Corona-CoV Cluster: Three Generations in One Family Infected with Corona-CoV, Hafar Al-Batin, Saudi Arabia

Middle East Respiratory Coronavirus (Corona-CoV) is reported to have infected a family cluster of three generations in Hafar Al-Batin in the Kingdom of Saudi Arabia (KSA) (see map below). Hafar Al-Batin is a city in the Eastern Province (ash-Sharqīyah) of KSA with a population of almost 400,000 people.[1] Official information from the KSA Ministry of Health is lacking on this cluster, however, scattered Arabic language media reports from the region allow a tentative reconstruction of this cluster of at least 4 cases. Other Corona-CoV cases are reported from Hafar Al-Batin, including a health care worker. Some of these other cases may be associated with this cluster.  Each of the cases in the cluster is described below. 

A. 60-70?, F died (within the past few days), newly reported, not confirmed by World Health Organization (WHO). [2] 

B. Fahad Al-Sahli, 38, M  died (Aug 17 or 18, 2013), son of Case A.   Confirmed by WHO.  [3]
 

C. 7 (8?), F reported recovered, granddaughter of Case A, may be daughter or niece of Case B. Confirmed by WHO. [3]

D. 16, M reported recovered,  grandson of Case A and may be son or nephew of Case B. Confirmed by WHO. [3]
 

No information is available for the onset dates, hospitalization dates, the physical residence of each of the individual, or contact details.   It is extremely unlikely that all of these family members were infected from an unidentified animal host.  It is much more likely this cluster is a result of human-to-human transmission than exposure to a common animal reservoir.

[1] Hafar Al-Batin

[2] Saudi Arabia - 3 relatives of man who died of nCoV coronavirus are suspected cases - at least 2 hospitalized with no diagnosis to date

[3]  Middle East respiratory syndrome coronavirus (Corona-CoV) - update

  

Researchers find Corona-CoV related Coronavirus in Bats in Africa (map)

In an upcoming article in Emerging Infectious Diseases, researchers are reporting that a coronavirus sample from a bat in South Africa is currently the closest match to the  Corona-CoV that has infected more than 90 people around the world since 2012. [1] The sample, PML/2011, was collected from a female Neoromicia zuluensis bat in 2011.  The genus Neoromicia is included in the Vespertilionidae bat family.  Because this sample was collected before the human outbreak, the authors suggest that Corona-CoV may have originated in bat populations in eastern or southern Africa and spread to the Arabian Peninsula. This new development means that surveillance for human Corona-CoV cases need to be expanded beyond the Arabian Peninsula into Africa as well.  Additional coronavirus research on Vespertilionidae bats in Kenya and surrounding countries is urgently needed.

 [1] Ithete NL, Stoffberg S, Corman VM, Cottontail VM, Richards LR, Schoeman MC, et al. Close relative of human Middle East respiratory syndrome coronavirus in bat, South Africa [letter]. Emerg Infect Dis [Internet]. 2013 Oct. http://dx.doi.org/10.3201/eid1910.130946