Middle East respiratory syndrome coronavirus disease is rare in children: An update from Saudi Arabia

Al-Tawfiq, Jaffar A; Kattan, Rana F; Memish, Ziad A

Despite the total number of MERS cases increasing, especially in KSA, the number of pediatric cases remained low during the study period. Initially, the testing in KSA was directed towards hospitalized patients with severe pneumonia. In 2015, the Saudi Ministry of Health added a specific case definition for MERS-CoV infection in children [30] . The definition includes those ≤ 14 years, meets the adult case definition and has either a history of exposure to a confirmed or suspected MERS-CoV in the proceeding 14 d or a history of contact with camels or camel products in the proceeding 14 d [30] . The case definition also includes children with unexplained severe pneumonia [30] . The 2015 change in the case definition does not account for the low rate of childhood MERS-CoV infection as 33% of the cases were reported in 2014 before the case definition was changed. One of the reasons for an increased number of cases in 2014 during the Jeddah outbreak was increased testing of asymptomatic and mildly symptomatic patients [11] .