Corona virus

UPDATE, CASE DEFINITIONS, AND GUIDANCEMERS UPDATE

? What is MERS

CDC continues to work closely with the World Health Organization (WHO) and other partners to better understand the public health risk presented by Middle East Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV used to be called “novel coronavirus,” or “nCoV

What is the new human coronavirus?

A novel coronavirus was identified in 2012 as the cause of respiratory illness in people. The new virus is a beta coronavirus. It is different from any other coronavirus previously found in people.

Is this virus the same as the SARS virus?

No. The novel coronavirus is not the same virus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, the novel coronavirus is most similar to those found in bats. CDC is still learning about this new virus.

The first cluster of two cases

The first cluster of two cases, both fatal, occurred near Amman, Jordan, in April 2012. Stored samples from these two cases tested positive retrospectively for the novel coronavirus. This cluster was temporally associated with cases of illness among workers in a hospital

A second cluster

A second cluster occurred in October 2012, in Saudi Arabia. Of the four individuals in the household, three were laboratory-confirmed cases, two of them died

MERS Cases and Deaths,April 2012 - May 2013 Current as of June 11, 2013 Countries Cases (Deaths) France 2 (1) Italy 3 (0) Jordan 2 (2) Qatar 2 (0)

Saudi Arabia 40 (26) Tunisia 2 (0) United Kingdom (UK) 3 (2) United Arab Emirates (UAE) 1 (1)

Total 55 (32)

MERS Cases and Deaths,April 2012 - Present

Countries Cases (Deaths)

France 2( 1)

Italy 3( 0)

Jordan 2( 2)

Qatar 2( 0)

Saudi Arabia 53( 32)

Tunisia 2( 0)

United Kingdom (UK) 3( 2)

United Arab Emirates (UAE)

1( 1)

Total 68( 38)

Current as of June 21, 2013, 9:00 AM EDT

The original source of MERS-CoV,

The original source of MERS-CoV, routes of transmission to humans, and mode of human-to-human transmission have not been determined. Genetic sequencing to date has determined the virus is most closely related to coronaviruses detected in bats. CDC is continuing to collaborate with WHO and affected countries to better characterize the epidemiology of MERS-CoV infection in humans.

What are the symptoms of novel coronavirus infection?

Most people who got infected with the novel coronavirus developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. Some people were reported as having a mild respiratory illness

Case Definitions

Patient Under Investigation (PUI)

Patient Under Investigation (PUI)

A person with an acute respiratory infection, which may include fever (≥ 38°C , 100.4°F) and cough; AND

suspicion of pulmonary parenchymal disease (e.g., pneumonia or acute respiratory distress syndrome based on clinical or radiological evidence of consolidation); AND

history of travel from the Arabian Peninsula or neighboring countries* within 10 days; AND

Probable Case

A person fitting the definition above of a “Patient Under Investigation” with clinical, radiological, or histopathological evidence of pulmonary parenchyma disease (e.g. pneumonia or ARDS) but no possibility of laboratory confirmation either because the patient or samples are not available or there is no testing available for other respiratory infections, AND

close contact with a laboratory confirmed case, AND not already explained by any other infection or

etiology, including all clinically indicated tests for community-acquired pneumonia according to local management guidelines.

Confirmed Case

A person with laboratory confirmation of infection with the novel coronavirus.

Does the virus spread from person to person?

The virus has been shown to spread between people who are in close contact. Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in Saudi Arabia, Jordan, the UK and France are being investigated .

modes of transmission

There is clear evidence of human-to-human transmission, possibly involving different modes of transmission such as droplet and contact transmission. But further studies are required to better understand the risks. The efficiency of person-to-person transmission of novel coronavirus is not well characterized.

Can I still travel to countries in the Arabian Peninsula or neighboring countries

Yes. WHO and CDC have not issued travel health warnings for any country related to novel coronavirus

What if I recently traveled to countries in the Arabian Peninsula or neighboring countries and got sick?

If you develop a fever and symptoms of lower respiratory illness, such as cough or

shortness of breath, within 10 days after traveling from countries in the Arabian Peninsula or neighboring countries(1),

you should see your healthcare provider and mention your recent travel

What are the treatments?

There are no specific treatments for illnesses caused by the novel coronavirus. Medical care is supportive and to help relieve symptoms.

Is there a lab test?

Lab tests (polymerase chain reaction or PCR) for the novel coronavirus are available at CDC and other international labs. Otherwise, these tests are not routinely available

What should healthcare providers and health departments do

For recommendations and guidance on the case definitions; infection control, including personal protective equipment guidance; case investigation; and specimen collection and shipment ,

Infection control recommendations for healthcare settings

Until the transmission characteristics of the novel coronavirus are better understood, patients under investigation and probable and confirmed cases should be managed according to CDC’s infection control recommendations for the coronavirus that caused SARS.

For Healthcare Providers Infection control recommendations for healthcare settings

Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection. These recommendations are consistent with those recommended for the coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. The recommendations are based on available information (as of June 10, 2013) and will be re-evaluated and updated as needed when new information becomes available