Global Alert and Response (GAR)

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

Disease Outbreak News

WHO has been informed of four (4) additional laboratory-confirmed cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia.

The first case is a 41 year-old female healthcare worker from Riyadh with no known underlying medical conditions and who became ill on 15 August, 2013. Her condition deteriorated and she passed away at the end of August. No known exposure to animals, or to a confirmed MERS-CoV case, has been identified and investigations into the source of infection are on-going.

The second case is a 30 year-old Saudi male healthcare worker from Riyadh, working in the same hospital as the above confirmed case. He developed severe pneumonia on 1 September, 2013, and is currently in critical condition.

The third case is a 79 year-old woman from Hafar al-Batin province who developed a respiratory illness on 21 August, 2013. She is a contact of a confirmed MERS-CoV case in a family cluster. Her condition deteriorated and she passed away on 2 September, 2013.

The fourth case is a 47 year-old Saudi man from Hafar al-Batin province with a chronic heart condition and who became ill on 23 August, 2013. He is a contact of a confirmed MERS-CoV case in a family cluster. He is currently in critical condition.

Globally, from September 2012 to date, WHO has been informed of a total of 114 laboratory-confirmed cases of infection with MERS-CoV, including 54 deaths.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhoea, in patients who are immunocompromised.

Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care 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, health care workers and visitors.

All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

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.

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.

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