Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia
Between 12 March and 31 July 2021 , the National IHR
Focal Point of Saudi Arabia reported four additional cases of Middle
East Respiratory Syndrome Coronavirus (MERS-CoV) infection, including
one associated death. The cases were reported from three regions
including Riyadh (two cases), Hafar Albatin (one case), and Taif (one
case). One death was also reported from a previously reported case
(Case #7, please see Disease outbreak news published on 14 April ) who died on 20 March. Since 2012, Saudi Arabia has reported 2178 confirmed MERS-CoV cases with 810 deaths.
The link below provides details of the four reported cases
Between
September 2012 until 31 July 2021, a total of 2578 laboratory-confirmed
cases of MERS-CoV and 888 associated deaths were reported globally to
WHO under the International Health Regulations (IHR 2005). The majority
of these cases have occurred in the Arabian Peninsula, with one large
outbreak outside this region in the Republic of Korea, in May 2015, when
186 laboratory-confirmed cases (185 in Republic of Korea and 1 in
China) and 38 deaths were reported. The total number of deaths includes
the deaths that WHO is aware of to date through follow-up with affected
Member States.
WHO risk assessment
Middle East respiratory syndrome (MERS) is a viral
respiratory infection of humans and dromedary camels which is caused by a
coronavirus called Middle East Respiratory Syndrome Coronavirus
(MERS-CoV). Infection with MERS-CoV can cause severe disease resulting
in high mortality. Approximately 35% of patients with MERS have died,
but this may be an overestimate of the true mortality rate, as mild
cases of MERS-CoV may be missed by existing surveillance systems and
until more is known about the disease, the case fatality rates are
counted only amongst the laboratory-confirmed cases.
Humans are
infected with MERS-CoV from direct or indirect contact with dromedaries
who are the natural host and zoonotic source of the MERS-CoV infection.
MERS-CoV has demonstrated the ability to transmit between humans. So
far, the observed non-sustained human-to-human transmission has occurred
among close contacts and in health care settings. Outside of the
healthcare setting there has been limited human-to human transmission.
The
notification of those additional cases does not change the overall risk
assessment. WHO expects that additional cases of MERS-CoV infection
will be reported from the Middle East and/or other countries where
MERS-CoV is circulating in dromedaries, and that cases will continue to
be exported to other countries by individuals who were exposed to the
virus through contact with dromedaries, or animal products (for example,
consumption of raw camel’s milk), or in a healthcare setting.
WHO
continues to monitor the epidemiological situation and conducts risk
assessment based on the latest available information. However, with the
current COVID-19 pandemic, the testing capacities for MERS-CoV have been
severely affected in many countries since most of the resources are
redirected to prevent and control the current COVID-19 pandemic. The
Ministry of Health of Saudi Arabia is working to increase the testing
capacities for better detection of MERS-CoV infections.
WHO advice
Based on the current situation and available information,
WHO re-emphasizes the importance of strong surveillance by all Member
States for acute respiratory infections and to carefully review any
unusual patterns.
Human-to-human transmission in healthcare
settings has been associated with delays in recognizing the early
symptoms of MERS-CoV infection, slow triage of suspected cases and
delays in implementing infection, prevention and control (IPC) measures,
therefore, IPC measures are critical to prevent the possible spread of
MERS-CoV between people in health care facilities. 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 or in settings where aerosol generating
procedures are conducted.
Early identification, case management
and isolation of cases, supported quarantine of contacts, together with
appropriate infection prevention and control measures and public health
awareness can prevent human-to-human transmission of MERS-CoV.
MERS-CoV
appears to cause more severe disease in people with underlying chronic
medical condition such as diabetes, renal failure, chronic lung disease,
and immunocompromised persons. Therefore, people with these underlying
medical conditions should avoid close contact with animals, particularly
dromedaries, 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.
Source; WHO Website