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Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia

Disease Outbreak News: Update
2 July 2020

Between 1 April and 31 May 2020, the National IHR Focal Point of Saudi Arabia reported nine new cases of MERS-CoV infection, including five deaths. The cases were reported from Riyadh (seven cases), Assir (one case) and Northern (one case) Regions. Most cases were and ages of the reported cases ranged from 40 to 96 years.
Of the cases reported in Riyadh six were from a hospital outbreak in the region between 21 and 31 May 2020: an index case who was a newly admitted patient, and five secondary cases identified through contact tracing. One of the secondary cases was a health care worker and the other four were in-patients admitted due to other health conditions. All four in-patients were bedridden and above 75 years of age. All reported cases had comorbidities with the exception of the healthcare worker.
The link below provides details of the nine reported cases.

• MERS-CoV cases reported from 1 April through 31 May 2020
  xlsx, 176kb

WHO risk assessment

Infection with MERS-CoV can cause severe disease resulting in high mortality. Humans are infected with MERS-CoV from direct or indirect contact with dromedaries. MERS-CoV has demonstrated the ability to transmit between humans. So far, the observed non-sustained human-to-human transmission has occurred mainly in health care settings.
The notification of additional cases does not change the overall risk assessment. WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to dromedaries, animal products (for example, consumption of camel’s raw milk), or humans (for example, in a health care setting). WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information.
Since 2012 until 31 May 2020, the total number of laboratory-confirmed MERS-CoV infection cases reported globally to WHO is 2 562 with 881 associated deaths (34.5%). The global number reflects the total number of laboratory-confirmed cases reported to WHO under IHR to date. The total number of deaths includes the deaths that WHO is aware of to date through follow-up with affected member states.

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 (IPC) 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 infection early because like other respiratory infections, the early symptoms of MERS-CoV infection are non-specific. Therefore, healthcare workers should always apply standard precautions consistently with all patients, regardless of their diagnosis. Droplet precautions should be added to the standard precautions when providing care to patients with symptoms of acute respiratory infection; contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection; airborne precautions should be applied when performing aerosol generating procedures. Early identification, case management and isolation, together with appropriate infection prevention and control measures can prevent human-to-human transmission of MERS-CoV.

MERS-CoV appears to cause more severe disease in people with diabetes, renal failure, chronic lung disease, and immunocompromised persons. Therefore, these people should avoid close contact with animals, particularly dromedaries, when visiting farms, markets, or barn areas where the virus is known to be potentially circulating. General hygiene measures, such as regular hand washing before and after touching animals and avoiding contact with sick animals, should be adhered to.

Food hygiene practices should be observed. People should avoid drinking raw camel milk or camel urine, or eating meat that has not been properly cooked.


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.