Middle East Respiratory Syndrome coronavirus

There have been various public health alerts relating to passengers travelling by air from countries affected by the Middle East Respiratory Syndrome Coronavirus (MERS-CoV).

Coronavirus is the name for a group of viruses that cause respiratory infections in humans and animals. It is mainly transmitted by large respiratory droplets and direct or indirect contact with infected secretions.

Public Health England has issued advice to the public on what to do if they develop a cough and fever or shortness of breath within 14 days after travelling to the area, which may result in an increase in these calls via the 111 system or 999.

The countries covered by this travel advice include: Syria, Iraq, Lebanon, Palestinian territories, Israel, Jordan, Saudi Arabia, Kuwait, Bahrain, United Arab Emirates, Oman, and Yemen. Patients affected will present with a febrile respiratory illness.

The clinical symptoms include:

A fever of 38°C or higher, AND

• lower respiratory tract infection symptoms (cough and / or shortness of breath), or clinical signs of a lower respiratory tract infection

OR

• other life threatening illness / symptoms suggestive of an infectious cause

The patient must have a history of travel to or from a high risk area within the last 14 days.

The MERS-CoV can in some cases lead to severe viral pneumonia and sometimes multi-organ failure, so treatment should follow the same guidelines as treating sepsis.

The risk of person to person infection is very low, but please take the following infection, prevention and control precautions:

• pre-alert the hospital so they can ensure a suitable isolation bed is available
• request that the patient wears a disposable face mask
• staff should wear PPE, if possible an FPP3 respirator, non-sterile surgical gloves, long sleeved, fluid-repellent disposable gown and eye protection. If this is not available wear a surgical face mask, plastic apron and gloves.

After transporting the patient to hospital, the ambulance will need to be left to ventilate for 20 minutes and cleaned afterwards, using standard disinfectants and detergents.

Patients with symptoms that are not severe enough to require hospital admission are unlikely to have MERS-CoV and more likely to have common influenza. These patients should be referred to their GP for blood screening and should be encouraged to remain in isolation at home.

You can download a copy of this update for print and display by clicking here.