Friday, May 30, 2014

Public Health England Launches Airport MERS Advisory Campaign



# 8685


With the Holy month of Ramadan less than a month away, and the Hajj coming up in early October, the number of people passing through London airports traveling to or from the Middle East is only going to increase over the next few months. As the MERS outbreak continues unabated on the Arabian peninsula, concerns run high over its potential to spread.


Already, at least two known MERS-CoV infected passengers have transited through Heathrow, sparking intensive contact tracing and follow up of airline passengers (see  Public Health England Press Release On MERS Case Transiting London).

In an attempt to mitigate the risks of travelers unwittingly carrying the virus on air flights, or spreading it once they arrive at their destinations,  PHE (Public Health England) has issued two new informational posters on MERS for placement at airports, and is advising up their 999 and 111 systems on how to handle possible enquires. 

The first poster (at top of post) deals with passengers headed to the Middle East.  A number of US airports posted a similar notice a couple of weeks ago (see MERS Advisories Go Up In Some U.S. Airports) – although  unlike the new PHE posters - those did not specifically warn about contact with camels.


The second (below) is for returning passengers.




PHE has issued a press release on this campaign, with quotes from experts on the risks of MERS infection:


Posters featuring advice for travellers to and from the Middle East have been distributed to UK airports and airlines.

Public Health England (PHE) is providing two posters to major UK airports to warn about the risks of Middle East respiratory syndrome coronavirus (MERS-CoV). The first poster gives general advice for travellers to the Middle East, while the second issues advice for travellers returning to the UK.


MERS-CoV is a new type of coronavirus, first identified in a Middle Eastern citizen in 2012. Although cases continue to be reported from the Middle East, no new cases of MERS-CoV have been detected in the UK since the cases linked to the Middle East in February 2013.


PHE scientists recently met to review the current risk assessment and concluded the risk to UK residents and travellers to the Middle East remains very low. Travellers, particularly people with underlying or chronic medical conditions, are advised to avoid contact with camels in the Middle East, avoid drinking raw camel milk and handling raw camel meat, and adhere to good general food and hand hygiene measures.


After diagnosing one of the first cases of MERS-CoV in the world at the health protection laboratories in Colindale in September 2012, PHE remains at the forefront of providing public health advice and information on MERS-CoV.

Professor Nick Phin, Head of Respiratory Diseases for PHE, said:

There is growing evidence of the possible role of camels in transmitting MERS-CoV to humans. We advise travellers, particularly those with underlying or chronic medical conditions, to avoid contact with camels in the Middle East and practice good hand and respiratory hygiene to reduce the risk of respiratory illnesses.


Healthcare professionals are advised to remain vigilant for severe unexplained respiratory illness occurring in anyone who has recently travelled in the Middle East, as well as any unexplained cluster of severe respiratory illness or healthcare worker with unexplained severe respiratory illness.


PHE will continue to provide advice on infection control, urgent diagnostic investigation and identification of contacts of suspected cases who may need to be followed up to check on their health.

Dr Brian McCloskey, Director of Global Health at PHE, said:

The recent reports of cases in travellers visiting the region and the rise in global cases we’ve seen is concerning, and we will continue to monitor the global situation and adjust our risk assessment as appropriate.


The risk of UK residents contracting infection in the UK remains very low. The risk to UK residents travelling to Middle Eastern countries may be slightly higher than within the UK, but is still very low.


PHE will maintain its current enhanced levels of surveillance and continue to liaise with WHO and ECDC colleagues to ensure we have the best available information so that our advice is accurate and up to date.



Meanwhile, NHS Pathways has issued the following guidance to those who must respond to calls from the public regarding possible infection.


MERS Coronavirus – General Advice for responding to calls from the public

Important information for anyone taking calls within a 999 or NHS 111 service.  Please print and circulate copies of this instruction sheet to all staff handling 111 and 999 calls

Public Health England are planning to publish posters at airports in the UK on 29th May 2014 regarding Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

There have been various public health alerts relating to passengers travelling by air from MERS--CoV affected countries in the Middle East.  Public Health England is issuing general guidance for members of the public travelling to and from the Middle East, which includes advice to call NHS 111. The countries covered by this travel advice include: Syria, Iraq, Lebanon, Palestinian Territories, Israel, Jordan, Saudi Arabia, Kuwait, Bahrain, United Arab Emirates, Oman, Yemen or Saudi Arabia.

If a caller identifies themselves as having been to a known MERS-CoV affected region within the 14 days before their symptoms started:

  • AND they have shortness of breath or cough with a fever
  • Triage their symptoms as normal
  • BUT if the final disposition is less urgent than ‘Contact a Primary Care Service within 12 hours’, you MUST upgrade the disposition to ‘Contact a Primary Care  Service within 12 hours’

It is vital that these callers are seen within this time frame They MUST tell the Primary Care Service that they have been to the Middle East when  they are seen.

Do not alter the disposition if it is more urgent than Contact Primary Care Service within 12 hours.
If an AMBULANCE has been dispatched to a caller who has declared travel to an affected area, ensure that the crew is made aware to enable them to follow the Public health guidance regarding MERS – CoV

If a caller identifies themselves as having travelled to the affected areas, but they DO NOT have any of the above symptoms:

  • Triage the presenting symptoms

If a caller identifies themselves as having travelled to the affected areas, but they DO NOT have ANY symptoms and are just concerned:

  • Pass the call to the NHS Pathways clinician for advice

FOR NHS Pathway’s Clinician

Reassure them that the risk of infection is low

  1. Give the following advice “If you develop shortness of breath or cough with a fever in the 2 weeks after return then”:
  • During normal working hours, contact a Primary Care Service within 12 hours.
  • Out of normal surgery hours, call 111

They MUST tell the Primary Care Service that they have been to the Middle East when they are seen.

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