Two new MERS cases confirmed

THE World Health Organization (WHO) has been notified of two additional laboratory-confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) in Saudi Arabia and Jordan. This brings the latest global number of confirmed MERS cases to 180, including 77 deaths.

The Saudi case involved a 54-year-old healthcare worker from Riyadh who developed symptoms on December 29. He was hospitalised on January 4 and died on January 14. He did not have a history of contact with animals or confirmed patients. He had a history of chronic disease, had no history of contact with animals or MERS known cases, and had no travel history.

The Jordanian case is a 48-year-old man who became ill on December 31. He was admitted to a hospital on January 9, and died on January 23. The patient had underlying health conditions, for he had travelled to the United Kingdom from November and December 25 to seek treatment. Health authorities in Jordan are following family contacts, medical staff and healthcare workers. Investigations are also ongoing in the UK.

Early identification of the MERS-CoV is important, but not all the cases could be reliably and timely detected, especially when disease is mild or presents atypically. Therefore, WHO said it is important to ensure that standard precautions are consistently used for all patients and all work practices all of the time, regardless of suspected or confirmed infection with the MERS-CoV or any other pathogen. Droplet precautions should be added when providing care to all patients with symptoms of acute respiratory infection, and contact precautions plus eye protection should be added when caring for confirmed or probable cases of MERS-CoV infection. Airborne precautions are indicated when performing aerosol generating procedures.

When the clinical and epidemiological clues strongly suggest MERS-CoV, the patient should be managed as potentially infected, even if an initial test on a nasopharyngeal swab is negative. Repeat testing should be done when the initial testing is negative, preferably on specimens from the lower respiratory tract.

WHO also encourages all Member States to continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns.

At this time, however, 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.