Emergencies preparedness, response

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

Disease outbreak news
28 June 2017

Between 16 and 23 June 2017, the national IHR Focal Point of Saudi Arabia reported seven additional cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection, including two deaths, and four deaths among previously reported cases.

Details of the cases

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

Three of the seven newly reported cases are associated with clusters 1 and 3 as reported in the Disease Outbreak News published on 13 June 2017 and 19 June 2017.

Cluster 1

An additional two cases have been reported in this cluster in Riyadh City, Riyadh Region. In total, 34 laboratory-confirmed cases reported to WHO are associated with this cluster.

Cluster 2

No newly reported cases are associated with cluster 2 as reported in the Disease Outbreak News published on 13 June 2017.

Cluster 3

An additional case has been reported in this cluster in Riyadh City, Riyadh Region. Thus far, this cluster involves nine laboratory-confirmed patients.

Globally, 2036 laboratory-confirmed cases of infection with MERS-CoV including at least 710 related deaths have been reported to WHO.

Public health response

The Ministry of Health is evaluating each case and their contacts and is still implementing the measures to limit further human-to-human transmission and bring these outbreaks to a control as described in the DON published on 19 June 2017.

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.

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.