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5 Dec 2016

Middle East respiratory syndrome #coronavirus (#MERS-CoV) – #Saudi Arabia (@WHO, Dec. 5 ‘16)

 

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

Subject: MERS-CoV, new human cases in Saudi Arabia.

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

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

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Disease outbreak news / 5 December 2016

Between 12 and 27 November 2016 the National IHR Focal Point of Saudi Arabia reported nine (9) additional cases of Middle East Respiratory Syndrome (MERS) including one fatal case.

 

Details of the cases

  1. A 56-year-old male national living in Hafer Albatin city, Eastern Region.
    • He developed symptoms on 18 November and was admitted to hospital on 25 November.
    • The patient who has comorbidities, tested positive for MERS-CoV on 26 November.
    • Investigation of history of exposure to the known risk factors is ongoing.
    • Currently the patient is in stable condition and admitted to a negative pressure isolation room on a ward.
  2. A 59-year-old female national living in Najran city, Najran Region.
    • She developed symptoms on 11 November and was admitted to hospital on 18 November.
    • The patient who had comorbidities tested positive for MERS-CoV on 20 November.
    • 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 and admitted to ICU on mechanical ventilation. Her conditions deteriorated and she passed away on 22 November 2016.
  3. A 34-year-old male national living in Arar city, Northern Border Region.
    • He developed symptoms on 10 November and was admitted to hospital on 15 November.
    • The patient who has no comorbidities tested positive for MERS-CoV on 17 November.
    • He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition and admitted to a negative pressure isolation room on a ward.
    • Ministry of Agriculture has been informed and investigation of camels is ongoing.
  4. A 29-year-old male national living in Az Zulfi city, Riyadh Region.
    • He developed symptoms on 9 November and was admitted to hospital on 15 November.
    • The patient who has no comorbidities tested positive for MERS-CoV on 17 November.
    • He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition and admitted to a negative pressure isolation room on a ward.
    • Ministry of Agriculture has been informed and investigation of camels is ongoing.
  5. A 53-year-old male non-national living in Buqayq city, Eastern Region.
    • He developed symptoms on 12 November and was admitted to hospital on 16 November.
    • The patient who has no comorbidities tested positive for MERS-CoV on 17 November.
    • 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 stable condition and admitted to a negative pressure isolation room on a ward.
  6. A 29-year-old female national living in Hafer, Albatin city, Eastern Region.
    • She developed symptoms on 15 November and was admitted to hospital on 16 November.
    • The patient who has no comorbidities tested positive for MERS-CoV on 17 November.
    • 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 stable condition and admitted to a negative pressure isolation room on a ward.
  7. A 45-year-old male national living in Aflaj city, Riyadh Region.
    • He developed symptoms on 10 November and was admitted to hospital on 14 November.
    • The patient who has comorbidities tested positive for MERS-CoV on 16 November.
    • He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms.
    • Currently the patient is in stable condition and admitted to a negative pressure isolation room on a ward.
    • Ministry of Agriculture has been informed and investigation of camels is ongoing.
  8. A 58-year-old female national and living in Afif city, Riyadh Region.
    • She developed symptoms on 3 November and was admitted to hospital on 11 November.
    • The patient who has comorbidities tested positive for MERS-CoV on 13 November.
    • 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 stable condition and admitted to a negative pressure isolation room on a ward.
  9. A 51-year-old male national living in Tabuk city, Tabuk Region.
    • He developed symptoms on 2 November and was admitted to hospital on 9 November.
    • The patient who has comorbidities tested positive for MERS-CoV on 11 November.
    • He has a history of contact with camels and consumption of their raw milk in the 14 days prior to the onset of symptoms.
    • Currently the patient is in critical condition and admitted to ICU but not on mechanical ventilation.
    • Ministry of Agriculture has been informed and investigation of camels is ongoing.

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

Globally, since September 2012, WHO has been notified of 1841 laboratory-confirmed cases of infection with MERS-CoV including at least 652 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 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.

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

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