July 31, 2013

WHO Update on the Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

The novel coronavirus (NCoV) is a new strain of the Coronaviridae that emerged in 2012 in the Middle East. Also known as Middle East respiratory syndrome (MERS), it was first discovered in early 2012 when a man in Saudi Arabia became ill with SARS-like symptoms - he subsequently died in June 2012.

In September 2012, a patient from Qatar who had recently traveled to Saudi Arabia was transferred to the United Kingdom for treatment; he suffered severe respiratory problems as well as renal failure.

When samples from both the Qatari and Saudi patients were tested, scientists found that they had been infected with the same virus - the 'novel coronavirus'. Learn more about the new coronavirus.

NCoV is sometimes referred to as the "Saudi SARS" informally, in order to differentiate it from the SARS pandemic that occurred in 2002/2003 (Hong Kong/Canadian SARS).

In mid-November 2012, the HPA published the complete genome sequence for the first UK patient who was infected with NCoV. The Agency said that this will help researchers in their quest to determine the origin of the virus, its diversity, as well as developing strategies for prevention and treatment.

WHO Global Alert and Response (GAR)

On 29 July 2013, the World Health Organization (WHO) published a notice that it "...has been informed of an additional laboratory-confirmed case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Saudi Arabia.

"The patient is an 83-year-old man from Assir region who became ill on 17 July 2013 and is currently hospitalized. Additionally, a previously laboratory-confirmed case, also from Assir region, has died.

Confirmed cases* of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) (N =55) reported as of June 7, 2013, to the World Health Organization, and history of travel from the Arabian Peninsula or neighboring countries within 14 days of illness onset — worldwide, 2012–2013
Confirmed cases* of MERS-CoV (N =55) reported as of June 7, 2013, to the WHO, and history of travel from the Arabian Peninsula or neighboring countries within 14 days of illness onset — worldwide, 2012–2013. NOTE: *Dots representing the cases are not geographically representative of the exact location of the residence of the patient. (Credit: CDC.gov - click image to enlarge)
Globally, from September 2012 to date, WHO has been informed of a total of 91 laboratory-confirmed cases of infection with MERS-CoV, including 46 deaths. UPDATE (9 DEC 2015): Outbreaks of illness have been reported in 24 countries, with over 1,300 lab-confirmed cases of the virus and over 480 deaths (two in the US). Learn more about the MERS-CoV Infection.

Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

Health care providers are advised to maintain vigilance. Recent travelers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

Specimens from patients’ lower respiratory tracts should be obtained for diagnosis where possible. Clinicians are reminded that MERS-CoV infection should be considered even with atypical signs and symptoms, such as diarrhea, in patients who are immunocompromised.

Health care facilities are reminded of the importance of systematic implementation of infection prevention and control (IPC). Health care facilities that provide care for patients suspected or confirmed with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus to other patients, health care workers and visitors.

All Member States are reminded to promptly assess and notify WHO of any new case of infection with MERS-CoV, along with information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.

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.

WHO has convened an Emergency Committee under the International Health Regulations (IHR) to advise the Director-General on the status of the current situation. The Emergency Committee, which comprises international experts from all WHO Regions, unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.

Also read: What Are Coronaviruses? Learn Key Facts About Them

1). World Health Organization: Middle East respiratory syndrome coronavirus (MERS-CoV) - update - Emergencies preparedness, response. Downloaded on 31 July 2013. Available here: http://www.who.int/csr/don/2013_07_29/en/index.html
First written 31 July 2015. Updated 9 December 2015

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