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MERS-CoV Infection in Jordan

29 May 2014

On 25 May 2014, the National IHR Focal Point of Jordan reported an additional Middle East respiratory syndrome coronavirus (MERS-CoV) case in Amman, Jordan. The case is a 69 year-old male Jordanian citizen with comorbidities who underwent a surgical procedure on 29 April 2014.

The patient gave no history of travel, contact with animals or a confirmed case. However, the surgical procedure was carried out in the same hospital where a confirmed MERS-CoV fatal case was admitted. The patient is currently in a critical condition. Contact tracing and screening of family members, health workers, and patients is currently ongoing.

Globally, 636 laboratory-confirmed cases of infection with MERS-CoV have officially been reported to WHO, including 193 deaths. As of 22 May 2014, Jordan has reported 16 cases and 4 deaths.

(Via WHO Global Alert and Response - accessed 29/05/14)

Advice for Travellers

The current Rapid Risk Assessment by ECDC is unchanged in that, the risk of MERS-CoV infection for Europeans visiting or residing in the region is low, and secondary transmission in the EU from imported cases is low.

Although the source of the virus and the mechanism of transmission is unknown, it would be sensible to try to reduce the general risk of infection while travelling by:

  • Avoiding close contact with people suffering from acute respiratory infections.
  • Frequent handwashing, especially after direct contact with ill people or their environment.
  • Avoiding contact with camels, consuming raw camel milk or camel products, eating undercooked camel meat.
  • Adhering to food safety and hygiene rules such as avoiding undercooked meats, raw fruits and vegetables unless they have been peeled, or unsafe water.
  • People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals should be adhered to.
  • People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) and to delay travel until they are no longer symptomatic.

Travellers to the Middle East who develop symptoms either during travel or after their return are encouraged to seek medical attention and to share their history of travel.

Advice for Healthcare Professionals

Consider the possibility of MERS-CoV infection in travellers with fever, cough, shortness of breath, or breathing difficulties, or other symptoms suggesting an infection, and with a recent history (within 14 days) of travel in the Middle East.

If a diagnosis of MERS–CoV infection is considered possible, apply infection prevention and control measures recommended by WHO, or outlined in national guidance, and refer the patient to a special infectious disease unit for further investigation.