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Investigation of a cluster of MERS CoV cases in a Family in Riyadh, March 2015.


The Field Epidemiology Training Program (FETP) assigned to investigate a cluster of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Riyadh, March 2015, focusing on identifying the source infection, the transmission sequence and the role of public health response in cluster identification and containment, and follow up.


FETP team visited the Riyadh Health Directorate to get information about the cluster, actions taken by different sectors of the health department, and current status of the cluster regarding MERS-CoV infection. The team visited different hospitals which notified and managed cases in order to collect information and also the team called the family members for data collection.


A cluster of 5 MERS-CoV positive cases belonging to a single family have been identified (2 symptomatic and 3 asymptomatic). Case Fatality Rate 40%, the mean age of these cases 64.8 years ± 21.77 SD. No community-based case investigation of the first patient was conducted and this led to case missing. Transmission of infection was due to close contact of first case and delay in diagnosis.


5 MERS-CoV cases have identified in one family. Follow-up of the cases and contacts was not efficient resulting in loss of follow-up of detected cases, transmission and missed early diagnosis among contacts.