Saudi Arabia has reported 18 more MERS-CoV cases since Sep 4, 15 of them in Riyadh, and the number of patients infected with the virus in hospitals in both Saudi Arabia and Jordan continues to grow, the World Health Organization (WHO) said in its latest updates.

Ongoing MERS-CoV (Middle East respiratory syndrome coronavirus) activity in the capital cities of the two countries during the lead-up to the Hajj pilgrimage, which begins in 2 weeks in Saudi Arabia, is raising concerns that international visitors might carry the virus back to their home countries.

Latest Riyadh infections

The 15 latest MERS-CoV cases in Riyadh appear to have links to an ongoing hospital outbreak at King Abdulaziz Medical City, according to separate updates from the Saudi Ministry of Health (MOH). It's not known how many cases are related to the hospital event, but 158 illnesses have been reported in Riyadh since Jul 21.

Five of the patients are healthcare workers who had contact with a suspected or confirmed case. Four of them are from foreign countries—two women, 29 and 38, and two men, 30 and 31. All are in stable condition. The fifth ill healthcare worker is a 27-year-old Saudi man from Riyadh who is also listed as stable.

Of the other 10 Riyadh cases, 1 involved contact with an earlier case, the exposure status was under review for 5, and no known exposure to an earlier cases has been found for 4.

The other three cases were reported in Al-Kharj, which has reported three cases so far this month, and in Medina and Al-Quway'iyah. The patient from Medina—an 80-year-old Saudi woman—had contact with a suspected or confirmed MERS case. No exposure source has yet been identified for the other two patients.

All of the 18 new cases involve adults, ranging in age from 27 to 85. Twelve patients are men and six are women. Fourteen are hospitalized in stable condition, and four are listed as critical.

In its update today, the MOH said 63 people are still being treated for their illnesses, and 13 are in home isolation.

Thirteen more people have recovered, lifting the overall total since the virus was detected in humans for the first time in 2012 to 627.

In addition, Saudi officials said seven more people with previously announced infections have died. All occurred in Riyadh, involving five Saudis and two from other countries. None of them were healthcare workers. All had underlying medical conditions.

The latest developments boost Saudi Arabia's MERS totals to 1,223 cases, 520 of them fatal.

WHO details Jordan, Saudi cases

The WHO on Sep 6 provided details on two MERS-CoV cases in Jordan, both linked to a hospital outbreak under way in Amman. The illnesses had been noted in recent Jordanian media accounts as the fifth and sixth recent cases recently reported in the country.

Both patients had been treated at a hospital experiencing a MERS-CoV outbreak, the WHO said. One is a 73-year-old woman from Amman who had been admitted to an outbreak hospital for a chronic health condition. She started having symptoms on Aug 28 and was admitted again to the same hospital, but was discharged the next day. As her symptoms worsened, she was admitted to a different hospital the same day, where she tested positive for the virus 2 days later and is in stable condition.

The second patient is a 56-year-old man who underwent a medical procedure on Aug 18 at a hospital experiencing an outbreak. Ten days later while still hospitalized he started having symptoms, tested positive for MERS-CoV shortly after, and died on Sep 1. The WHO said authorities are still investigating any possible links to other MERS cases or shared healthcare workers.

In an update today on 22 recent cases reported from Saudi Arabia between Aug 26 and Aug 31, the WHO said 15 were linked to an ongoing hospital outbreak in Riyadh. Sporadic MERS-CoV infections, however, continue to be reported in other parts of Saudi Arabia, with three of those cases involving contact with camel or raw camel products.

All of the cases involve adults, ages 24 to 87. Thirteen are men and 9 are women. Illness onsets range from Aug 16 to Aug 28. Ten patients are hospitalized in critical condition, nine are listed as stable, and three died.

Four of the patients are healthcare workers, two of them from outside of Saudi Arabia.

Ten of the patients appear to have contracted the virus after being in a hospital for treatment of chronic health conditions. Two of the patient in the update got sick after visiting confirmed MERS case-patients in the hospital.

Cases reported from other parts of Saudi Arabia include a 55-year-old man from Al- Muzahmiyya, a 50-year-old man from Ad Dilam, and a 65-year-old man from Hofuf, all of whom had frequent camel contact and consumed raw camel milk.

In addition, a case reported in Delam involves a 32-year-old male healthcare worker whose possible exposure to hospitalized patients is under investigation. He had no other known exposure to the virus.

In addition to the lab-confirmed infections, Saudi Arabia also reported eight more deaths involving earlier cases to the WHO.

The WHO said the newly reported Saudi cases raise its MERS numbers to 1,517 cases, including at least 539 deaths.

New Jordan cases?

Reports in Arabic from Jordan's news agency suggest that two more MERS-CoV cases have been detected, the infectious disease news blog Avian Flu Diary reported today.

A machine translation of a report yesterday from Petra, the country's news agency, noted a fatal case, which appears to be the country's seventh recent death from the disease. A new report today from Petra notes another fatality from the disease and says that eight cases have now been reported, five of them fatal.

Few details are available about the cases and deaths, and so far no official confirmation has come from Jordan's health ministry, Mike Coston, author of the blog, cautioned.

See also:

Sep 5 Saudi MOH update

Sep 6 Saudi MOH update

Sep 7 Saudi MOH update

Sep 8 Saudi MOH update

Sep 6 WHO update on MERS-CoV in Jordan

Sep 8 WHO update on MERS-CoV in Saudi Arabia

Sep 8 Avian Flu Diary post