During the month of April, the Middle East Respiratory Syndrome coronavirus (MERS-CoV) outbreak has spiked, particularly in Saudi Arabia and the United Arab Emirates. This has resulted in imported cases being seen in such diverse places as Malaysia and Greece.

Maureen Metcalfe; Azaibi Tamin/CDC
Maureen Metcalfe; Azaibi Tamin/CDC

On Friday, the Egyptian Ministry of Health and Population (MOHP) reported (computer translated) a suspected case of the MERS virus in a 27-year-old civil engineer working the past four years in Riyadh. This is the first such case in Egypt.

The patient was tested for the virus with nose and throat swabs and a sputum sample and the results were reported positive on Saturday. He is currently being treated for pneumonia in a Cairo hospital and is reportedly in stable condition.

The recent uptick in cases in Saudi Arabia and the United Arab Emirates has caused the World Health Organization to respond with concern noting, “Approximately 75% of the recently reported cases are secondary cases, meaning that they are considered to have acquired the infection from another case through human-to-human transmission,” WHO Regional Director for the Eastern Mediterranean Dr Ala Alwan said.

The European Centre for Disease Prevention and Control (ECDC) said that it is unknown why we are seeing the rise of cases reported in April 2014. They do offer a few possible scenarios to include more sensitive case detection through more active case finding and contact tracing or changes in testing algorithms, increased zoonotic transmission with subsequent transmission in healthcare settings, breakdown in infection control measures or otherwise increased transmission in the local healthcare setting, change in the virus resulting in more effective human-to-human transmission, resulting in both nosocomial clusters, and increased numbers of asymptomatic community acquired cases, or false positive lab results.

The current number of cases worldwide varies depending on which organization you read. The WHO said that as of April 23, they have received reports of 254 laboratory-confirmed cases of infection with MERS-CoV, including 93 deaths.

The ECDC reports as of 23 April 2014, 345 laboratory-confirmed cases of MERS-CoV have been reported to public health authorities worldwide, including 107 deaths. Fourteen countries have identified cases; four of which have only reported one case, whilst 272 cases have been in Saudi Arabia. Seventy-two of the 345 cases have been healthcare workers.