaths that are part of the Riyadh outbreak involve a 56-year-old woman and a 50-year-old man, both of whom had underlying medical conditions.

The fourth death was reported yesterday in a 68-year-old man from Abha, located in southwestern Saudi Arabia. The MOH said he also had a preexisting health condition.

Overall outbreak metrics

Two more people, both from Riyadh, have recovered from their infections over the past few days, the MOH said. Over the course of the outbreak, which began in 2012, 590 people have recovered from MERS-CoV.

The 1,105 total cases include 479 deaths, the MOH noted in today's update.
http://www.cidrap.umn.edu/news-perspective/2015/08/thirteen-new-mers-cases-confirmed-riyadh-outbreak


Med- I haven't looked it up but I thought Haj was in September this year!
Do you think Mers has changed?

If the super spreader that took MERS to S. Korea had been going to India, Pakistan or any other over populated 3rd world country this would be a pandemic by now! That's why Haj is so worrying.

http://www.huffingtonpost.com/entry/mers-outbreak-prompts-saudi-arabian-hospital-to-close-emergency-ward_55d49363e4b055a6dab22d8b?kvcommref=mostpopular

RIYADH, Saudi Arabia (AP) -- Saudi authorities closed an emergency ward in one of the kingdom's largest hospitals after at least 46 people, including hospital staff, contracted the potentially fatal Middle East respiratory syndrome, also known as MERS, a health official said Wednesday.

Dr. Hanan Balkhi of the Health Ministry's department for infectious diseases said that of the 46 people infected at King Abdulaziz Medical City in the capital, Riyadh, 15 were medical staff. Another 20 people showing symptoms are being tested, she added.

comment: The infections have more than doubled.

Medclinician

http://www.scmp.com/news/world/article/1851185/three-dead-mers-cases-soar-saudi-arabia-ahead-haj-pilgrimage



A thermal camera monitor shows the body temperature of passengers arriving from overseas against possible Mers. Photo: AP

Three dead as Mers cases soar in Saudi Arabia ahead of hajj pilgrimage

Mers coronavirus infections have soared in Saudi Arabia ahead of the hajj pilgrimage, forcing the closure of a major hospital's emergency ward in Riyadh and killing three people, officials said.

The latest deaths occurred in Riyadh, and the victims were all Saudis aged between 65 and 86, the ministry said. That raises to 483 the number of deaths from 1,118 Mers infections in Saudi Arabia, where the virus first appeared in 2012.

This is a 43% case fatality ratio in diagnosed cases.

Medclinician

http://www.saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20150822254114

The first Haj flight from Indonesia carrying 436 pilgrims arrived at Prince Muhammad Bin Abdulaziz International Airport in Madinah Friday afternoon.

Indonesian Charge D’Affaires in Riyadh Sunarko and Consul General in Jeddah Dharmakirty Syailendra Putra welcomed the pilgrims, who arrived at 12:30 p.m. on board a Garuda Indonesia flight from Ujung Pandang, South Sulawesi.

comment: Travelers for the Hajj are beginning to arrive.

Medclinician

http://news.kuwaittimes.net/pdf/2015/aug/26/p05.pdf
Wednesday August 26, 2015 - Kuwait Times

KUWAIT: The United States embassy in Kuwait released
the following fact sheet that includes general guidelines
as well as health recommendations that Muslims intending
to perform Hajj or Umrah pilgrimage are advised to
take concerning the outbreak of the MERS virus in Saudi Arabia:
Hajj Fact Sheet

MERS Corona Virus Advisory

The US Department of State wishes to inform any US
citizens who may be considering travel to Saudi Arabia
for the Hajj (approximately September 21 - 26, 2015) and
ongoing Umrah, of Saudi government health recommendations
concerning the outbreak of Middle East
Respiratory Syndrome Corona Virus (MERS CoV) in the
country.

The Saudi government recommends that pilgrims
who have “chronic diseases such as heart, kidney,
and respiratory diseases, not to forget diabetes, as well as
patients with congenital and acquired immune deficiency,
in addition to patients suffering from tumors, and
pregnant women and children” postpone plans to participate
in the pilgrimage this year. These recommendations
were made by the Saudi government “to maintain
the public health and ensure a safe and healthy atmosphere.”
The full text of the statement may be found on
the Saudi Ministry of Health website. Interested parties
should review the US Centers for Disease Control and
Prevention (CDC) website for additional information
about the MERS CoV outbreak.

