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Published Date: 2016-01-25 20:46:25
Subject: PRO/AH/EDR> MERS-CoV (10): Saudi Arabia (MK), Thailand ex Oman, RFI
Archive Number: 20160125.3964309

MERS-COV (10): SAUDI ARABIA (MAKKAH), THAILAND ex OMAN, REQUEST FOR INFORMATION
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A ProMED-mail post
http://www.promedmail.org
ProMED-mail is a program of the
International Society for Infectious Diseases
http://www.isid.org

In this update:
[1] Saudi Arabia, 2 new asymptomatic infections - Saudi MOH
[2] Thailand ex Oman (more details) - media report, RFI
[3] Thailand, airport screening - media report

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[1] Saudi Arabia, 2 new asymptomatic infections - Saudi MOH
Date: 25 Jan 2016
Source: Saudi MOH [edited]
http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2016-01-25-001.aspx


As of 12 PM today [25 Jan 2016] there have been a total of:
1289 cases of laboratory confirmed MERS-CoV infection including:
551 deaths [reported case fatality rate 42.7 percent],
731 recoveries,
4 currently active cases,
3 asymptomatic cases.

On 24 Jan 2016, there were 2 newly confirmed infections in Alkhumra, both of whom had a history of contact with camels:
One is a 21-year-old expat male, the other is a 45-year-old expat male. Both were reported to be asymptomatic [details available at http://www.moh.gov.sa/en/CCC/PressReleases/Pages/Statistics-2016-01-24-001.aspx - Mod.MPP].

No additional cases, deaths or recoveries were reported today [25 Jan 2016].

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[While specific information is not provided, I suspect that these 2 newly confirmed infections were in individuals working in the camel farm in Alkhumra where 11 infected camels were identified (see MERS-COV (08): Thailand ex Oman, Saudi Arabia corr 20160124.3962172, and MERS-CoV (07): Saudi Arabia 20160123.3959982 for more details on the camel outbreak).

Another change has been added to the MOH website this week showing the number of new cases reported with history of direct or indirect contact with camels and those without history of contact with camels. It's interesting that of the 15 cases of MERS-CoV infection reported by Saudi Arabia since 1 Nov 2015, only 2 (13.3 percent) were reported as secondary healthcare acquired cases, whereas 13 (86.7 percent) were reported as primary cases with history of contact with camels.

A map showing the location of Alkhumra can be found at the source URL.

The HealthMap/ProMED map of Saudi Arabia can be found at http://healthmap.org/promed/p/131. - Mod.MPP]

******
[2] Thailand ex Oman (more details) - media report, RFI
Date: 25 Jan 2016
Source: Bangkok Post [edited]
http://www.bangkokpost.com/travel/tourists-and-expats/837572/ministry-confirms-second-mers-case


The Public Health Ministry on Sunday [24 Jan 2016] announced the country's 2nd confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV).

The patient is a 71-year-old man from Oman who travelled to Thailand last Friday [22 Jan 2016] after he was treated at a hospital in that country for about one week for fever and a cough, according to Public Health Minister Piyasakol Sakolsatayadorn.

The man tested positive for [the MERS-CoV] at Bumrungrad and Chulalongkorn hospitals.

The man was referred to the Bamrasnaradura Infectious Diseases Institute on Saturday [23 Jan 2016] at 6:20 pm, and another laboratory test by the Medical Science Department confirmed he had contracted [MERS-CoV].

Dr Piyasakol said the Omani man is now being quarantined at the Institute's Diseases Control Department.

The Public Health Ministry is looking for people who had contact with the patient. They include a relative who accompanied the man, 218 crew and passengers who are still in Thailand, a taxi driver, a hotel employee, and 30 hospital staff.

These people will be kept under close surveillance for 14 days. Of this group, 37 are categorised as high-risk. They are the patient's relative, 23 air passengers, the taxi driver, the hotel employee, and 11 hospital staff, Dr Piyasakol said. Those in the high-risk grouping will be quarantined, he said.

Government spokesman Sansern Kaewkamnerd said Prime Minister Prayut Chan-o-cha has been informed of the latest case in Thailand and asked Thais not to panic about it because steps in place to detect the disease and prevent its outbreak are effective and internationally recognised.

Maj Gen Sansern said the prime minister asked people to pay more attention to their own health. If they have a fever, a cough, a feeling of vibrations in the chest when breathing and diarrhoea, they should consult a doctor or call the Disease Control Department hotline at 1422 around the clock. ...

