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Between Jan. 3 and Jan. 5, 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia (KSA) notified the World Health Organization (WHO) of three additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.
Details of the cases are as follows:
1. A 69-year-old male from Najran city developed symptoms on Dec. 23 and was admitted to a hospital on Jan. 2. The patient has comorbidities. Although his neighbors rear camels, the patient has neither a history of direct contact with them nor of consuming raw camel products. In the 14 days prior to the onset of symptoms, he traveled to Yemen. He has no history of exposure to other known risk factors in the 14 days that preceded the onset of symptoms. Currently, the patient is in stable condition and remains in an isolation ward.
2. A 76-year-old male from Taif city developed symptoms on Dec. 26 and was admitted to a hospital on Dec. 31. The patient has comorbidities as well as a history of frequent contact with camels and raw camel milk consumption. 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 ICU and remains in critical condition.
3. A 45-year-old male from Dammam city developed symptoms on Dec. 31 and was admitted to a hospital on Jan. 1. The patient has no comorbidities. Although he frequently visits his friends’ camel farm, the patient has no history of direct contact with camels. 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 and remains in isolation.
Contact tracing of household contacts 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 one previously reported MERS-CoV case.
Globally, WHO has been notified of 948 laboratory-confirmed cases of infection with MERS-CoV, including at least 349 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 health care 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, health-care 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 hand washing 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.