Published Date: 2013-06-02 16:08:16
Archive Number: 20130602.1751356
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
In this posting:
 Italy (ex Jordan): WHO
 Saudi Arabia: new case, MOH
 Italy (ex Jordan): WHO
Date: Sun 2 Jun 2013
Source: WHO Global Alert and Response (GAR), Disease Outbreak News [edited]
MERS-CoV - update 2 Jun 2013
Ministry of Health in Italy, through the European Union's Early Warning
Response System has notified WHO of an additional 2 laboratory
confirmed cases with Middle East respiratory syndrome coronavirus
(MERS-CoV) in the country.
Both patients are close contacts of
the recent laboratory confirmed case [who had] recently travelled from
Jordan. The 1st patient is a 2 year old girl and the 2nd patient is a 42
year old woman. They are in stable condition.
September 2012 to date, WHO has been informed of a total of 53
laboratory confirmed cases of infection with MERS-CoV, including 30
WHO has received reports of laboratory confirmed cases
originating in the following countries in the Middle East to date:
Jordan, Qatar, Saudi Arabia, and the United Arab Emirates (UAE). France,
Germany, Italy, Tunisia, and the United Kingdom have also reported
laboratory confirmed cases; they were either transferred there for care
of the disease or returned from the Middle East and subsequently became
ill. In France, Italy, Tunisia, and the United Kingdom, there has been
limited local transmission among patients who had not been to the Middle
East but had been in close contact with the laboratory confirmed or
Based on the current situation and available
information, WHO encourages all member states to continue their
surveillance for severe acute respiratory infections (SARI) and to
carefully review any unusual patterns.
Health care providers are
advised to maintain vigilance. Recent travellers returning from the
Middle East who develop SARI should be tested for MERS-CoV as advised in
the current surveillance recommendations. Specimens from patients'
lower respiratory tracts should be obtained for diagnosis where
possible. Clinicians are reminded that MERS-CoV infection should be
considered even with atypical signs and symptoms, such as diarrhoea, in
patients who are immunocompromised.
Health care facilities are
reminded of the importance of systematic implementation of infection
prevention and control (IPC). Health care facilities that provide care
for patients suspected or confirmed with MERS-CoV infection should take
appropriate measures to decrease the risk of transmission of the virus
to other patients, health care workers and visitors.
states are reminded to promptly assess and notify WHO of any new case of
infection with MERS-CoV, along with information about potential
exposures that may have resulted in infection and a description of the
clinical course. Investigation into the source of exposure should
promptly be initiated to identify the mode of exposure, so that further
transmission of the virus can be prevented.
WHO does not advise
special screening at points of entry with regard to this event nor does
it currently recommend the application of any travel or trade
WHO continues to closely monitor the situation.
ProMED-mail rapporteurs Kunihiko Iizuka and Marianne Hopp
report above is the official WHO confirmation of infection of the
contact cases, raising the official case count to 53 laboratory
confirmed cases of MERS-CoV infection including 30 deaths. According to
reports on the Saudi Ministry of Public Health website and posted in the
most recent ProMED-mail post (MERS-CoV - Eastern Mediterranean (16):
Italy ex Jordan, contact cases, WHO 20130602.1750425) there were an
additional 3 fatalities reported by Saudi Arabia yesterday (1 Jun 2013)
that would bring the global number of fatalities attributable to
MERS-CoV infection to 33. We await clarification of this.
subscriber Roberto Labanti <firstname.lastname@example.org> submitted an
additional translated clarification and update with respect to the
contact cases and contact tracing ongoing in Italy. Apparently, while
one of the machine translations referred to the 2 year old contact case
as the granddaughter of the index case, in fact, the word "nipote" in
Italian can refer to grandson, granddaughter, nephew, or niece. More
information on the 2nd contact case was also provided: the co-worker who
was in contact with the index patient for a few hours at work last
Monday (27 May 2013) and is a married woman with 3 children, all of whom
are currently under observation, according to http://firenze.repubblica.it/cronaca/2013/06/01/news/sars_controlli_su_una_bambina_la_nipote_del_paziente_giordano-60124632/?ref=HREC2-8 (in Italian).
More details are available at https://www.ansa.it/web/notizie/specializzati/saluteebenessere/2013/05/31/Nuova-Sars-Italia-ricoverato-fuori-pericolo_8802284.html (in Italian).