Wadi Al Dawasir General Hospital. Credit: Al Wadye.com
I've been trying to learn more about what's going on in Wadi Al Dawasir, but finding very little. It's a small city of around 70,000 people in Najran province. Presumably the nosocomial outbreak is in its General Hospital; I took the photo from a March 6 report in Al Wadye, which seems to be a local paper.
The gist of that report is that there had been "more than six" MERS cases in the previous few days. Officially, as of March 6 there had been three cases: a 31-year old man and a 32-year-old woman on March 5, whose cases were "under review"; and a 48-year-old woman on March 6, who was a secondary, hospital-acquired case.
On March 8, arkan-news.com reported that an "official source" had denied reports of an increase in cases, and stated that only the cases reported by the Command and Control Center were real.
The KSA MOH Command and Control Center then reported no cases until March 10, when four new cases appeared. One is a 52-year-old woman listed as secondary household contact (the mother of one or both of the March 5 cases?). The other three are all hospital-acquired cases, two women in their 50s and a 72-year-old man in critical condition.
Today, March 11, an expatriate 39-year-old male healthcare worker was reported as an asymptomatic case.
So here's where we stand. In a town that I don't think has had a previous MERS case, two young persons last Sunday were reported as cases with no obvious cause. They weren't even listed as "primary." The next day, a hospitalized patient had tested positive. Whenever the first two cases were actually diagnosed (not just reported), a nosocomial outbreak was soon under way.
We then have a pause from Tuesday through Thursday; on Friday we have three more nosocomial cases and a household contact. Presumably the hospital has started contact tracing, and finds the expat HCW as an asymptomatic case today. I have no idea if he carried MERS from the original cases to those already in the hospital for other illnesses. But it seems reasonable to speculate that a hospital in a hitherto MERS-free town would be less concerned about infection control than in big, MERS-rich cities like Riyadh and Jeddah.
We'll probably never know the details, given the Saudis' modesty about providing useful information to the rest of the world. No doubt a lot of Saudi MERS experts are now on the ground, and Wadi Al Dawasir General Hospital will clean up its act. But when this outbreak ends, we won't be much closer to finding an effective way to suppress MERS.