Experts who commented on today's announcement welcomed the Saudi move toward greater transparency and expressed hope that it continues and increases. 

Connie Savor Price, MD, chief of infectious diseases at Denver Health and Hospital, commented, "When the new [minister of health] came into office, I do believe one of his priorities was to re-examine the data to ensure experts were getting accurate data to inform interventions. More rigorous case findings identified the additional cases and deaths that you heard about today. My sense is that most of these cases are healthcare associated." 

She denied any knowledge of the reasons for Memish's dismissal, but said she found the timing of today's announcement "interesting." 

"The MOH seems to want to be clear that they are here to collaborate and value transparency. That is a step in the right direction," she added. 

Michael T. Osterholm, PhD, MPH, who has done consulting work on MERS-CoV in the Middle East, said it's unclear why the additional cases were not reported earlier and what implications they have for understanding the MERS outbreak in Saudi Arabia. He is director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News. 

"We welcome this new level of transparency and hope it will continue with more detailed information about these cases and what will be done so that this doesn't happen in the future," he said. 

"It also reinforces the point that we need much more information about the risk factors for transmission, which can be answered only by the completion of a comprehensive case control study.  

"The bottom line message that we've got to understand is that this is not a Kingdom of Saudi Arabia problem or even a Middle East problem; this is an international problem," he said. "All it would take is one super-shedder of this virus to land in Tokyo or New York or London or Toronto, and this situation would turn on a dime."