UAE Health Authority: 2 More Coronavirus Cases

 

# 10,069

 

On Monday, in WHO: Asymptomatic MERS-CoV Case – UAE, we learned of an asymptomatic camel transport truck driver who tested positive for the MERS virus, and was in hospital isolation.   Contact tracing was underway to see if anyone he had been in contact with was also infected.

Today we’ve a report of two new asymptomatic coronavirus cases – and while not explicitly referencing the earlier case – they are stated to have been discovered through `active case finding’ ,  which seems likely to have been part of the first case’s epidemiological investigation.

 

(UPDATE: In reviewing this report, it is possible that one of these `two’ cases may be the original truck driver, although that case was reported to the WHO a week ago. Hopefully we’ll see a clarification from the WHO in the next couple of days).

 

Although many MERS cases are linked to nosocomial transmission or direct contact with infected cases, and camels are presumed to play some part in introduction of the virus to humans, for most community acquired cases the source of infection remains unknown.

 

If (and it’s a big `if’) a `plausible chain of infection’ can be established between 2 or more asymptomatic MERS cases, we’d suddenly have a lot more information about how the virus may be being transmitted in the community.

 

While asymptomatic or very mildly ill cases are not all that uncommon, whether or not they can transmit the virus has not been established (see Study: Possible Transmission From Asymptomatic MERS-CoV Case).

 

So, while we don’t yet know enough about these cases – or how they might be connected – to come to any firm conclusions, we will definitely be watching these latest MERS infections in the UAE with interest.

 

 

Health Authority – Abu Dhabi Announces 2 Coronavirus cases

 

The Health Authority – Abu Dhabi (HAAD) announced two positive cases with MERS Coronavirus (MERS CoV).

HAAD said that the two cases have no symptoms and are in stable condition - and were confirmed positive through active case finding. The two cases are currently isolated at hospitals as a precautionary measure and the close contacts screening was conducted

From previous asymptomatic cases, individuals tend to clear the virus themselves within 10 - 14 days, but are kept in isolation in hospital during this time.

HAAD confirmed that it is coordinating with the Ministry of Health (MOH) and other Authorities in the country, and has taken all necessary measures as per international standards and recommendations from the World Health Organisation (WHO).

The MOH confirmed that it is monitoring the situation closely to ensure the health and safety of everyone.

WHO: Asymptomatic MERS-CoV Case – UAE

 

# 10,063

 

We’ve not seen anywhere near the number of MERS cases this year as we did during the spring of 2014, but we continue to see sporadic reports – mostly from Saudi Arabia – but also from Iran and now the UAE. Today’s notification is of an asymptomatic truck driver who was tested after some camels he was transporting from Oman tested positive for the virus.

This is only the second UAE MERS case reported in 2015, with the first being a fatal case last February.

 

In Lancet: Camels Found With Antibodies To MERS-CoV-Like Virus we saw a study showing specific antibodies to the MERS coronavirus in all 50 (100%) dromedary camel samples gathered (from multiple locations) in Oman, indicating past infection. 

 

While most have antibodies, since camels clear the virus fairly quickly, most camels are not actively infected at any given time.

Since one of the unknowns with the MERS coronavirus is how it is being transmitted in the community, finding and studying asymptomatic (yet PCR positive) cases is of particular interest.  It is unknown whether asymptomatic cases can spread the virus on to others, but some studies have suggested it is possible (see Study: Possible Transmission From Asymptomatic MERS-CoV Case).

 

Also unknown is how many asymptomatic (or mildly symptomatic) cases go undetected. Testing of asymptomatic contacts of known cases has turned scores of them, however.

 

In November of 2013, we looked at a study published in The Lancet Infectious Diseases, that attempted to quantify the likely extent of transmission of the MERS virus in the Middle East. (Middle East respiratory syndrome coronavirus: quantification of the extent of the epidemic, surveillance biases, and transmissibility).

 

They calculated  that for every case identified, there were likely 5 to 10 that went undetected.

 

While only an estimate, this is in line with studies of other novel viruses that seek to estimate uncounted cases.  And if true, would provide a plausible answer as to how hundreds of people – without obvious exposures – continue to contract the virus in the community.


Here is today’s report from the World Health Organization.

 

 

 

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

Disease outbreak news
18 May 2015

On 13 May 2015, the National IHR Focal Point of the United Arab Emirates (UAE) notified WHO of 1 additional case of Middle East respiratory syndrome coronavirus (MERS-CoV) infection.

Details of the case are as follows:

A 29-year-old, non-national male from Abu Dhabi tested positive for MERS-CoV on 12 May. The patient works as a truck driver and frequently transports camels from Oman to UAE. He travelled to Ibri city, Oman on 6 May and transported camels to Abu Dhabi on 9 May. As part of the national policy of testing all imported camels for MERS-CoV, on 9 May, laboratory examinations were carried out on the camels that the truck driver was transporting. The animals tested positive for MERS-CoV on 10 May. This triggered an investigation of the truck driver, which started on the same day. Following hospital admission, the patient tested positive for MERS-CoV on 12 May. He was asymptomatic at the time of laboratory testing. The patient has no comorbidities and no history of exposure to other known risk actors in the 14 days prior to detection. Currently, he is asymptomatic in a negative pressure room on a ward.

Contact tracing of household contacts and healthcare contacts is ongoing for the case. The National IHR Focal Point of the United Arab Emirates informed the National IHR Focal Point of Oman to undertake the necessary investigation back in Oman.

Globally, WHO has been notified of 1118 laboratory-confirmed cases of infection with MERS-CoV, including at least 423 related deaths.

(Continue . . . )

Germany Reports Imported MERS Case - ex UAE

 

Credit Wikipedia

 

# 9792

 

 

While we are waiting for confirmation on this morning’s report of 3 suspected cases of MERS in Turkey, Germany’s RKI (Robert Koch Institute) has announced a recently returned traveler from Abu Dhabi is in isolation, being treated for MERS in Lower Saxony.

 

Given this patient returned from the UAE in early February, and the RKI report indicates that his contacts were `were determined and monitored by the relevant health authorities’, it seems likely we are hearing about this case somewhat belatedly.

Although the UAE has been pretty quiet regarding MERS since last summer, there was one case recently reported  to the WHO and posted on February 11th, who fell ill on January 29th, and died on the 6th.  At this point we don’t have any information on how this latest case was exposed.

