umrah-2014A recent WHO alert has reported a possible person-to-person transmission of MERS-CoV in Iran, following contact with an individual returning from the Umrah pilgrimage in Saudi Arabia. While the report identifies the 2nd case as having contact with the 1st case as the probable source of infection, the fact that both cases had the same date of onset suggests there was a common exposure for both of the cases, or perhaps a common exposure to fomites on surfaces that both cases had contact with. It also suggests that at least one individual returned from Umrah with transmissible MERS-CoV infection that was not detected by the routine surveillance activities in the country. This serves as an indicator of probable under-reporting of MERS-CoV infection globally.

Globally the total number of laboratory-confirmed cases of infection with MERS-CoV stands at 683 including 204 related deaths have been reported officially to WHO.

Current WHO advice

Based on the current situation and available information, WHO encourages all member states to continue their surveillance for acute respiratory infections and to carefully review any unusual patterns.

Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities. It is not always possible to identify patients with MERS-CoV early because like other respiratory infections, the early symptoms of MERS-CoV are non-specific.

Until more is understood about MERS-CoV, people with diabetes, renal failure, chronic lung disease, and impaired immunity are considered to be at high risk of severe disease from MERS-CoV infection.

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.