The new coronavirus that’s killed almost two-thirds of the people it’s infected, mostly in Saudi Arabia, spreads easily in hospitals, according to the first detailed description of the outbreak since it started in September.
A 56-year-old man with Middle East respiratory syndrome coronavirus, or MERS-CoV, admitted to a hospital in Saudi Arabia’s eastern province of al-Ahsa in April, sparked a chain of transmission that infected 22 others in four hospitals in an eight-week period, according to the study, published today in the New England Journal of Medicine.
A 55-year-old patient probably passed the virus to six others who were receiving dialysis in the same ward at the same time, confirming a theory that the outbreak involves so-called super-spreaders who infect multiple people, a pattern also seen in the SARS epidemic a decade ago.
“The rapid transmission and high attack rate in the dialysis unit raises substantial concerns about the risk of health care-associated transmission of this virus,” researchers led by Ziad Memish, Saudi Arabia’s deputy minister of health, wrote in the journal.
Most of the patients were men with an average age of 56, Memish and colleagues wrote. Most had a fever and cough, and about a third had vomiting or diarrhea. The median time from the onset of symptoms to death was 11 days.
Still, it’s not clear where the virus came from, whether there was one introduction of the virus from outside the hospital or more, or how the pathogen was transmitted between patients, they said.
The nation’s health ministry was criticized today by the European Centre for Disease Prevention and Control for not disclosing more details about the outbreak. While the study helps fill some gaps in knowledge, the information should have been provided earlier, said Michael Osterholm, director of the University of Minnesota’s Center for Infectious Disease Research and Policy in Minneapolis.
“This is the kind of information that we need to have on a real-time basis,” Osterholm said by phone. “If this information was being held for the purposes of publication, that is unfortunate.”
Globally, MERS-CoV has sickened 64 people and killed 38 since September, 32 of which have been in Saudi Arabia, according to the World Health Organization. The source of the outbreak hasn’t been identified, and infections in other parts of Saudi Arabia since since today’s study was concluded show that transmission is continuing, Osterholm said.
“It’s a dot, and it takes two dots to make a line,” Osterholm said. “If we keep getting more information, more dots, we can talk about a trend.”