 

Two reports, a brief (translated) press account, followed the the RKI statement.

 

Infected man from Osnabrück region with fatal Mers-Virus

Osnabrück - When a man from the region of Osnabrück deadly Mers coronavirus was detected. The patient had returned early February from a vacation trip from Abu Dhabi to Germany, said the Lower Saxony Ministry of Health on Saturday in Hanover. He will now be treated in an isolation hospital in Osnabrück. How is the man who was not initially know. Even people from his environment stood now under medical observation. It is the first case of illness of its kind in Lower Saxony. A threat to the population but not there. Mers can lead to kidney failure among others and severe pneumonia. A vaccine does not exist.

 

 

Information of the RKI disease cases by the MERS -Coronavirus

Stand: 07.03.2015

Situation in Germany (change)

In Germany, for the third time occurred a MERS-CoV case, as in the two previous cases, the disease was brought by a-arrived from the Arabian Peninsula patients. It is a 65-year-old German who had traveled to the United Arab Emirates, and is currently being treated at a hospital in Lower Saxony. In the Lower Saxony Minsterium of Health has informed in a press release on 7 March 2015 (see link below, all links mentioned here can be found at the end of the text). People with close contact with the patient were determined and monitored by the relevant health authorities, the authorities are at the local and state level in close contact with the Robert Koch Institute. Generally MERS-CoV is not easily transferable, so that even in the case of secondary cases can not be expected that longer chains of infection occur. In Germany, therefore, there is no increased risk of disease in the general population.

Previously, one patient each in 2012 and 2013 were treated, Qatar and the United Arab Emirates in Germany, one of the two patients could be discharged recovered, the other died. The investigation of contacts in both cases had no evidence of secondary infections result (Buchholz et al., Euro Surveillance 02/21/2013;. Epidemiological Bulletin No. 31/2013, see link below).

The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is known since April 2012. Clinically proven cases present at the beginning with an acute beginning, flu-like illness. The incubation period is usually one to two weeks. In severe cases, a pneumonia may develop, which may turn into an acute respiratory distress syndrome. A common accompaniment is diarrhea; in severe cases even kidney failure may occur. Severe reactions mainly occur in persons with chronic underlying medical conditions such as diabetes, cancer or immunosuppression.

Since the first appearance of MERS 2012 were WHO reported laboratory confirmed cases over a thousand, especially in the Arabian Peninsula, about 40% of them died. The current state of affairs on diseases at the World Health Organization (WHO) available (see link below).

(Continue . . .)

Abu Dhabi HAAD Statement On Two New Coronavirus Cases

UAE’s Proximity to Saudi Arabia

 

# 8817

 

My thanks to Crof for the head’s up on the announcement of two new coronavirus cases being reported by the the Abu Dhabi Health Authority.  Here is  the barebones statement that has been posted on the HADD website.

 

 

Health Ministry announces two new cases of Coronavirus

ABU DHABI, 9th July, 2014 - The Ministry of Health, MoH, has announced two new cases of Coronavirus (MERS-CoV) in Abu Dhabi, which are stable and receiving necessary medical care.

The Ministry in a statement confirmed that it is coordinating with the competent departments and other medical authorities in the country, and has taken all necessary measures as per international standards and recommendations from the World Health Organisation, WHO.

To help prevent respiratory illnesses the MoH has advised the public to wash hands often with soap and water, If not available, use hand sanitiser, cover nose and mouth with a tissue when coughing or sneezing and then throw the tissue in the trash. "Avoid touching your eyes, nose, and mouth with unwashed hands. Avoid close contact with people with fever or flu-like illnesses," it says.

The Ministry also advised Hajj and Umrah pilgrims to take necessary vaccines two weeks prior to their journey to Hajj and Umrah. "Elderly, those with chronic illnesses and immune deficiencies, pregnant women and children below 12, are advised to postpone Hajj and Umrah this year," the MoH said.

The Ministry stated that the WHO confirmed the virus is not a public health concern at the moment, and that the current situation does not require a travel ban to any country in the world, screenings at different ports, or any restrictions on trade.

The MoH confirmed that it is monitoring the situation closely to ensure the health and safety of everyone.

UAE: Undiagnosed Camel Deaths Continue

Credit FAO

 

# 8770

 

 

With dromedaries ranked high on the list of animal suspects for introducing the MERS coronavirus to humans (see WHO Update On MERS-CoV Transmission Risks From Animals To Humans), reports of an increased number of camel deaths in the UAE has understandably caught people’s attention (see last week’s ProMed Mail report UNDIAGNOSED MORTALITY, CAMEL - UNITED ARAB EMIRATES (02): REQUEST FOR INFORMATION).

 

Thus far we’ve only seen reports of mild illness from MERS-CoV infection in camels (although research in this area is sorely lacking), making it probable that something other than the MERS coronavirus is at work here. 

 

Still, the UAE has the second highest number of known human MERS infections in the world, and exactly how the virus is being seeded into the community remains unknown.

 

Yesterday Emirates 24/7 News (h/t Shiloh on FluTrackers) carried a lengthy report on these ongoing camel deaths, that – while it doesn’t answer the basic question as to the cause – does give us a better idea of the scope of the problem.

 

 

Dozens of camels die in UAE central region

National Council member claims 200 animals have died in the past few weeks

By Staff

Published Sunday, June 22, 2014

Livestock owners in the UAE’s Central Region fear the outbreak of an unknown virus, following the death of dozens of camels, the Arabic daily ‘Emarat Al Youm’ has reported.

Camel owners say this has caused them considerable financial damage and pushed them to go to expensive private veterinary clinics.

According to Musapah Bel Ajeed Al Ketbi, member of the National Council for the Central Region, about 200 camels had died in the past few weeks.

Al Ketbi told ‘Emarat Al Youm’ that the deaths of camel started in livestock breeding centres in the Central Region and spread to neighbouring Emirates.

An owner of breeding camels had lost two animals in the last two days, each worth about Dh200,000. Municipal vehicles have been carrying six dead camels per day for the past few weeks, he added.

Al Ketbi submitted a query to the Minister of Environment and Water, seeking reasons for the deaths of more than 200 camels in the Central Region and some areas of Dubai and Al Ain.

But  Saif Al Shara’a said  the ministry had not received any complaints from the camel breeders about mass deaths except for individual cases as a result of common diseases.

