Emergencies preparedness, response

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

Disease outbreak news
22 October 2015

Between 10 and 13 October 2015, the National IHR Focal Point for the Kingdom of Saudi Arabia notified WHO of 4 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. The four cases are from the same compound in Riyadh city.

Details of the cases

  • A 26-year-old, non-national female developed symptoms on 1 October and, on 8 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 9 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. Investigation of history of exposure to the known risk factors in the 14 days prior to the onset of symptoms is ongoing.
  • A 27-year-old, non-national female developed symptoms on 1 October and, on 10 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 11 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient is a household contact of a laboratory-confirmed MERS-CoV case (see above – case no. 1). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
  • A 26-year-old, non-national female developed symptoms on 7 October and, on 11 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 12 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient is a household contact of two laboratory-confirmed MERS-CoV cases (see above – case no. 1, 2). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.
  • A 26-year-old, non-national female developed symptoms on 10 October and, on 11 October, was admitted to hospital. The patient, who has no comorbidities, tested positive for MERS-CoV on 12 October. Currently, she is in stable condition in a negative pressure isolation room on a ward. The patient lives in the same area as three laboratory-confirmed MERS-CoV cases (see above – case no. 1, 2, 3). She has no history of exposure to other known risk factors in the 14 days prior to the onset of symptoms.

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 3 MERS-CoV cases that were reported in previous DONs on 27 September (case no. 13), on 17 September (case no. 9) and on 2 September (case no. 1).

Globally, since September 2012, WHO has been notified of 1,599 laboratory-confirmed cases of infection with MERS-CoV, including at least 574 related deaths.

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.

Public health authorities in host countries preparing for mass gatherings should ensure that all recommendations and guidance issued by WHO with respect to MERS-CoV have been appropriately taken into consideration and made accessible to all concerned officials. Public health authorities should plan for surge capacity to ensure that visitors during the mass gathering can be accommodated by health systems.