Between April 2, 2015 and April 12, 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified the World Health Organization (WHO) of four additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including two deaths.
Details of the cases are as follows:
1. An 82-year-old male from Hail city developed symptoms on March 26 and was admitted to a hospital on April 2. Since the patient did not show signs of improvement, he was transferred to a hospital in Riyadh city on 4 April. The patient, who had comorbidities, died on April 12. Investigation of contacts in the 14 days prior to the onset of symptoms is ongoing.
2.A 65-year-old female from Riyadh city developed symptoms on April 3 and was admitted to a hospital on the same day. The patient, who had comorbidities, died on April 5. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
3. A 66-year-old, non-national male from Makkah city developed symptoms on March 27 and was admitted to a hospital on April 3. The patient visited a private health center for an unrelated medical condition on April 1. Currently, he is in stable condition in a negative pressure isolation room on a ward. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing.
4. A 51-year-old, non-national, male health worker from Jeddah city developed symptoms on March 28 and was admitted to a hospital on March 29. The patient has comorbidities. He has history of contact with a laboratory-confirmed MERS-CoV case that was reported previously. The patient did not provide care to any of the MERS-CoV cases that were admitted to the hospital where he works in during the 14 days prior to the onset of symptoms. 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 in a negative pressure isolation room on a ward.
The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of three previously reported MERS-CoV cases.
Contact tracing of household contacts and healthcare contacts is ongoing for these cases.
Globally, WHO has been notified of 1,106 laboratory-confirmed cases of infection with MERS-CoV, including at least 421 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.