The World Health Organization (WHO) has been informed of an additional four laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV). These include one laboratory-confirmed case from the United Arab Emirates, one laboratory-confirmed case in Qatar, and an additional two laboratory-confirmed cases from Kuwait.
The patient reported from the United Arab Emirates is a national of Oman. He is 75 years old, with underlying medical conditions. He became ill on Oct. 1, 2013, was hospitalized on Oct. 12, 2013 and died on Nov. 10, 2013.
The patient from Qatar is a 61-year-old man with underlying medical conditions. He became ill on Nov. 4, 2013, and was hospitalized on Nov. 7, 2013. He is in critical condition. Preliminary epidemiological investigation indicates that the patient had exposure to farms where livestock are kept.
The first patient in Kuwait is a 47 year-old man who became ill on Oct. 30, 2013 and was hospitalized on Nov. 7,2013. He is in critical condition. The second patient is a 52-year-old man with underlying medical conditions. He became ill on Nov. 7, and was hospitalized on Nov. 10, 2013. He is in critical condition.
Globally, from September 2012 to date, WHO has been informed of a total of 157 laboratory-confirmed cases of infection with MERS-CoV, including 66 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.
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, healthcare workers and visitors.
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.
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.