Emergencies preparedness, response

Middle East respiratory syndrome coronavirus (MERS-CoV) – Thailand

Disease outbreak news
29 January 2016

On 24 January 2016, the National IHR Focal Point of Thailand notified WHO of 1 laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection. This is the country’s second case of MERS-CoV infection (see DON published on 10 July 2015).

Details of the case

The case is a 71-year-old Omani national who arrived in Bangkok, Thailand on 22 January. The patient travelled to Thailand to seek medical care. Once in Bangkok, the patient was admitted to hospital. On 23 January, he tested positive for MERS-CoV.

The patient, who has comorbidities, first developed symptoms on 14 January while in Oman. On 18 January, he was admitted to hospital. On 21 January, against medical advice, the patient self-discharged from hospital. The patient was sampled before leaving the hospital. The sample tested positive for MERS-CoV on 25 January, after the patient had already left Oman.

On 24 January, the National IHR Focal Point of Oman was informed about the case for the necessary follow up on contacts back in Oman and investigation of history of exposure. Investigations revealed that the case had contacts with camels in the 14 days prior to the onset of symptoms. No epidemiological links have been established between this case and the latest case detected in Oman.

Measures are being taken to trace all contacts of the cases in Oman, during his journey to Thailand, and within Bangkok.

Globally, since September 2012, WHO has been notified of 1,633 laboratory-confirmed cases of infection with MERS-CoV, including at least 587 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.