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[Note, this was taken from the HAN380 Issues June 11, 2015:
CDC continues to recommend that healthcare providers and health departments throughout the US be prepared to detect and manage cases of MERS. Healthcare providers should continue to routinely ask their patients about their travel history and healthcare facility exposure and to consider a diagnosis of MERS-CoV infection in persons who meet the criteria for patient under investigation (PUI), which has been revised to include considerations of recently being in a Korean healthcare facility and is available at http://www.cdc.gov/coronavirus/mers/case-def.html. ...]
Case Definitions
Patients should be evaluated for MERS-CoV infection in consultation with the state and local health departments. For more information, see CDC?s Interim Guidance for Healthcare Professionals. Patient Under Investigation (PUI)
A person who has both clinical features and an epidemiologic risk should be considered a patient under investigation (PUI) based on one of the following scenarios:
The above criteria serve as guidance for testing; however, patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain history of health care exposure). Confirmed Case
A confirmed case is a person with laboratory confirmation of MERS-CoV infection. Confirmatory laboratory testing requires a positive PCR on at least two specific genomic targets or a single positive target with sequencing on a second. Probable Case
A probable case is a PUI with absent or inconclusive laboratory results for MERS-CoV infection who is a close contact2 of a laboratory-confirmed MERS-CoV case. Examples of laboratory results that may be considered inconclusive include a positive test on a single PCR target, a positive test with an assay that has limited performance data available, or a negative test on an inadequate specimen.
Footnotes
CDC continues to recommend that healthcare providers and health departments throughout the US be prepared to detect and manage cases of MERS. Healthcare providers should continue to routinely ask their patients about their travel history and healthcare facility exposure and to consider a diagnosis of MERS-CoV infection in persons who meet the criteria for patient under investigation (PUI), which has been revised to include considerations of recently being in a Korean healthcare facility and is available at http://www.cdc.gov/coronavirus/mers/case-def.html. ...]
Case Definitions
Patients should be evaluated for MERS-CoV infection in consultation with the state and local health departments. For more information, see CDC?s Interim Guidance for Healthcare Professionals. Patient Under Investigation (PUI)
A person who has both clinical features and an epidemiologic risk should be considered a patient under investigation (PUI) based on one of the following scenarios:
| Severe illness Fever and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence) |
and | A history of travel from countries in or near the Arabian Peninsula1 within 14 days before symptom onset, or close contact2 with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula1. ? or ? A history of being in a healthcare facility (as a patient, worker, or visitor) in the Republic of Korea within 14 days before symptom onset. ? or ? A member of a cluster of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments in the US. |
| Milder illness Fever and symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath) |
and | A history of being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified. |
| Fever or symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath) | and | Close contact2 with a confirmed MERS case while the case was ill. |
A confirmed case is a person with laboratory confirmation of MERS-CoV infection. Confirmatory laboratory testing requires a positive PCR on at least two specific genomic targets or a single positive target with sequencing on a second. Probable Case
A probable case is a PUI with absent or inconclusive laboratory results for MERS-CoV infection who is a close contact2 of a laboratory-confirmed MERS-CoV case. Examples of laboratory results that may be considered inconclusive include a positive test on a single PCR target, a positive test with an assay that has limited performance data available, or a negative test on an inadequate specimen.
Footnotes
- Countries considered in the Arabian Peninsula and neighboring include: Bahrain; Iraq; Iran; Israel, the West Bank, and Gaza; Jordan; Kuwait; Lebanon; Oman; Qatar; Saudi Arabia; Syria; the United Arab Emirates (UAE); and Yemen.
- Close contact is defined as: a) being within approximately 6 feet (2 meters) or within the room or care area for a prolonged period of time (e.g., healthcare personnel, household members) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection? see Infection Prevention and Control Recommendations); or b) having direct contact with infectious secretions (e.g., being coughed on) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection ? see Infection Prevention and Control Recommendations). Data to inform the definition of close contact are limited. At this time, brief interactions, such as walking by a person, are considered low risk and do not constitute close contact.
- Page last reviewed: June 8, 2015
- Page last updated: June 11, 2015
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