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Paradigm Shift Intervention Monitoring
MERS Jeddah Export To The Hague The Netherlands
The above translation indicates the latest reported MERS export from the Kingdom of Saudi Arabia (KSA) is another Jeddah/Mecca export, increasing the total to eight in seven countries (Jordan, Malaysia, Greece, United Arab Emirates, Jordan, Egypt, United States, The Netherlands).
Three of these cases (two in Jordan, as well as the case in Greece) sought treatment in KSA for MERS symptoms, but were not diagnosed until they sought treatment in the importing country.
Three more (United Arab Emirates, United States, and Egypt) had exposure to hospitalized and/or MERS confirmed cases in Jeddah.
Two more (Malaysia and The Netherlands) developed symptoms shortly after returning from performing Umrah in Mecca and likely flew out of Jeddah).
In addition to the eight cases above, a case (4M) in Abu Dhabi developed symptoms after his mother returned from performing Umrah in KSA, while at least two pilgrims (from Turkey and Indonesia) were hospitalized and MERS confirmed while in KSA.
Six nearly complete sequences from patients in four hospitals in Jeddah and Mecca ((C8826 and C9055) collected on April 12 and April 14 from hospital A and C, respectively, as well as Mecca (C9355) collected on April 15. The three earlier sequences were from two hospitals ((C7149 and C7770 from hospital A collected on April 3 and 7, respectively as well as C7569 from hospital B collected on April 5) were virtually identical and match 25 partial Spike gene sequences from 25 additional patients in Jeddah. The match between 31 of 31 sequences in multiple hospitals in Jeddah and Mecca signaled widespread human to human transmission in and out of hospitals in Jeddah and Mecca.
The export of this novel sub-clade was confirmed by partial (Spike and N genes from Greece-Saudi Arabia_2014, from an April 18 oropharyngeal swab from the Jeddah export to Greece, 69M) or complete sequences from Orlando, Florida, Florida/USA-2_Saudi Arabia_2014 (44M) from the above Greece and United States imports, respectively.
The sequence match between 31 of 31 cases in Jeddah/Mecca with the exports to Greece and the United States raises serious pandemic concerns, WHO proclamations notwithstanding.