Medclinician

http://www.cidrap.umn.edu/news-perspective/2015/08/news-scan-aug-25-2015

MERS sickens eight more in Riyadh outbreak

Saudi Arabia's Ministry of Health (MOH) today reported eight more lab-confirmed Middle East respiratory coronavirus (MERS-CoV) cases, one of them fatal and all from Riyadh, where a large hospital-linked outbreak is ongoing. The MOH also said five case-patients announced previously have died from their infections.

All of the patients—five men and three women—are adults, with ages ranging from 30 to 81 years old. Two are foreign healthcare workers, a 30-year-old woman and a 51-year-old man. Exposure to confirmed or suspected contacts has been pinned down for one patient but is still under review for the other seven.

The newly confirmed patient who died was a 69-year-old woman. Among the other new cases, five are hospitalized in stable condition and two are listed as critical.

Meanwhile, the five deaths in previously announced case-patients are all from Riyadh and are adults ranging from ages 56 to 87. The group includes four men and two women. All five of them had underlying medical conditions, a common theme in people who die from MERS-CoV infections.

Currently, 57 people are still being treated for their illnesses and nine are on home isolation. Six recent patients from Riyadh have recovered from their MERS-CoV infections, raising the overall recovery number since the virus was first detected in 2012 to 598.

Medclinician

http://www.who.int/csr/don/27-august-2015-mers-saudi-arabia/en/

World Health Organization current report

Medclinician

https://english.alarabiya.net/en/News/middle-east/2015/09/02/Six-fresh-MERS-cases-two-deaths-in-48-hours.html

Two Deaths in 24 hours - September 2, 2015

Six new confirmed cases of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) and two deaths were registered during the past 48 hours, the Health Ministry announced.

It said the new cases and the two deaths were registered in Riyadh which has the highest number of the coronavirus cases.
The ministry said two patients have recovered and were discharged from a government hospital in Riyadh.

According to the ministry, a suspected case of coronavirus was reported at Prince Muhammad Bin Abdulaziz Hospital in Madinah and was immediately transferred to a government hospital in Riyadh.

The hospital’s department of information and public relations said it was not a confirmed MERS case but was transferred to Riyadh as a precautionary measure.

Medclinician

http://blogs.wsj.com/middleeast/2013/09/02/saudis-mers-concerns-grow-as-hajj-season-approaches/

Saudi Arabia continues to report sporadic new cases and deaths from a lethal new coronavirus, as hajj season in October — when the kingdom expects more than 3 million pilgrims from 187 countries –- approaches.

While the World Health Organization and most – but not all – international disease experts interviewed generally have commended the measures Saudi Arabia has put in place since the virus surfaced last year, interviews with visitors to the kingdom underscore what seems to be a gap in WHO-recommended health measures – public notices in Saudi Arabia of the disease, and of basic precautions against it.

“To be honest, we have no idea how to protect ourselves, how to prevent it,” one of two Japanese businessmen said last week at Riyadh’s airport. Like Muslim pilgrims and other visitors interviewed over the course of the summer, the two business people – who declined to give their names – said they came and left the kingdom without seeing or hearing any public health advisory on MERS.

Medclinician

comment: This is a disaster waiting to happen. A gathering of 3 million people in a place infected by a contagious virus is not good at all.

This virus can have up to a 50% fatality rate and all it takes is a mutation for it to be come more contagious.

http://www.ngrguardiannews.com/2015/09/anxiety-as-cases-of-deadly-mers-rise-in-saudi-arabia/

• Nigeria moves to protect own pilgrims
• WHO urges vigilance by states 

THERE is growing apprehension over the health of more than two million pilgrims participating in this year’s Hajj as the Saudi Arabia’s Health Ministry announced six new Middle East Respiratory Syndrome (MERS)-CoV cases in three different parts of the country.

A total of 76,000 Nigerians are expected to perform the spiritual exercise this year. More than 40,000 pilgrims from Nigeria are already in Saudi Arabia.

However, National Hajj Commission of Nigeria (NAHCON) through the Commissioner-in-charge of Health, Dr. Ibrahim Kana, has assured that adequate measures are being taken to protect Nigerian pilgrims.

Kana, who spoke with The Guardian yesterday, listed the measures to include increased awareness among pilgrims, setting up of surveillance unit that is working with Saudi Arabia officials, and warning that Nigerian pilgrims should avoid eating camel meat while in the holy land.

comment: With each coming of the Hajj pilgrimage there have been outbreaks and deaths in Saudi Arabia. Years later there is still no Pandemic. What has never been posted or said is that perhaps it did spread and just isn't that serious in the strain that went out to cause many deaths or be that much of a problem.

I currently am putting together a list of countries who have or have had MERS. This includes the U.S. - and is rather hard to find without a big of work.