Al Shara’a added that the ministry had sent a medical team to the Central Region to investigate the matter after receiving Al Ketbi’s query .

(Continue . . .)

 

We’ve no indication at this time that this increased camel mortality poses any human health risks, or that it is connected in any way to the MERS-CoV.  That said,  according to last week’s ProMed Mail report - the first cases began about 2 years ago – roughly the same time that MERS emerged in humans.

 

Why it has taken two years for `official notice’ to be taken of this outbreak isn’t clear, but hopefully now some answers will be forthcoming.

 

History has shown that perhaps 70% of the infectious diseases plaguing humans began in other species, and then adapted to people. This illustrates the importance of promoting the `One Health Concept’, where human, animal, and environmental health are all interconnected (see the One Health Initiative website).

 

Whether it is the emergence of a novel avian flu strain in China, the spread of a mosquito-borne emerging arbovirus in the Caribbean, or an unexplained illness in camels, what happens in animal health often ends up impacting human health as well.

 

For more on this inextricable link between human and animal health, you may wish to revisit:

 

FAO: Surge In Animal Disease Increases Zoonotic Threats

The Third Epidemiological Transition

EID Journal: Predicting Hotspots for Influenza Virus Reassortment

WHO MERS-CoV Risk Assessment Trip To The UAE

UAE’s Proximity to Saudi Arabia

 

 

# 8714

 

While nowhere near the magnitude of the MERS outbreak in Saudi Arabia, since late March the UAE has reported several (apparently) hospital-centric outbreaks of MERS infection, numbering nearly 50 cases during the past couple of months (see WHO MERS Update – UAE).

Today the World Health Organization has published a report on a visit by their experts to the UAE to conduct a risk assessment of the situation. 

 

While more of a feature article, than a scientific report, we do learn that their experts found no evidence of sustained human to human infection, and instead attributed these outbreaks to a: `breach in infection prevention and control measures in health care settings, active surveillance and increase in community acquired cases’.

 

Once again we see calls for greater regional sharing of information on this disease, and a stressing of the `importance of participating in multi-country case control studies from both the human health and animal health perspective’.  The quantity and quality of information and cooperation has varied considerably between Gulf states, and that has slowed progress on both understanding, and containing, this emerging virus.

 

WHO concludes a MERS-CoV risk assessment mission in the United Arab Emirates

June 2014

A team from the WHO and technical partners from the Global Outbreak Alert and Response Network (GOARN) has concluded a 5 day mission in United Arab Emirates (UAE).

WHO/R. Sidani

The team assessed the risk posed by the Middle East respiratory syndrome coronavirus, or MERS-CoV in the country. The team consisted of 6 experts in coordination, epidemiology, infection prevention and control, food safety and the human-animal interface, and risk communication.

Health authorities in the UAE had invited WHO to review the current situation after an upsurge in MERS-CoV infections in April. Upon arrival, the WHO team met with H.E Mr Abdul Rahman bin Mohammed Al Owais, the Minister of Health, in Dubai to discuss the mission.

Investigation and evaluation

During the mission, the team had extensive meetings with experts from Health Authority Abu Dhabi, Dubai Health Authority and the Abu Dhabi Food Control Authority. The team visited the hospital to which two-thirds of the country’s cases can be traced, in order to review the epidemiological investigation and assess the infection prevention and control measures that have been applied. The WHO team evaluated the work done on investigating possible exposure routes, transmission patterns, and the clinical situation.

"We are impressed by the amount of data and information generated during the investigation of MERS cases by UAE to help better understand MERS- CoV. This knowledge is of utmost importance to the rest of the world to better discover the source of the virus and the routes of transmissions from animals to humans, "said Peter Ben Embarek, WHO team leader.

“The UAE health authorities have been following up diligently on the MERS-CoV cases, including repeated laboratory testing to check when cases have been cleared of the virus. This data will make an important contribution to the risk assessment and to guide the health response internationally," Ben Embarek concluded.

Need to share experience and knowledge

The preliminary result of the mission indicates that the cases in UAE do not show evidence of sustained human to human infection. The recent upsurge of cases in Abu Dhabi appears to have been caused by a combination of factors, including a breach in infection prevention and control measures in health care settings, active surveillance and increase in community acquired cases.

WHO recommends that the UAE health authorities to continue to investigate MERS, including the source of infection, and share new information as it becomes available. There is an ongoing need to share experiences and knowledge from all countries that have cases of MERS-CoV to better understand this emerging disease, including the role of animals in the spread of the MERS-CoV.

WHO stressed the importance of participating in multi-country case control studies from both the human health and animal health perspective. There are opportunities to do joint analysis of samples from infected camels and the infected humans around them. These studies will help understand the role of camels in the disease - particularly how human infection happens. This information will help inform people who are in close contact with camels to gain a realistic picture of the risk, and the level of precaution needed.

Globally, as of 4 June, 681 laboratory-confirmed cases of infection with MERS-CoV have officially been reported to WHO, including 204 deaths.

 

WHO MERS Update – UAE

 

UAE’s Proximity to Saudi Arabia

 

# 8659

 

The World Health Organization has published a GAR (Global Alert & Response) update with three new cases from the UAE, which – based on FluTracker’s MERS Case Line Listing - brings the number of cases reported out of the United Arab Emirates over the past 60 days to roughly 48.

 

 

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

Disease Outbreak News

23 May 2014 - On 21 May 2014, the National IHR Focal Point of the United Arab Emirates (UAE) reported 3 additional cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in Abu Dhabi, UAE.

Details of the patients are as follows:

• A 71 year-old male in Abu Dhabi. He was admitted to hospital on 11 February 2014 and is known to have several comorbidities. On 4 May, he developed fever and on 7 May tested positive for MERS-CoV by PCR. Currently, he is in a stable condition. He had contact with a previously confirmed case in the hospital: a health-care worker (a 39 year-old female) reported to WHO on the 11 May 2014. He has no history of contact with animals and no history of consumption of raw camel products.
• A 26 year-old male in Abu Dhabi. He was detected through general screening at his workplace on 7 May without any history of contact to a laboratory confirmed MERS-CoV case. He tested positive for MERS-CoV by PCR on 8 May 2014. While asymptomatic at the time of screening, the investigation revealed that he had mild cough on 1 May 2014. He has no comorbidities and no travel history. He had contact with animals (cows and sheep but not camels), but has no history of consumption of raw camel products. He was admitted to hospital for isolation on 8 May and discharged on 14 May.
• A 36 year-old male from Abu Dhabi. He developed symptoms, including fever and mild breathing difficulty, on 2 May and was seen in an outpatient service on 4 May. His condition deteriorated and he was admitted to hospital on 7 May with high grade fever and developed breathing difficulty. On 9 May, he tested positive for MERS-CoV by PCR. He recovered and was discharged on 12 May. He is known to have comorbidities, but reported no contact with a laboratory confirmed MERS-CoV case and has no travel history. He also has no contact with animals and no history of consumption of raw camel products.

