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Oman Confirms First MERS Case
Recombinomics Commentary 23:55
November 1, 2013

The patient in Oman is a 68-year-old man from Al Dahkliya region who became ill on 26 October 2013 and was hospitalized on 28 October 2013. Preliminary epidemiological investigations revealed that he did not recently travel outside the country.

The above comments from the latest WHO MERS update describe the first reported confirmed case in Oman.  Although some media reports cited development of symptoms while traveling outside of Oman, other reports, as noted in the WHO update, cite a lack of travel outside of the country.

The development of MERS inside Oman is consistent with the Kingdom of Saudi Arabia (KSA) comments noting that MERS is circulating in neighboring countries, but not reported because of limited surveillance.  Recent surveillance has increased because of the Hajj, which may have contributed to the detection of the above case.

Increased surveillance due to Ramadan may have also contributed to the first case confirmed in Qatar.  Although confirmation of MERS in Qatari citizens was reported in 2012, those cases were diagnosed in Europe (England and Germany).  Similarly, cases linked to the UAE were diagnosed in Germany and Tunisia, again highlighting surveillance failures in countries neighboring KSA.

However, Qatar identified a resident returning from Medina after Ramadan, as well as contacts of the Qatari. Similarly, Qatar also recently reported the first confirmed asymptomatic case, which nwas made recently, after the Hajj ended.

Thus, it is likely that MERS is widespread in Oman and detection was linked to increased surveillance.  Recent studies have also identified MERS antibodies in 100% of tested racing camels in Oman, supporting additional human cases. 

The recent nosocomial cluster in Jubail as well as the prior clustering in Al Hasa also supports widespread MERS in eastern KSA as well as adjacent countries including Kuwait, Bahrain, UAE, and Oman.

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