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Download Situation update - Middle Eastern Respiratory syndrome coronavirus
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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) • • 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: • • 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