Contact investigations are ongoing and further information will be communicated when available.

Globally, 635 laboratory-confirmed cases of infection with MERS-CoV have officially been reported to WHO, including 193 deaths. This global total includes all of the cases reported in this update, plus 17 laboratory confirmed cases officially reported to WHO by Saudi Arabia between 16 and 18 May. WHO is working closely with Saudi Arabia for additional information on these cases and will provide further updates as soon as possible.

(Continue . . . )

 

Media Reports: Iraqi Quarantined At Dubai Airport Suspected MERS

UAE’s Proximity to Saudi Arabia

 

# 8597

 

Although I’ve found nothing yet on Abu Dhabi Health Authority (HAAD) website, two media outlets are reporting that at least one Iraqi pilgrim, en route home after making a pilgrimage to Mecca, has been detained and quarantined at the Dubai Airport on suspicion of having the MERS virus.

 

From the media reports, it sounds as if more than one person has been quarantined, but only one is symptomatic.  It isn’t clear from the text of this report if the sick individual has actually tested positive for the virus, or is merely suspected to be infected.

Two versions of the same report, first from Al Assabeel.net.

 

Isolate Iraqi pilgrims in Dubai for being infected with Corona

• Saturday, 10 May 2014 15:1

Way detained by UAE authorities on Saturday, pilgrims from the Iraqi city of Mosul, Nineveh province in northern Iraq, to being infected with Corona, and this is the first injury to Iraqis since the onset of illness.

Said Rashid Mohammed, Director of Media Health Nineveh "The UAE authorities in Dubai and placed under quarantine today, pilgrims Iraqis from Mosul to being infected with Corona." He also explained that the pilgrim "aged 65 years, who were returning from Mecca after performing the Umrah,

Upon arrival at Dubai airport Ketranzi before moving to Iraq, was wounded by a state of nausea and some complications, prompting authorities to resuscitate him, and examined, and then advertising it is infected with Corona. " is a virus, "Corona", or so-called Severe Acute Respiratory Syndrome, a virus that infects respiratory, and do not yet exist in the world accurate information about the origin of this virus nor its modes of transmission, as there is no vaccine and preventative or antibiotic to treat it.

 

And this report from Alqurtas news.

 

The first injury to Iraqis as "Corona" ... isolate pilgrims in Dubai for viral infection

Saturday 10 May 2014 | 16:03

Detained by UAE authorities on Saturday, pilgrims Iraqi city of Mosul, Nineveh province in northern Iraq, to being infected with Corona, and this is the first injury to Iraqis since the advent of the corona. said Rashid Mohammed, Director of Media Health Nineveh "The UAE authorities in Dubai and placed under quarantine today, pilgrims Iraqis from Mosul to being infected with Corona. "

He also explained that the pilgrim "aged 65 years, who were returning from Mecca after performing the Umrah, and upon his arrival at Dubai airport Ketranzi before moving to Iraq, was wounded by a state of nausea and some complications, prompting authorities to resuscitate him, and examined, the results show having the virus.

UAE Announces 4 New MERS Cases

UAE’s Proximity to Saudi Arabia

 

 

 

# 8567

 

In the latest of a string of press releases from Abu Dhabi Health Authority (HAAD), we are reassured that `6 cases diagnosed with MERS Coronavirus tested negative’ – meaning they have cleared their viral infection and can now leave isolation.  Good news, obviously. 

 

But almost as an afterthought, roughly halfway through the announcement, we learn that four more cases have been identified and are in isolation.

 

The tally of cases in this spring outbreak in the UAE remains murky, although based on FluTracker’s MERS Case List and the Global Alert & Response (see below) updates from the WHO,  the number appears to now exceed 40.  Unlike with Saudi Arabia, we rarely get any patient information until the UAE officially notifies the World Health Organization.

 

 

HAAD announces 6 cases diagnosed with MERS Coronavirus tested negative

The Health Authority – Abu Dhabi (HAAD) is pleased to announce that 6 more of the individuals who are in isolation in hospital with MERS Coronavirus (MERS-CoV) have now tested negative for the virus, and will be leaving hospital soon. With this, the number of negative tested individuals has risen to 27.

HAAD said that these 6 cases were kept in isolation at hospitals as a precautionary measure. They were able to clear the virus within 10 -14 days themselves without any treatment.

It is expected that the other individuals with positive MERS Coronavirus currently in isolation in hospitals will likewise soon test negative and be able to go home. They are being tested daily to check on their positive status. 

HAAD also announced 4 new cases with MERS-CoV. Most have either no symptoms or mild symptoms, and are expected to clear virus soon. They have been admitted to hospital for isolation until they clear the virus.

HAAD confirmed that it is coordinating with the Ministry of Health (MOH) and other Authorities in the country, and has taken all necessary measures as per international standards and recommendations from the World Health Organisation (WHO).

HAAD has been engaging world authorities from expert international organizations who are now in Abu Dhabi to help shed light on various aspects of the virus, including modes of transmission, and best practice in managing viral infections of this type.

The MOH stated that the WHO confirmed the virus is not a concern for public health at the moment, and that the current situation does not require a travel ban to any country in the world, screenings at different ports, or any restrictions on trade.

The MOH confirmed that it is monitoring the situation closely to ensure the health and safety of everyone.

