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MERS-CoV Cluster In Italy ex-Jordan
Recombinomics Commentary 17:30
June 1, 2013

 The patient was in good condition and was being monitored in isolation, the ministry said in a statement. He was admitted to a hospital in Tuscany with a high fever, a cough and breathing difficulties.

A resident of Italy with foreign nationality, the man recently spent 40 days in Jordan where one of his sons was suffering from an unspecified flu.

The above MERS-CoV cluster increases the number of examples of export of the coronavirus from the Middle East to Europe or Africa.  The case in Italy (45M) is confirmed, while his son in Jordan is a suspect case (see map).  This export of a confirmed MERS-CoV case via commercial airline to Italy from Jordan follows similar exports from Qatar/ Saudi Arabia to Tunisia, UAE to France, and Saudi Arabia to England.  In addition, there was a suspect export from UAE to Morocco.  Additional cases which began in the Middle East were confirmed and treated in Europe including Saudi Arabia/Qatar to England, Qatar to Germany, and UAE to Germany.  Moreover, the first confirmed case from Saudi Arabia was diagnosed in the Netherlands and the ICU cluster in Jordan was confirmed in Egypt.  Similarly, a case diagnosed in Saudi Arabia developed symptoms while in Egypt.

The increase in exports has been dramatic with confirmed or suspect cases imported into France, Tunisia, Morocco, and Italy (all by commercial airline).  None of the exporting countries (UAE, Qatar, Jordan) have reported a case identified by surveillance.  Jordan’s ICU cluster began in March, 2012 and was identified by NAMRU-3 in Egypt.  The dramatic increase in exports in countries surrounding Saudi Arabia, as well as the high case fatality rate for case in Saudi Arabia, indicate only a small portion of cases are being detected or reported.

Although WHO issues updates almost daily citing new confirmed case and reminding countries to conduct surveillance and report cases, these updates are actively ignored. 

Several of the exported cases have travel to Saudi Arabia to perform Umrah, and the traffic will increase in the near term because of Ramadan in July.  However, WHO ineffectiveness in provide any real numbers on the breadth and number of MERS-CoV infections continues to place the world’s health in extreme peril.

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