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Jordan UAE ex-KSA MERS Cluster Raises Concerns
Recombinomics Commentary 20:30
November 30, 2013

The director of health care at the Ministry of Health, Dr. Bassam Hijjawi that the tests conducted by the Public Health Authority in Abu Dhabi proved wounding three Jordanians residing there Corona virus, they are the same family (father, mother and child, 9 years old).
He said in a statement to «opinion» that the wife was hit in multiples of being pregnant and went into a coma as a result of the corona virus that causes respiratory syndrome,

Hijjawi said that contacts revealed that the patients went through Saudi Arabia before traveling to the UAE expected to be infected during their stay in Saudi Arabia

The above comments provide detail for a MERS confirmed cluster in United Arab Emirates (UAE) involving a Jordanian family who traveled through the Kingdom of Saudi Arabia (KSA) prior to hospitalization in Abu Dhabi (see map).  The two adults were announced by UAE state media and were cited in many reports (in Arabia and English), but the reports on the third family member (9M), the status of the wife (in a coma), and travel history (through KSA) are limited two a few local media reports.

The travel through KSA increases concerns that the number of KSA cases is significantly higher than those reported.  This concern began to rise at the end of Ramadan.  Although KSA failed to any MERS cases in pilgrims performing Umrah in KSA during Ramadan, a traveler (59M) returned to Qatar and was MERS confirmed (as were subsequent contacts in Qatar).  Although the traveler was not performing Umrah, he was infected in Medina, where additional local cases were reported by KSA, but these cases were also not cited as pilgrims.

Similarly KSA failed to report MERS in any pilgrims attending the Hajj, but two pilgrims returned to Madrid, Spain and were MERS confirmed.  The index case (61F) developed symptoms shortly after arriving in Mecca from Medina.  She subsequently sought medical attention in Mecca and was pneumonia confirmed by X-ray, but she refused treatment in KSA and flew to Madrid from Jeddah.  A travel companion was also confirmed. But details on the second case were limited, although the recovery of both cases was reported.

The reports of these two pilgrims was followed by a report of MERS in a Jeddah resident (43M), which was followed by reports of MERS confirmation in a symptomatic camel owned by the Jeddah case.  This cluster, like the cluster in Medina following Ramadan raised concerns that these cases were directly or indirectly linked to traveling pilgrims.
These events linked to western KSA were followed by reports in countries adjacent to eastern KSA.  Oman reported its first confirmed case, who had contact with relatives who had just returned from the Hajj.  Another Omani sought treatment in UAE, where he was MERS confirmed.  Kuwait then reported its first two confirmed cases and at least one had returned from KSA.

The travel through KSA by the Jordanian family hospitalized in UAE raises concerns that the export of MERS from KSA is increasing following the Hajj.

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