 

 

WHO GAR REPORTS FROM UAE       CASES

26 April 2014  (MERS-CoV) – update         7

23 April 2014 (MERS-CoV) – update          9

17 April 2014 (MERS-CoV) – update          4

16 April 2014 (MERS-CoV) – update         10

14 April 2014 (MERS-CoV) – update           1

10 April 2014 (MERS-CoV) – update           1

26 March 2014 (MERS-CoV) – update        1

25 March 2014 (MERS-CoV) – update        1

20 March 2014  (MERS-CoV) – update       1

12 March 2014 (MERS-CoV) – update        1

                                          TTL                     36  confirmations by WHO

WHO MERS-CoV Update – UAE

Photo Credit WHO

 

# 8516

 

 

This morning the World Health Organization has released an update detailing an additional 9 MERS cases from the UAE, adding to the 16 cases previously announced by WHO over the past 2 weeks. 

 

As to the total case count with this cluster, the numbers are murky at best (more on that in a later post), given the `blind’ announcements from the HAAD (Abu Dhabi Health Authority) providing numbers, but no details, making it impossible to match their announcements up with the WHO’s.

 

That said, here is the latest GAR (Global Alert & Response) DON.

 

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

Disease Outbreak News

23 April 2014 - On 21 April 2014, 18 April 2014 and 16 April 2014, the Ministry of Health of the United Arab Emirates (UAE) reported an additional 9 laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV).

The following details were provided to WHO on 21 April 2014 by the Ministry of Health UAE:

• A 52 year-old woman from Abu Dhabi. She became ill and was admitted to a hospital on 16 April. She has underlying medical conditions and is currently in a stable condition. The patient travelled to Jeddah, Saudi Arabia from 5-16 April, where she visited the hospital 3 times. She has no history of contact with animals. All her contacts are being investigated.

The following details were provided to WHO on 18 April by the Ministry of Health UAE:

• A 63 year-old woman from Abu Dhabi who had close contact with a previously laboratory-confirmed case reported on 14 April. She was screened on 13 April and became ill on 15 April. She is reported to have an underlying medical condition. She is reported to have no exposure to animals or a recent travel history.
• A 73 year-old woman from Abu Dhabi who has been an in-patient at the hospital since 26 February due to other illnesses. She has underlying medical conditions. The patient was admitted to the intensive care unit (ICU) on 14 April. She is reported to have no exposure to animals or a recent travel history.

Globally, from September 2012 to date, WHO has been informed of a total of 253 laboratory-confirmed cases of infection with MERS-CoV, including 93 deaths.

Case totals published in the Disease Outbreak News on MERS-CoV on 20 April 2014, already included the 6 laboratory-confirmed cases reported from the UAE on 16 April, 2014 below.

The following details were provided to WHO on 16 April 2014 by the Ministry of Health UAE:

All the cases are from Abu Dhabi and have had close contact with a laboratory-confirmed case reported on 10 April. To date, the cases are kept in isolation in a hospital and are well. Screening of other health care contacts and family members are ongoing.

• A 52 year-old woman who had mild illness on 9 April and was screened on 10 April. She is reported to have no underlying medical condition and does not have exposure to animals or a recent travel history.
• A 28 year-old who was screened on 10 April. He has no illness and is reported not to have any underling medical condition and does not have exposure to animals or a recent travel history.
• A 59 year-old man who was screened on 12 April. He has no illness. He is reported to have an underlying medical condition. He is reported not to have exposure to animals or a recent travel history.
• A 28 year-old man who was screened on 10 April. He developed mild illness on 11 April. He is reported to have no underlying medical condition and does not have exposure to animals or a recent travel history.
• A 55 year-old woman who was screened on 12 April. She developed mild illness on 8 April. She is reported to have no underlying medical condition and does not have exposure to animals or a recent travel history.
• A 28 year-old woman who was screened on 10 April. She developed mild illness on 8 April. She is reported to have no underlying medical condition and does not have exposure to animals or a recent travel history.

(Continue . . .)

 

Philippines Quarantines Imported Asymptomatic MERS Case & Contacts

 

 

 

# 8481

 

The past two hours a report has been circulating on twitter regarding an (asymptomatic) imported case of MERS-CoV in the Philippines – that of a colleague of the paramedic who died last week in the UAE (see UAE Ministry Of Interior Announces 6 MERS-CoV Cases (1 Fatality)). 

 

This cluster has reportedly since grown to at least 10 cases (see UAE Announces 3 More MERS-CoV Cases).

 

The story has now broken in multiple media outlets.  Here are excerpts from the Gulf News.

 

Manila quarantines Filipino nurse from UAE after testing positive for Mers

Nurse who flew from UAE was quarantined along with family members in Manila

Published: 13:52 April 16, 2014

A Filipino nurse was quarantine along with his family after testing positive for the Middle East Respiratory Syndrome (Mers) virus upon arrival at the Manila international airport, making him the first confirmed case in the Philippine, Health Secretary Enrique Ona announced Wednesday.

In a press conference, the official said the patient, whose name was not disclosed, had been quarantined in a government hospital along with nine members of his family who were exposed to the virus, the GMA news website reported.

The nurse was taken directly to a government hospital upon landing at the Ninoy Aquino International Airport (Naia). Tagalog-language Tweets made by GMA from the press conference stated that Ona said passengers on the plane seated next to the nurse with Mers-CoV symptoms will also be quarantined.

The nurse is a friend of the Filipino hospital employee who died last week in the UAE for the same illness, Ona told reporters.

(Continue . . )

While a statement has yet to appear on the Philippines Ministry of Health website, in the past few hours they have announced renewed 04/16/2014 Measures set against entry of MERS-CoV.   A PDF File that contains the following image:

Another report from Gulf News fleshes these safeguards out a bit:

 

Aquino moves to stop MERS-CoV from spreading in the Philippines

Surveillance system reactivated at airport terminals to screen incoming passengers

• By Barbara Mae Dacanay, Bureau Chief
• Published: 13:25 April 16, 2014

(EXCERPT)

The Bureau of Quarantine has reactivated, at the three terminals of the Ninoy Aquino International Airport (NAIA) in suburban Pasay City, a surveillance system that the health department started using to monitor incoming passengers for bird flu and influenza virus (H7N9 and H1N1) in 2003, the health department said in a statement.

Hospitals have been ordered to report to authorities cases of patients with severe respiratory illnesses, the statement said, adding that passengers coming from the Middle East should watch out for symptoms of respiratory ailments within 10 days of arrival.

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Although often the first, and most visible line of defense mounted against a viral threat like bird flu or MERS,  airport surveillance has a less-than-sterling history of success in keeping infected passengers from coming into a country. A topic we’ve discussed before (and likely will again soon):

UAE Announces 3 More MERS-CoV Cases

@WHO Twitter feed this morning.

