On Sept. 30, 2014, the National IHR Focal Point for Austria notified the World Health Organization (WHO) via the European Commission’s Early Warning and Response System (EWRS) of a laboratory confirmed case of Middle-East respiratory syndrome coronavirus (MERS-CoV) infection diagnosed in Vienna, Austria. This is the first MERS-CoV case in Austria.
The case is a 29-year-old female citizen of the Kingdom of Saudi Arabia (SAU), who traveled on Sept. 22, 2014 to Vienna, Austria on a flight from Doha, Qatar. She had originally travelled from Affif, SAU, via Riyadh, by car. The case was symptomatic with an upper respiratory infection and fever prior to arrival in Austria.
The patient sought medical treatment in Austria on Sept. 24, 2014, and was transferred to a private hospital on Sept. 26 and then on Sept. 28, 2014, to the reference hospital for highly infectious diseases in Vienna. The patient is currently in a stable condition. No exposure to camels or their products, no prior hospital admission, nor contact to a known MERS-CoV case, nor any sick person has been reported.
The MERS-CoV infection was laboratory confirmed on Sept. 29, 2014 by RT-PCR targeting two distinct targets. A further target was confirmed positive on Sept. 30, 2014.
All of the contacts identified in Austria have been informed about the disease and are being followed up by Austrian health authorities. So far two close contacts have presented with upper respiratory symptoms and are admitted to hospital. Laboratory results of these contacts are pending.
The Austrian health authorities assume that the patient was infectious prior to, and during the international flights. Follow-up with passengers on the flight is ongoing and personal data of the crew on the flight has been communicated to Qatar.
WHO is facilitating contacts between the IHR NFPs of Austria and SAU to allow for exchange of information, and identification and follow-up of contacts of the case in SAU. Contact tracing will depend on the availability of the passenger data.
Globally, 853 laboratory-confirmed cases of infection with MERS-CoV including at least 301 related deaths have officially been reported to WHO.
With the annual pilgrimage of Hajj underway, WHO encourages its member states to review WHO’s travel advice on MERS-CoV for pilgrimages, published in June 2014.
Based on the current situation and available information, WHO encourages 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 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.