Middle East respiratory syndrome coronavirus (MERS-CoV) – Oman
On 1 November, the International Health Regulations (2005) national focal point of Oman reported one case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. Prior to this case, the most recent case of MERS-CoV from Oman was reported on 30 August 2017.
Details of the case
The patient, a 27-year-old male living in Sharqiyah Region, reported contact with dromedaries prior to symptom onset. Details of the case reported to WHO can be found in a separate document (see link below).
Globally, 2103 laboratory-confirmed cases of infection with MERS-CoV including at least 733 related deaths have been reported to WHO.
Public health response
Investigations are ongoing into the source of infection and exposure to other known risk factors in the 14 days prior to the onset of symptoms. The Ministry of Agriculture has been informed and investigations into dromedaries are ongoing. Contact tracing and follow up of 10 family contacts and all health care workers at the hospital/s where the patient was treated are ongoing. All identified contacts are monitored for 14 days from the last date of exposure.
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 non-sustained human-to-human transmission has occurred mainly in health care settings. Close direct or indirect contact with infected dromedaries is the source of human infections in the community.
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.
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.
Community and household awareness of MERS and MERS prevention measures in the home may reduce household transmission and prevent community clusters.
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, in addition to avoiding close contact with suspected or confirmed human cases of the disease, people with these conditions should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be or 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.