MERS in Kuwait...

It's a "MERS-in.." kinda day. 

The World Health Organization todayannounced a fatal case of confirmed MERS-CoV infection diagnosed in Kuwait [1].

Summary of the case details:

1. The infected person was a 60-year old male
2. A Syrian national
3. Hospitalised 13-Feb-2014
4. Died 6-Mar-2014
5. Lab confirmed 9-Mar-2014
6. He had comorbidities

A few things here worth noting I think:

• There was quite a gap (24-days) between being hospitalised (not sure when the case started showing signs of illness) and having a laboratory confirmation (also 3-days after death)
• While this is the 3rd case identified within Kuwait, it seems to be the first case that could be nailed down as having been acquired in Kuwait. I tend to try and list my numbers and maps by where the case was acquired rather than where they were diagnosed. Two previous MERS-CoV cases (FluTrackers #158 and #159; includes 1 case with camel contact noted) diagnosed in Kuwait had travelled outside Kuwait blurring the ability to see where they had picked up the virus

.@setiogi @MackayIM @FluTrackers Not the first Kuwaiti case. and infection acquired in #Kuwait, we believe. #MERS
� Gregory H�rtl (@HaertlG) March 20, 2014

References...

1. WHO Disease Outbreak Notification 20-Mar-2014
   http://www.who.int/csr/don/2014_03_20_mers/en/
2. FluTrackers thread on Kuwait MERS-CoV case #1
   
   http://www.flutrackers.com/forum/showthread.php?p=514258#post514258
3. FluTackers on Kuwait MERS-CoV case #2
   
   http://www.flutrackers.com/forum/showthread.php?p=528694#post528694

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MERS-CoV tally....

Click on image to enlarge.

The global MERS-CoV map as of 18-11-2013.

Kuwait is currently depicted as having imported, 

rather than locally transmitted or acquired cases.

The WHO tally for Middle East respiratory syndrome coronavirus (MERS-CoV) lab-confirmed cases now stands at 157, of which 66 have died. 

The 2 latest cases, with lots of relevant WHO details are from Kuwait but are reportedly not contacts.

• FT#158. 47-year old male, ill on 30-Oct, hospitalized 7-Nov. He is critically ill. Travel outside of Kuwait, within a time-frame that might suggest MERS-CoV acquisition, has not been noted so far so I am marking this in red on the map to indicate a local acquisition for now.
• FT#159. 52-year old male, ill on 7-Nov, hospitalized 10-Nov. He recently travelled overseas and there is possible exposure to camels (WHO tweet without specific detail, 16-Nov). Also critically ill.

One of the #MERS cases in #Kuwait has had a history of frequent travels to Saudi Arabia and a history of contact with camels
� WHO (@WHO) November 16, 2013

My tally lists another case, that of the case imported into Spain (61-year old female). However, that case has not yet been confirmed to WHO standards which may require a change to the map if the case, like the 2 from Italy in September, are classified as "probable" rather than confirmed cases. 

.@MackayIM Spanish #MERS case is not yet confirmed to @WHO standards.
� Gregory H�rtl (@HaertlG) November 18, 2013

Thus the proportion of fatal cases stands at 42%.

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