Saudi Arabia Ministry of Health notifies WHO of five additional MERS-CoV cases

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The Ministry of Health in Saudi Arabia has notified WHO of an additional five laboratory-confirmed cases with Middle East respiratory syndrome coronavirus (MERS-CoV).

All five patients are from the Eastern region of the country, but not from Al-Ahsa, where an outbreak began in a health care facility in April 2013. The patients had underlying medical conditions which required multiple hospital visits. The government of Saudi Arabia is conducting investigations into the likely source of infection in both the health care and community settings.

The first patient is a 56-year-old man with underlying medical conditions, who became ill on 12 May 2013 and died on 20 May 2013. The second patient is an 85-year-old woman with underlying medical conditions who became ill on 17 May and is currently in a critical condition. The third patient is a 76-year-old woman with underlying medical conditions who became ill on 24 May 2013 and was discharged from the hospital on 27 May 2013. The fourth patient is a 77-year-old man with underlying medical conditions who became ill on 19 May and died on 26 May 2013. The fifth patient is a 73-year-old man with underlying medical conditions who became ill on 18 May and died on 26 May 2013.

Additionally, a patient earlier reported from Al-Ahsa, an 81-year-old woman has died. The government is continuing to investigate the outbreaks in the country.

In France, the first laboratory-confirmed case in the country, with recent travel from the United Arab Emirates has died.

From September 2012 to date, WHO has been informed of a global total of 49 laboratory-confirmed cases of infection with MERS-CoV, including 27 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 four additional countries: France, Germany, 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, Tunisia and the United Kingdom, there has been limited local transmission among patients who had not been to the Arabian Peninsula but had been in close contact with the laboratory-confirmed or probable cases.

On May 17th 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 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.

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

See also:
European Centre for Disease Prevention and Control 
Health Protection Agency UK
World Health Organization

WHO Global overview of an emerging novel coronavirus (MERS-CoV)
World Health Organization-Europe