Global & Disaster Medicine

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WHO: MERS-CoV situation update, March 2018

WHO

MERS situation update March

At the end of March 2018, a total of 2189 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 782 associated deaths (case–fatality rate: 35.7%) were reported globally; the majority of these cases were reported from Saudi Arabia (1814 cases, including 708 related deaths with a case–fatality rate of 39%).

In March, 7 laboratory-confirmed cases of MERS were reported in Saudi Arabia including 1 associated death. A cluster-case from a hospital in Riyadh region was reported, with 6 laboratory-confirmed cases including 3 associated deaths. The date of onset of the first case was 23 February 2018. The date of onset of the last laboratory-confirmed case from the hospital cluster was 3 March 2018; since then, there have been no new cases reported from this cluster. Further investigation on the nature of transmission is ongoing.

The demographic and epidemiological characteristics of the cases reported in March 2018 do not show any significant difference compared to cases reported during the same period from 2012 to 2017. Owing to improved infection prevention and control practices in hospitals, the number of hospital-acquired cases of MERS has dropped significantly since 2015.

The age group 50–59 years continues to be at the highest risk for acquiring infection as primary cases. The age group 30–39 years are most at risk for secondary cases. The number of deaths is higher in the age group 50–59 years for primary cases and 70–79 years for secondary cases.”


The Saudi Arabian Ministry of Health announced three new cases of MERS-CoV

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Saudi Arabia’s MERS-CoV total cases since 2012 have now reached 1,816, including 736 deaths.

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Saudi Arabia has spent billions in fighting Middle East Respiratory Syndrome (MERS) since 2012.

Saudi Gazette

“…..The ministry has taken a number of precautionary and preventive measures to contain the disease.

More than 3,000 firms have been closed down as part of temporary and permanent punitive measures.

Seven health ministers have worked to eradicate MERS-CoV since it broke out first in the Kingdom. They are Dr. Abdullah Al-Rabeeah (1430-35 Hijri), Adel Fakeih (1435-36 Hijri), Dr. Mohammed Ali Al-Hayazie (1436 Hijri), Ahmed Oqail Al-Khateeb (1436 Hijri), Mohammed Abdulmalik Al-Asheikh (1436 Hijri), Khalid Al-Falih (1436-37 Hijri) and Dr. Tawfiq Al-Rabiah (the present minister)…..”

 


Disease X: A pathogen with the potential to spread and kill millions but for which there are currently no, or insufficient, countermeasures available.

The Telegraph

“……It was the third time the committee, consisting of leading virologists, bacteriologists and infectious disease experts, had met to consider diseases with epidemic or pandemic potential. But when the 2018 list was released two weeks ago it included an entry not seen in previous years.

In addition to eight frightening but familiar diseases including Ebola, Zika, and Severe Acute Respiratory Syndrome (SARS), the list included a ninth global threat: Disease X…….”
Diseases threatening a public health emergency*
  • Crimean-Congo haemorrhagic fever (CCHF)
  • Ebola virus disease and Marburg virus disease
  • Lassa fever
  • Middle East respiratory syndrome coronavirus (MERS-CoV) and Severe Acute Respiratory Syndrome (SARS)
  • Nipah and henipaviral diseases
  • Rift Valley fever (RVF)
  • Zika
  • Disease X

*Diseases posing significant risk of an international public health emergency for which there is no, or insufficient, countermeasures. Source: World Health Organization (WHO), 2018


Saudi MOH: Another MERS-CoV case in a presumed hospital-based outbreak that has included 3 other patients and 1 healthcare provider

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Over the past few days, Saudi Arabia reported 7 more MERS-CoV infections and 2 deaths from the disease.

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he Saudi Arabian Ministry of Health (MOH) confirmed one new case of MERS-CoV on Feb 17.

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Saudi MOH: ‘1 New Confirmed Corona Cases Recorded’

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MERS-CoV – Saudi Arabia: Between 9 December 2017 and 17 January 2018, the National IHR Focal Point of The Kingdom of Saudi Arabia reported 20 additional cases.

WHO

Disease outbreak news
26 January 2018

Between 9 December 2017 and 17 January 2018, the National IHR Focal Point of The Kingdom of Saudi Arabia reported 20 additional cases of Middle East Respiratory Syndrome (MERS), including eight deaths. In addition, one death from a previously reported case was reported to WHO.

Details of the cases

Detailed information concerning the cases reported can be found in a separate document (see link below).

The 20 cases of MERS-CoV infection reported during this time period are from 11 areas of the country. The reported cases range in age from 28 to 89 years old, and five of the 20 report direct or indirect contact with dromedary camels. One patient was admitted to hospital for other conditions prior to symptom onset.

See MERS-CoV maps and epicurves

Public health response

The source of infection for each case reported is under investigation by the Ministry of Health and Ministry of Agriculture (when dromedaries are involved) in Saudi Arabia. The Saudi Arabian Ministry of Health has identified and is following up contacts, including health care worker and household contacts, of known MERS patients.

Globally, 2143 laboratory-confirmed cases of infection with MERS-CoV including at least 749 related deaths have been reported to WHO.

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 the 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. 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 animals or animal products (for example, following contact with dromedaries) or human source (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment 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 early because, like other respiratory infections, the early symptoms of MERS-CoV are non-specific. Therefore, health care 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.

Community and household awareness of MERS and MERS prevention measures in the home may reduce household transmission and prevent community clusters.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. Therefore, in addition to avoiding close contact with suspected or confirmed human cases of the disease, people with these conditions should avoid close contact with animals, particularly camels, when visiting farms, markets, or barn areas where the virus is known to be or 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.


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