The pattern of Middle East respiratory syndrome coronavirus in Saudi Arabia: a descriptive epidemiological analysis of data from the Saudi Ministry of Health

Alghamdi, Ibrahim G; Hussain, Issam I; Almalki, Shaia S; Alghamdi, Mohamed S; Alghamdi, Mansour M; El-Sheemy, Mohammed A

Our findings indicate that those in the age groups of 45-59 years and 60 years had the highest rate of MERS-CoV cases and related deaths. It has been documented that people over 65 years of age and younger people with chronic diseases are at a greater risk of complications resulting from influenza or viral infections than are healthy adults. This indicates that older and unhealthy younger people are more likely to become infected with MERS-CoV, owing to a weak immune system, and infection is more likely to be fatal in these groups. 10 Our study also reports that the region of Riyadh had the highest rate of MERS-CoV infections and deaths in However, despite the high number of cases and deaths in Riyadh and Jeddah, the case fatality rate was highest in the Eastern Region, and for this reason, MERS-CoV was first discovered here. In Jeddah and Mecca, there is concern about the increase of MERS-CoV cases because hundreds of thousands of people frequently travel to Saudi Arabia to perform Umrah and Hajj. Although no Hajj-associated MERS-CoV cases have been reported, Umrah-associated cases have. [11] [12] [13] Therefore, the World Health Organization suggests that governments should provide advice on the risk of infection to pilgrims with major medical problems, such as chronic diseases. In addition, general travel health information should be provided, including advice on food safety practices, good personal hygiene, and avoiding unnecessary farm visits and contact with animals. 14 We have observed that MERS-CoV incidence rates are higher in environments with low relative humidity (20%) and high temperatures (20°C-35°C). Therefore, increasing relative humidity to above 35% and maintaining temperatures ranging 5°C-15°C in hospitals and indoor places may decrease the spread of this disease. However, it has been observed that higher relative humidity levels above 43% may decrease the activity of influenza virus particles to 14%, while a relative humidity of 23% or less may increase the activity of influenza virus particles from 70%-77%. 15 The source of infection should also be investigated and identified with epidemiological surveillance, either passively or actively, in order to control MERS-CoV in Saudi Arabia.