Emergencies preparedness, response

Middle East respiratory syndrome coronavirus (MERS-CoV) – United Arab Emirates

Disease outbreak news
28 August 2017

On 29 July 2017, the national IHR focal point of the United Arab Emirates reported one additional case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Details of the case

Detailed information concerning the case reported can be found in a separate document (see link below).

The patient, who lives and works in Al Ain, United Arab Emirates, presented at a hospital in Al Ain on 16 July 2017. On 16 July, a chest X-ray showed pneumonia and he was treated with antibiotics and non-invasive ventilation. On 25 July, his symptoms worsened and a sputum sample was collected and tested for MERS-CoV and influenza. On 26 July, showing no signs of improvement, the patient was transferred to a second hospital in Al Ain and placed in an intensive care unit.

A second sputum sample was collected on 26 July and both samples tested positive for MERS-CoV on 27 July 2017. The patient is currently in ICU on mechanical ventilation. Investigations into the source of infection are ongoing. At the time of writing the results of the investigation were not yet provided to WHO.

Globally, 2067 laboratory-confirmed cases of infection with MERS-CoV including at least 720 related deaths have been reported to WHO.

Public health response

The Ministry of Health in Abu Dhabi carried out contact tracing and followed up 89 health care workers and 95 contacts at his place of employment. All identified contacts were monitored for 14 days from the last date of exposure. No additional cases were detected.

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 the disease are nonspecific.

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.

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 the 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.