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


The World Health Organization (WHO) has been informed of an additional two cases of a laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) in Qatar.

The patients include a 59-year old man with an underlying medical condition who became ill on 15 August 2013. He is currently hospitalised and is in a stable condition.

Preliminary epidemiological investigations reveal that the patient travelled to Medina, Saudi Arabia for 6 days and returned to Qatar on 15 August 2013. He did not take part in Umrah and did not visit Al-Masjid an-Nabawi in Medina. Further investigation is ongoing.
The second patient is a 29-year-old man with an underlying medical condition who had no history of recent travel outside the country.
The results of both the cases were confirmed by an international reference laboratory. A total of 138 healthcare workers, family and community contacts have been screened in the country and so far all tested negative for MERS-CoV infection.

Globally, from September 2012 to date, WHO has been informed of a total of 104 laboratory-confirmed cases of infection with MERS-CoV, including 49 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 July 19th 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 Peninsula1 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.

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.

For details on the Middle East respiratory syndrome coronavirus Joint Kingdom of Saudi Arabia/WHO mission- Riyadh, 4-9 June 2013 see here

The following document was published on the WHO website on August 13th:

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