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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate (ECDC/CDTR, November 4 2013, edited)
[Source: European Centre for Disease Prevention and Control (ECDC), full PDF document: (LINK). Edited.]
COMMUNICABLE DISEASE THREATS REPORT
Week 44, 27 Oct - 2 Nov 2013
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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 31 October 2013
Epidemiological summary
As of 31 October 2013, there have been 149 laboratory-confirmed cases of MERS-CoV worldwide, including 63 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East.
Saudi Arabia has reported 124 symptomatic and asymptomatic cases including 52 deaths, Jordan two cases, who both died, United Arab Emirates five cases, including one fatality, Qatar five cases, including two deaths and Oman one case.
Twelve cases have been reported from outside the Middle East: in the UK (4), France (2), Tunisia (3), Germany (2) and Italy (1).
In France, 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 before the Umrah and Hajj pilgrimage regarding MERS-CoV. This year, the pilgrimage took place from 13 to 18 October. No new cases were reported in Saudi Arabia during that period.
WHO has convened an Emergency Committee under the International Health Regulations (IHR), comprising international experts from all WHO Regions, in September 2013 to advise the Director-General on the current situation. The Emergency Committee unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.
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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.
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 26 September 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 27 August 2013 regarding the isolation of MERS-CoV from a bat sample. The first 133 cases are described in EuroSurveillance published on 26 September 2013. ECDC is closely monitoring the situation in collaboration with WHO and the EU Member States.
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COMMUNICABLE DISEASE THREATS REPORT
Week 44, 27 Oct - 2 Nov 2013
(...)
Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 31 October 2013
Epidemiological summary
As of 31 October 2013, there have been 149 laboratory-confirmed cases of MERS-CoV worldwide, including 63 deaths. All cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East.
Saudi Arabia has reported 124 symptomatic and asymptomatic cases including 52 deaths, Jordan two cases, who both died, United Arab Emirates five cases, including one fatality, Qatar five cases, including two deaths and Oman one case.
Twelve cases have been reported from outside the Middle East: in the UK (4), France (2), Tunisia (3), Germany (2) and Italy (1).
In France, 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 before the Umrah and Hajj pilgrimage regarding MERS-CoV. This year, the pilgrimage took place from 13 to 18 October. No new cases were reported in Saudi Arabia during that period.
WHO has convened an Emergency Committee under the International Health Regulations (IHR), comprising international experts from all WHO Regions, in September 2013 to advise the Director-General on the current situation. The Emergency Committee unanimously advised that, with the information now available, and using a risk-assessment approach, the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.
(?)
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.
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 26 September 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 27 August 2013 regarding the isolation of MERS-CoV from a bat sample. The first 133 cases are described in EuroSurveillance published on 26 September 2013. ECDC is closely monitoring the situation in collaboration with WHO and the EU Member States.
(?)
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