MERS-CoV Primary Care Algorithm

For MERS-CoV Primary Car Algorithm, you can refer below:

MERS-CoV Case Definitions

Patients should be evaluated for MERS-CoV infection in consultation with the state and local health departments. You can find more information, at CDC’s here:

Patient Under Investigation (PUI)

A person who has both clinical features and an epidemiologic risk should be considered a patient under investigation (PUI) based on one of the following scenarios:

Severe illness:

• Fever and pneumonia or acute respiratory distress syndrome based on clinical or radiological evidence, AND
• A History of travel from countries in or near the Arabian Peninsula within 14 days before symptoms onset, or close contact with a asymptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula, OR
• A History of being in healthcare facility as a patient, worker, or visitor in the Republic of Korea within 14 days before symptoms onset, OR
• A member of a cluster of patients with severe acute respiratory illness (e.g. fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments in the US.

Milder illness

• Fever and symptom of respiratory illness not necessarily pneumonia (cough, shortness of breath) AND a history of being in a healthcare facility as a patient, worker or visitor within 14 days before symptoms onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified
• Fever or symptoms of respiratory illness not necessarily pneumonia (cough, shortness of breath) AND close contact with a confirmed MERS case while the case was ill.

The above criteria serve as guidance for testing; however, patients should be evaluated and discussed with public health departments on a case-by-case basis if their clinical presentation or exposure history is equivocal (e.g., uncertain history of health care exposure).

Confirmed Case

A confirmed case is defined when a person has laboratory confirmation of MERS-CoV infection. Confirmatory laboratory testing requires a positive PCR on at least two specific genomic targets or a single positive target with sequencing on a second.

Probable Case

A probable case is defined when a PUI has absent or inconclusive laboratory results for MERS-CoV infection who is a close contact of a laboratory-confirmed MERS-CoV case. Examples of laboratory results that may be considered inconclusive include a positive test on a single PCR target, a positive test with an assay that has limited performance data available, or a negative test on an inadequate specimen.

Notes:

Countries considered in the Arabian Peninsula and neighboring include: Bahrain; Iraq; Iran; Israel, the West Bank, and Gaza; Jordan; Kuwait; Lebanon; Oman; Qatar; Saudi Arabia; Syria; the United Arab Emirates (UAE); and Yemen.

Close contact is defined as: 

• Being within approximately 6 feet (2 meters) or within the room or care area for a prolonged period of time (e.g., healthcare personnel, household members) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection, or
• Having direct contact with infectious secretions (e.g., being coughed on) while not wearing recommended personal protective equipment (i.e., gowns, gloves, respirator, eye protection.
• Data to inform the definition of close contact are limited. At this time, brief interactions, such as walking by a person, are considered low risk and do not constitute close contact.

MERS-CoV Brief Update

Until now, according to WHO and affected countries’ health authorities, there are at least 87 laboratory confirmed cases of MERS-CoV in Seoul, South Korea since May 20, with 6 fatalities. Most cases were either acquired during hospitalization or through close personal contact (health care providers and family members) or with someone who was infected at the hospital. The lates on June 2015 there are currently 2,000 people under quarantine.

There is no travel restrictions into or out of South Korea. Temperature screening at International airports and entry ports is commonly exercised at country level.

While we are continuing our surveillance closely to provide regular updates, we encourage you all to to emphasize the following precaution you can take:

1. All travelers are advised to practice personal hygiene such as frequent hand washing, especially before eating or drinking.
2. Avoid touching your face with your hands while traveling.
3. Don’t start travel if you are ill.
4. If you happen to sit near a person with a persistent cough or looks ill, don’t hesitate to ask to be reseated.
5. See a doctor if you develop a fever and respiratory illness symptoms, such as cough or shortness of breath, within 14 days after you have been to an affected area or in close contact with an infected person.