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Beta2c Coronavirus Cluster In Al-Ahsa Grows To Ten
Recombinomics Commentary 18:00
May 3, 2013

 1:  59M symptoms [14 Apr 2013] died [19 Apr 2013].
 2:  24M symptoms [17 Apr 2013] ICU in critical but stable condition.
 3:  87M symptoms [17 Apr 2013] died [28 Apr 2013].
 4:  58M symptoms [22 Apr 2013] ICU in stable but critical condition.
 5:  94M symptoms [22 Apr 2013] died [26 Apr 2013].
 6:  56M symptoms [22 Apr 2013] died [30 Apr 2013].
 7:  56M symptoms [22 Apr 2013] died [29 Apr 2013].
 8:   53F  symptoms [27 Apr 2013] stable but critical condition
 9:   50M  symptoms [30 Apr 2013] with pneumonia inpatient ward.
10:  33M* symptoms [28 Apr 2013] Inpatient ward and doing well
 *Family contact of fatal case

The above summary of nCoV cases in Al Ahsa provided by Ziad A Memish to ProMED includes age, gender and disease onset dates which suggest multiple rounds of human to human transmission of the SARS-like  nCoV (see map).

However, the relationship of the first nine cases to each other is unclear.  The 10th case is a relative of one of the fatal cases.  The first seven cases were in the WHO update, while the last three were listed in ProMed.  These three cases have a gap of at least five days with the prior cases, raising concerns that they represent a new and larger round of infections in cases not yet confirmed.

This cluster already includes five fatal cases and is likely to grow into the largest cluster of confirmed nCoV cases reported to date. 

More information on the relationships between the first 9 cases would be useful. 

Like the prior cases the above cases are predominantly adult males.

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