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16 Sep 2016

Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia (@WHO, September 16 2016)

 

Title: Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia.

Subject: MERS-CoV, Saudi Arabia.

Source: World Health Organization (WHO), full page: (LINK).

Code: [     ]

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Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease outbreak news / 16 September 2016

Between 20 July and 18 August 2016, the National IHR Focal Point of Saudi Arabia reported eight (8) additional cases of Middle East Respiratory Syndrome (MERS) including one (1) fatal case. The death of two (2) previously reported MERS cases was also reported.

 

Details of the cases

  1. A 39-year-old male from Alkharj city, Riyadh Region developed symptoms on 11 August and was admitted to a hospital on 16 August.
    • A nasopharyngeal swab was collected on 17 August and tested positive for MERS-CoV on 18 August.
    • The case has no comorbid conditions.
    • He had a history of contact with camels and consumption of their raw milk.
    • There is no history of exposure to any of the other known risk factors.
    • Currently the patient is in stable condition admitted to a negative pressure room on a ward.
    • The Ministry of Agriculture was informed and investigation of camels is ongoing.
  2. A 36-year-old male from Huraymila city, Riyadh Region developed symptoms on 4 August and was admitted to a hospital on 7 August.
    • The patient who has comorbidities tested positive for MERS-CoV on 8 August.
    • Investigation of history of exposure to any of the known risk factor is ongoing.
    • Currently the patient is in stable condition admitted to a negative pressure room on a ward.
  3. A 76-year-old male from Madinah city, Madinah Region developed symptoms on 31 July and was admitted to a hospital on 2 August.
    • The patient has comorbidities and tested positive for MERS-CoV on 3 August.
    • Investigation of history of exposure to any of the known risk factors is ongoing.
    • Currently the patient is in stable condition admitted to a negative pressure room on a ward.
  4. A 49-year-old male from Hofouf city, El Hasa Region developed symptoms on 24 July and was admitted to a hospital on 31 July.
    • The patient has comorbidities and tested positive for MERS-CoV on 2 August.
    • He had a history of indirect contact with camels.
    • He has no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition admitted to a negative pressure room on a ward.
    • The Ministry of Agriculture was informed and investigation of camels is ongoing.
  5. A 52-year-old female from Jubail city, Eastern Region developed symptoms on 31 July and was admitted to hospital on 1 August.
    • The patient has no comorbid conditions and tested positive for MERS-CoV on 2 August.
    • She has a history of caring for the case reported to WHO on 29 of July 2016 (see below, case number 6).
    • She has no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition in home isolation.
  6. A 58-year-old male from Jubail city, Eastern Region developed symptoms on 19 July and was admitted to a hospital on 27 July.
    • The patient has comorbidities and tested positive for MERS-CoV on 28 July.
    • He has a history of indirect contact with camels and consumption of their raw milk.
    • He has no history of exposure to the other known risk factors in the 14 days prior to the onset of symptoms.
    • Currently the patient is in critical condition admitted to the ICU on mechanical ventilation.
    • The Ministry of Agriculture was informed and investigation of camels is also ongoing.
  7. A 27-year-old male from Buridah city, Qassim Region developed symptoms on 17 July and was admitted to a hospital on 20 July.
    • He tested positive for MERS-CoV on 22 July.
    • The patient has no comorbid conditions.
    • Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
    • Currently the patient is in critical condition admitted to the ICU on mechanical ventilation.
  8. A 49-year-old male from Najran city, Najran Region developed symptoms on 16 July and was admitted to a hospital on 17 July.
    • The patient had comorbidities and tested positive for MERS-CoV on 19 July.
    • Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
    • The patient was in critical condition admitted to the ICU on mechanical ventilation. He passed away on 20 July.

Contact tracing of household and healthcare contacts is ongoing for these cases.

The National IHR Focal Point for the Kingdom of Saudi Arabia also notified WHO of the death of 2 previously reported MERS-CoV cases. See case no.6 in DON posted 22 June and case no.3 in DON posted 25 July.

Globally, 1800 laboratory-confirmed cases of infection with MERS-CoV including at least 643 related deaths have been reported to WHO.

 

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.

 

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.

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.

WHO remains vigilant and is monitoring the situation. 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.

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Keywords: WHO; Updates; Saudi Arabia; MERS-CoV.

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