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Between June 30, 2014 and July 1, 2014, the National IHR Focal Point for Saudi Arabia reported an additional three laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV), and a death in a previously reported case.
Details of the case reported on June 30 are as follows:
A 15-year-old boy from Riyadh City, Riyadh Region became ill on June 26. He visited a hospital where samples were collected for laboratory test on June 28. Following laboratory-confirmation with MERS-CoV infection on June 30, the patient was called back and admitted at the hospital. He is currently in a stable condition. The patient had a recent history of travel to Mecca City, Mecca Region. He had no history of contact with a previously laboratory-confirmed case with MERS-CoV. The patient had no history of contact with animals or history of consumption of camel products in the last 14 days prior to onset of symptoms.
Details of the two cases reported on July 1 are as follows:
A 53-year-old pharmacist from Najran city, Najran Region became ill on June 16 and was admitted to a hospital on June 28 and is currently in a stable condition. He was laboratory-confirmed with MERS-CoV infection on June 30. The patient has underlying medical conditions. He has no history of contact with animals or history of consumption of camel products in the last 14 days prior to developing the illness. He travelled to Abha city, Asir region, 20 days before falling ill and stayed there for a day.
A 28-year-old-housewife from Riyadh city, Riyadh Region became ill on June 23, was admitted to a hospital on June 29, and is currently in a stable condition. The patient was laboratory-confirmed with MERS-CoV on June 30. She is reported not to have any underlying medical condition. The patient had no contact with previously laboratory-confirmed case with MERS-CoV, and no history of travel. She has no history of contact with animals or history of consumption of camel products in the 14 days prior to developing the illness.
Investigation into contacts of the patients are ongoing.
In addition, an additional death in a previously laboratory-confirmed case with MERS-CoV infection has been reported
Globally, 827 laboratory-confirmed cases of infection with MERS-CoV, including at least 287 related deaths have officially been reported to the World Health Organization (WHO).
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 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.