The World Health Organization (WHO) has been informed of four additional laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia. Two cases are female health workers from Riyadh who have not reported any symptoms.
The third case is a 53-year-old male from Ryadh with underlying chronic diseases. He was hospitalized on Nov. 26, 2013 and is currently receiving treatment in an intensive care unit. He had no exposure to animals and no travel history outside Riyadh region. He had contact with a confirmed case.
The fourth case is a 73-year-old male from Riyadh with underlying chronic diseases who died on Dec. 18, 2013, three days after being hospitalized. He had exposure to animals but no travel history.
Globally, from September 2012 to date, WHO has been informed of a total of 170 laboratory-confirmed cases of infection with MERS-CoV, including 72 deaths.
Healthcare providers are advised to maintain vigilance. Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.
Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.
Healthcare facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Healthcare facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.
People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
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.