Medclinician

arirish wrote: They are starting to report cases in Medina, which is the second holiest city in Islam and is visited by most Hajj pilgrims!

http://www.cidrap.umn.edu/news-perspective/2015/09/three-new-saudi-mers-cases-hint-medina-hospital-cluster

It is spreading. I am very concerned that this may be a variant or genetic recombination as  happened in China.  Since the formal numbers released are very small it is hard to know what other cases there are.  This one of the two primary cities - Mecca and Medina-  where more than ... it may be like 3,000,000 - pilgrims journey to.  Many tens of thousands have already arrived and countries are putting up health advisories about this.  Do we have a mutated form of the virus and could one become a super spreader like was in South Korea?

http://news.sciencemag.org/asiapacific/2015/06/superspreading-event-triggers-mers-explosion-south-korea

Medclinician

http://www.cidrap.umn.edu/news-perspective/2015/09/health-workers-among-3-new-saudi-mers-patients

Reflecting on the heavy toll that continued MERS-CoV activity is taking on medical staff, Saudi Arabia reported three more illnesses today, two of them in foreign healthcare workers in Riyadh.

The new MERS-CoV (Middle East respiratory syndrome coronavirus) infections come against the backdrop of an ongoing large hospital outbreak in the Saudi capital, as well as continued transmission in a handful of other cities, including Medina, one the country's holy cities set to host large crowds for the Hajj pilgrimage, which starts on Sep 20.

The two new cases in Riyadh, likely linked to an outbreak at King Abdulaziz Medical City, involve two women, ages 28 and 29. Both had contact with an earlier case and are hospitalized in stable condition, according to a statement today from the Saudi Ministry of Health (MOH).

So far 164 cases have been reported in Riyadh since Jul 21, a large portion of them associated with the hospital outbreak.

Medclinician

comment: Note the approach of Hajj on September 20th. This far more than other outbreaks of ones and twos we have seen. 

http://www.cidrap.umn.edu/news-perspective/2015/09/news-scan-sep-16-2015

Saudi Arabia reports 2 new MERS case, 1 death

Saudi Arabia's Ministry of Health (MOH) reported two new MERS-CoV cases in Riyadh today that don't appear to be linked to a large hospital outbreak, and it confirmed a death in a previously reported patient.

The new Riyadh MERS-CoV (Middle East respiratory syndrome coronavirus) cases involve a 21-year-old Saudi woman and a 38-year-old male expatriate. Both have mild respiratory symptoms and are listed in stable condition, the MOH said. Neither is a health worker, and neither had contact with another MERS patient.

The MOH also noted that a 70-year-old Saudi woman in Riyadh has died from her infection. She was not a healthcare worker and had pre-existing disease.

The agency also reported that three Riyadh patients have recovered from their infections, 51- and 63-year-old women and a 61-year-old man. All are Saudi nationals with underlying conditions and none are healthcare workers.

The new developments push the MERS-CoV total in Saudi Arabia since 2012 to 1,240 cases and 524 deaths. Forty-four patients are still undergoing treatment, 8 are in home isolation, and 664 have recovered.

Medclinician

Spread of MERS from Saudi Arabia

https://www.google.com/maps/d/viewer?mid=zv94AJqgUct4.kJ2r_J6Kj6Pg&authuser=0&vps=2&hl=en&ie=UTF8&oe=UTF8&msa=0

comment: very informative. I received a call from Henry Niman yesterday and got a lot more information on the recombination and the new strain of SARS which may have spread to China.
If was from two strains, on in Jiddah and the other in Riyadh. I posted earlier on this thread that the Chinese did a report in June 2015 and released it September 9th that the virus has recombined and that the new strain may be more contagious.

Medclinician

This is what is being reported. Let's hope that MERS backs off as the pilgrims arrive for the Hajj.

http://www.cbc.ca/news/health/mers-saudi-arabia-hajj-1.3234135?cmp=rss

A recent surge in cases of Middle East Respiratory Syndrome (MERS), a sometimes deadly virus, in Saudi Arabia has ebbed in the run-up to Islam's annual hajj pilgrimage, the kingdom's Health Minister Khaled al-Falih said on Thursday.

As pilgrims poured into Mecca from around the world, the Health Ministry said it had confirmed two more cases of the disease in Riyadh on Thursday, but the number of cases has declined since last month, Falih said.

"With the help of God and then with the measures taken by the ministry of health we hope to prevent the virus from getting to the pilgrims," said Falih in a news conference.

So far around 1.2 million Muslims have arrived in the kingdom for hajj.

