Over the past 3 days, Saudi Arabia’s Ministry of Health (MOH)
announced 12 new MERS-CoV cases, 9 of them in Riyadh, with at
least 8 linked to a quickly growing healthcare outbreak in the
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Middle East respiratory syndrome (MERS) is a novel infectious
disease caused by a coronavirus (MERS-CoV) first reported in
Saudi Arabia in September 2012. MERS later spread to other
countries in the Arabian Peninsula, followed by an outbreak
in South Korea in 2015. At least 26 countries have reported
MERS cases, and these numbers may increase over time. Due to
international travel opportunities, all countries are at
risk of imported cases of MERS, even if outbreaks do not
The Centers for Disease Control and Prevention (CDC) issued a
health advisory to provide updated guidance to state health
departments and healthcare providers in the evaluation of
patients for MERS-CoV infection. The advisory includes a summary,
background, current status and recommendations for healthcare
providers for detection and testing of MERS-CoV infections
worldwide and recommendations for healthcare providers and health
June 2013: Since April 2012, there have
been 64 laboratory-confirmed cases of human infection with
MERS-CoV and 72% have been male. 38% of the confirmed cases have
Affected countries include Jordan, Saudi Arabia, the United Arab
Emirates, and Qatar. Additional cases have been found in
France, Germany, the United Kingdom and Italy, all of which
have had a direct or indirect link to the Middle East.
Although the exact timing and nature of exposures is unknown, in
cases where exposure is known or suspected, the incubation period
for laboratory confirmed cases has generally been less than one
week. In some cases, the incubation may exceed one week but is
less than two weeks.
CDC continues to work on better understanding the public health
risks posed by MERS-CoV.
The continued reporting of new cases indicates that there is an
ongoing risk for transmission to humans in the area of the
Arabian Peninsula. New reports of cases outside the region raise
concerns about importation to other geographic areas.
To date, a total of 55 confirmed cases have been reported with
onsets occurring between April 2012 through May 29, 2013.
Reported cases were directly or indirectly linked to one of four
countries: Saudi Arabia, Qatar, Jordan, and the United Arab
The Centers for Disease Control and Prevention (CDC) is working
closely with the World Health Organization (WHO) and other
partners to better understand the public health risk posed by
Middle East Respiratory Syndrome Coronavirus (MERS-CoV), a novel
coronavirus that was first reported to cause human infection in
No cases have been reported in the United States. The purpose of
this advisory is to provide updated guidance to state health
departments and health care providers in the evaluation of
patients for MERS-CoV infection including expansion of
availability of laboratory testing and, in consultation with WHO,
expansion of the travel history criteria for patients under
investigation from within 10 to 14 days for investigation and
modification of the case definition.
Please disseminate this information to infectious diseases
specialists, intensive care physicians, internists, infection
preventionists, as well as to emergency departments and