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CDC guidance – first MERS virus case in US

Premier Communications

Brought to you by the Premier Safety Institute®
May 5, 2014

Gina Pugliese, RN, MS, editor


First US case of Middle East Respiratory Syndrome Coronavirus
(MERS-CoV) – CDC guidance provided

On May 2, 2014, the CDC reported the first case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in the United States in a patient
flying from Saudi Arabia to Chicago via London. The patient is in a hospital in Indiana and is isolated using standard, contact and airborne precautions as
recommended by the CDC.

The CDC is alerting clinicians, health officials, and others to increase their index of suspicion to consider MERS-CoV infection in travelers from the
Arabian Peninsula and neighboring countries.

The first known cases of MERS-CoV occurred in Jordan in April 2012 and to date, there have been 401 confirmed cases in 12 countries. Most of the cases
developed severe acute respiratory illness, with fever, cough and shortness of breath and 93 people have died, although mild and asymptomatic infections
have been reported too. There is no specific treatment for this virus or any available vaccine.

No evidence of sustained person-to-person transmission

There have been a small number of cases in persons who were in close contact with an infected person. However, there is no evidence of sustained
person-to-person spread of MERS-CoV in community settings and CDC has explained that CoV infection represents a very low risk to the general public.

Although the CDC does not know exactly how this virus is spread, they advise Americans to help protect themselves from any respiratory illness by washing
hands often, avoiding close contact with people who are sick, avoid touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently
touched surfaces.

Be alert for patients with respiratory illness traveling from Arabian Peninsula

Healthcare providers should be alert for and evaluate patients for MERS-CoV infection who

  1. develop severe acute lower respiratory illness within 14 days after traveling from countries in or near the Arabian Peninsula, excluding those who only
    transited at airports in the region; or
  2. are close contacts of a symptomatic recent traveler from this area who has fever and acute respiratory illness; or
  3. are close contacts of a confirmed case.

Testing and reporting patients

Testing patients suspected of having MERS-CoV and other respiratory pathogens can be done simultaneously. Positive results for another respiratory pathogen
(e.g H1N1 Influenza) should not necessarily preclude testing for MERS-CoV because co-infection can occur. Any person being evaluated for MERS-CoV infection
should be immediately reported to their state or local health department.

Persons at highest risk – follow up isolation at home or hospital

Persons at highest risk of developing infection are those with close contact to a case, defined as those who:

  1. provided care to a patient (e.g. healthcare provider or family member) not adhering to recommended infection control precautions (i.e. not wearing
    recommended personal protective equipment,
  2. had similarly close contact; or
  3. any person who stayed at the same place (e.g. lived with, visited) as the patient while the patient was will.

Healthcare professionals should carefully monitor for the appearance of fever (T> 100F) or respiratory symptoms in any person who has had close contact
with a confirmed case, probable case, or a patient under investigation while the person was ill. If fever or respiratory symptoms develop within the first
14 days following the contact, the individual should be evaluated for MERS-CoV infection. Ill people who are being evaluated for MERS-CoV infection and do
not require hospitalization for medical reasons may be cared for and isolated in their home. (Isolation is defined as the separation or restriction of
activities of an ill person with a contagious disease from those who are well.).

CDC has provided infection control guidance and isolation for

For more Information:

For more information for healthcare providers, home care providers, health departments, and laboratories, visit CDC website at

For consultation, or to report possible cases, please contact the CDC Emergency Operations Center at (770) 488-7100.


Safety Institute




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