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Epidemiological update: Middle East respiratory syndrome coronavirus (MERS-CoV)

01 Oct 2014

​On 29 September, the Austrian Department of Health reported a confirmed case of MERS-CoV infection in a citizen of the Kingdom of Saudi Arabia recently arrived in Austria. The patient is isolated in a medical facility in Vienna. Tracing of contacts is currently underway.

Since the last ECDC rapid risk assessment of 21 August and as of 30 September 2014, 31 additional cases have been reported in Saudi Arabia. Of these 31, 19 are retrospective cases with date of onset prior to 3 June 2014 reported on 18 September 2014.
Overall, 887 laboratory-confirmed cases of MERS-CoV have been reported to public health authorities worldwide, including 352 deaths (Figure 1). Most of the cases have occurred in the Middle East (Saudi Arabia, United Arab Emirates, Qatar, Jordan, Oman, Kuwait, Egypt, Yemen, Lebanon and Iran) (Table 1). All cases reported outside of the Middle East have had recent travel history to the Middle East or contact with a case who had travelled from the Middle East (Figure 2).

In September 2014, the World Health Organization (WHO) revised the interim recommendations for laboratory testing for MERS-CoV.

Case definitions and surveillance guidance updated in July 2014 are now available on the WHO website.

On 22 September 2014, the Saudi Ministry of Health published a revised version of the MERS-CoV case definition.

The Hajj is taking place between 1 and 6 October. Those travelling from the EU to Saudi Arabia for the Hajj pilgrimage should consult the recommendations made by the Saudi Ministry of Health under Health Regulations for travellers to Saudi Arabia, which provide a comprehensive overview of the measures implemented by the local health authorities in the preparation of this event attended by over 3 million pilgrims.

The number of cases reported in the last months has decreased in Saudi Arabia, likely reflecting decreased transmission of the virus in the community compared to the previous year. However, general travel health advice, including avoiding unsafe water, undercooked meats, and raw fruits and vegetables unless freshly peeled and washed, remain important for those travelling in the Middle East.

ECDC will enhance the epidemic intelligence activities during and after the Hajj to detect possible events posing a threat to Europe. Currently the advice presented in the last ECDC rapid risk assessment remain valid.

Figure 1. Distribution of confirmed cases of MERS-CoV reported September 2012–30 September 2014, by date and reporting country (n=887)

 

 

Table 1. Number of confirmed cases and deaths, by country of reporting, March 2012–30 September 2014

Reporting country

Cases

Deaths

Date of onset/reporting for most recent case

Saudi Arabia

754

319

30/09/2014

United Arab Emirates

73

9

11/06/2014

Qatar

7

4

04/11/2013

Jordan

18

5

23/05/2014

Oman

2

2

20/12/2013

Kuwait

3

1

07/11/2013

Egypt

1

0

22/04/2014

Yemen

1

1

17/03/2014

Lebanon

1

0

22/04/2012

Iran

5

2

25/06/2014

Austria

1

0

29/09/2014

United Kingdom

4

3

06/02/2013

Germany

2

1

08/03/2013

France

2

1

08/05/2013

Italy

1

0

31/05/2013

Greece

1

1

08/04/2014

Netherlands

2

0

05/05/2014

Tunisia

3

1

01/05/2013

Algeria

2

1

24/05/2014

Malaysia

1

1

08/04/2014

Philippines

1

0

11/04/2014

United States of America

2

0

01/05/2014

Total

887

352

 

 

Figure 2. Geographical distribution of confirmed MERS-CoV cases and place of probable infection, worldwide, as of 30 September 2014 (n=887)

 

Related links:

ECDC rapid risk assessment: Severe respiratory disease associated with Middle East respiratory syndrome coronavirus (MERS-CoV) – Update, 27 August 2014
Saudi Ministry of Health: press releases
WHO Laboratory Testing for Middle East Respiratory Syndrome Coronavirus, interim recommendations (revised)
WHO travel advice on MERS-CoV for pilgrimages to Umra and Hajj
NaTHNaC - Advice for pilgrims: Hajj and Umrah 1435 (2014)
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