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Another Confirmed Riyadh Beta2c Coronavirus Cluster
Recombinomics Commentary 14:00
March 23, 2013

The patient is a contact of the previous case reported in the Disease Outbreak News on 12 March 2012. This person suffered a mild illness, and has recovered and been discharged from hospital. Currently, there is insufficient information available to allow a conclusive assessment of the mode and source of transmission.

The above comments, describing the second Riyadh nCoV cluster, are from the latest WHO cornavirus update.  This case forms the fourth confirmed cluster, which accounts for 10 of the 16 confirmed cases, as well as all 11 of the probable nCoV cases.  However, as was seen for the two clusters from Riyadh, Saudi Arabia, as well as the Jordan cluster (SARS-like linked to health workers in ICU), WHO has withheld disease onset dates, age and gender, as well as relationships for the confirmed and probable cases linked to the index cases.

For the second Riyadh cluster, the index case (39M) was fatally infected and had a link to a farm, based on media reports.  However, there has been no evidence supporting a closely related nCoV in any animal, including bats, which have been shown to be infected with distantly related beta2c coronaviruses.

The disease onset dates or dates of death fully support human to human transmission, as does the concentration of confirmed and probable cases in clusters.  The human transmission is also fully supported by full sequences from three of the confirmed cases, including the index case for the UK cluster, as well as partial sequences for two additional cases.  The humans cases have virtually identical sequences and most have no linkage to animals.

However, instead of providing key data for the confirmed and probable cases in these clusters, WHO has mounted a twitter campaign denying sustained transmission of a novel coronavirus that has been transmitting in humans for many years.

Release of disease onset dates for confirmed and probable cluster members in the Middle East is long overdue.

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