Thailand confirmed its 1st case of [MERS-CoV infection] on [18 Jun] last year [2015]. The patient was also a 75-year-old male who travelled en route from Oman to Thailand. He was treated and declared free of the virus and was eventually allowed to leave the kingdom. The disease did not spread to any other person.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[This article was included as it contained more information on this case than was available in earlier press releases. Of interest is that the patient reported was ill and hospitalized in Oman for a week preceding the travel to Thailand, a similar history as given by the 1st reported case in Thailand, also from Oman, back in June 2015 (see prior ProMED-mail reports listed below). The 1st reported case (a 75-year-old male) had travelled to Thailand for treatment of a "heart condition" (travel that is referred to commonly as "medical tourism") and had a history of having been hospitalized in Oman prior to travel to Thailand. Information on this current case (a 71-year-old male) indicates that apparently he was also hospitalized in Oman prior to travel to Thailand for medical treatment (type of treatment sought not presently available). One can't help but wonder whether these individuals were infected while in the hospital(s) in Oman, having sought medical care initially for other medical reasons, or whether they were hospitalized for MERS-CoV-consistent symptoms in Oman. Either explanation suggests that there is quite possibly undiagnosed MERS-CoV illness occurring in Oman resulting in healthcare associated transmission.

Of additional note is that Oman reported its 7th confirmed case of MERS-CoV infection in a 44-year-old male on 4 Jan 2016 (see prior ProMED-mail reports listed below). It would be of interest to know whether the current case (the 71-year-old male traveller to Thailand) had been admitted to the same hospital in Oman where the 44-year-old case had been admitted. More information on the epidemiologic investigation of this case in both Thailand and Oman would be greatly appreciated.

The HealthMap/ProMED map of Oman is available at: http://healthmap.org/promed/p/124,
The HealthMap/ProMED map of Thailand is available at: http://healthmap.org/promed/p/151. - Mod.MPP]

******
[3] Thailand, airport screening - media report
Date: 25 Jan 2016
Source: Bangkok Post [edited]
http://www.bangkokpost.com/news/general/838696/suvarnabhumi-isolates-middle-east-flights-for-mers-checks


Airports of Thailand Plc (AoT) has reserved 2 concourses at Bangkok's Suvarnabhumi airport for flights from the Middle East to effectively screen passengers for Middle East respiratory syndrome [MERS].

AoT president Nitinai Sirismatthakarn said on Monday [25 Jan 2016] that as another MERS patient had arrived in Thailand from the Mideast, planes arriving from the region would now be directed to concourses E and G.

There, special screening stations equipped with thermal scanners and staffed by experienced officials were set up to observe the condition of each passenger, he said.

In addition, AoT and disease-control officials asked airlines and the Airline Operators Committee to help pre-screen passengers travelling from where [the MERS-CoV] has spread so those with suspicious symptoms could be treated quickly. Passengers on such flights would receive written instructions and warnings related to [MERS-CoV.]

The measures were implemented at Suvarnabhumi airport because most flights from the Middle East landed there, Mr. Nitinai said.

AoT also is screening passengers at its airports in Bangkok (Don Mueang airport), Chiang Mai, Chiang Rai, Phuket and Songkhla (Hat Yai airport) provinces where thermal scanners were applied to identify travellers with high temperatures, he said.

Finally, hand sanitisers were distributed in airport areas where travellers gathered, including information booths, form-filling spots and taxi stands. Workers were cleaning surfaces people touched, such as luggage trolleys and handrails, Mr. Nitinai added.

--
Communicated by:
ProMED-mail
<promed@promedmail.org>

[According to one of the Thai websites, in 2012, there were approximately 664 000 tourists arriving in Thailand coming from the Middle East (see http://www.thaiwebsites.com/tourism-income-Thailand.asp and http://www.thaiwebsites.com/tourists-nationalities-Thailand.asp. Official data from the Tourism Authority of Thailand is not available for years after 2007 http://www2.tat.or.th/stat/web/static_download.php?Rpt=cre). This contrasts with statistics contained on a Wikipedia report stating that Suvarnabhumi airport handled over 53 million passengers in 2012 (https://en.wikipedia.org/wiki/Suvarnabhumi_Airport), an enormous undertaking, especially since concourse E and G are also used for flights not arriving from the Middle East (I have arrived from further east in Asia at gates on concourse E and G in Suvarnabhumi airport). A map showing the airport concourses can be seen at http://www.bangkokairportonline.com/node/33. - Mod.MPP]

