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Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate (ECDC/CDTR, November 22 2013)

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  • Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate (ECDC/CDTR, November 22 2013)

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


    Week 47, 17-23 November 2013


    Middle East respiratory syndrome- coronavirus (MERS CoV) Multistate

    Opening date: 24 September 2012 Latest update: 20 November 2013

    Epidemiological summary

    As of 21 November 2013, 160 laboratory-confirmed cases of MERS-CoV have been reported by local health authorities worldwide, including 69 deaths.

    • Saudi Arabia has reported 130 symptomatic and asymptomatic cases including 55 deaths;
    • Jordan two fatal cases;
    • United Arab Emirates six cases, including two deaths;
    • Qatar seven cases, including three deaths;
    • Oman one fatal case and
    • Kuwait two cases.

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

    The previously reported patient in Spain has not yet been confirmed by laboratory testing and is now considered a probable case.

    Spain reported another probable case last week, participating in the same tour and returning from Saudi Arabia on the same flight as the first probable case. Both patients have recovered.


    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.


    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 EU Member States.