Saudi reports two more cases of new coronavirus

Medical investigators travel to city of Hofuf, where nearly half of infections reported so far have occurred.

International investigators have arrived in Hofuf, Saudi Arabia, to tackle the spread of a novel coronavirus that has killed 18 people.

At least 33 people, including 25 in the kingdom, have been infected by the virus which now has a higher fatality rate than Sars, the related coronavirus.

Sars appeared in 2002 in South China and spread to 37 countries, causing 775 deaths among 8,273 cases before petering out in 2003, the World Health Organisation (WHO) says.

The Saudi health ministry on Thursday announced two more cases of coronavirus in Hofuf, men aged 48 and 58. That makes 15 cases in Hofuf, seven of whom have died.

In France, authorities said three people had taken ill and were in hospital after coming into contact with a Frenchman, 65, believed to have contracted the virus during a visit to Dubai.

They are a patient who shared a ward with him and a doctor and nurse who treated him.

It is still not clear how the virus, which was first detected in September last year in Saudi Arabia, is spreading.

But the WHO believes it has seen at least two instances of "very limited, human-to-human transmission" outside of Saudi Arabia, said Gregory Hartl, a spokesman for the organisation.

"However, we have not yet seen any instances where there is sustained, community spread of the virus," Mr Hartl said.

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In announcing the latest cases, Saudi Arabia's deputy health minister, Dr Ziad Memish, wrote to the International Society for Infectious Diseases telling it that his team had been "effective to date in preventing new cases related to this cluster from emerging".

The two cases announced on Thursday were found by testing patients who had fallen ill last month but no one realised at the time it was the coronavirus, Dr Memish said.

One of those reported recovered from the illness and was discharged on May 3.

Although the spread of the disease is so far limited, Saudi and international authorities have raised concerns that health centres have become the primary locale for transmission, and the international team, comprising experts from WHO, the Saudi health ministry and international universities and hospitals, will focus their work around the Saudi hospitals.

Many of the 15 cases in Hofuf are thought to have originated in Al Moosa Hospital, but no exact figures have been given.

"So far there is no apparent community transmission and transmission seems linked to one healthcare facility," Dr Memish wrote to colleagues on May 5.

But this has sparked concerns among residents and health workers in Saudi Arabia about the readiness of healthcare centres.

One of the hospitals in the area where local media say cases have been reported was criticised this year by Saudi Arabia's National Corruption Commission for poor sanitation, inadequate facilities and negligent management.

Officials from the commission said in February that they observed a "low level of hygiene" at King Fahd Hospital in Hofuf. They cited "negligence and shortcomings" in sanitation, including "the cleaning and disinfection of toilets, kitchens, rooms [and] waste collection."

Facilities were also inadequate, the corruption commission said, leaving patients to "jam" into the hallways. Medical personnel were not at the desks during working hours, the report claimed.

"Neglect is clear from the management of the hospital," the commission's report said, and called on the Saudi health ministry to investigate.

This week, Dr Memish and another Saudi deputy minister of health, Dr Mansour bin Nasser Hawasi, toured hospitals in the region of Alhasa, where Hofuf is located, in a bid to reassure residents.

They said that the health situation was under control and "nothing to worry about".

Mr Hartl confirmed there were no current plans to issue travel warnings related to the virus.