 

# 8478

 

The World Health Organization telegraphed this announcement  earlier this morning (see tweet graphic above), and I expect we’ll get more information from a GAR DON update in short order, but in the meantime we have this report from KUNA – the Kuwait News Agency.

 

All three cases are apparently asymptomatic contacts of a previous case, discovered during the epidemiological investigation. Hopefully the next WHO update will help unravel the particulars. 

I’ve checked the Abu Dhabi Health Authority’s website, but so far no announcement has been posted.

 

 

Emirates announces the discovery of three new cases of HIV (Corona) in Abu Dhabi

15/04/2014 | 05:42  |
 

ABU DHABI - 15-4 (KUNA) - The Health Authority in Abu Dhabi, here today the discovery of three new cases of HIV (Corona) that causes Acquired Middle East respiratory in Abu Dhabi through medical examinations for Mkhaltin for patients.

Authority said in a press release that the new cases do not showing any symptoms and enjoy good health, saying that the general health status of the path of the virus (Corona) in the country are assured not to worry.

Added that he observed through the follow-up similar cases earlier found no any symptoms that people getting rid of the virus self during the period between 10 and 14 days but is keep them in the hospital and preventive during this period.

The Commission called upon all citizens and residents to adhere to guidelines of public health to reduce the spread of flu and respiratory infections infectious Kalmdaoma to wash your hands thoroughly with soap and water or disinfectant other, especially after coughing or sneezing, and before and after handling foods and use handkerchief when coughing or sneezing, cover your mouth and nose with it.

Showed It has coordinated with the Ministry of Health and health authorities and stakeholders in the United Arab Emirates to take precautionary measures necessary necessary and in accordance with the recommendations of the scientific and conditions and criteria adopted by the World Health Organization, noting that the health authorities all working around the clock to monitor and control the general health status. (end) p PSC

MERS And Loathing In The UAE

 

Photo Credit http://www.24.ae/

 

# 8477

 

The headline in the photo above says quite clearly what is all-too-apparent when monitoring Arabic twitter feeds discussing the MERS coronavirus; regardless of government assurances that everything is `stable’, the level of anxiety in the UAE (and elsewhere in the Middle East) has been on the rise over the past week. 

 

Parents are keeping their children out of school, masks are being worn in public (and are reportedly in short supply), and social media rumors are rushing in to to fill the `vacuum’  left by a dearth of official information.

 

We’ve some excerpts from the newspaper report above, which indicates a brisk trade in both masks and Oseltamivir (Tamiflu ®) at regional pharmacies (Note: Tamiflu is an influenza-specific antiviral, and would not be expected to provide therapeutic benefits for coronavirus infections), and a statement from the Abu Dhabi Health Authority.

 

A state of anxiety felt by parents

Dubai: Rising demand for masks for fear of "Corona" and the Health Authority denies the existence of injuries

See pharmacies in Dubai were high on the masks and anti viral "Tammy-Flo", with some residents worried about injuries to the coronavirus in the UAE, said an informed source in DHA for 24 free Principality of cases of Corona, said Dubai ambulance did not deal with possible cases of the disease and its symptoms, sound and educationalists that back-to-school season came naturally and absenteeism among students.

Pharmaceutical said Ruba ESRB for 24 that there was a large turnout in recent masks covering nose and mouth, and said: "people are reluctant to buy boxes full of gags, asking about its effectiveness in the non-transmission of disease or virus to their children among school children."

<SNIP>

Political disclosures
An informed source said the Dubai health authority, who wished to remain anonymous, for 24 not recording any infected with the disease at the level of hospitals and medical centers of the body, showing that the Commission is committed to a policy of non-disclosure of any information about the virus, as instructed by the Ministry of health, the prevalence and seriousness of the virus in the State.

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As we’ve seen in neighboring Saudi Arabia, the UAE seems heavily focused on quashing rumors and reassuring the public, insisting that the coronavirus is `not a public health concern’.  Here is the official statement as it appears on the Abu Dhabi Health Authority Website:

 

The Health Authority – Abu Dhabi (HAAD) reassures citizens and residents in the Emirate on the MERS Coronavirus

The Health Authority – Abu Dhabi (HAAD) reassures citizens and residents in the Emirate on the MERS Coronavirus (MERS COV) illness status and asks the public to practise their daily life activities normally. HAAD calls all residents to avoid rumors and refer to official reliable sources for information on the illness.

 

HAAD confirmed that the current situation is not a public health concern and that it is coordinating with the Ministry of Health (MOH) and other authorities in the country, and has taken all necessary measures as per international standards and recommendations from the World Health Organisation (WHO), including screenings for all contacts of affected individuals as per international standards and best practice.

 

HAAD advises the public to follow these tips to help prevent respiratory illnesses:

• Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use hand sanitizer
• Cover your nose and mouth with a tissue when you cough or sneeze then throw the tissue in the trash.
• Avoid touching your eyes, nose, and mouth with unwashed hands.
• Avoid close contact, such as kissing, sharing cups, or sharing eating utensils, with people with fever or flu-like illnesses
• Clean and disinfect frequently touched surfaces, such as toys and doorknobs.
• Wear masks in mass gatherings like Hajj or Umrah.

HAAD stressed the need to follow information released about the illness by the Ministry of Health and health authorities. Cases of MERS COV have been reported by the WHO from 2012.

The MOH stated that the WHO confirmed the virus is not a concern for public health at the moment, and that the current situation does not require a travel ban to any country in the world, screenings at different ports, or any restrictions on trade.

The MOH reassured everyone that globally, detected cases continue to be very low compared to other types of flu-like illness. The MOH confirmed that it is monitoring the situation closely to ensure the health and safety of everyone.

The MOH and Health Authorities along with the WHO are working closely with all government and health authorities to understand the risks of this virus and the way it spreads between people.

While the MERS situation in the UAE, Yemen, Jordan, and most particularly Saudi Arabia remains fluid and confusing, and case numbers are bound to change, last night CIDRAP News put together as cogent of a review of the situation as was possible at the end of day yesterday.

