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

Between June 13 and June 17, 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified the World Health Organization (WHO) of five additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the cases are as follows:

1. A 28-year-old male from Hofuf city developed symptoms on June 2. He works as an administrative assistant in a hospital that had been experiencing a MERS-CoV outbreak. The patient was in home isolation since the onset of symptoms; however, as symptoms worsened, he was admitted to hospital on June 14. The patient, who has comorbidities, tested positive for MERS-CoV on June 15. Investigation of epidemiological links with MERS-CoV cases admitted to the hospital where he works at, and of history of exposure to other known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

2. A 69-year-old female from Hofuf city developed symptoms on June 12 and was admitted to hospital on June 13. The patient, who has comorbidities, tested positive for MERS-CoV on June 14. She has a history of frequent visits to a hospital that had been experiencing a MERS-CoV outbreak. Investigation of epidemiological links with healthcare workers and MERS-CoV cases that were at the hospital, and of history of exposure to other known risk factors in the 14 days prior to the onset of symptoms is ongoing. Currently, the patient is in stable condition in a negative pressure isolation room on a ward.

 3. A 54-year-old female from Hofuf city developed symptoms on June 5 and, on June 12, was admitted to a hospital that had been experiencing a MERS-CoV outbreak. The patient, who has comorbidities, tested positive for MERS-CoV on June 13. 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 stable condition in a negative pressure isolation room on a ward.

4. A 46-year-old male from Hurimala city developed symptoms on June 9 and was admitted to hospital on June 12. The patient, who has comorbidities, tested positive for MERS-CoV on June 12. He has a history of contact with camels and consumption of their raw 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 stable condition in a negative pressure isolation room on a ward.

5. A 55-year-old female from Hofuf city developed symptoms on May 23 and was admitted to hospital on May 25. The patient, who has comorbidities, tested positive for MERS-CoV on June 12. Between April 18 and May 17, the patient was hospitalized in a healthcare facility that had experienced a MERS-CoV outbreak. Furthermore, she visited the outpatient department of the same healthcare facility on May 20. Investigation of epidemiological links with MERS-CoV cases and healthcare workers who were at the healthcare facility during her admission, and exposure to other known risk factor is ongoing. Currently, the patient is in critical condition in ICU.

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

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

Globally, since September 2012, WHO has been notified of 1,339 laboratory-confirmed cases of infection with MERS-CoV, including at least 476 related deaths.

WHO advice

Based on the current situation and available information, WHO encourages all 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