See Also

MERS-CoV (09): Saudi Arabia, animal reservoir, camel, vaccination considered 20160125.3963370
MERS-COV (08): Thailand ex Oman, Saudi Arabia corr 20160124.3962172
MERS-CoV (07): Saudi Arabia 20160123.3959982
MERS-CoV (06): UAE (AZ) 20160114.3937314
MERS-COV (05): Saudi Arabia (MD) 20160113.3933448
MERS-CoV (04): Saudi Arabia 20160112.3929848
MERS-COV (03): Korea, virus mutation 20160108.3921223
MERS-COV (02): Oman, WHO 20160107.3918976
MERS-COV (01): Oman, Saudi Arabia 20160105.3911188
2015
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MERS-COV (167): acute management and long-term survival 20151231.3904300
MERS-COV (166): Saudi Arabia (AQ) 20151230.3902499
MERS-CoV (165): Saudi Arabia (MK) Jeddah 20151227.3895143
MERS-CoV (164): South Korea, fomite contamination 20151223.3886268
MERS-CoV (163): Saudi Arabia, animal reservoir, camel, research, vaccine 20151219.3873486
MERS-CoV (162): Saudi Arabia (NJ) primary case, comment Buraidah 20151217.3869765
MERS-CoV (161): Saudi Arabia (RI) 20151216.3867868
MERS-CoV (160): Saudi Arabia (RI) 20151216.3867868
MERS-CoV (150): WHO update, Saudi Arabia (RI, AH) MOH, S. Korea quarantine 20151027.3747926
MERS-CoV (140): Saudi Arabia, Jordan, WHO, RFI 20151012.3709062
MERS-CoV (90): South Korea, Saudi Arabia, Thailand, Philippines, WHO 20150713.3505516
MERS-CoV (82): South Korea, Saudi Arabia, Thailand, RFI 20150629.3472461
MERS-CoV (76): South Korea, Saudi Arabia, Thailand, WHO 20150624.3459401
MERS-CoV (75): South Korea, Saudi Arabia, Thailand 20150623.3457227
MERS-CoV (74): South Korea, Saudi Arabia, Thailand ex Oman 20150621.3454450
MERS-CoV (73): South Korea, Saudi Arabia, Thailand, WHO, RFI 20150620.3453094
MERS-CoV (72): South Korea, Saudi Arabia, Thailand, WHO, RFI 20150619.3451230
MERS-cOv (71) Thailand ex Oman, South Korea, Saudi Arabia, UAE 20150618.3447481
MERS-CoV (70) - Thailand ex Oman, 1st report, RFI 20150618.3447631
MERS-CoV (130): Saudi Arabia, animal reservoir, camels, Hajj 20150912.3641457
MERS-CoV (120): Saudi Arabia 20150830.3612300
MERS-CoV (100): Saudi Arabia, South Korea 20150804.3558326
MERS-CoV (01): Saudi Arabia, new cases, new death 20150104.3069383
2014
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MERS-CoV (69): Saudi Arabia, new case, RFI 20141230.3063059
MERS-CoV (01): Bangladesh, KSA, Algeria, UAE, Iran, WHO, RFI 20140616.2541707
MERS-CoV - Eastern Mediterranean (82): anim res, camel, seroepidemiology 20140613.2537848
MERS-CoV - Eastern Mediterranean (01): Saudi Arabia, UAE, Oman, WHO 20140103.2150717
2013
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MERS-CoV - Eastern Mediterranean (106): animal reservoir, camel, Qatar, OIE 20131231.2145606
MERS-CoV - Eastern Mediterranean: Saudi Arabia, new case, RFI 20130518.1721601
Novel coronavirus - Eastern Mediterranean (29): MERS-CoV, ICTV nomenclature 20130516.1717833
Novel coronavirus - Eastern Mediterranean: bat reservoir 20130122.1508656
2012
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Novel coronavirus - Eastern Mediterranean (06): comments 20121225.1468821
Novel coronavirus - Eastern Mediterranean: WHO, Jordan, conf., RFI 20121130.1432498
Novel coronavirus - Saudi Arabia (18): WHO, new cases, cluster 20121123.1421664
Novel coronavirus - Saudi Arabia: human isolate 20120920.1302733
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by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : 1289
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : 2
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by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : 2
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by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : 1289
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : 1289
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
by : Timothy Muokadisease : Mers Cov place : SAUDI ARABIA Number of cases : unknown
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by : Stephen Mutuvidisease : Mers Cov place : SAUDI ARABIA Number of cases : 1289