Headlines - MERS-CoV Update as of October 5

The modes of transmission for confirmed cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) are becoming better understood, with evidence currently pointing to camels as the virus reservoir. Transmission from animals to humans likely occurs through droplets or contaminated objects and may also occur through milk. Human-to-human transmission of this virus has been documented, and several clusters of cases have been identified, including within healthcare facilities. Investigations into cases, particularly during episodes of nosocomial transmission, have confirmed the existence of paucisymptomatic or asymptomatic forms of the infection. To date, the virus’s epidemic potential remains low. As of September 30, 2014, coordinated surveillance had identified 887 cases worldwide, of whom 352 have died. Only countries on the Arabian Peninsula have reported locally acquired cases. Cases identified in other countries are all cases that were exposed on the Arabian Peninsula, or secondary cases linked to these imported cases. This indicates that the source of transmission remains localized on the peninsula to date.Approximately two million Muslims, including more than 20,000 French nationals, are currently completing a pilgrimage to Mecca. The Hajj concludes with the Eid al-Adha holiday on October 5, and the pilgrims are expected to begin returning starting October 10 (one week earlier than in 2013). This is an opportunity to remind the public that MERS-CoV should be suspected in any person who has traveled to or stayed in the Arabian Peninsula (Saudi Arabia, Bahrain, United Arab Emirates, Iraq, Iran, Israel, Jordan, Kuwait, Lebanon, Oman, Qatar, Syria, the Occupied Palestinian Territories, Yemen), and who, within 14 days of their return, has presented:

• clinical and/or radiological signs of acute respiratory distress syndrome (ARDS) or lung parenchymal infection,

• with a fever ≥38°C and cough, without any other identified cause that could explain the condition;

as well as for any contact (e.g., family, caregivers) of a possible or confirmed case who has presented with an acute respiratory infection, regardless of severity, within 14 days of the last contact with the possible/confirmed case while the latter was ill (i.e., symptomatic).