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Between May 4 and 9, 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 75-year-old male from Abqaiq city developed symptoms on April 30 and was admitted to a hospital on May 3. He is an ex-smoker and 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 stable condition in a negative pressure room on a ward.
2. A 61-year-old, non-national male from Najran city developed symptoms on April 28 and was admitted to a hospital on May 1. He had comorbidities. The patient had no history of direct contact with camels or consuming raw milk; however, he lived in an area with camels and sheep. The patient had no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms. The patient died on May 8.
3. A 48-year-old male from Taif city developed symptoms on May 3 and was admitted to a hospital on May 8. He 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.
4. A 39-year-old male from Hofuf city developed symptoms on April 28 and was admitted to a hospital on May 3. The patient is a smoker and has no comorbidities. He is a contact of a laboratory-confirmed MERS-CoV case that was reported previously. 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.
5. A 41-year-old, non-national male from Huraimla city developed symptoms on April 13 and was admitted to a hospital on April 23. He has comorbidities as well as 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 in ICU.
Contact tracing of household contacts and healthcare contacts is ongoing for these cases.
Globally, WHO has been notified of 1,116 laboratory-confirmed cases of infection with MERS-CoV, including at least 423 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.