Emergencies preparedness, response

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

Disease Outbreak News: Update
31 January 2020

On 9 and 13 January 2020, the National IHR Focal Point of the United Arab Emirates (UAE) reported an additional two (2) laboratory-confirmed cases of Middle East respiratory syndrome Coronavirus (MERS-CoV) to WHO.

The link below provides details of the 2 reported cases:

The first MERS-CoV case in the United Arab Emirates (UAE) was reported in July 2013. Since then, UAE has reported 91 cases of MERS-CoV (including these cases) and 12 associated deaths. From 2012 until 15 January 2020, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2506 with 862 associated deaths. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with affected member states.

Public health response

Upon identification of these above-mentioned cases, an incident report, case investigation and contact tracing were initiated. The investigation included screening of all close contacts, including occupational contacts in the two farms, household contacts and healthcare workers at the health care facilities. All close contacts have been tested for MERS-CoV and the results are negative. All of them have been monitored on a daily basis for the appearance of respiratory or gastrointestinal symptoms for 14 days after the last exposure to the confirmed cases. The veterinary authorities have been notified and investigation in animals is ongoing.

WHO risk assessment

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

MERS-CoV appears to cause more severe disease in people with underlying chronic conditions such as diabetes, renal failure, chronic lung disease, and immunocompromised persons. Therefore, these people should avoid close contact with animals, particularly dromedary 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.