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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate (ECDC/CDTR, September 20 2013, edited)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Extracts.]
COMMUNICABLE DISEASE THREATS REPORT
Week 38, 15-21 September 2013
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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 19 September 2013
Epidemiological summary
As of 19 September 2013, 135 laboratory-confirmed cases of MERS-CoV, including 59 deaths worldwide have been reported by national health authorities. 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 19 September 2013, Saudi Arabia has reported 111 symptomatic or asymptomatic cases including 49 deaths, Jordan two cases, who both died, United Arab Emirates five cases including one fatality and Qatar three cases including one fatality. The reason for the discrepancy between the number of cases reported for Saudi Arabia here and on the official Saudi Ministry of Health website is being investigated.
Fourteen cases have been reported from outside the Middle East: in the UK (4), Italy (3), France (2), Germany (2) and Tunisia (3). In France, Italy, Tunisia and the United Kingdom, there has been local transmission among patients who have not been to the Middle East but have been in close contact with laboratory-confirmed or probable cases. Person-to-person transmission has occurred both among close contacts and in healthcare facilities. However, with the exception of a possible nosocomial outbreak in Al-Ahsa, Saudi Arabia, secondary transmission has been limited. Sixteen asymptomatic cases were reported by Saudi Arabia and two by the UAE. Seven of these cases were healthcare workers.
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.
On 18 September WHO has issued an interim recommendation to laboratories and stakeholders involved in laboratory testing for Middle East respiratory syndrome coronavirus (MERS-CoV).
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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. The source of infection and the mode of transmission have not been identified.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 risk assessment is currently being updated. 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 27 August 2013 regarding the isolation of MERS-CoV from a bat sample. ECDC is closely monitoring the situation in collaboration with WHO and the EU Member States.
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COMMUNICABLE DISEASE THREATS REPORT
Week 38, 15-21 September 2013
(...)
Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 19 September 2013
Epidemiological summary
As of 19 September 2013, 135 laboratory-confirmed cases of MERS-CoV, including 59 deaths worldwide have been reported by national health authorities. 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 19 September 2013, Saudi Arabia has reported 111 symptomatic or asymptomatic cases including 49 deaths, Jordan two cases, who both died, United Arab Emirates five cases including one fatality and Qatar three cases including one fatality. The reason for the discrepancy between the number of cases reported for Saudi Arabia here and on the official Saudi Ministry of Health website is being investigated.
Fourteen cases have been reported from outside the Middle East: in the UK (4), Italy (3), France (2), Germany (2) and Tunisia (3). In France, Italy, Tunisia and the United Kingdom, there has been local transmission among patients who have not been to the Middle East but have been in close contact with laboratory-confirmed or probable cases. Person-to-person transmission has occurred both among close contacts and in healthcare facilities. However, with the exception of a possible nosocomial outbreak in Al-Ahsa, Saudi Arabia, secondary transmission has been limited. Sixteen asymptomatic cases were reported by Saudi Arabia and two by the UAE. Seven of these cases were healthcare workers.
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.
On 18 September WHO has issued an interim recommendation to laboratories and stakeholders involved in laboratory testing for Middle East respiratory syndrome coronavirus (MERS-CoV).
(?)
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. The source of infection and the mode of transmission have not been identified.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 risk assessment is currently being updated. 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 27 August 2013 regarding the isolation of MERS-CoV from a bat sample. ECDC is closely monitoring the situation in collaboration with WHO and the EU Member States.
(?)
-
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