Thanks to Lucie Lecomte for sending the link to this new post on VDU's blog by Dr. Ian Mackay: MERS-CoV case in Spain, imported from Saudi Arabia during visit for Hajj pilgrimage. Click through for the full link-rich post. Excerpt:
The case is being presumed to be imported from the Kingdom of Saudi Arabia (KSA). The subject, a 61-year old Moroccan woman (61F; presumably FluTrackers' #153) living in Spain, had spent a month in the KSA (Oct 2 to Nov 1; the Hajj specifically occurred during Oct 13-18) and was showing signs and symptoms of a febrile cough illness on the 15th of October. She did attend the Hajj according to Helen Branswell's article.
So can we now put the "no cases during the Hajj" story to bed? We don't technically know when the virus was acquired. 61F was in the KSA for a long period so acquisition may have occurred before or after but let's not split hairs, it was a Hajj-related acquisition.
61F is stable with a diagnosis of pneumonia which was made sometime around October 20th in a hospital in the KSA.
Timeliness is a big concern here. It seems that it took 5-days for a clinical diagnosis of pneumonia after which the case flew back to Spain for a laboratory diagnosis (at the National Center for Microbiology in Spain) of MERS-CoV infection on Nov 1st. That's perhaps 12-days between onset and laboratory confirmation.And that delay, Dr. Mackay points out, raises an important question: Why wasn't she tested in MERS-hypersensitive Saudi Arabia?