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Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate (ECDC/CDTR, November 8 2013)

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  • Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate (ECDC/CDTR, November 8 2013)

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


    COMMUNICABLE DISEASE THREATS REPORT - Week 45, 3-9 November 2013

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    Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate

    Opening date: 24 September 2012 Latest update: 7 November 2013


    Epidemiological summary

    As of 7 November 2013, WHO reports 151 laboratory-confirmed cases of MERS-CoV worldwide, including 64 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 125 symptomatic and asymptomatic cases including 53 deaths;
    • Jordan two cases, both of whom died;
    • United Arab Emirates five cases, including one fatality;
    • Qatar five cases, including two deaths; and
    • Oman one case.
    Thirteen cases have been reported from outside the Middle East: in the UK (4), France (2), Tunisia (3), Germany (2), Italy (1) and
    Spain (1, pending confirmatory testing).


    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 have been reported by Saudi Arabia and two by the UAE. Seven of these cases were healthcare workers.

    A new imported case was reported on 6 November by Spain: a 61-year-old female with no known chronic conditions. She stayed in Saudi Arabia from 2 October to 1 November 2013, initially in Medina, then in Mecca for the Hajj. No contacts with animals or confirmed cases were reported. Initial lab tests for MERS-CoV on three different samples were positive on 5 November, and further tests are ongoing to confirm the findings. This is the first case reported in Spain and the first case in the EU since May 2013.

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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.

    The case of MERS-CoV infection reported in Spain should remind EU citizens of the risk of contracting MERS-CoV through exposure while travelling to the Middle East. 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 update of a rapid risk assessment was published on 7 November 2013. 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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