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Dhaka Bangladesh MERS ex-New York USA
Recombinomics Commentary 07:15
June 16, 2014

The condition of the unidentified 53-year-old man had improved but he was still in intensive care in a Dhaka clinic, Mahmudur Rahman, the director of the Institute of Epidemiology, Disease Control and Research, told AFP.”He is Bangladesh-born but lives in the US.

He came to the country on June 4 and became sick two days later. Most probably he contracted the virus during the three hours at Abu Dhabi airport or in the plane,” he said.

The above comments describe the first confirmed MERS case in Bangladesh.  The patient arrived from New York, via a connection in Abu Dhabi.  Disease onset 48 hours after arrival signals an infection in the originating country.  Although an infection could have occurred during flight or during the brief layover, both are unlikely.  No MERS transmission during flight or airport layover has been cited previously and since the typical incubation period is from 2-5 days, infection while in the United States (New York) is the most likely source.
The US has reported two MERS cases to date, which represent the two sub-clades identified in 2014 cases.  One sub-clade has been found in Jeddah and Mecca, as well as exports to Athens, Greece and Orlando, Florida
(Florida/USA-2_Saudi Arabia_2014).  The other sub-clade has been identified in exports to Munster, Indiana (Indiana/USA-1_Saudi Arabia_2014) and Amsterdam, Netherlands.  These latter exports are linked to Medina and Riyadh in Saudi Arabia, but sequences from the record number of cases in both cities has been withheld.

Thus, the United States is the only country in the world with confirmed sequences from both sub-clades.  More detail on contacts and history in New York would be useful.

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