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

Between 10 January and 3 February 2017 the national IHR focal point of Saudi Arabia reported seventeen (17) additional cases of Middle East Respiratory Syndrome (MERS) including four (4) fatal cases. Three (3) deaths among previously reported MERS cases (case no. 1 and 2 in DON published on 26 January 2017 and case no. 6 in DON published on 17 January 2017) were also reported.

Detailed information concerning these cases can be found in a separate document (see link below). One of the cases reported is a health care worker (case no. 5). The limited outbreak in Buridah, Saudi Arabia reported in the previous DON (published on 26 January 2017) is now over. A total of 6 cases were linked to this hospital outbreak. All contacts have been followed for the 14 day period and no further cases have been identified.

Globally, since September 2012, 1905 laboratory-confirmed cases of infection with MERS-CoV including at least 677 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 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.