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Date: Sunday, May 5, 2013, 11:18 PM
From: Ziad Memish
Subject: Urgent follow up re nCOV cluster in Alhassa KSA
Dear colleagues,
As a follow up to the most recently reported 10 case cluster of nCOV in Alhasa in the Eastern Province of KSA. Our investigation is still ongoing and we picked up 3 more cases:
Case 11: 62 year old female with multiple comorbidities. Start of symptoms [19 Apr 2013] and deceased [3 May 2013]
Case 12: 71 year old male with multiple comorbidities. Start of symptoms [15 Apr 2013], deceased [3 May 2013]
Case 13: 58 year old female with comorbidities. Start of symptoms [1 May 2013] and currently ventilated in critical but stable condition.
So far there is no apparent community transmission and transmission seem linked to one HCF [health care facility].
We will keep you posted on progress
--
Ziad A Memish MD, FRCP(Can), FRCP(Edin), FRCP(Lond), FACP
Deputy Minister for Public Health
Director WHO Collaborating Center for Mass Gathering Medicine
Ministry of Health
Professor, College of Medicine
Alfaisal University
Riyadh 11176
Kingdom of Saudi Arabia
[ProMED-mail would like to thank Dr Memish for sharing this information on the 3 new cases associated with the cluster of severe acute respiratory illness (SARI) cases in Alhasa, Eastern Province.
As enumerated in the above report, there are now 13 cases associated with this cluster, 7 of whom have died (54 per cent). As with the 10 previously reported cases, all 3 of these have existing comorbidities. The statement from the above report -- "So far there is no apparent community transmission and transmission seem linked to one HCF [health care facility]" supports a conclusion that this outbreak is a nosocomial outbreak, and the reason that all confirmed cases to date have had existing comorbidities is that they were presumably infected with the nCoV while hospitalized in this HCF for other pre-existing illnesses.
The dates of onset of the 13 cases in the cluster in Alhasa are:
1 case on 14 Apr 2017;
1 case on 15 Apr 2013;
2 cases on 17 Apr 2017,
1 case on 19 Apr 2013;
4 cases on 22 Apr 2013;
1 case on 27 Apr 2013;
1 case on 28 Apr 2013;
1 case on 30 Apr 2013;
1 case on 1 May 2013.
As for route of transmission within the hospital, we await findings of epidemiologic investigations currently under way.
As of today, 5 May 2013, the breakdown of total confirmed cases of SARI associated with infection with the nCoV (and deaths) by country of report is:
- Saudi Arabia: 22 (13 deaths)
- Jordan: 2 (2 deaths)
- UK: 4 (one patient from Qatar -- under treatment, 3 patients from UK -- one with history of travel to Saudi Arabia and Pakistan prior to illness; one recovered, 2 deaths)
- Germany: 2 (one patient from Qatar -- discharged, one patient from the UAE -- one death).
Including the 3 newly confirmed cases, there are now 30 confirmed cases with 18 deaths (60 per cent CFR).
For the HealthMap/ProMED map of Saudi Arabia and the surrounding countries, see http://healthmap.org/r/1HAJ. For a map showing the location of Al-Ahsa, see http://en.wikipedia.org/wiki/Al-Hasa, and for maps of Saudi Arabia showing provinces, see http://mapsof.net/map/saudi-arabia-r...p#.UYPOLkqxnts and http://mapsof.net/map/saudi-arabia-2...p#.UYPOpUqxnts. Note that Riyadh (where earlier cases were reported) is not far from the location of Al-Ahsa. - Mod.MPP]
