The World Health Organization (WHO) has been informed of an additional three laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) in Saudi Arabia.
The first patient is a 73-year-old woman with underlying medical conditions from Riyadh who became ill on Nov. 12,Â 2013, was hospitalized on Nov. 14,Â 2013 and died on Nov. 18, 2013. The second patient is a 65-year-old man with an underlying medical condition from Jawf region who became ill on Nov. 4,Â 2013 and was hospitalized on Nov. 14,Â 2013. The third patient is a 37-year-old man from Riyadh who became ill on Nov. 9,Â 2013, was hospitalized on Nov. 13, 2013 and died on Nov. 18,Â 2013. None of the three patients had exposure to animals or contact to a previously laboratory-confirmed case with MERS-CoV.
Globally, from September 2012 to date, WHO has been informed of a total of 160 laboratory-confirmed cases of infection with MERS-CoV, including 68 deaths.
Based on the current situation and available information, WHO encourages all of its member states to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.
Healthcare providers are advised to maintain vigilance. Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.
Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.
Healthcare facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Healthcare facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, healthcare workers and visitors.
WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.