On Feb. 3, 2014, United Arab Emirates (UAE) notified the World Health Organization (WHO) of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection. The case is a 66-year-old male UAE national, residing in Abu Dhabi. He had onset of symptoms on Jan. 20, 2014 with an upper respiratory tract illness and was admitted to the hospital on Jan. 24, 2014 with pneumonia and renal failure. He had underlying medical conditions.
MERS-CoV was laboratory-confirmed at the national laboratory in Abu Dhabi on Jan. 30, 2014 by two positive PCR targets. The patient is currently in the Intensive Care Unit (ICU) in stable condition. Public health authorities are carrying out contact tracing and an epidemiological investigation.
The patient owns camels in UAE and has recent travel history to Oman where he had contact with camels.
Globally, from September 2012 to date, WHO has been informed of a total of 182 laboratory-confirmed cases of infection with MERS-CoV, including 79 deaths.
Based on the current situation and available information, WHO encourages all of its member states to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
MERS-CoV infections that may be acquired in healthcare facilities illustrate the need to continue to strengthen infection prevention and control measures. 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, healthcare workers and visitors. Education and training for infection prevention and control should be provided to all healthcare workers and regularly refreshed.
Early identification of the MERS-CoV is important, but not all the cases could be reliably and timely detected, especially when disease is mild or presents atypically. Therefore, it is important to ensure that standard precautions are consistently used for all patients and all work practices all of the time, regardless of suspected or confirmed infection with the MERS-CoV or any other pathogen. Droplet precautions should be added when providing care to all patients with symptoms of acute respiratory infection, and contact precautions plus eye protection should be added when caring for confirmed or probable cases of MERS-CoV infection. Airborne precautions are indicated when performing aerosol generating procedures.
When the clinical and epidemiological clues strongly suggest MERS-CoV, the patient should be managed as potentially infected, even if an initial test on a nasopharyngeal swab is negative. Repeat testing should be done when the initial testing is negative, preferably on specimens from the lower respiratory tract.