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Saudi Arabia SARS-CoV Closely Related To Bat Coronaviruses
Recombinomics Commentary 23:15
September 24, 2012

The virus RNA was tested also in Dr. Ron Fouchier's laboratory in the Netherlands and was confirmed to be a new member of the beta group of corononaviruses, closely related to bat coronaviruses.

The above comments from Ali Mohamed Zaki of Dr Fakeeh hospital in Jeddah, Saudi Arabia (as posted at ProMED) indicate the SARS CoV from the fatal case in Saudi Arabia is closely related to the SARS CoV that caused the SARS outbreaks in 2002 and 2003.  The more recent case (Qatar via Saudi Arabia was 99.5% identical based on a short sequence of about 200 BP, as noted by the HPA in the UK.  This second cases is in critical condition with renal failure, which was also confirmed in the index case.  Additional severe cases from the Middle East are under investigation.

The similarities with the 2003 outbreak raise concerns.  The international spread in February, 2003 was largely linked to a physician who had been infected after treating cases in Guangdong Province.  He came to Hong Kong for a wedding and stayed in room 911 at the Metropole Hotel where he infected multiple visitors / tourists on the 9th floor, who spread the virus to Hong Kong, Singapore, Vietnam (Hanoi), and Canada (Toronto).

The link of the rapid spread outside of mainland China to a single case raises concerns that the two confirmed and multiple suspect cases linked to Saudi Arabia may represent a similar situation.  The SARS-CoV from the 2003 outbreak had been infecting patients in Guangdong Province in late 2002, but the Hong Kong physician precipitated the global expansion, raising concerns that the upcoming Hajj in Saudi Arabia may pose a significant world health risk.

Release of the sequences from the labs in the Netherlands and UK would be useful.

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