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This update summarizes available information and WHO recommendations as of 9 July 2013 related to human infections with Middle East respiratory syndrome coronavirus (MERSCoV) for Member States of the WHO European Region.
What is new in this update?
• The total number of laboratory confirmed cases as of 5 July is 79 cases with 42
reported deaths (page 3)
• Convening of an Emergency Committee under the International Health
Regulations(IHR) (page 3)
• The WHO interim MERS-CoV surveillance guidance has been updated and the
latest version was posted on 27 June (page 4)
• Publication of WHO guidelines for investigation of cases of human infection with
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) (page 5)
• Recommendations on preparedness measures to be taken (page 6).
• The laboratory testing for novel coronavirus – interim recommendations is now
available in Russian (page 7)
• The total number of laboratory confirmed cases as of 5 July is 79 cases with 42
reported deaths (page 3)
• Convening of an Emergency Committee under the International Health
Regulations(IHR) (page 3)
• The WHO interim MERS-CoV surveillance guidance has been updated and the
latest version was posted on 27 June (page 4)
• Publication of WHO guidelines for investigation of cases of human infection with
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) (page 5)
• Recommendations on preparedness measures to be taken (page 6).
• The laboratory testing for novel coronavirus – interim recommendations is now
available in Russian (page 7)
Excerpt:
2. Situation update and assessment
As of 5 July 2013, and since April 2012, 79 laboratory-confirmed cases of human infection with MERSCoV have been reported to WHO, of which 42 have died. Countries that have reported cases are Jordan,
Qatar, Saudi Arabia, Tunisia and the United Arab Emirates (UAE). Cases have also been reported by four
countries in the WHO European Region (France, Germany, Italy and the United Kingdom). All European
and North African cases have had a direct or indirect connection to the Middle East. In France, Italy, the United Kingdom and Tunisia there has been limited local transmission among close contacts who had not been to the Middle East but had been in contact with a sick traveller recently returned from the Middle East.
The newest cases reported indicate that the source of infection remains active in the Middle East and is present throughout a large area. The first case in Tunisia was likely infected in Qatar; however, this cannot be definitively shown without further investigation. Both the Tunisian and Qatari public health
authorities are pursuing further investigations.
As of 5 July 2013, and since April 2012, 79 laboratory-confirmed cases of human infection with MERSCoV have been reported to WHO, of which 42 have died. Countries that have reported cases are Jordan,
Qatar, Saudi Arabia, Tunisia and the United Arab Emirates (UAE). Cases have also been reported by four
countries in the WHO European Region (France, Germany, Italy and the United Kingdom). All European
and North African cases have had a direct or indirect connection to the Middle East. In France, Italy, the United Kingdom and Tunisia there has been limited local transmission among close contacts who had not been to the Middle East but had been in contact with a sick traveller recently returned from the Middle East.
The newest cases reported indicate that the source of infection remains active in the Middle East and is present throughout a large area. The first case in Tunisia was likely infected in Qatar; however, this cannot be definitively shown without further investigation. Both the Tunisian and Qatari public health
authorities are pursuing further investigations.
The appearance of cases in Europe and North Africa but not in other countries with frequent travel in and out of the Middle East is likely a result of differences in surveillance and testing. All Member States are encouraged to remind travellers returning from the affected area to seek medical attention if they develop a respiratory illness, and to test those who meet the profile described in the current surveillance recommendations posted on the WHO coronavirus web site.
Human-to-human transmission has not been observed to persist beyond small clusters of individuals
with close contact. However, it is likely that more sporadic cases with subsequent limited transmission
will occur in the near future. The large number of cases with reported co-morbidities suggests that
persons with underlying medical conditions may have increased susceptibility to infection1
.
Convening of an Emergency Committee under the International Health Regulations (IHR)
WHO is convening an Emergency Committee under the IHR for MERS-CoV, which will meet on 9 and 11
July 2013. The outcome of the Emergency Committee will be announced on the WHO web site and will
also be summarized in the next WHO/Europe MERS-CoV summary.
Clinical presentation of MERS-CoV
The majority of cases have respiratory disease, from mild symptoms to severe pneumonia. The clinical
presentation includes acute respiratory illness with fever, cough, shortness of breath, breathing
difficulties and pneumonia. Atypical symptoms including diarrhoea and renal failure can be predominant
if the patient is immunocompromised. Recently, a small number of asymptomatic cases have been
detected through contact tracing among close contacts of cases.
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