Saudi health authorities confirmed that an 81-year-old male has died from MERS-CoV (Middle East Respiratory Syndrome Coronavirus) infection, bringing the death toll in the kingdom to 33.

The Saudi Ministry of Health also confirmed that six new MERS-CoV infections have been registered, as experts from all over the world congregate in Cairo to discuss the SARS-like virus.

According to the World Health Organization and Saudi authorities, 55 people have become infected with MERS-CoV, of whom 33 died. Worldwide there have been at least 70 (confirmed) infections and 39 deaths.

On Friday, June 21st, a spokesman for the Saudi Ministry of Health announced that a woman, aged 41, in the capital Riyadh was in a stable condition with MERS-CoV infection. He added that a 32-year-old patient who also has cancer is being treated for confirmed MERS-CoV infection.

On Thursday, June 20th, four new cases were announced; they have all made a full recovery.

According to a team of experts from Johns Hopkins University who traveled to Saudi Arabia a few weeks ago, MERS-CoV is easily transmitted in hospitals and poses a serious public health threat. They published their findings in NEJM (New England Journal of Medicine).

They explained that MERS-CoV is far more deadly than SARS-CoV which infected more than 8,098 people in 37 countries, killing 774 of them in 2003. While SARS-CoV killed 10% of people it infected, the death rate for MERS-CoV is over 60%.

Trish Perl, MD, senior hospital epidemiologist for Johns Hopkins Medicine explained that MERS-CoV can transmit from person-to-person and circulate easily in a hospital setting with “considerable morbidity”.

Last month, Dr Margaret Chan, the Director-General of WHO (World Health Organization) described MERS-CoV as a threat to the entire world. Chan said this as she closed a 7-day international meeting on new public health measures and recommendations. As she surveyed the overall global health situation, Chan said “my greatest concern right now is the novel coronavirus“. WHO is concerned that “we understand too little” about MERS-CoV, when viewed against the magnitude of its potential threat.

MERS-CoV (Middle East Respiratory Syndrome Coronavirus) is a member of the coronavirus family. Coronaviruses cause respiratory illness in humans and other mammals and are responsible for approximately one third of all common colds.

MERS-CoV is a new coronavirus strain. The virus started infecting humans last year in the Middle East. It was first identified when a man in Saudi Arabia became ill with “SARS-like” symptoms. The patient died in June 2012. Very little is known about the virus – it is possible MERS-CoV was circulating before all this in Jordan (see further down).

A few months later, a Qatari man came down with SARS-like symptoms after a trip to Saudi Arabia. He was flown to the UK for further treatment. Lab tests confirmed MERS-CoV infection.

So far, confirmed cases of MERS-CoV infections have been confirmed in:

  • Saudi Arabia
  • Jordan
  • UAE (United Arab Emirates)
  • France
  • United Kingdom
  • Germany
  • Tunisia

Recent blood test results confirmed that eight people had MERS-CoV infection in a hospital outbreak in Zarqa, Jordan, in April 2012. Most of them had no pre-existing diseases or conditions, while one of them had no symptoms at all.

This is unusual, because most MERS-CoV infections affect people with pre-existing health problems, such as heart disease or diabetes. All cases of infection so far, except for this one Jordanian, have had symptoms.

The outbreak at the Jordanian hospital involved 11 patients, two of them died. The hospital stored their blood samples, which later were tested and confirmed that the two fatalities had been infected with MERS-CoV. The other cases could not be confirmed but were probably MERS-CoV, said WHO.

Antibody tests carried out recently by the CDC (US Centers for Disease Control and Prevention), at the request of Jordanian authorities, on 124 people related to the Jordanian cluster identified 8 mores cases of MERS-CoV infection, bringing the confirmed number of cases to 10.

The CDC says that of those eight MERS-CoV cases, six were healthcare workers, including the one with no symptoms.

Mark Pallansch, PhD, director of the Division of Viral Diseases, CDC, explained that if people can become infected and have no symptoms (not get ill), there may be people out there who are not sick unwittingly spreading the virus.

Ramadan, the Muslim month of fasting between sunrise and sunset, begins on July 9th, 2013. Towards the end of Ramadan approximately 2 million pilgrims from all over the world are expected at the holy city of Mecca.

Saudi Health authorities and WHO are concerned about so many people congregating in one place while a new, deadly coronavirus is in circulation. At the best of times controlling infectious diseases is an enormous challenge during such gatherings.

We know very little about MERS-CoV – we don’t know where it comes from, how many infected people without symptoms are walking around, or how human transmissible it is outside hospital settings. How many of the two million pilgrims will carry the virus back to their own countries?

Written by Christian Nordqvist