From 27 to 31 January 2019, the Oman National Focal Point of the International Health Regulations (IHR) reported five cases of infection with the Middle East Respiratory Syndrome Coronavirus (MERS-CoV). The five laboratory-confirmed cases are women in the same family aged 30 to 59 years. The source of infection in this cluster is under study in Oman and four of the five cases appear to be secondary cases resulting from interpersonal transmission. Although not all cases reported direct contact with camels, they were living on a farm where camels and other animals were being held. The Ministry of Agriculture is testing the dromedaries. The details of these five cases are contained in a separate document (see link below).

Taking into account these five other cases, 16 cases of laboratory-confirmed MERS-CoV infection have been reported by Oman since 2013. Prior to this case group, the last case of infection by the MERS- CoV reported in Oman dates back to March 2018.

Globally, as of February 8, 2019, 2,311 cases of laboratory-confirmed MERS-CoV infection, including at least 811 deaths, have been reported to WHO1.

Public health response

In all cases, an investigation into the exposure to known risk factors in the 14 days prior to the onset of symptoms is ongoing. Officials from the Oman Ministry of Health have established a contact list for health workers and family contacts in the North Batinah governorate. As of 4 February, a total of 60 family contacts had been identified, of which 26 were classified as high risk. All household members of the MERS-CoV cases were screened for MERS-CoV research by RT-PCR and tested negatively, except for one case reported above, which was reported to be negative. is revealed positive on January 28th. As of 4 February, 119 contacts with health workers had been identified. All contacts of high-risk health workers were screened for MERS-CoV by RT-PCR and all were negative. All identified contacts are under surveillance for 14 days from the last date of exposure, in accordance with national and WHO guidelines for infection by the MERS-CoV.

None of these cases were reported by direct contact with camels, but they lived on a farm where camels and other animals were being held. The Ministry of Agriculture is investigating dromedary farms. Samples were collected and initial screening results were negative for MERS-CoV. Other results are pending. Health workers were trained and followed a refresher course on infection prevention and control measures. Family members were briefed on MERS-CoV and personal advice on respiratory and respiratory hygiene was provided.

WHO risk assessment

MERS-CoV infection can cause serious illness leading to high mortality. Humans are infected with MERS-CoV by direct or indirect contact with camels. MERS-CoV has demonstrated its ability to transmit between humans. Until now, unsustainable transmission from man to man observed has mainly been produced in health care facilities.

Additional case notification does not change the overall risk assessment. WHO hopes that more cases of MERS-CoV infection will be reported in the Middle East and that cases will continue to be exported to other countries by people susceptible to infection after exposure. camels, animal products (eg, consumption of raw camel milk), or humans (for example, in a health care facility). WHO continues to monitor the epidemiological situation and conducts a risk assessment based on the latest available information.

Council of the WHO

On the basis of the current situation and available information, WHO encourages all Member States to continue their surveillance of acute respiratory infections and to carefully consider any unusual trends.

Infection prevention and control measures are essential to prevent the possible spread of MERS-CoV in health facilities. It is not always possible to identify MERS-CoV patients at an early stage because, as with other respiratory infections, the first symptoms of MERS-CoV are not specific. As a result, health care workers should always apply standard precautions consistently to all patients regardless of their diagnosis. Droplet precautions should be added to standard precautions when treating patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when treating probable or confirmed cases of MERS-CoV infection; airborne precautions must be applied when performing procedures that generate an aerosol.

Until MERS-CoV is better understood, people with diabetes, kidney failure, chronic lung disease and immunocompromised people are considered to be at high risk of acquiring a serious illness related to HIV. MERS-CoV infection. Therefore, people with these conditions should avoid close contact with animals, especially camels, when visiting farms, markets or barns where the virus is known or could circulate. General hygiene measures, such as regular washing of hands before and after contact with animals and avoidance of contact with sick animals, must be respected.

The practices of food hygiene must be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been cooked properly.

The WHO does not recommend special filtering at the points of entry with respect to this event and currently does not recommend the application of travel or trade restrictions.

1This overall figure reflects the total number of laboratory-confirmed cases reported to WHO under the RSI to date. The total number of deaths includes deaths that WHO has been aware of to date through follow-up with affected Member States.