After a two-month hiatus, the mysterious coronavirus that killed one man and hospitalized another is back on the scene. This time it has infected members of the same family.
The new cases raise the known total to six, including two deaths.
Scientist are trying to figure out if the involvement of a family says something new about the virus.
"There is a possibility that it represents person-to-person transmission, but it's also possible that the family members were exposed to a common animal source of the virus, too," Dr. Larry Anderson, an infectious disease specialist at Emory University, tells Shots. "What we know for sure is that there's an ongoing reservoir or source of the virus that humans are still, periodically encountering."
The new coronavirus first appeared in June, when a Saudi Arabian man died from severe respiratory problems and eventually kidney failure. A few months later a Qatari man came down with similar symptoms but recovered after several months in intensive care.
Scientists quickly sequenced the virus and realized it had never been seen before. It's most closely related to a bat coronavirus and a first cousin with the SARS virus, which infected nearly 8,000 people in 2003.
Even if the new coronavirus has spread between family members, Anderson says, "it doesn't mean the virus poses a global risk similar to SARS." Other viruses, he says, such as H5N1 bird flu and Nipah virus, have transmitted between people for years, but their infectiousness is so low that outbreaks have been rare and small.
The family that caught the coronavirus lives together in Saudi Arabia's capital of Riyadh, Dr. Ziad Memish from the Saudi Ministry of Health told Shots in an email. "They have not traveled abroad or within the country prior to the start of illness," he wrote.
Four family members have become ill, but only two have tested positive for the virus so far. One of them died, and the other recovered. "We expect the test results for the remaining family members any time now," Memish wrote.
He also said that doctors in Saudi Arabia are now screening for the virus in every patient who is admitted to a hospital with severe pneumonia. "I think that's why we are picking up new cases," he wrote. "The flow of samples is continuous, and we test all samples for the novel corona in our regional reference lab in Jeddah."
So far, all six cases have their origins in Saudi Arabia or Qatar. But the World Health Organization says it's time to widen the net and start looking for the virus elsewhere. WHO now recommends countries around the world start testing for the coronavirus when patients have unexplained pneumonias.
"It's impossible to know at this point because of the limited amount of testing just how widespread this problem is," a WHO told The Canadian Press. "But it just seems inappropriate to continue to focus on two countries in the region when there's really not much that would lead you to suppose that those were the only two countries affected."