Surveillance and Testing for Middle East Respiratory Syndrome Coronavirus, Saudi Arabia, April 2015-February 2016.

Saudi Arabia has reported >80% of the Middle East respiratory syndrome coronavirus (MERS-CoV) cases worldwide. During April 2015-February 2016, Saudi Arabia identified and tested 57,363 persons (18.4/10,000 residents) with suspected MERS-CoV infection; 384 (0.7%) tested positive. Robust, extensive, and timely surveillance is critical for limiting virus transmission.

Alkhurma hemorrhagic fever in humans, Najran, Saudi Arabia.

Alkhurma virus is a flavivirus, discovered in 1994 in a person who died of hemorrhagic fever after slaughtering a sheep from the city of Alkhurma, Saudi Arabia. Since then, several cases of Alkhurma hemorrhagic fever (ALKHF), with fatality rates up to 25%, have been documented. From January 1, 2006, through April 1, 2009, active disease surveillance and serologic testing of household contacts identified ALKHF in 28 persons in Najran, Saudi Arabia. For epidemiologic comparison, serologic testing of household and neighborhood controls identified 65 serologically negative persons. Among ALKHF patients, 11 were hospitalized and 17 had subclinical infection. Univariate analysis indicated that the following were associated with Alkhurma virus infection: contact with domestic animals, feeding and slaughtering animals, handling raw meat products, drinking unpasteurized milk, and being bitten by a tick. After multivariate modeling, the following associations remained significant: animal contact, neighboring farms, and tick bites.

Cutaneous Leishmaniasis in Saudi Arabia: A Comprehensive Overview.

Despite the great efforts by health authorities in Kingdom of Saudi Arabia (KSA), Cutaneous leishmaniasis (CL) continues to be a major public health problem in the country. Many risk factors make KSA prone to outbreaks and epidemics; among these, rapid urbanization and the huge population movement are the most important. The disease is endemic in many parts of KSA, with the majority of cases concentrated in six regions, including Al-Qaseem, Riyadh, Al-Hassa, Aseer, Ha'il, and Al-Madinah. Leishmania major (L. major) and Leishmania tropica (L. tropica) are the main dermotropic species, and Phlebotomus papatasi (vector of L. major) and Phlebotomus sergenti (vector of L. tropica) are the proved vectors of the disease. Psammomys obesus and Meriones libycus have been defined as the principal reservoir hosts of zoonotic CL in Al-Hassa oasis, Al-Madinah, and Al-Qaseem provinces. Clinically, males are affected more than females, and there is no variation between the Saudis and expatriates in terms of number of reported cases, but the disease tends to run a more severe course among non-Saudis. Face is the most commonly affected site, and ulcerative pattern accounts for 90% of lesions. Despite local and international recommendations of using laboratory diagnostics to confirm CL cases, most cases in KSA are diagnosed and treated on clinical grounds and local epidemiology. However, systemic parenteral sodium stibogluconate (SSG) is the first line of therapy and used to treat all CL patients irrespective of their clinical presentation or the incriminated species. In brief, more efforts are needed to combat this disease. Several aspects of the disease require more evaluation through encouragement of national and regional studies. Development of evidence based national diagnostic and management guidelines, as well as algorithms, is urgently needed to improve the practice of diagnosing and treating CL in KSA.

Geographical distribution and spatio-temporal patterns of dengue cases in Jeddah Governorate from 2006-2008.

BACKGROUND: Dengue remains a major health problem in Jeddah, Saudi Arabia. A surveillance system was initiated to detect new cases in 2006. The study aims to examine these data for detection of space-time clustering and identify target areas for effective interventions. METHODS: Through a cross-sectional design, we included all confirmed dengue cases among residents of Jeddah with a clearly written addresses (n = 2288). Cases were geo-coded at the district level, and then analyzed by ArcGIS for geographical distribution and by the space-time permutation model of SaTScan for detection of clusters of cases. RESULTS: This study showed a seasonal pattern of dengue infections mainly in the first half of the year. Males and younger age-groups were more likely to be affected (70.8 and 67.3%, respectively). Descriptive spatial analysis showed that the infection was concentrated in the south and central-north regions. Space-time permutation scan statistics demonstrated five spatio-temporal clusters of dengue cases with no variations by age-groups, gender and nationality-group. Our results showed clear geographical patterns of dengue in Jeddah. CONCLUSIONS: Our unique data with geographical coding enabled us to detect and target dengue clusters that support the use of geospatial information in infection control in Saudi Arabia and would allow for better targeting of interaction progress.

Pattern of diseases among visitors to Mina health centers during the Hajj season, 1429 H (2008 G).

BACKGROUND: While performing the Hajj, hajjis face different risks related to the environment, their behaviors and their health conditions that can result in a variety of diseases. The objective of this study was to determine the pattern of diseases among pilgrims seeking medical services in Mina primary health care centers (PHCCs) during the Hajj season in 1429 (2008). METHODS: This is a descriptive study based on the medical records of a random sample of 4136 patients who attended 13 randomly selected Mina PHCCs from 8 to 12 Dhu-Alhijja, 1429 H (6-10 December 2008). RESULTS: The majority of the patients were men (70.7%), and most of the patients were between 45 and 64 years of age (42.8%). One-fifth (20.2%) of the patients suffered from multiple diseases. Respiratory diseases were the most common (60.8%), followed by musculoskeletal (17.6%), skin (15.0%) and gastrointestinal (13.1%) diseases. Diabetes, asthma and hypertension each constituted less than 3% of the total diseases. Respiratory diseases were the most common independent of nationality or the day of visit, while the frequency of the other diseases varied according to nationality and the day of visit. The most frequently prescribed drugs were analgesics, antipyretics, antibiotics and cough syrups. CONCLUSION: This study describes the pattern of diseases among pilgrims attending Mina PHCCs, which may aid in providing the best possible health care services to pilgrims.