Update on Middle East respiratory syndrome coronavirus (MERS-CoV) – Austria and Saudi Arabia


On 30 September 2014, the National IHR Focal Point for Austria notified WHO via the European Commission’s Early Warning and Response System (EWRS) of a laboratory confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection diagnosed in Vienna, Austria. This is the first MERS-CoV case in Austria. For more details see http://www.who.int/csr/don/02-october-2014-mers-austria/en/.

The National IHR Focal Point of Saudi Arabia (KSA) has reported additional laboratory-confirmed cases of infection with MERS-CoV to WHO. Between 11 August and 28 September 2014, 15 cases of infection with MERS-CoV including 4 deaths were reported to WHO. For more details see http://www.who.int/csr/don/02-october-2014-mers-saudi-arabia/en/

The total numbers of globally reported cases and deaths have also been updated taking into consideration a review of cases. Globally, 853 laboratory-confirmed cases of infection with MERS-CoV including at least 301 related deaths have been reported to WHO.

Travel Advice
With the annual pilgrimage of Hajj underway (October 2nd to 7th 2014), the Kingdom of Saudi Arabia (KSA) recommends that elderly people, pregnant women, children and those with chronic diseases (e.g. heart diseases, kidney diseases, respiratory diseases, nervous system disorders, diabetes and immune deficiency postpone the performance of the Hajj and Umrah rituals for this year for their own safety. See advice at http://www.moh.gov.sa/en/Hajj/HealthGuidelines/HealthGuidelinesDuringHajj/Pages/HealthRegulations1435.aspx

WHO has issued specific travel advice on MERS-CoV for pilgrimages.

See Irish Travel Advice also http://www.hpsc.ie/A-Z/Respiratory/CoronavirusInfections/TravelAdvice/ 

WHO Advice
Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns. Healthcare providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop Severe Acute Respiratory Infection (SARI) should be tested for MERS-CoV as advised in the current surveillance recommendations. See http://www.hpsc.ie/A-Z/Respiratory/CoronavirusInfections/

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. Health-care facilities that provide for patients suspected or confirmed to be infected with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus from an infected patient to other patients, healthcare workers and visitors. Health care workers should be educated, trained and refreshed with skills on infection prevention and control.

It is not always possible to identify patients with MERS-CoV early because some have mild or unusual symptoms. For this reason, it is important that healthcare workers apply standard precautions consistently with all patients regardless of their diagnosis in all work practices all the time. See infection prevention and control guidance at http://www.hpsc.ie/A-Z/Respiratory/CoronavirusInfections/Guidance/

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, these people should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating.

General hygiene measures such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.

WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restriction.

Seventh meeting of the IHR Emergency Committee concerning MERS-CoV
The seventh meeting of the Emergency Committee (EC) convened by the Director-General of the WHO under the International Health Regulations (IHR 2005) regarding MERS-CoV was held from 26 September 2014 through 30 September 2014. The Committee unanimously concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met.

For more information on MERS-CoV see also the Health Protection Surveillance Centre website at http://www.hpsc.ie/A-Z/Respiratory/CoronavirusInfections/

See also WHO and ECDC websites on MERS-CoV