Increase in Middle East Respiratory Syndrome-Coronavirus Cases in Saudi Arabia Linked to Hospital Outbreak With Continued Circulation of Recombinant Virus, July 1-August 31, 2015.

Assiri AM1, Biggs HM2, Abedi GR2, Lu X2, Bin Saeed A3, Abdalla O1, Mohammed M1, Al-Abdely HM1, Algarni HS1, Alhakeem RF1, Almasri MM1, Alsharef AA1, Nooh R1, Erdman DD2, Gerber SI2, Watson JT2.

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Abstract

During July-August 2015, the number of cases of Middle East respiratory syndrome (MERS) reported from Saudi Arabia increased dramatically. We reviewed the 143 confirmed cases from this period and classified each based upon likely transmission source. We found that the surge in cases resulted predominantly (90%) from secondary transmission largely attributable to an outbreak at a single healthcare facility in Riyadh. Genome sequencing of MERS coronavirus from 6 cases demonstrated continued circulation of the recently described recombinant virus. A single unique frameshift deletion in open reading frame 5 was detected in the viral sequence from 1 case.