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WHO: Middle East respiratory syndrome coronavirus (MERS-CoV) - United Arab Emirates (March 17, 2021)

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  • WHO: Middle East respiratory syndrome coronavirus (MERS-CoV) - United Arab Emirates (March 17, 2021)


    Middle East respiratory syndrome coronavirus (MERS-CoV) - United Arab Emirates

    17 March 2021

    The case is a 39-year-old male national, owner of a camel farm. He developed fever and cough on 18 January and visited a private hospital several times with no improvement. The condition of the case worsened, and on 24 January, a chest X-ray confirmed the diagnosis of pneumonia. On 26 January, he was admitted to a private hospital and was transferred to a governmental hospital on 28 January. A nasopharyngeal swab was collected on 31 January and tested positive for MERS-CoV by reverse transcription polymerase chain reaction (RT-PCR) on 1 February at the Shiekh Khalifa Medical Center laboratory in Abu Dhabi. He has no underlying conditions. SARS-CoV-2 testing was performed more than once, and it was negative. No history of previous infection or exposure to SARS-CoV-2 was reported. The case reported a history of close contact with dromedary camels at his farm in the 14 days prior to the onset of symptoms. No travel history was reported during the same period. Currently, the patient is in stable condition.
    The first MERS-CoV case in the United Arab Emirates (UAE) was reported in July 2013. Since then, a total of 92 cases of MERS-CoV (including the above case) and 12 associated deaths have been reported in the United Arab Emirates. At a global level, from 2012 until 2 February 2021, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2567 with 882 associated deaths. Most of the cases have been reported from the Kingdom of Saudi Arabia. The global number reflects the total number of laboratory-confirmed cases reported to WHO under International Health Regulations (IHR 2005) to date. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with the affected Member States.
    In UAE, the surveillance for MERS-CoV during the COVID-19 pandemic mandate testing for all cases meeting severe acute respiratory infection (SARI) definition.

    Public health response

    Upon identification, an incident report, case investigation, and contact tracing were initiated. The investigation included screening of all close contacts at household and healthcare facilities. All identified contacts of the confirmed case were monitored on a daily basis for the appearance of respiratory or gastrointestinal symptoms for 14 days after their last exposure to the confirmed case. All of them have completed the 14-day monitoring period and no further cases were reported. Additionally, all close contacts of the patients have been tested for MERS-CoV and so far all are negative.
    The veterinary authorities have been notified and investigation in animals is ongoing.

    WHO risk assessment

    Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels. MERS-CoV has demonstrated limited ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.
    The notification of additional cases does not change the overall risk assessment. However, with the current COVID-19 pandemic, the testing capacity for MERS-CoV have been severely affected in many countries since most of the resources have been redirected towards SARS-CoV-2. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to dromedary camels, animal products (for example, consumption of camel?s raw milk), or humans (for example, in a health care setting).
    WHO continues to monitor the epidemiological situation and conducts risk assessments based on the latest available information.

    WHO advice

    Based on the current situation and available information, WHO encourages all Member States to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.
    Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV infection early because like other respiratory infections, the early symptoms of MERS-CoV infection are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol-generating procedures.
    Early identification, case management, and isolation, together with appropriate infection prevention and control measures can prevent human-to-human transmission of MERS-CoV.
    MERS-CoV appears to cause more severe disease in people with diabetes, renal failure, chronic lung disease, and immunocompromised persons. Therefore, these people should avoid close contact with animals, particularly dromedary camels, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.
    Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine or eating meat that has not been properly cooked.
    WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.

    Further information

    Middle East respiratory syndrome coronavirus (MERS-CoV)