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Another Hospital MERS-CoV Cluster In Eastern KSA
Recombinomics Commentary 12:45
May 30, 2013

The first patient is a 56-year-old man with underlying medical conditions, who became ill on 12 May 2013 and died on 20 May 2013. The second patient is an 85-year-old woman with underling medical conditions who became ill on 17 May and is currently in critical condition. The third patient is a 76-year-old woman with underlying medical conditions who became ill on 24 May 2013 and was discharged from the hospital on 27 May 2013. The fourth patient is a 77-year-old man with underlying medical conditions who became ill on 19 May and died on 26 May 2013. The fifth patient is a 73-year-old man with underlying medical conditions who became ill on 18 May and died on 26 May 2013.
The above comments are from the May 29 WHO MERS-CoV update, which includes disease onset dates as well as age and gender data (see map).  The cases are more recent and represent another coronavirus hospital outbreak in the eastern province.  Media reports cite a new (but unnamed hospital) at a new (but unnamed location) location in the eastern region. 

However, earlier reports noted the transfer of cases from the Al Hofuf to Dammam area and it is likely that this new outbreak involves the hospitals in Al Qatif or Dhahran.  Regardless of the specific hospital, the new cases signal increased human to human transmission, which is the source of most or all of the MERS-CoV cases.

The recently released disease onset dates for the hospital outbreak in Jordan as well as the earlier outbreak in Al Hofuf involve health care workers and hospital cases which are similar to the 2003 SARS-CoV outbreaks.  The initial international spread was linked to the Metropole Hotel in Hong Kong and international travelers, and similar patterns have also been noted for travels from the Middle East to England, France, and Tunisia.
The striking parallels between MERS-CoV and SARS-CoV are clear and the high case fatality rate indicates only a small sub-set of cases are being detected / reported.

The failure to detect or report the milder cases remains hazardous to the world’s health.

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