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


WHO has been informed on August 1st of an additional three cases of laboratory-confirmed Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia.

The first patient is a 67-year-old woman from Riyadh with underlying medical conditions. She became ill on 25 July 2013. She has no known exposure to animals or to a case confirmed with MERS-CoV infection. She is currently hospitalised.

The other two patients are health care workers, both women, from Assir and Riyadh regions. Both of them have mild symptoms and were exposed to patients who were laboratory-confirmed cases.

Globally, from September 2012 to date, WHO has been informed of a total of 94 laboratory-confirmed cases of infection with MERS-CoV, including 46 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.

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 ie Arabian peninsula1 and surrounding countries.

On July 22nd the European Centre for Disease Prevention and Control issued an updated rapid risk assessment on MERS-CoV.

On July 25th, WHO issued interim travel advice on MERS-CoV for pilgrimages to the Kingdom of Saudi Arabia, see here. 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.

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.

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.

International Health Regulations Emergency Committee concerning MERS-CoV
WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised 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.  

For details see here.

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

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