19 Jul 2017

MERs-CoV update: TravelHealthPro country pages

Update to county pages; addition of MERS CoV risk assessment MERs-CoV update: TravelHealthPro country pages

NaTHNaC has recently reviewed the country specific guidance for countries with a known or a possible risk of Middle East respiratory syndrome coronavirus (MERS-CoV). Detailed information on MERS-CoV epidemiology and cases reported globally to the World Health Organization (WHO) were reviewed [1- 3]. NaTHNaC now includes country specific recommendations in the "other risks" section of the country information pages for the following countries:

Bahrain, Iran, Iraq, Jordan, Kuwait, Oman, Qatar, Saudi Arabia, United Arab Emirates and Yemen.

Risk assessment

Dromedary camels have been identified as an important host species for MERS-CoV. Cases have been reported following close contact with camels. Human to human cases in hospital settings have also been reported in the Middle East [2] and in the Republic of Korea in 2015 following a single imported case with a history of travel to the Middle East [1]. 

Risk of infection with MERS-CoV to UK residents travelling to the Middle East is very low. The risk may be higher in those with exposure to specific risk factors within the region such as camels (or camel products) or the local health care system [4].

Advice for travellers

All travellers, particularly those with chronic medical conditions, should practise good general health measures, such as regular hand washing with soap and water, at all times, but especially after visiting farms, barns or market areas. They should:

  • avoid contact with camels
  • avoid raw camel milk and/or camel products
  • avoid consumption of any type of raw milk, raw milk products and any food that may be contaminated with animal secretions unless peeled and cleaned and/or thoroughly cooked

There is currently no vaccine to prevent MERS CoV.

If you are planning to visit the Kingdom of Saudi Arabia to undertake Hajj or Umra, please read our factsheet for further information.

If you have returned from the Middle East, and are experiencing mild respiratory (breathing) symptoms, it is most likely you have a common respiratory illness, such as a cold. However, if you have more severe respiratory symptoms you should seek medical advice by calling your GP or NHS111. It is important to give details of your recent travel history to the health professional, so that appropriate measures and testing can be undertaken [4].

Advice for health professionals

There remains a risk of imported cases to the UK from the Middle East, and health professionals should remain vigilant. MERS-CoV transmission can occur in health care settings if suspected cases are not promptly identified and isolated. Early identification and implementation of strict infection control measures for suspected cases is crucial [4].

Health care providers in the UK are reminded to remain alert for recent travellers returning from areas affected by the virus who develop a severe unexplained respiratory illness and who meet the case definition. See PHE MERS-CoV: public health investigation and management of possible cases algorithm for further advice. Although the likelihood of MERS-CoV is low in such travellers, testing should be undertaken to exclude infection [4].

In addition, unexplained clusters of severe respiratory infection, whether or not they have travelled, should be investigated, particularly if they occur in health care settings. The likelihood of MERS-CoV is very low, but warrants investigation and testing; a history of recent travel to the Middle East would increase the possibility of MERS-CoV [4].

Public Health England provides guidance for health professionals on the management of MERS-CoV.

Clinical queries about the management of potential cases of severe respiratory infections in people recently returned from countries affected by MERS-CoV should be directed in the first instance to the local infectious disease physician or microbiologist. The Public Health England Imported Fever Service is available to local infectious disease physicians or microbiologists should specialist advice be required.

For specific country advice, check our Country Information pages.

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