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This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

New MERS cases include fatal infection in otherwise healthy hospital worker in Saudi Arabia

Four new cases of Middle East respiratory syndrome (MERS) coronavirus in Saudi Arabia include a fatal infection in an otherwise healthy hospital worker. A co-worker in the same hospital is listed in critical condition, the World Health Organization reports .

The death of a healthy hospital worker is particularly concerning. The emerging consensus has been that MERS is primarily a threat to patients and people in the community with underlying chronic conditions. In a recently published MERS case series, only two of 47 cases were previously healthy. The other 45 cases had underlying comorbid medical disorders that included 32 (68%) with diabetes, 23 (49%) with chronic renal disease, 16 (34%) with hypertension, and 13 (28%) with chronic cardiac disease.

In the four new cases, one was a 41-year-old female health care worker from Riyadh with no known underlying medical conditions who became ill on Aug. 15 , 2013. Her condition deteriorated and she passed away at the end of August. No known exposure to animals or to a confirmed MERS case has been identified. Investigations into the source of infection are on-going, the WHO reported.

A 30-year-old Saudi male health care worker from Riyadh, who worked at the same hospital as his fatally infected colleague, developed severe pneumonia on Sept 1, 2013 and is currently in critical condition.

The third case is a 79-year-old woman from Hafar al-Batin province who developed a respiratory illness on Aug. 21. A contact of a confirmed MERS case in a family cluster, her condition deteriorated and she died on Sept. 2.

The fourth case is a 47-year-old Saudi man from Hafar al-Batin province with a chronic heart condition who became ill on Aug. 23. A contact of a confirmed MERS case in a family cluster, he is currently in critical condition, the WHO reported. Little additional information about the cases has been released.

Since September 2012, there have been 114 laboratory-confirmed cases of MERS, with the 54 deaths resulting in a mortality rate of 47%. The morality rate is probably considerably lower due to an unconfirmed spectrum of milder MERS cases.