Medclinician

comment: Always we should hope for the best and prepare for the worst. Although many people have caught this over the years, it still has been contained within medical facilities primarily with diligence and the tracking of those exposed. May God help those who are trying to stop and deal with this disease and doing their best to prevent it from spreading.

http://avianflutalk.com/new_reply_form.asp?PID=254445&PN=2&TR=37

MERS is not over in Saudi Arabia.

As about 2 million Muslims from across the globe gather in Saudi Arabia to launch the annual Hajj pilgrimage, the host country over the past 3 days reported three more MERS-CoV cases in as many cities.

And neighboring Jordan reported two more Middle East respiratory syndrome coronavirus (MERS-CoV) cases yesterday, raising its number of recent cases to 13.

Medical preparations for Hajj

In a statement today from its Eastern Mediterranean regional office, World Health Organization (WHO) officials acknowledged the threat from MERS-CoV and other health issues in such an immense mass gathering, thought to be the largest in the world.

comment: There are still new cases being confirmed in Saudi Arabia as well as Jordon. This is something that must be monitored on a daily basis and still has the potential for a more serious outbreak.

Medclinician

Thanks for keeping us posted, even about the "news blackout".

We will need to watch the news for western countries as the the pilgrims start returning to see if MERS was wide spread or just kept to a few hospitals. 

arirish wrote: Med- there's still a trickle of info coming out of KSA but you are right that the news organizations that are either owned or controlled by the royal family stop reporting it! Today the MOH reported 3 cases to WHO, two in Riyadh and one in a small town to the East of Riyadh. What worries me are the number of pilgrims this year going to hospitals, with the crane accident and now a stampede! Every pilgrim in hospital increases the odds of it being exported!

Arirish - there have been new cases and the outbreak continues in Riyadh.

http://www.cidrap.umn.edu/news-perspective/2015/09/three-saudi-mers-cases-survey-notes-knowledge-gaps-hajj-pilgrims

After 2 days with no new MERS-CoV cases, Saudi Arabia today announced three infections, two of them in Riyadh, as a survey found that people from Turkey who planned to make Hajj pilgrimages had little understanding of the disease and its risk factors.

One of the two cases reported from Riyadh is likely related to the hospital outbreak at King Abdulaziz Medical City. The patient is a 27-year-old female foreign healthcare worker who was exposed to the virus in a health setting, according to a statement from the country's Ministry of Health (MOH). She has an asymptomatic infection and is listed in stable condition.

The other individual is a 52-year-old Saudi woman who in stable condition and is a household contact of an earlier case. Since Jul 21, 170 cases have been reported in Riyadh, many with connections to the hospital outbreak.

The third case involves a 93-year-old Saudi man from Al-Oyoon, located in the east central part of Saudi Arabia. He is in stable condition, and the investigation into the source of his illness found that he had contact with camels.

Medclinician

arirish wrote: Med- What worries me about this year is the number of pilgrims being hospitalized! Between the crane collapse, a hotel fire and the stampede there has been over a thousand people admitted to hospital or seen in out patient clinics. This doesn't even count the ones who are just plain sick! Health facilities enable kidney patients to perform Haj with ... http://www.arabnews.com/node/318888 Patients on Hemodialysis Visiting Madina Munawarah http://www.sjkdt.org/article.asp?issn=1319-2442;year=2000;volume=11;issue=1;spage=31;epage=34;aulast=Mohamed Pilgrims all praises for healthcare services http://www.saudigazette.com.sa/index.cfm?method=home.regcon&contentid=20121030141201 This is just a small sample!

Arirish, there is a serious concern here because this virus seems to thrive and spread in a health care environment. While I am sure the health care in many areas of Saudi Arabia is good, it is unfortunate this recent disaster has put a greater load on some of the hospitals  and clinics.

Beyond the "who is allowing what to be known" as far as how many cases there are, this is a very contagious and lethal virus.

It has been estimated 1/3 of the people who get this die.

Also the history of accurate reporting on this is questionable. In one report last year in the Wall Street Journal it was said that there 50% more deaths compared to number reported to the media.

http://www.wsj.com/articles/saudi-arabia-mers-death-toll-nearly-50-higher-than-reported-1401900859

DUBAI—The MERS virus has caused nearly 50% more deaths in Saudi Arabia than has been officially reported, a review of medical data by Saudi health authorities shows.

comment: My last data from Sputnik which is a little more than  a month old gives these numbers

http://sputniknews.com/middleeast/20150819/1025905267.html

The statement released by the Ministry of Health on Tuesday, confirmed the death of a 71-year-old man living in the country’s capital Riyadh. The statement also reported about 9 other registered cases of the MERS. Therefore the number of infected people reached 1115 and the number of dead reached 480 since 2012.

This is not 30% but 43% CFR (case fatality rate)

Medclinician