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Another MERS Super Spreader In Eastern Region KSA?
Recombinomics Commentary 14:30
November 1, 2013

"Al- Watan" sources of responsible health East , that the hospital , who scored the deaths of the three disease governorate of Al Jubail reservations as well as currently 3 other cases in the isolation of intensive care two days ago , including a girl of 15 years old , while Taatjaozat cases other two sixth decade of age , stressed sources also that the detention of the three cases does not mean a record sure to HIV infection , but they are suspected cases just yet, which raised analyzes three cases to the central laboratory in Dammam was not sure yet of the final result ,

The above translation suggests 2 or 3 additional symptomatic cases in Jubail are being MERS tested, raising concerns that the index case (54M) is another eastern region super spreader (see map).  Although neither the Kingdom of Saudi Arabia Ministry of Health (KSA-MoH) nor WHO has confirmed his death (which was widely reported in local media last week), his origin from Riyadh was acknowledged, raising concerns that he is linked to the Riyadh case (73M) announce within a day of his announcement.  Media reports indicate the index case visited clinics in Riyadh and Al Kobar prior to his arrival in Jubail.

One (49M) of the three cases announced earlier by KSA-MoH has not been cited in media reports describing the cases in Jubail, raising the possibility that the case was in the eastern province, but not in Jubail.  Similarly, the health care worker (56M) who was Jubail may have been transferred there, and thus may have been infected in Al Kobar also.

The first announced death (83F) by the KSA-MoH is a case who was hospitalized in Jubal for deep vein thrombosis a month prior to developing MERS symptoms, suggesting she was infected in the hospital by the index case.  Similarly, the second death (56F) acknowledged by KSA-MoH also had contact with a confirmed case, suggesting she was infected directly or indirectly by the index case.

It is also likely that the three ICU cases cited in the above translation were also infected directly or indirectly by the index case, raising concerns that he was a super spreader.

More detail on contact between the index case and the most recent case from Riyadh, the other four confirmed cases in the eastern region, and the three cases cited in the translation above (and additional cases under investigation in Riyadh or Al Kobar) would be useful.

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