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MERS In Hajj Pilgrim Raises Transparency Concerns
Recombinomics Commentary 23:30
November 6, 2013

According to the director explained how the Coordinating Center and Emergency Health Alerts, Fernando Simón, it is "a woman of 61 years who was in Saudi Arabia between October 2 and November 1" and "initiated a respiratory symptoms with fever and cough on 15 October. "

After that, "the 28 and October 20 began a process in which he was diagnosed with pneumonia in a hospital in Saudi Arabia." Later, Simon explained that she "traveled back to Spain on November 1 and was diagnosed back in Puerta de Hierro".

The above translation provides additional information on the Hajj pilgrim (61F) who was MERS confirmed in Spain (see map).  She developed symptoms on October 15, during the Hajj.  Although the hospital in the Kingdom of Saudi Arabia (KSA) diagnosed pneumonia, they failed to identify the etiological agent, which was done is Spain.

Consequently, the pilgrim returned to Spain, leading to significant exposure of other passengers as well as contacts in Spain, including health care workers.  However, the vast majority of Hajj pilgrims did not come from Spain raising concerns that MERS was widely dispersed, although only Spain has reported a confirmed case and all recent confirmed cases in KSA were in Riyadh and the Eastern Region (primarily Jubail).

Many countries reported symptomatic returning pilgrims, but all reported cases were negative, including a fatality in Egypt who was H1N1pdm09 confirmed.

Detection of MERS is a challenge as seen by the failure of KSA to identify MERS in any of the millions of pilgrims participating in the Hajj.  The Spain pilgrim was hospitalized with pneumonia, which is similar to the Al Hasa outbreak where 11 cases were classified as probably because they had pneumonia and contacts with a confirmed MERS case, but were either not tested or only tested once.

The current confirmed case in Spain raises concerns that MERS was widely dispersed from KSA and largely missed by receiving countries.

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