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21 Sep 2016

Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia (@WHO, September 21 2016)

 

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

Subject: MERS-CoV, new cases in 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 / 21 September 2016

Between 23 August and 11 September 2016 the National IHR Focal Point of Saudi Arabia reported five (5) additional cases of Middle East Respiratory Syndrome (MERS).

 

Details of the cases

  1. A 55-year-old, national, male, living in Arar city, Northern Border region.
    • He developed symptoms on 3 September and was admitted to hospital on 8 September.
    • The patient, who has no comorbidities, tested positive for MERS-CoV on 10 September.
    • The case also reports contact with camels and consumption of their raw milk in the 14 days prior to onset of symptoms.
    • Currently, he is in stable condition admitted to a negative pressure isolation room on a ward.
    • The Ministry of Agriculture was informed and investigation of camels is ongoing.
  2. A 65-year-old, national, male, living in Riyadh city, Riyadh region.
    • He developed symptoms on 29 August and was admitted to hospital on 4 September.
    • The patient, who has comorbidities, tested positive for MERS-CoV on 5 September.
    • He has a history of contact with camels in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
    • Ministry of Agriculture was informed and investigation of camels is ongoing.
  3. A 40-year-old, non-national, male, living in Hofouf city, Al Ahssa region.
    • He developed symptoms on 15 August and was admitted to hospital on 28 August.
    • The patient, who has comorbidities, tested positive for MERS-CoV on 30 August.
    • He works in a camel market and has history of contact with camels and consumption of their raw milk in the 14 days prior to onset of symptoms.
    • Currently the patient is in critical condition admitted to the ICU on mechanical ventilation.
    • Ministry of Agriculture was informed and investigation of camels is ongoing.
  4. A 69-year-old, national, male, living in Taif city, Taif region.
    • He developed symptoms on 21 August and was admitted to hospital on 24 August.
    • The patient, who has comorbidities, tested positive for MERS-CoV on 25 August.
    • Investigation of history of exposure to the known risk factor in the 14 days prior to onset of symptoms is ongoing.
    • Currently the patient is in stable condition admitted to a negative pressure isolation room on a ward.
  5. A 43-year-old, national, male living in Hriymala city, Riyadh region.
    • He developed symptoms on 12 August but tested negative for MERS-CoV on 13 August.
    • Due to persistence of symptoms, he was admitted to hospital on 17 August and tested positive for MERS-CoV on 21 August.
    • The patient has no co-morbidities.
    • He is a household contact of a previously reported case (see DON posted 16 September, case no.2).
    • He has no other history of exposure to the 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 isolation room on ward.

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

Globally, since September 2012, WHO has been notified of 1,806 laboratory-confirmed cases of infection with MERS-CoV, including at least 643 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.

 

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; MERS-CoV; Saudi Arabia.

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