An outbreak of Middle East Respiratory Syndrome (MERS) due to coronavirus in Al-Ahssa Region, Saudi Arabia, 2015

Between 19 April and 23 June 2015, 52 laboratory-confirmed cases of Middle East Respiratory Syndrome due to coronavirus [MERS] were reported from Al-Ahssa region, eastern Saudi Arabia. The first seven cases occurred in one family; these were followed by 45 cases in three public hospitals. The objectives of this investigation were to describe the epidemiological characteristic of the cluster and identify potential risk factors and control measures to be instituted to prevent further occurrence of MERS. We obtained the medical records of all confirmed cases, interviewed the members of the affected household and reviewed the actions taken by the health authorities. All the cases were connected. The index case was a 62-year-old man with a history of close contact with dromedary camels; three of the seven infected family members and 18 people in hospitals died [case-fatality rate, 40.4%]. The median incubation period was about 6 days. The cluster of cases appeared to be due to high exposure to MERS, delayed diagnosis, inadequate risk communication and inadequate compliance of hospital health workers and visitors with infection prevention and control measures

Entre le 19 avril et le 23 juin 2015, 52 cas confirmés en laboratoire de syndrome respiratoire du Moyen-Orient [MERS] causé par le coronavirus ont été notifiés dans la région d'Al-Ahssa, partie orientale de l'Arabie saoudite. Les sept premiers cas sont survenus dans une seule famille ; ils ont été suivis de 45 cas déclarés dans trois hôpitaux publics. Cette investigation avait pour objectifs de détailler les caractéristiques épidémiologiques de ce groupe de cas et d'identifier les facteurs de risque potentiels ainsi que les mesures de lutte à mettre en place afin d'empêcher la survenue de nouveaux cas de MERS. Nous avons consulté les dossiers médicaux de l'ensemble des cas confirmés, avons interrogé les membres des foyers touchés et passé en revue les interventions entreprises par les autorités sanitaires. Tous les cas étaient reliés entre eux. Le cas indicateur était un homme de 62 ans ayant eu des contacts étroits avec des dromadaires ; trois des sept membres infectés de la famille et 18 patients hospitalisés sont décédés [taux de létalité : 40,4%]. La période d'incubation médiane était d'environ 6 jours. Le groupe de cas était vraisemblablement dû à une forte exposition au MERS, associée à un diagnostic tardif, une communication sur les risques inappropriée et une mauvaise observance des mesures de prévention et de lutte contre les infections par les personnels de santé de l'hôpital et les visiteurs

What is the experience from previous mass gathering events? Lessons for Zika virus and the Olympics 2016.

All previous experiences from different mass gathering show that vaccine preventable diseases is the most important infections like influemza, hepatitis A, polio and meningitis. Three mass gathering held in Africa during the Ebola outbreak accepted participants from West Africa and was able to handle the theoretical risk without any incident. Therefore we believe that the Olympc games in Rio de Janeiro should not be canceled. The number of visitors to the games is a tine fraction (1%) of other visitors to Zika endemic con tries and it will have no measurable effect on the risk of spreading Zika virus, if the games was cancelled.

Smoking among Saudi university students: consumption patterns and risk factors

Tobacco use is increasing among young people, especially in Gulf nations such as Saudi Arabia. The objectives of this study were to estimate the prevalence and behavioural patterns of tobacco use among undergraduate students at King Saud University, Riyadh, Saudi Arabia during the academic year 2008/09 and investigate factors that influenced their tobacco use. A cross-sectional study was done of a representative sample [n = 6793] of the undergraduate student population using a modified version of the global youth tobacco survey questionnaire. The prevalence of smoking was 14.5% among students, 22.2% and 2.2% among fathers and mothers and 43.1% and 14.8% for male and female siblings; 15.0% reported all or most of theirfriends smoked. The most important independent predictors of smoking were: friends' smoking [some: OR - 6.7 and all: OR - 54.9], sister's smoking [OR - 2.2], mother's smoking [OR = 2.1], single status [OR -1.7] and age [OR -1.18]

Sleep duration and its correlates in a sample of Saudi elementary school children.

INTRODUCTION: This study was conducted to estimate sleep duration in Saudi elementary school children, sleep habits and practices that may affect it, and compare our results to published data in other societies. METHODS: Parents of elementary school children were surveyed regarding their children's bedtime, rise time, sleep duration at night and daytime nap duration during weekdays and weekends. A questionnaire inquiring about demographical data, specific sleep problems and habits, and home environment was completed by the parents. RESULTS: The study comprised 511 (50.5 percent) boys and 501 (49.5 percent) girls. During weekdays, bedtime for the whole group was 21.3 +/- 1.8 hours, rise time was 5.9 +/- 0.5 hours, total sleep time (TST) was 8.4 +/- 1.1 hours, and TST and nap was 9.98 +/- 1.3 hours. Multivariate analysis revealed that TST was affected by regularity of bedtime, mother's level of education, daytime naps, and the habits of watching television (TV) and playing computer games after 20.00 hours. CONCLUSION: Nighttime sleep duration is shorter in Saudi school children compared to published data. Several factors appeared to affect sleep duration, including mother's educational level, daytime naps and watching TV at night.

Intrafamilial person-to-person spread of bacillary dysentery due to Shigella dysenteriae in southwestern Saudi Arabia.

OBJECTIVE: To identify the factors that influence transmission of bacillary dysentry (BD) within families during a propagated outbreak of bacillary dysentery. DESIGN: A retrospective cohort study. SETTING: Eighteen neighbouring villages in rural Gizan, southwestern Saudi Arabia. SUBJECTS: Two hundred and thirty three cases of BD were identified among seventy nine families. RESULTS: Secondary cases of BD occurred in 57 of 79 families with a primary case of BD. The secondary attack rate per cent (AR%) within families ranged between 7.7% and 80%. Age of primary cases did not correlate with degree of secondary AR% in exposed families (p > 0.04; p > 0.05); however, within households, the age of the first secondary cases (median = two years) was usually less than the age of the primary case (median = six years). Children under five years of age constituted 43% of secondary cases. The median interval between successive cases within a house ranged from three and seven days. Two hundred and twenty cases (94.4%) gave history of close contact within another case of BD. Cases of BD were exposed to close relatives with BD (79.1%), neighbours (11.4%), and friends (9.5%). Risk factors influencing the spread of BD within families included two rooms or fewer per house (OR = 4.3, 9.5% CI 1.3-14.3), family size of five or more (p = 0.012, two-tailed Fisher's exact test), and presence of more than two persons per room (OR = 11.2, 95% CI 3.1-42.4). CONCLUSION: Person-to-person secondary transmission can amplify the spread of bacillary dysentery within households and neighbouring villages. Crowding was a risk factor that amplified transmission of BD within families.