2 Middle East respiratory syndrome coronavirus (MERS-CoV) cases emerge in the Philippines and Malaysia [UPDATED]

In a surprising pair of temporally related announcements, there has been an imported and fatal case of MERS occurring in a 54-year old man (54M) originally from Johor, Malaysia [1] and a distinct case in a  recently returned 45-year old [5] Filipino male nurse working in the United Arab Emirates (UAE).[2,3,4]

• 54M had returned from performing an Umrah pilgrimage ("mini-Hajj")  at Mecca (Makkah), Saudi Arabia on 29-March , becoming ill 8-9-Apr, dying of pneumonia secondary to his MERS-CoV infection, 13-Apr.[8]
• Passengers on board the same flights are urged to contact the Health Ministry for testing but he was not symptomatic while in transit [8]
• Diabetic (a comorbidity) [6]
• Had visited a camel farm but source of infection remains unknown [6]
• 45M, currently in quarantine with his family, was a friend of the recent fatal MERS case in a Filipino paramedic
• The nurse was asymptomatic
• Returning from vacation in the Philippines when retrospective testing results were released to Philippines embassy by UAE authorities  [5]
• Testing was conducted in the UAE, referred to as a "blood test" ?serology not PCR-based?
• Source of infection remains unknown

In 2013, Kingdom of Saudi Arabia's (KSA) Health Minister Abdullah Al-Rabeeah, said that 4,800,000 pilgrims visited to perform Umrah and not one left having had MERS-CoV infection. That will not be the case in 2014.

References...

1. FluTrackers thread on fatal MERS-CoV case in 54M, Malaysia
   http://www.flutrackers.com/forum/showthread.php?t=221664
2. FluTrackers on Filipino nurse positive for MERS-CoV
   http://www.flutrackers.com/forum/showthread.php?p=531474#post531474
3. http://www.gmanetwork.com/news/story/357189/news/nation/pinoy-nurse-tests-positive-for-mers-virus-first-case-in-phl
4. OFW who returned home from UAE tests positive for MERS-CoV � DOH chief|Inquirer.net article http://newsinfo.inquirer.net/594740/ofw-who-returned-home-from-uae-tests-positive-for-mers-cov-doh-chief#ixzz2z2x7xUEr
5. OFW with MERS arrives in Manila
   http://www.philstar.com/headlines/2014/04/17/1313580/ofw-mers-arrives-manila
6. Health Ministry Confirms Umrah Pilgrim Died Of MERS-CoV
   http://www.bernama.com/bernama/v7/bu/newsmarkets.php?id=1031217
7. MERS Coronavirus Makes First Appearance In Asia: Malaysia, Philippines Report MERS-CoV Cases
   http://www.theglobaldispatch.com/mers-coronavirus-makes-first-appearance-in-asia-malaysia-philippines-report-mers-cov-cases-43672/
8. First Mers death recorded in Asia
   http://www.thenational.ae/world/first-mers-death-recorded-in-asia
9. Mike Coston on Malaysia imported case
   http://afludiary.blogspot.com.au/2014/04/malaysian-moh-statement-on-imported.html
10. Mike Coston on Philippines imported case
    http://afludiary.blogspot.com.au/2014/04/philippines-quarantines-imported.html