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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate (ECDC/CDTR, August 26 2013, extract)

Giuseppe

Emeritus
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extract.]


COMMUNICABLE DISEASE THREATS REPORT

Week 34, 18-24 August 2013

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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate

Opening date: 24 September 2012 Latest update: 19 August 2013


Epidemiological summary

As of 16 August 2013, 94 laboratory-confirmed cases of MERS-CoV, including 47 deaths worldwide have been acknowledged by WHO. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East.

As of 22 August, Saudi Arabia has reported 80 cases (six of these still pending WHO acknowledgement), including 41 deaths (two pending WHO acknowledgement), the UAE has reported five, Jordan two cases, both of which died and Qatar one case.

Thirteen cases have been reported from outside the Middle East: in the UK (4), Italy (3), France (2), Germany (2) and Tunisia (2).

In France, Italy, Tunisia and the United Kingdom, there has been local transmission among patients who have not been to the Middle East but had been in close contact with laboratory-confirmed or probable cases.

Person-to-person transmission has occurred both among close contacts and in healthcare facilities, but, with the exception of a nosocomial outbreak in Al-Ahsa, Saudi Arabia, secondary transmission has been limited. Eight asymptomatic cases were reported by Saudi Arabia and two by the UAE. Six of these cases were healthcare workers.

On 9 July, WHO established an Emergency Committee to advise WHO's Director-General on the status of the current situation concerning MERS-CoV. On 17 July, the second meeting of the Emergency Committee under the International Health Regulations (2005) was held by teleconference. It concluded unanimously that with the information now available, and by using a risk assessment approach, the conditions for a Public Health Emergency of International Concern have not been met.

The Ministry of Health of Saudi Arabia updated its Health Regulations for travellers to Saudi Arabia for the Umrah and Hajj pilgrimage regarding MERS-CoV and now recommends that the elderly, those with chronic diseases, pilgrims with immune deficiency, malignancy and terminal illnesses, pregnant women and children coming for Hajj and Umrah this year should postpone their journey.

WHO published a travel advice on MERS-CoV for pilgrimages on 25 July 2013.

The WHO guidelines for investigation of cases of human infection with MERS-CoV were published in July 2013. On 30 July 2013, the MERS-CoV Initial Interview Questionnaire of Cases ? Guide for the interviewer was published to support the investigators.

On 21 August 2013, WHO published a joint report of a mission to Riyadh, 4-9 June 2013 together with Saudi Arabia on Middle East respiratory syndrome coronavirus.

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ECDC assessment

The continued detection of MERS-CoV cases in the Middle East indicates that there is an ongoing source of infection present in the region. There is therefore a continued risk of cases occurring in Europe associated with travel to the area. Surveillance for cases is essential, particularly with expected increased travel to Saudi Arabia for the Hajj in October.

The risk of secondary transmission in the EU remains low and could be reduced further through screening for exposure among patients presenting with respiratory symptoms and their contacts, and strict implementation of infection prevention and control measures for patients under investigation.


Actions

The latest ECDC rapid risk assessment was published on 22 July 2013.

The results of an ECDC coordinated survey on laboratory capacity for testing the MERS-CoV in Europe were published in EuroSurveillance.

ECDC published a Public Health Development on 12 August 2013 regarding a comparative serological study on MERS in camels and other animals.

ECDC is closely monitoring the situation in collaboration with WHO and the EU Member States.

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