WHO Update On Jordanian MERS Cluster

Credit WHO

 

#10,477

 

The World Health Organization has released an update (h/t @lisaschnirring) on the first 4 cases of the Jordanian MERS cluster which we’ve been following for a week,  and which now numbers 6 cases.  As suspected, this cluster appears to have begun with an imported case, but has since spread within a healthcare facility and in one case,  to a contact of one in that facility.

The index case was treated, and released after a week, from a hospital in Amman.  He relapsed, and was admitted to another hospital five days later, where he tested positive for MERS two days post-admission, and died two days later. 

 

During this symptomatic period of roughly two weeks prior to being properly diagnosed, there appear to have been ample opportunities for others to be exposed.  Where he contracted the virus is unknown at this time.

 

Two of the other three cases are described as having been admitted to the same hospital as this index case, but there is no documentation of direct exposure to, or contact with, the first case  One case (#4) is a contact of one of those hospitalized cases (#2). 

 

Patterns of spread similar to those we’ve seen in other hospital outbreaks both in the Middle East and South Korea.

 

Middle East Respiratory Syndrome coronavirus (MERS-CoV) – Jordan

Disease outbreak news
1 September 2015

Between 26 and 28 August 2015, the National IHR Focal Point of Jordan notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including 1 death. All these cases are associated with a MERS-CoV outbreak currently occurring in a hospital in Amman city.

Details of the cases

1. A 60-year-old male living in Jeddah city, Saudi Arabia travelled to Amman city, Jordan on 28 July. He developed symptoms on 31 July and, on 10 August, was admitted to hospital. The patient, who had comorbidities, was treated symptomatically and discharged on 18 August. As symptoms relapsed, on 20 August, the patient was admitted to another hospital in Amman on 23 August. He tested positive for MERS-CoV on 25 August and passed away on 27 August. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
2. A 38-year-old male from Kuwait city, Kuwait travelled to Amman city, Jordan on 7 August. He developed symptoms on 12 August and, on 17 August, was admitted to the hospital where a laboratory-confirmed MERS-CoV case was hospitalized (case no. 1 – see above). Since his arrival in Amman city, he frequently visited a family member at the same hospital. The patient, who has no comorbidities, has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He tested positive for MERS-CoV on 26 August. Currently, the patient is in critical condition in ICU. Investigation of possible epidemiological links with the index case or with shared health care workers is ongoing.
3. A 76-year-old male from Amman city developed symptoms. On 16 August, due to his chronic condition, the patient was admitted to the hospital where a laboratory-confirmed MERS-CoV case was hospitalized (case no. 1 – see above). He was discharged on the same day. On 20 August, the patient was admitted to the same hospital for a medical procedure for his chronic condition and, on 24 August, was discharged. On 25 August, he developed symptoms and was admitted to the same hospital. The patient tested positive for MERS-CoV on 25 August. Currently, he is in critical condition in ICU. Investigation of possible epidemiological links with MERS-CoV cases admitted to his hospital or with shared health care workers is ongoing.
4. A 47-year-old female from Kuwait city, Kuwait travelled to Amman city, Jordan on 15 July. She was identified through the screening of contacts of a laboratory-confirmed MERS-CoV case (case no. 2 – see above). The patient, who has no comorbidities, tested positive for MERS-CoV on 27 August. Currently, she is asymptomatic in home isolation. The patient visited her family members at the hospital where a laboratory-confirmed MERS-CoV case was hospitalized (case no. 1 – see above). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.

Contact tracing of household contacts and healthcare contacts is ongoing for these cases. The National IHR Focal Point of Jordan informed the National IHR Focal Point for the Kingdom of Saudi Arabia about the index case to trace contacts in Saudi Arabia.

Globally, the WHO has been notified of 1,478 laboratory-confirmed cases of infection with MERS-CoV, including at least 516 related deaths.