 

Nine Saudi MERS cases add to Jeddah outbreak; Yemen has first case

Robert Roos | News Editor | CIDRAP News |

Apr 14, 2014

UAE Ministry Of Interior Announces 6 MERS-CoV Cases (1 Fatality)

AL AIN (aka AL AYN) population 568,000 (2010)

 

UPDATED 0800 EDT:   Although earlier reports were ambiguous, additional English Language reporting now makes it appear that there are 6 cases, and 1 fatality in this cluster (see Mers virus claims another victim in UAE –khaleejtimes).

 

# 8459

 

The United Arab Emirates Ministry of Interior’s official twitter stream is https://twitter.com/AbuDhabiPolice, which over the past few hours has been tweeting details of an outbreak of MERS-CoV involving 5 healthcare workers in the city of Al Ain (on the Omani border) – one of whom has died.

 

(Note: Some reports show 1 death, and 5 other cases.  The total number is unclear). – See update above.

 

Here are (translated) screenshots of that twitter feed.

 

 

The most recent tweet (approx. 6am EDT) contains a link to the following official announcement on the Abu Dhabi Police website:

 

Saturday, April 11, 2014

5 deaths and injuries to paramedics Filipino employees of the "internal" Pkorona

Revealed the Ministry of Interior for the death of a Msafeeha, and wounding five others, (Filipinos) of the employees of the emergency department in the city of Al Ain, virus infection Corona, through disclosure and conduct periodic medical examinations on them.ministry said in a statement that it has taken measures health and preventive necessary; placing them in quarantine health, and continued ministry with people who have been first aid from members of the community in the last period for precautionary check on them.ministry confirmed its commitment to the principle of continuous transparency in the News revealed that fall within the community's interest and related to its security and integrity.

 

Another report appears on the Al Bayan News site:

 

Interior announces the death of a Corona virus Msafeeha

Date: April 11, 2014

Interior Ministry announced via computed on e-networking site Twitter about the death of a Msafeeha and wounding five other paramedics (Vlpini nationality) employees of the emergency department in the city of Al Ain corona virus.

The ministry said action was taken and the necessary preventive health, have been communicating with members of the community who have been their ministry in the last period for precautionary check on them.

The ministry confirmed its commitment to the principle of continuous transparency in the News revealed that fall within the framework of citizens' interest and relate to their security and safety.

 

This latest UAE announcement comes just three days after the announcement of a MERS case in Abu Dhabi (see Meanwhile, In The UAE . . .).

 

Neighboring Saudi Arabia continues to deal with a significant outbreak in Jeddah (see Saudi MOH Announces 3 More MERS-CoV Cases In Jeddah), along with scattered cases reported in the Riyadh region.

After a quiet start to the new year,  MERS reports across the Arabian Peninsula have definitely begun to increase again.

WHO MERS-CoV Update KSA & UAE – April 10th

Photo Credit NIAID

 

 

# 8456

 

The World Health Organization has posted an update on the MERS coronavirus, with details on 5 recent cases (4 from Saudi Arabia, 1 from the UAE).  The two cases from Jeddah are part of a much larger event (see Saudi MOH Statement On Jeddah Cluster) which has received considerable attention over the past couple of days, and additional case information is expected.

 

 

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

Disease Outbreak News

10 April 2014 - The Ministries of Health of Saudi Arabia and the United Arab Emirates (UAE) recently announced additional laboratory-confirmed cases of infection with Middle East respiratory syndrome coronavirus (MERS-CoV).

The 4 additional laboratory-confirmed cases reported to WHO by the Ministry of Health of Saudi Arabia on 28 March and 2 April 2014 include:

• A 26 year-old man from Jeddah. He became ill on 22 March, was hospitalised on 23 March, and died on 6 April.
• A 26 year-old man from Jeddah. He became ill on 16 March and has been hospitalised since 25 March.
• A 77 year-old woman from Riyadh region. She became ill on 25 March and is currently in a stable condition. She is not known to have a history of exposure to animals.
• A 59 year-old man from Riyadh region who became ill on 22 March, 2014. He is not known to have contact with animals or a known case.

The additional laboratory-confirmed case reported to WHO by the Ministry of Health of the UAE on 30 March includes:

• A 64 year-old man from Abu Dhabi with underlying medical conditions. He became ill on 21 March, was hospitalised on 25 March and died on 30 March. He had underlying medical conditions. He did not have contact with a previously laboratory-confirmed case, but has had exposure to animals. The patient visited a camel farm in Harb city in Saudi Arabia on 10 March and visited Nezwa city in Oman for a day on 20 March. He owned an animal farm in the UAE with poultry and sheep, but had no recent visit to the farm. Investigation into the family and health care contacts is ongoing.

Globally, from September 2012 to date, WHO has been informed of a total of 211 laboratory-confirmed cases of infection with MERS-CoV, including 88 deaths.

(Continue . . .)

Meanwhile, In The UAE . . .

UAE’s Proximity to Saudi Arabia

 

 

# 8449

 

The Abu Dhabi Health Authority has announced the detection of a new case of MERS-CoV, this time a 59-year old renal patient.  Shiloh on FluTrackers has a version of the story from Arabian Business News, while I’ve a report from Gulf News below.

Thus far, we’ve no indication of how or where this patient contracted the virus.

 

New coronavirus case in Abu Dhabi

59-year-old Abu Dhabi resident diagnosed with the illness

Published: 16:24 April 8, 2014

 Abu Dhabi: A 59-year-old Abu Dhabi male resident was diagnosed with Mers-Coronavirus, the Health Authority-Abu Dhabi has announced.

The patient, who is currently on dialysis and known to have diabetes and final-stage renal failure, complained of respiratory symptoms and was admitted and diagnosed with the illness.

HAAD has confirmed that it is coordinating with the Ministry of Health and other authorities in the country, and has taken all necessary measures according to international standards and recommendations from the World Health Organisation.

(Continue . . . )

 

Based on FluTracker’s MERS Line Listing, this would make the 21st case reported out of the UAE, and the 7th of 2014.

 

WHO MERS-CoV Update & A New Epidemiological Study

UAE’s Proximity to Saudi Arabia

# 8420

 

Last week (see WHO: Two MERS-CoV Updates From The UAE) we saw a report from the World Health Organization on two new MERS cases – one of which had been a contact of a previously reported case.  Today, the WHO has published details on a new case – who reportedly had contact with animals, including camels  - but no contact with previously known cases.

