Download Situation update - Middle Eastern Respiratory syndrome coronavirus

COMMUNICABLE DISEASE
CONTROL BRANCH
- Please bring to the attention of all doctors Date: 26 June 2015
Contact telephone number: 1300 232 272 (24 hours/7 days)
Situation update - Middle Eastern Respiratory syndrome coronavirus (MERS-CoV)
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Take a travel history from patients presenting with an acute respiratory illness, and consider
the possibility of MERS-CoV infection in patients who have travelled to the Middle East or other
countries where an outbreak of MERS-CoV infection is currently occurring.
Notify urgently any patient suspected to have MERS-CoV infection to CDCB (1300 232 272
24 hours/7 days).
Middle East respiratory syndrome is caused by a novel coronavirus which was first identified in Saudi
Arabia in 2012. Nearly all reported cases have had recent travel to, or residence in, the Middle East
(specifically the countries of: Saudi Arabia, Bahrain, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman,
Palestinian territories, Qatar, the United Arab Emirates (UAE), and Yemen), or contact with travellers
returning from these areas. The Republic of Korea (RoK) reported its first imported case in May 2015 which
has led to a cluster of 179 cases transmitted within health care facilities (as of 25 June 2015). There has
been no community transmission of MERS-CoV infection recorded in the RoK, despite extensive
contact tracing and follow-up. Imported cases have also been reported in Europe, North America and Asia
but no cases have been reported in Australia to date. Person-to-person spread of MERS-CoV occurs
mostly in health care settings and to a lesser extent within households.
As always, it is important to take a travel history and maintain appropriate infection control
precautions for all patients who present with a potentially infectious illness.
Symptoms of MERS-CoV infection may include fever, cough, dyspnoea, myalgia, and less commonly
diarrhoea, nausea and vomiting. MERS-CoV infection is clinically indistinguishable from other respiratory
infections. Severe disease and death are more common in persons with underlying disease. Some cases
are asymptomatic or have mild influenza-like illness. There is no vaccine and no specific treatment.
Doctors should consider the possibility of MERS-CoV infection in patients with:
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an illness consistent with an acute febrile respiratory infection AND a history of:
o travel to, or residence in, the Middle East (specifically the countries of: Saudi Arabia, Bahrain,
Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Palestinian territories, Qatar, UAE, and
Yemen) in the 14 days before illness onset (excluding transiting through an international airport
i.e. <24 hours stay, remaining within the airport) OR
o contact with health care facilities in the RoK in the 14 days before illness onset
an illness consistent with an acute respiratory infection AND contact with a suspected or confirmed
MERS-CoV case in the 14 days before illness onset.
Doctors with patients suspected of having MERS-CoV infection are asked to:
• notify urgently any patient suspected to have MERS-CoV infection to the CDCB (1300 232 272
24 hours/7 days),
• isolate the patient, and if arranging transfer to an emergency department, inform the facility of the
suspected diagnosis and travel history,
• use airborne (i.e. single room with routine use of a N95/P2 respirator) and contact precautions in
addition to standard precautions,
• arrange laboratory testing through SA Pathology for MERS-CoV PCR on respiratory specimens
(preferably lower respiratory tract specimens), and
• if the patient requires hospitalisation, discuss suspected cases with an infectious diseases physician in
a tertiary care hospital.
An update from the Australian Government Department of Health is expected in approximately 10 days.
For further information see www.health.gov.au/mers-coronavirus; for information about the global situation,
including updated case numbers and countries affected, see
www.who.int/csr/disease/coronavirus_infections/en and for current travel advice, see dfat.gov.au
For all enquires please contact the CDCB on 1300 232 272 (24 hours/7 days)
Further clinical information is available from www.sahealth.sa.gov.au/InfectiousDiseaseControl
Dr Jane Raupach – Acting Director, Communicable Disease Control Branch
Public – I4-A1