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MERS-CoV: Situation Update as of August 25, 2015Since the start of the outbreak in April 2012, the WHO has reported 1,461 cases of MERS-CoV, including 514 deaths worldwide—an observed case fatality rate of 35% (Source: WHO – August 23, 2015). The majority of cases have been reported on the Arabian Peninsula, particularly in Saudi Arabia (78%), and in 25 other countries. Since July 21, 2015, new clusters of MERS-CoV transmission have emerged in two hospitals in the city of Riyadh (primarily at King Abdulaziz Medical City, a modern healthcare facility). In one month, 110 cases, including 21 deaths, were reported in Riyadh by the Saudi Ministry of Health (MoH) (see figure). Of the 110 cases, 12 are healthcare workers. The hospital’s emergency department has been closed. A WHO expert is scheduled to arrive in Riyadh this week to assess this cluster with national teams. The index case and the exact locations of infection or exposure have not been reported. The outbreak has demonstrated that it can affect countries with high-level healthcare infrastructure, such as South Korea: between May and July 2015, 186 cases, including 36 deaths, were reported throughout South Korea, primarily resulting from nosocomial transmission. Nosocomial transmission underscores the need to adhere to prevention and control measures for respiratory infections to prevent the spread of MERS-CoV in healthcare facilities.The situation continues to be monitored with the utmost attention by Saudi and international authorities in light of the major pilgrimage to Mecca (Hajj), where several million pilgrims are expected to gather beginning around September 21, 2015, for a period of one month.