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Statement on MERS-CoV infection advice with regard to travelling, 14 June 2013 (EC/EWRS, April 29 2014)

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  • Statement on MERS-CoV infection advice with regard to travelling, 14 June 2013 (EC/EWRS, April 29 2014)

    [Source: European Commission, full PDF document: (LINK). Edited.]

    Draft Health Security Committee/ Early Warning and Response System

    Statement on MERS-CoV infection advice with regard to travelling, 14 June 2013

    The Middle East respiratory syndrome coronavirus MERS-CoV represents a new threat to public health. At this stage all cases remain associated with transmission in the Arabian Peninsula; nonetheless, it is necessary to carefully monitor the situation. Under the current situation, notwithstanding the large number of individuals travelling either for personal (i.e. tourism) or professional reasons to affected areas, the number of individuals that may develop symptoms when returning to EU is expected to be low.

    In this context, travelling refers to crossing the border of an EU Member State by land, maritime or air modes of transport. Under the Treaty establishing the European Community article 18.1 on Freedom of Movement applies. Countries should not implement measures and travel restrictions that lead to restriction of movement between EU Member States.

    The following statement is a summary of the technical guidance for consideration by national contact points. It intends to provide a general guide to the Member States that would be reviewed according to the evolution of the situation:
    • The Health Security Committee supports travel advice which imposes no travel or trade restrictions in relation to MERS-CoV. However, EU citizens travelling to the Middle East need to be aware of the presence of MERS-CoV in this geographical area and of the small risk of infection. Member States may consider active information efforts for travellers to areas most at risk. In view of forthcoming religious pilgrimages to the region, specific advice should be drawn up in regional languages and circulated through travel and religious organisations where appropriate.
    • Although the reservoir of infection in the Middle East is unknown, other novel coronaviruses are zoonoses and have come from animal sources. Travellers should therefore follow standard good hygiene practise and avoid contact with animals or their waste products.
    • Healthcare workers in the EU should be vigilant in identifying patients that may require further investigation. Patients developing symptoms of respiratory infection and who have been in the Middle East in the preceding 14 days should be investigated rapidly. Special attention should be given to medically evacuated patients from the Middle East and to immunocompromised patients.
    • Patients with chronic underlying conditions who develop severe infections (not just respiratory infections) should also be investigated rapidly for MERS-CoV if they have been in the Middle East in the preceding 14 days.
    • Any probable or confirmed case being diagnosed in the EU/EEA should be reported to national authorities through the Early Warning and Response System (EWRS) and to WHO under the International Health Regulations (2005). Reporting through EWRS qualifies as IHR notification and avoids double reporting.
    • If contact tracing is required the following rules should be applied:
      • Close contacts of confirmed cases must be monitored for 14 days after the last exposure, should be tested with polymerase chain reaction (PCR) using appropriate sampling, as well as by acute and convalescent serology, and should be informed what to do should they become ill.
        • A close contact in an air travel setting is defined as:
          • Aircraft passengers in the same row and the three rows in front and behind a symptomatic case.
          • Considering the uncertainties in determining the efficiency of transmission of the MERS-CoV, public health authorities may consider contact tracing of all passengers on the aircraft, following the RAGIDA guidance on SARS.
          • Any person, including aircraft cabin personnel, health-care workers and staff involved in medical evacuations, who had prolonged (>15 minutes) face-to-face contact with a confirmed symptomatic case in any enclosed setting.

    The Health Security Committee will re-evaluate the evidence and situation on a regular basis and revise this statement accordingly.