Emergencies preparedness, response

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

Disease Outbreak News: Update
24 July 2019

From 1 through 30 June 2019, the National International Health Regulations (IHR) Focal Point of Saudi Arabia reported 7 additional cases of Middle East respiratory syndrome (MERS-CoV) infection. These cases were from Al-Qassim (3 cases), Riyadh (2 cases), Madinah (1 death) and Eastern (1 case) regions. One of the newly reported cases is a health care worker, contact of a case included in the Disease outbreak news published on 16 July 2019 (Case no. 14). Two deaths were reported, one (Case no. 5) from the current reporting month, and a second death (Case no. 13) previously described as a case in the Disease outbreak news on 16 July 2019 .

The link below provides details of the 7 reported cases :

From 2012 until 30 June 2019, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2449, with 845 associated deaths. The global number reflects the total number of laboratory-confirmed cases reported to WHO under IHR. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with affected member states.

WHO risk assessment

Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from unprotected direct or indirect contact with dromedary camels. MERS-CoV 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.

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 dromedary camels, animal products (for example, consumption of camel’s raw milk), or other infected patients (for example, in a health care setting or if they are a household contact).

WHO continues to monitor the epidemiological situation and regularly conducts risk assessment based on the latest available information provided by Member States and from scientific literature.

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 infection early because, like other respiratory infections, the early symptoms of MERS-CoV infection are non-specific. Therefore, healthcare 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.

Early identification, case management and isolation, together with appropriate infection prevention and control measures can prevent human-to-human transmission of MERS-CoV, particularly in health care settings.

Individuals with underlying chronic medical conditions such as diabetes mellitus, renal failure, chronic lung disease, and compromised immune systems are at a higher risk of developing severe disease. Therefore, people with these underlying medical conditions should avoid close unprotected contact with animals, particularly dromedary camels, when visiting farms, markets, or barn areas where the virus is known to be 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.