Middle East respiratory syndrome coronavirus (MERS-CoV) – update / 01/04/2014

01/04/2014

1 April 2014 - On 30 March 2014, the National IHR Focal Point of the United Arab Emirates (UAE) notified WHO of an additional laboratory-confirmed case of infection with Middle East respiratory syndrome coronavirus (MERS-CoV).

Details of the case provided to WHO are as follows:

• 
  A 64 year-old man from Abu Dhabi with underlying medical conditions. He became ill on 21 March, and was admitted to hospital on 25 March. His condition deteriorated and he was placed in intensive care. He passed away on 30 March. The patient had no reported contact with laboratory-confirmed cases, however did report having contact with animals, including camels. The patient also had a recent history of travel to Oman and to Saudi Arabia. Further epidemiological investigation in ongoing.

Globally, from September 2012 to date, WHO has been informed of a total of 207 laboratory-confirmed cases of infection with MERS-CoV, including 87 deaths.

 

Based on FluTrackers  MERS Case Line Listing, this appears to be the 6th case reported out of the UAE in 2014, and  the 30th case reported this year globally.

While secondary human-to-human transmission of the MERS coronavirus has been well demonstrated, evidence increasingly implicates camels as being the initial source of the virus (see CIDRAP NEWS report WHO sees camels as MERS source, but route uncertain).

Another study, published yesterday in the International Journal of Infectious Disease, looked at two clusters of MERS cases in Hafr Al-Batin district of Saudi Arabia, and found additional evidence of a camel connection.

 

  A link and an excerpt follow:

 

Memish ZA, Cotten M, Watson SJ, Kellam P, Zumla A, Alhakeem RF, Assiri A, Rabeeah AAA, Al-Tawfiq JA,

Community Case Clusters of Middle East Respiratory Syndrome Coronavirus in Hafr Al-Batin, Kingdom of Saudi Arabia: A Descriptive Genomic study,

International Journal of Infectious Diseases (2014), http://dx.doi.org/10.1016/j.ijid.2014.03.1372

Summary

The Middle East respiratory syndrome coronavirus (MERS-CoV) was first described in September 2012 and had caused a total of 191 cases of MERS-CoV infection with 82 deaths. Camels have been implicated as the reservoir of MERS-CoV, but the exact source and mode of transmission for most patients remain unknown.

During a 3 month period, June to August 2013, there were 12 positive MERS-CoV cases reported from the Hafr Al-Batin district in the north east region of the Kingdom of Saudi Arabia. In addition to the different regional camel festivals in neighboring countries, Hafr Al-Batin has the biggest camel market in the entire Kingdom and host an annual camel festival.

Thus, we conducted a detailed epidemiological, clinical and genomic study to ascertain common exposure and transmission patterns of all cases of MERS-CoV reported from Hafr Al-Batin.

The genetic data indicated that at least two of the infected contacts could not have been directly infected from the index patient and alternate source should be considered. Camels appear as the likely source but other animals have not been ruled out. More detailed case control studies with detailed case histories, epidemiological information and genomic analysis are being conducted to delineate the missing pieces in the transmission dynamics of MERS-CoV outbreak.

WHO MERS-CoV Update – UAE

UAE On the Arabian Peninsula

 

# 8275

 

 

The World Health Organization this morning announced a new MERS coronavirus case in the United Arab Emirates (UAE), which is their first case reported with an onset in 2014.  This 66 year-old patient, who is currently hospitalized in stable condition, has both contact with camels and recent travel history to Oman.

 

This patient fell ill, and was hospitalized, more than two weeks ago.  An epidemiological investigation, and contact tracing, are ongoing.

 

 

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

Disease outbreak news

7 February 2014 - On 3 February 2014, United Arab Emirates notified WHO of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) infection .

 

The case is a 66 year-old male, UAE national residing in Abu Dhabi. He had onset of symptoms on 20 January 2014 with an upper respiratory tract illness and was admitted to hospital on 24 January 2014 with pneumonia and renal failure. He had underlying medical conditions.

 

MERS-CoV was laboratory-confirmed at the national laboratory in Abu Dhabi on the 30 January 2014 by two positive PCR targets. The Patient is currently in the ICU in stable condition. Public health authorities are carrying out contact tracing and an epidemiological investigation.

 

The case owns camels in UAE and has recent travel history to Oman from 20 January 2014 where he had contact with camels.

 

Globally, from September 2012 to date, WHO has been informed of a total of 182 laboratory-confirmed cases of infection with MERS-CoV, including 79 deaths.

(Continue . . .)

WHO: UAE Reports New MERS-CoV Case (HCW)

 

Coronavirus – Credit CDC PHIL

 

 

# 8125

 

 

The World Health Organization has just posted a GAR update  (h/t @MackayIM & @HelenBranswell)  with information on a new MERS case in the UAE – a 33 year-old Health Care Worker who was in contact with an earlier confirmed case (see WHO Coronavirus Update – December 22nd) who has since died.

. 

 

This newest case is described as being hospitalized with bilateral pneumonia, acute renal failure and thrombocytopenia on December 28th, and is currently listed in stable, but critical, condition.

 

One of the ongoing concerns over MERS is the relatively high number of hospital (nosocomial) transmissions we continue to see, despite presumed increases in infection control procedures.  Today’s WHO update once again contains a strong reminder for vigilance among medical staff to prevent transmission.

 

 

Middle East respiratory syndrome coronavirus (MERS-CoV) - update

Disease outbreak news

3 January 2014 - On 31 December 2013, WHO has been informed of an additional laboratory-confirmed case of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in United Arab Emirates.

 

The case is a 33 year-old male healthcare worker in Dubai who was in contact with the confirmed MERS-CoV case reported to WHO on 20 December. He developed symptoms on 27 December, and was hospitalized on 28 December with bilateral pneumonia, acute renal failure and thrombocytopenia. The patient has underlying history of bronchial asthma and chronic kidney disease. The case was laboratory confirmed for MERS-CoV on 29 December 2013. The patient is in critical but stable condition.

 

Globally, from September 2012 to date, WHO has been informed of a total of 177 laboratory-confirmed cases of infection with MERS-CoV, including 74 deaths.

 

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 travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations.

 

Patients diagnosed and reported to date have had respiratory disease as their primary illness. Diarrhoea is commonly reported among the patients and severe complications include renal failure and acute respiratory distress syndrome (ARDS) with shock. It is possible that severely immunocompromised patients can present with atypical signs and symptoms.

 

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.

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