MERS Update

IHR EC: No evidence of sustained human-to-human transmission


The National IHR (International Health Regulations) Focal Point of Saudi Arabia reported 7 additional laboratory-confirmed cases including one death - of infection with Middle East respiratory syndrome coronavirus (MERS-CoV) between 29 September and 11 October 2014 to WHO.

WHO said the tracing of household contacts was ongoing for these cases. In addition, the deaths of 4 previously reported MERS-CoV cases from Saudi Arabia were also reported.

Cases identified in KSA following a retrospective review

Following a retrospective review of laboratory records in non-Ministry of Health hospitals, the National IHR Focal Point of Saudi Arabia has also reported 19 additional cases of MERS-CoV infection, including 11 deaths.

Of the additional cases, 1 occurred in August 2013, 2 occurred in March 2014, 10 occurred in April 2014 and 6 occurred in May 2014. Of the additional cases reported by Saudi Arabia, 79% (15 people) are Saudi nationals. Sixteen of the reported cases resided in Jeddah, 2 in Kharj and 1 in Dhahran. The median age is 56 years (ranging from 27 to 89), 68% (13/19) were men, and 11% (2/19) of the reported cases were health care workers.

The retrospective identification of these 19 cases does not alter the pattern and dynamic of the epidemic and the global risk assessment remains unchanged, according to WHO.

As of October 18, globally, 877 laboratory confirmed cases of infection with MERSCoV including at least 317 related deaths have been reported to WHO.

WHO advice

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.

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.

Seventh Meeting of the IHR Emergency Committee

The seventh meeting of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (IHR 2005) regarding the Middle East respiratory syndrome coronavirus (MERS-CoV) was conducted with members and advisors of the Emergency Committee through electronic correspondence from 26 September 2014 through 30 September 2014.

The Committee noted that: (i) there have been significant efforts made to strengthen infection prevention and control measures, with an epidemiological situation that has not changed since the 6th meeting of the IHR EC; (ii) the number of cases has fallen since the April upswing, and cases continues to appear sporadically with no evidence of sustained human-tohuman transmission in communities; (iii) although transmission in healthcare settings is still occurring in small clusters, transmission seems generally contained; (iv) activities conducted to reduce the international spread of MERSCoV seem to be effective; and (v) the current data suggest that MERS-CoV transmission could be seasonal, with an upsurge expected next spring.

Infection prevention for healthworkers

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.

 Date of upload: 14th Nov 2014


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