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MERS-CoV KSA Western Spread Raises Ramadan Concerns
Recombinomics Commentary 12:15
June 15, 2013

The first case is a Saudi citizen in Taif governorate, aged 65 who is suffering from chronic diseases, and still at ICU receiving the proper treatment. The Second one is a Saudi female citizen in Taif governorate, aged 68 who is suffering from chronic diseases as well, and still at ICU receiving the proper treatment. However, the third case is a resident, aged 46 in Wadi Al-Dawaser, who passed away today

The above comments from the KSA-MOH website on MERS-CoV describe three newly confirmed cases, which are in addition to the three cases described in the latest WHO update which describes cases in eastern KSA (see map).  Recent hospital outbreaks have accounted for the vast majority of recent cases in the east and four full sequences from cases in Al Hufu (
Al Hasa 1/2013, Al Hasa 2/2013, Al Hasa 3/2013, Al Hasa 4/2013) have been virtually identical to each other confirmed human to human transmission in the hospital which was similar to SARS-CoV spread in 2003. 

Moreover, the close relationship to the index case (
England2/2013, who developed symptoms while performing Umrah in KSA and was subsequently linked to the England onward transmission) provided more evidence for MERS-CoV evolution in humans. 

The above three cases are from central and western KSA including the two cases in Taif, which is near Mecca (see map).
Ramadan begins in three weeks and the influx of pilgrims into the western region of KSA has raised serious concerns about subsequent export of MERS-CoV by departing pilgrims in August.

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