Saudi Arabia’s Health Ministry on Monday urged residents of the world’s top oil exporter to renew precautions against Middle East Respiratory Syndrome (MERS) after a rise in new cases of the disease since early September.

The Health Ministry has announced a total of 23 confirmed new cases this month of the virus, which causes coughing, fever and sometimes fatal pneumonia. In addition to the 12 cases detected in September, this brings the total number in the kingdom to 777 since it was identified in 2012, of which 331 died.