Riyadh, KSA: Announced two more deaths overnight Monday in the latest outbreak of a severe acute respiratory syndrome-like virus currently centered on a small hospital in the kingdom’s east, bringing the toll reported by the government at the health center since Wednesday to seven dead and another six who have fallen ill.
The latest deaths, a 62-year-old woman and a 71-year-old man, heightened worries in Saudi Arabia and abroad that the outbreak of an apparently Middle East-based disease known as the novel coronavirus could be escalating.
The surge of fatalities brings confirmed deaths in the year-old outbreak to 18 and overall cases to 30. It has heightened concern among ordinary Saudis and international medical officials that the kingdom isn’t disclosing enough information on the outbreak to help limit and stop the spread. Most of the cases reported have been in Saudi Arabia.
The 13 cases linked to one Saudi hospital suggest the spread of this coronavirus may have reached a dangerous new stage in which it is spreading from one human to another, rather than infecting humans from another source such as an infected animal, according to infectious disease experts.
The virus has spread quickly: 13 people were infected between April 14 and May 1, nearly half of the 30 total cases that have been reported to the World Health Organization. Of those 30 cases, 18 have died, giving the disease a case fatality rate similar to that of the feared H5N1 avian flu.
Saudi Deputy Health Minister Ziad Memish announced the two new deaths, and another case of a patient in critical condition with coronavirus, in an email published late Sunday on the international Promed medical website.
“Transmission seems linked to one (health-care facility)” in the city of Hofuf, in Saudi Arabia’s Eastern Province, Dr. Memish said in the brief email. It stated that no community transmission appeared likely in the latest outbreak, but didn’t clarify or elaborate further on the cases.
Dr. Memish didn’t immediately respond to requests seeking comment Monday.
According to the World Health Organization, the coronavirus–which is related to the SARS virus that struck Asia a decade ago–first appeared in a “health-care setting” in April 2012 in Jordan, where it killed two people. More cases since have been confirmed in Saudi Arabia, Britain, Qatar and the United Arab Emirates.
Some of those who fell ill had contact with camels or goats, suggesting those animals could be carriers for the virus, although there is no certainty yet of the original, animal sources. Other people who became sick had contact only with other people who were carrying the virus, confirming the illness could spread from person-to-person, international health officials said.
Two terse emails posted on Promed over the past few days by the Saudi government suggest the virus spread multiple times from one person to another.
“It has to be person to person–I can’t imagine any other way,” said Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.
“Animal contact doesn’t appear to play a role at all” in the latest cases, he said. Moreover, he said, the length of time between the dates of onset of disease in the 13 people–from April 14 to May 1–suggests “multiple chains of transmission.”
“This should really cause concern,” he said.
It isn’t clear from the emails whether the cases were inpatients or outpatients at the hospital, or where they were infected.
Signs of a wider spread could emerge if the cases were outpatients who took the disease home with them, or if family members or hospital workers were exposed and spread the disease outside.
International health regulations require countries to report public health events of international importance to the World Health Organization in a timely and open way.
China was sharply criticized for failing to disclose the emergence and spread of SARS until it spilled beyond its borders and spread globally in 2003.
Saudi Arabia’s handling of the coronavirus “has all the makings of deja vu all over again with regard to SARS,” Dr. Osterholm said.
“They may have much more information but it surely hasn’t been forthcoming,” he said of the Saudi government. “The Saudis need to lay this out as completely as possible. We’ve all been concerned about the lack of transparency with regard to the Saudi investigation. It isn’t just about an endemic problem within the country. It represents a global threat.”
© Dow Jones NewswiresMay 2013