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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate (ECDC/CDTR, January 3 2014, extract)
[Source: European Centre for Disease Prevention and Control (ECDC), full page: (LINK). Extract.]
COMMUNICABLE DISEASE THREATS REPORT
Week 1, 29 December-4 January 2014
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Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 19 December 2013
Epidemiological summary
As of 3 January 2014, 176 laboratory-confirmed cases of MERS-CoV have been reported by local health authorities worldwide, including 74 deaths.
The following countries have reported MERS-CoV cases:
Oman News Agency quoting a Ministry of Health official, reported the death of a 59-year-old Omani man who died on 30 December and tested positive for MERS-CoV. This case is not yet confirmed by WHO. It is therefore not included in the above distribution.
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 United Arab Emirates (UAE).
The 4th meeting of the IHR Emergency Committee concerning MERS-CoV was held on 4 December 2013. The Committee concluded that there was no reason to change its previous advice to the Director-General. Their unanimous decision was that the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.
Based on events since its last meeting, the Committee emphasised the need for:
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ECDC assessment
The source of MERS-CoV infection and the mode of transmission have not been identified, but the continued detection of cases in the Middle East indicates that there is an ongoing source of infection in the region. There is therefore a continued risk of cases presenting in Europe following exposure in the Middle East, and surveillance for MERS-CoV 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
ECDC's latest epidemiological update was published on 25 November 2013. 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.
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COMMUNICABLE DISEASE THREATS REPORT
Week 1, 29 December-4 January 2014
(...)
Middle East respiratory syndrome- coronavirus (MERS CoV) ? Multistate
Opening date: 24 September 2012 Latest update: 19 December 2013
Epidemiological summary
As of 3 January 2014, 176 laboratory-confirmed cases of MERS-CoV have been reported by local health authorities worldwide, including 74 deaths.
The following countries have reported MERS-CoV cases:
- Saudi Arabia: 141 cases / 57 deaths
- United Arab Emirates: 11 cases / 4 deaths
- Qatar: 7 cases / 4 deaths
- Oman: 1 case / 1 death
- Kuwait: 2 cases/ 0 deaths
- Jordan: 2 cases / 2 deaths
- UK: 4 cases / 3 deaths
- Germany: 2 cases / 1 death
- France: 2 cases / 1 death
- Italy: 1 case / 0 deaths
- Tunisia: 3 cases / 1 death
Oman News Agency quoting a Ministry of Health official, reported the death of a 59-year-old Omani man who died on 30 December and tested positive for MERS-CoV. This case is not yet confirmed by WHO. It is therefore not included in the above distribution.
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 United Arab Emirates (UAE).
The 4th meeting of the IHR Emergency Committee concerning MERS-CoV was held on 4 December 2013. The Committee concluded that there was no reason to change its previous advice to the Director-General. Their unanimous decision was that the conditions for a Public Health Emergency of International Concern (PHEIC) have not at present been met.
Based on events since its last meeting, the Committee emphasised the need for:
- investigative studies, including international case-control, serological, environmental, and animal-human interface studies, to better understand risk factors and the epidemiology
- further review and strengthening of such tools such as standardised case definitions and surveillance, and further emphasis on infection control and prevention.
(?)
ECDC assessment
The source of MERS-CoV infection and the mode of transmission have not been identified, but the continued detection of cases in the Middle East indicates that there is an ongoing source of infection in the region. There is therefore a continued risk of cases presenting in Europe following exposure in the Middle East, and surveillance for MERS-CoV 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
ECDC's latest epidemiological update was published on 25 November 2013. 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.
(?)
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