MERS SITUATION UPDATE JANUARY 2020 Published by the World Health Organization (WHO), Eastern Mediterranean Regional Office (EMRO), Cairo, Egypt. For Correspondence: Tel + 20-2-22765492, Fax + 20-2-2765456. E-mail: [email protected] Epidemiological characteristics of MERS cases reported globally between August–January 2014 and August–January 2020 Characteristic Number Median age in years Gender (% male) % of primary cases % of secondary cases (%) of unknown contact history % of HCW % of Fatal Aug 14-Jan 15 130 55 78 40 33 27 12 45 Aug 15-Jan 16 240 53 61 10 83 6 18 34 Aug 16-Jan 17 107 56 77 75 21 4 5 33 Aug 17-Jan 18 106 52 71 58 42 0 8 35 Aug 19-Jan 20 59 57 76 43 20 38 8 27 Aug 18-Jan 19 68 56 82 51 47 2 0 25 Characteristics of MERS cases reported from Kingdom of Saudi Arabia, June 2012–January 2020 HIGHLIGHTS At the end of January 2020, a total of 2519 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 866 associated deaths (case-fatality rate: 34.3%) were reported globally. The majority of these cases were reported from Saudi Arabia (2121 cases), including 788 related deaths with a case-fatality rate of 37.1%. Since the last update was published (December MERS situation update), a total of 17 new laboratory-confirmed cases of MERS were reported globally. Two of the cases were reported from the United Arab Emirates, both males, with a history of exposure to camels and their products. The other 15 cases were reported from Saudi Arabia with five associated deaths. The deaths occurred among patients aged 45-85 years with comorbidities. They have no clear history of exposure to any of the known risk factors. A hospital outbreak was reported in Saudi Arabia with a cluster of six cases. Three of the cases were health care workers, two were patients (one of whom died) and one was a visitor. The source of infection of the first case reported in the cluster is currently unknown and under investigation. Investigation of household and hospital contacts revealed no further secondary cases. The demographic and epidemiological characteristics of reported cases, when compared with the same corresponding periods in 2014–2020, do not show any significant difference or change. The number of cases reported in this period was less than all other corresponding periods. The age group 50–59 years continues to be at the highest risk for acquiring infection as primary cases. The age group 30–39 years is most at risk for secondary infections. 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 by week of symptoms onset, June 2012–January 2020 Laboratory-confirmed cases of MERS reported in the Eastern Mediterranean Region, July 2012–January 2020 SUMMARY 2519 12 Laboratory-confirmed cases reported since April 2012 countries reported cases since April 2012 in the Eastern Mediterranean Region 866 deaths reported since April 2012 27 countries reported cases globally Age and fatality distribution of primary and secondary cases of MERS reported from Saudi Arabia, 2012–January 2020 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 75 60 103 11 249 2017 70 90 68 5 233 2018 54 35 52 1 142 2019 57 75 57 15 204 Grand Total 512 844 408 357 2121 2020 1 3 10 14 Survived Died Cases of MERS in healthcare workers reported from Saudi Arabia, Jan 2013–Jan 2020 Health care worker Non HCW HCW= 19.1% 19.1% Community versus hospital acquired (symptomatic) MERS cases in Eastern Mediterranean Region, Jan 2014-Jan 2020 Community acquired Hospital acquired © World Health Organization 2020. Some rights reserved. This work is available under the Creative Commons Attribution-Non Commercial-Share Alike 3.0 IGO license (CC BY-NC-SA 3.0 IGO; https://creativecommons.org/licenses/by-nc-sa/3.0/igo). Document no. WHO-EM/CSR/254/E Survived Died n*=1356 Survived Died MERS in Saudi Arabia 2020 (January)* January 2020 Total 4 4 10 10 * Based on date of symptom onset or laboratory confirmation for asymptomatic cases Primary Secondary No. of cases Saudi Arabia United Arab Emirates Jordan Oman Qatar Kuwait Iran (Islamic Republic of) Lebanon Epi week 0 50 100 150 200 250 300 2014 2015 2016 2017 2018 2019 2020 Number of cases Year 0 50 100 150 200 250 1 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 911 1 3 5 7 9 11 1 3 5 7 9 11 1 3 5 7 911 1 3 5 7 9111 2013 2014 2015 2016 2017 2018 2019 2020 Number of cases Month Percentage 30 25 20 15 10 5 0 5 10 15 20 25 Age group 00-9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 80-89 90&>90 0 10 20 30 40 50 60 70 80 90 100 22 30 38 50 2 10 18 26 34 42 50 1 9 17 25 33 41 53 4 12 20 28 36 52 4 12 20 28 44 52 4 12 20 28 36 52 4 12 20 28 36 44 52 4 12 20 28 36 44 1 5 2012 2013 2014 2015 2016 2017 2018 2019 2020 0 20 40 60 80 100 120 140 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 4250 2 10 18 26 34 4250 2 10 18 26 34 4250 2 10 18 26 34 4250 3 11 19 27 35 43 51 3 2012 2013 2014 2015 2016 2017 2018 2019 2020