MERS SITUATION UPDATEFEBRUARY 2019

HIGHLIGHTS

Published by the World Health Organization (WHO), Eastern Mediterranean Regional O�ce (EMRO), Cairo, Egypt.For Correspondence: Tel + 20-2-22765492, Fax + 20-2-2765456. E-mail: emrgohspoutbreak@who.int

Epidemiological characteristics of MERS cases reported globallybetween Sep-February 2013 and Sep-February 2019

Characteristic

Number

Median age in years

Gender (% male)

% of primary cases

% of secondary cases

(%) of unknown contact history

% of HCW

% of Fatal

Sep 13-Feb 14

93

54

72

27

34

39

22

54

Sep 14-Feb 15

207

55

75

27

35

37

13

49

Sep 15-Feb 16

123

49

67

26

67

7

22

23

Sep 16-Feb 17

120

57

77

78

19

3

4

36

Sep 17-Feb 18

96

56

76

77

23

0

4

41

Sep 18-Feb 19

125

51

80

38

61

1

10

18

Characteristics of MERS cases reported fromKingdom of Saudi Arabia, June 2012-February 2019

At the end of February 2019, a total of 2374 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 823 associated deaths (case–fatality rate: 34.6%) were reported globally; the majority of these cases were reported from Saudi Arabia (1983 cases, including 745 related deaths with a case–fatality rate of 37.5%).

During the month of Feburary, a total of 76 laboratory-confirmed cases of MERS were reported globally: 68 of the cases were reported from Saudi Arabia with 10 associated deaths and 8 from were reported from Oman with 2 associated deaths. This month, Saudi Arabia experienced an outbreak in Wadi Aldwaser city and one of its hospitals. From January 29 to end of February, a total of 52 laboratory-confirmed cases with 7 associated deaths have been reported for this outbreak: 1 suspected index, 3 unknown exposures, 10 sporadic primary cases, 38 secondary cases (7 household contacts and 31 hospital-acquired cases, including 11 healthcare workers). There is no ongoing active transmission occurring. In Oman this month, 4 additional secondary cases have been linked to the cluster previously reported in January and a new non-linked cluster of 4 cases (including 1 HCW) with 2 deaths was reported as well. The new cluster includes 1 suspected index case and 3 secondary cases (including 1 HCW).

The demographic and epidemiological characteristics of reported cases, when compared during the same corresponding period of 2013 to 2019, do not show any significant di�erence or change, except for the increase in the number of secondary cases and healthcare worker cases due to the hospital outbreak this month. Owing to improved infection prevention and control practices in hospitals, the number of hospital-acquired cases of MERS has dropped significantly since 2015.

The age group 50–59 years continues to be at highest risk for acquiring infection of primary cases. The age group 30–39 years is most at risk for secondary cases. The number of deaths is higher in the age group 50–59 years for primary cases and 70–79 years for secondary cases.

MERS cases reported from the Kingdom of Saudi Arabia byweek of symptoms onset, June 2012-February 2019

Laboratory-confirmed cases of MERS reported inEastern Mediterranean Region, April 2012-February 2019 SUMMARY

2374823

27

12

Laboratory-confirmed cases reportedsince April 2012

countries reported cases since April 2012in the Eastern Mediterranean Region

13 laboratory-confirmed cases reportedfrom Oman in 2019

deaths reported since April 2012

countries reported cases globally

Community versus hospital acquired (symptomatic) MERScases in Eastern Mediterranean Region, Jan 2014-Feb 2019

Age and fatality distribution of Primary and Secondary casesof MERS reported from Saudi Arabia, 2012-February 2019

Type of case

Primary

Secondary

Missing

Unknown

Total

2012

3

2

5

2013

36

93

1

28

158

2014

164

264

15

219

662

2015

52

222

102

78

454

2016

74

60

103

11

248

2017

71

90

68

5

234

2018

54

35

52

1

142

2019

21

43

16

80

Grand Total

456

771

346

342

1983

Survived Died

MERS in Saudi Arabia (January-February 2019)

January 2019 11 3

February 2019 58 10

Total 69 13

Community acquired

Hospital acquired

Saudi Arabia

United Arab Emirates

Qatar

Oman

Kuwait

Jordan

IRAN (ISLAMIC REPUBLIC OF)

Lebanon

Survived

Died

Survived

Died

n*=1284

Cases of MERS in healthcare workers reportedfrom Saudi Arabia Jan 2013 - Feb 2019

Health care worker

Non HCWHCW= 19.0%

19.0%Primary Secondary

Percentage

Age group

00-9

10-19

20-29

30-39

40-49

50-59

60-69

70-79

80-89

90&>90

Num

ber

of c

ases

2014 2015 2016 2017 2018 2019Year

Num

ber

of c

ases

0

50

100

150

200

250

2013 2014 2015 2016 2017 2018 2019Month

0

20

40

60

80

100

120

140

Epi week

11 19 27 35 43 51 3 11 19 27 35 43 51 3 11 19 27 35 43 51 2 10 18 26 34 42 50 2 10 18 26 34 42 50 2 10 18 26 34 42 50 2 10 18 26 38 42 46 48 3 72012 2013 2014 2015 2016 2017 2018 2019

No. of cases

0

10

20

30

40

50

60

70

80

90

100

30 20 10 0 10 20 301 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 9 11 1

0

50

100

150

200

250

300

WH

O-E

M/C

SR

/20

7/E

22 30 38 50 2 10 18 26 34 50 1 9 17 25 33 53 4 12 20 28 36 52 4 12 20 28 36 52 4 12 20 28 36 52 4 12 20 28 40 46 48 4 8

2012 2013 2014 2015 2016 2017 2018 2019

Epi week