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CDC updates MERS-CoV guidance as cases rise

Premier Communications

Brought to you by the Premier Safety Institute®

Gina Pugliese, RN, MS, editor

June 26, 2013


CDC Notice to Health Care Providers:

Updated guidelines for evaluation of severe respiratory illness associated with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is a newly identified virus with documented spread internationally that can cause severe acute
respiratory illness and death. The majority of laboratory-confirmed cases have been reported in Saudi Arabia. The United Kingdom
(UK), Italy, France, and Tunisia have reported cases in returning travelers and their close contacts. No cases have been reported in the United States. Additional details about the cases are available in the June 7, 2013 MMWR.


Clusters, high fatality rate, and healthcare worker transmission

As of July 8, there have been 68 documented cases of MERS-CoV infection,
38 cases were fatal. Eight clusters of illness have been reported by six countries (France, Italy, Jordan, Saudi Arabia, Tunisia, and UK), providing clear evidence of person-to-person transmission. The largest cluster, which was associated with a
healthcare facility in Saudi Arabia, consisted of 25 cases, 14 of which were fatal. Two of the case-patients in the cluster were health-care personnel who
acquired the infection after exposure to patients with confirmed MERS-CoV infection.

CDC urges clinicians to remain vigilant for suspect cases

The CDC issued a
Health Update Advisory
to provide updated guidance to healthcare providers and state health departments in the
evaluation of patients for MERS-CoV infection. The advisory describes increased availability of laboratory testing, a revised case definition, and an
increase from 10 to 14 days in the defined incubation period and the criteria for travel history for suspect patients after returning from the Arabian
peninsula or neighboring countries.

Isolation recommended
The documented transmission of MERS-CoV to healthcare personnel highlights the importance of infection control procedures to prevent transmission. CDC is
currently recommending standard, contact, and airborne precautions for the management of hospitalized patients with known or suspected MERS-CoV infection.
The use of appropriate personal protective equipment, including gloves, gowns, eye protection, and respiratory protection that is at least as protective as
a NIOSH-certified N95 respirator, is recommended.

Additional guidance on MERS-CoV case definitions, case investigation, specimen collection and shipment for testing, and infection control (including use of
personal protective equipment) are available at the CDC MERS website.



Safety Institute




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