Middle East respiratory syndrome coronavirus (MERS-CoV) – Qatar
On 12 June 2016, the National IHR Focal Point of Qatar notified WHO of 1 additional case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.
Details of the case
A 23-year-old, non-national male from Al-Shahaniya City presented with symptoms at a health centre on 8 June. The patient, who has no comorbidities, tested positive for MERS-CoV on 9 June. He has a history of frequent contact with camels and consumption of their raw milk. The patient also has a history of travel to Saudi Arabia on 28 May. He is currently in stable condition admitted to a negative pressure isolation room on a ward.
The Department of Health Protection and Communicable Disease Control within the Ministry of Public Health immediately carried out case investigation and contact tracing. All the healthcare workers who attended the patient followed recommended infection prevention and control measures. Respiratory swabs were collected from 26 household contacts and all results were negative for MERS-CoV by PCR. All contacts were monitored until the end of the 14-day period following last exposure to the case and none of them developed symptoms. Health education messages about appropriate preventive measures were shared with all contacts, who were also advised to comply with the recommended MERS-CoV preventive measures and to report to health authorities on the development of any respiratory symptoms. The Animal Health Resources Department has been notified and investigation of camels is ongoing.
Globally, since September 2012, WHO has been notified of 1,769 laboratory-confirmed cases of infection with MERS-CoV, including at least 630 related deaths.
WHO risk assessment
MERS-CoV causes severe human infections resulting in high mortality and has demonstrated the ability to transmit between humans. So far, the observed human-to-human transmission has occurred mainly in health care settings.
The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.
Based on the current situation and available information, WHO encourages all 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 MERS‐CoV 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.
Given the lack of evidence of sustained human-to-human transmission in the community, WHO does not recommend travel or trade restrictions with regard to this event. Raising awareness about MERS-CoV among travellers to and from affected countries is good public health practice.