Middle East respiratory syndrome coronavirus (MERS-CoV) - Update


The Ministry of Health in the United Arab Emirates (UAE) notified WHO of a laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) on July 13th.

The patient is an 82-year-old man with underlying medical conditions and is currently in a critical condition.

Globally, from September 2012 to date, WHO has been informed of a total of 82 laboratory-confirmed cases of infection with MERS-CoV, including 45 deaths.

Several countries in the Arabian Peninsula have been affected, including Jordan, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). Cases have also been reported by France, Germany, Italy, Tunisia and the United Kingdom- they were either transferred for care of the disease or returned from the Arabian Peninsula and subsequently became ill. In France, Italy, Tunisia and the United Kingdom, there has also been limited local transmission among patients who had not been to the Arabian Peninsula but had been in close contact with laboratory-confirmed or probable cases.

On June 18th the European Centre for Disease Prevention and Control issued an updated rapid risk assessment on MERS-CoV.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns. Any clusters of SARI or SARI in healthcare workers should be thoroughly investigated, regardless of where in the world they occur.

Testing for MERS-CoV should be considered in patients with unexplained pneumonias, or in patients with unexplained severe, progressive illness or complicated respiratory illness not responding to treatment, particularly in persons travelling from or resident in areas of the world known to be affected i.e. Arabian Peninsula[1] and surrounding countries.

Health care facilities that provide care for patients with suspected MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors. Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC) measures.

Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms such as diarrhoea in patients who are significantly immunocompromised.

New cases and clusters of MERS-CoV should be promptly reported to local Departments of Public Health.

WHO does not advise special screening at points of entry with regard to this event nor does it recommend that any travel or trade restrictions be applied.

International Health Regulations Emergency Committee concerning MERS-CoV
WHO has convened an Emergency Committee under the International Health Regulations (IHR) on a precautionary basis in order to be prepared for a change in the situation. The Emergency Committee, which comprises international experts from all WHO Regions provides expert technical advice to the WHO Director-General in accordance to the IHR (2005). The first meeting of the Committee took place on 9 July 2013. A second meeting of the Emergency Committee was held by teleconference on Wednesday, 17 July 2013.

The Committee reviewed and deliberated on information on a range of aspects of MERS-CoV, which was prepared or coordinated by the Secretariat and States in response to questions presented by Members during the first meeting.

It is the unanimous decision of the Committee that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

The WHO Secretariat will provide regular updates to the Members and will reconvene the Committee, in September, on a date to be determined. However, serious new developments may require an urgent re-convening of the Committee before then.

Based on these views and the currently available information, the Director-General accepted the Committee’s assessment that the current MERS-CoV situation is serious and of great concern, but does not constitute a PHEIC at this time.

For details see here.

The following document was published on the WHO website on July 9th:

MERS-CoV summary and literature update

For more information see http://www.hpsc.ie/hpsc/A-Z/Respiratory/CoronavirusInfections/

For travel advice see http://www.hpsc.ie/hpsc/A-Z/Respiratory/CoronavirusInfections/TravelAdvice/

See also:
Public Health England
WHO Global overview of an emerging novel coronavirus (MERS-CoV)
World Health Organization - Europe
European Centre for Disease Prevention and Control
Centers for Disease Control and Prevention, USA

[1] Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, Palestinian territories, Oman, Qatar, Saudi Arabia, Syria, the United Arab Emirates (UAE), and Yemen