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Outbreak of Middle East Respiratory Syndrome Coronavirus in Wadi AlDawasir, Saudi Arabia, 2019.


In 2012, a novel coronavirus emerged in Saudi Arabia. Named Middle East Respiratory Syndrome Coronavirus (MERS-CoV), it causes severe lower respiratory infection in humans. In January 2019, a MERS-CoV outbreak was reported in Wadi AlDawasir. We sought to: determine the risk factors for MERS-CoV transmission and infection, determine key epidemiological characteristics of cases and prevent future spread of the disease by implementing appropriate infection control measures.n.


We identified all laboratory confirmed MERS-CoV cases in Wadi AlDawasir reported to Saudi Arabian Ministry of Health between 26 January - 5 April 2019. We interviewed confirmed patients and reviewed hospital records. We conducted descriptive statistical analyses.


By February 24, we identified 51 confirmed cases. Cases ranged in age from 23-84 years (mean = 46 years), 38 (74%) were male. Overall, 25 (49%) cases reported camel exposure. Eleven cases were classified as primary cases: all reported camel exposure and 2 (20%) also reported exposure to WDGH prior to symptom onset. Of all 51 cases, 14 (27%) were classified as secondary cases: 24 (47%) were classified as tertiary cases. Two (4%) were classified as sustained human-to-human transmission (quaternary cases). Fourteen (35%) cases worked at WDGH, although 6 (43%) did not provide direct patient care. Seven cases died (case fatality rate=14%).


The majority of patients in the outbreak had contact with both the hospital and camels. This highlights the need for more precise categorization of cases as either primary or secondary which would be possible through genetic comparison of camel isolates and human isolates.nkI