Nine Cases of MERS-CoV in Saudi Arabia are Reported to WHO

Between Jan. 4 and 22, 2015, the IHR National Focal Point for the Kingdom of Saudi Arabia (SAU) notified the World Health Organization (WHO) of nine additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including four deaths.

Details of the cases are as follows:
1. An 84-year-old female from Riyadh city developed symptoms on Jan. 19 and was admitted to a private hospital on Jan. 20. The patient has comorbidities but no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. The patient was in ICU in critical condition. Since then, she recovered and was discharged on Jan. 27.

2. A 77-year-old male from Riyadh city developed symptoms on Jan. 18 and was admitted to a private hospital on Jan. 21. The patient has comorbidities but no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. The patient was in ICU in critical condition. Since then, he recovered and was discharged on Jan. 28.

3. An 80-year-old male from Riyadh city developed symptoms on Dec. 26 and was admitted to a hospital on the same day. The patient had comorbidities. On Dec. 26, he was in an emergency room where two previously reported MERS-CoV cases had been treated, although the patient had no direct contact with either case. He had no history of exposure to other known risk factors in the 14 days prior to the onset of initial symptoms. The patient was in ICU and died on Jan. 23.

4. A 38-year-old male from Riyadh city developed symptoms on Jan. 14. The patient, who has comorbidities, was initially admitted to a hospital on Jan. 1 for a surgical procedure. On Jan. 7, during his admission, he went out on a day-release where he visited his family in Aldawadmi city. On Jan. 12, the patient underwent surgery in a hospital where a laboratory confirmed MERS-CoV case had also been treated, although there is no history of contact between the patient and the case. He has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition and remains in isolation.

5.A 76-year-old male from Riyadh city developed symptoms on Jan. 12. The patient, who had comorbidities, was initially admitted to a hospital for an unrelated medical condition on Nov. 3. He received care in a hospital where a laboratory confirmed MERS-CoV case had also been treated. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He was in critical condition and died  on Jan. 18.

6. A 67-year-old male from Riyadh city developed symptoms on Jan. 12  and was admitted to a hospital on Jan. 16. The patient has comorbidities. He frequently visited a healthcare facility in Riyadh to treat his unrelated medical condition but has no history of contact with patients with respiratory symptoms. The facility is not associated with previous known MERS-CoV cases. There is no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition and remains in an isolation ward.

7. A 62-year-old male from Riyadh city developed symptoms on Jan. 14 and was admitted to a hospital on Jan. 16. The patient has comorbidities. He has no history of exposure to any known risk factors in the 14 days prior to the onset of symptoms. Currently, the patient is in stable condition and remains in an isolation ward.

8. A 67-year-old male from Taif city developed symptoms on Jan. 5 and was admitted to a hospital on Jan. 9. The patient had comorbidities. He had no history of direct contact with camels or consumption of camel products but lived in an area with heavy presence of camels. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He was in critical condition and died on Jan. 21.

9. A 93-year-old male from Riyadh city developed symptoms on Jan. 11. The patient, who had comorbidities, was initially admitted to a hospital for an acute injury on Dec. 28. At that time, the hospital was treating a laboratory confirmed MERS-CoV case. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. The patient was in critical condition in ICU and died on Jan. 15.

Contact tracing of household contacts and healthcare contacts is ongoing for these cases.

The IHR National Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of two previously reported MERS-CoV cases.

Globally, WHO has been notified of 965 laboratory-confirmed cases of infection with MERS-CoV, including at least 357 related deaths.

Based on the current situation and available information, WHO encourages all of its member states to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in healthcare facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures.

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 MERSCoV 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 handwashing 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 restrictions.

Source: WHO

TAGS: WHO Pathogens
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