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

Between March 3, 2015 and March 10, 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified the World Health Organization (WHO) of 15 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, including five deaths. Details of the cases are as follows:

1. A 72-year-old female from Buridah city developed symptoms on Feb. 23 and was admitted to a hospital on March 2. She had comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. The patient died on March 9.

2. A 61-year-old male from Riyadh city developed symptoms on March 7 while admitted to hospital since Feb. 22 due to an unrelated medical condition. The patient was admitted to the same hospital as other laboratory-confirmed MERS-CoV cases; investigation of epidemiological links with these cases and with shared health workers is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

3. A 48-year-old female from Riyadh city developed symptoms on March 4 while admitted to a hospital since Jan. 19 due to an unrelated medical condition. The patient was admitted to the same hospital as other laboratory-confirmed MERS-CoV cases during the 14 days prior to the onset of symptoms; investigation of epidemiological links with these cases and with shared health workers is ongoing. Currently, the patient is in critical condition in ICU.

4. A 37-year-old, non-national, male health worker from Riyadh city developed symptoms on March 7 and was admitted to a hospital on March 8. The patient has comorbidities. He works in a hospital where laboratory-confirmed MERS-CoV cases were treated during the 14 days prior to the onset of symptoms; investigation of epidemiological links with these cases is ongoing. Currently, the patient is in critical condition in ICU.

5. A 48-year-old female from Riyadh city developed symptoms on March 7 and was admitted to a hospital on the same day. The patient has comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in critical condition in ICU.

6. A 61-year-old male from Riyadh city developed symptoms on Feb. 27 and was admitted to a hospital on March 5. The patient had comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. The patient died on March 9.

7. A 57-year-old male from Hafouf city developed symptoms on March 4 and was admitted to a a hospital on March 6. The patient has no comorbidities. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in critical condition in ICU.

8. A 56-year-old male from Riyadh city developed symptoms on March 4 and was admitted to a hospital on March 5. The patient has comorbidities. He is a contact of a laboratory-confirmed MERS-CoV case that was reported in a previous DON on 23 February (case n. 11). 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.

9. A 48-year-old, non-national, female health worker from Riyadh city developed symptoms on Marc 3 and was admitted to hospital on March 5. The patient has no comorbidities. She works in a hospital where laboratory-confirmed MERS-CoV cases were treated during the 14 days prior to the onset of symptoms; investigation of epidemiological links with these cases is ongoing. The patient 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.

10. A 59-year-old female from Khurmah city developed symptoms on Feb. 23 and was admitted to a hospital in Jeddah on Feb. 28. The patient has comorbidities. She has no history of direct contact with camels; however, her household contacts have history of frequent contact with camels and consumption of raw camel milk. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, she is in critical condition in ICU.

11. A 53-year-old male from Riyadh city developed symptoms on March 3 while admitted to a hospital since July 13, 2014 due to an unrelated medical condition. The patient was admitted to the same hospital as other laboratory-confirmed MERS-CoV cases during the 14 days prior to the onset of symptoms; however, he had no direct contact with these cases. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. He died on March 5.

12. A 44-year-old, non-national male from Shaqra city developed symptoms on Feb. 23 and was admitted to a hospital on Feb. 25. The patient has no comorbidities. He has a history of frequent contact with camels and consumption of raw camel milk. The patient has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. Currently, he is in critical condition in ICU.

13. A 30-year-old, non-national male from Onizah city developed symptoms on March 2 and was admitted to a hospital on the same day. The patient had no comorbid conditions. Investigation of history of exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. The patient died on March 8.

14. A 69-year-old female from Riyadh city developed symptoms on March 3 while admitted to a hospital since Feb. 20 due to an unrelated medical condition. The patient was admitted to the same hospital as other laboratory-confirmed MERS-CoV cases during the 14 days prior to the onset of symptoms; investigation of epidemiological links with these cases and with shared health workers is ongoing. She 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.

15. A 70-year-old female from Riyadh city developed symptoms on Feb. 24 and was admitted to a hospital on Feb. 2. The patient had comorbidities. She had no history of exposure to known risk factors in the 14 days prior to the onset of symptoms. The patient died on March 4.

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

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

Globally, WHO has been notified of 1,075 laboratory-confirmed cases of infection with MERS-CoV, including at least 404 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