20 September 2013 - Two patients earlier reported as laboratory-confirmed with Middle East respiratory syndrome coronavirus (MERS-CoV) infection in Italy in the Disease Outbreak News on 2 June 2013 are being reclassified as probable cases.
The reclassification follows further analysis of the
laboratory tests performed in May 2013, which has shown that the two
cases do not fulfil the current WHO case definition for a "confirmed
case" for MERS-CoV. The two cases are the two-year-old girl and a
42-year-old woman who were identified as close contacts of the index
case who travelled from Jordan.
A "probable" designation by WHO criteria refers to patients
who are considered to have a high likelihood of having been infected
with MERS-CoV, but from whom adequate samples could not be obtained for
complete testing according to the current criteria established for
Globally, from September 2012 to date, WHO has been informed
of a total of 130 laboratory-confirmed cases of infection with MERS-CoV,
including 58 deaths.
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
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
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.
All Member 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 restrictions.
WHO has convened an Emergency Committee under the International
Health Regulations (IHR) to advise the Director-General on the status of
the current situation. The Emergency Committee, which comprises
international experts from all WHO Regions, unanimously advised that,
with the information now available, and using a risk-assessment
approach, the conditions for a Public Health Emergency of International
Concern (PHEIC) have not at present been met.