Official advice for New Zealanders living and travelling overseas

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Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

There is ongoing concern about the outbreak of Middle East Respiratory Syndrome Coronavirus (MERS-CoV), which was first reported by the World Health Organization (WHO) in September 2012. Cases of MERS-CoV have been reported in several Middle Eastern countries, including Saudi Arabia, Jordan, Qatar, Kuwait, Oman, the United Arab Emirates, Yemen, Lebanon. The virus appears to be circulating widely throughout the Arabian Peninsula and most cases of MERS-CoV have been reported by Saudi Arabia.

Several other countries have also reported MERS-CoV infections including China, Malaysia, the Philippines and South Korea.

All cases outside the Middle East have either lived in or travelled to affected countries, had close contact with travellers returning from the Middle East and/or contact with a case of MERS-CoV.

Some governments may conduct screening on incoming passengers from affected countries. There have been no cases in New Zealand to date.

What are the symptoms and who is at risk?
MERS-CoV can cause a rapid onset of severe respiratory illness with a fatality rate of around 40%. There is no vaccine for MERS-CoV. Symptoms include fever, cough, shortness of breath and breathing difficulties. A variety of other symptoms, including muscle pain, diarrhoea, vomiting and nausea have also been reported. Some patients have mild symptoms or are asymptomatic. Severe cases have most frequently occurred in people with underlying conditions that may have made them more susceptible to infection.

People with pre-existing health conditions (including diabetes, hypertension, cardiovascular disease, chronic lung disease, pre-existing renal failure, or those who are immuno-compromised) are at increased risk of severe disease.

Reducing the risk of exposure
At this time, the primary source of infection remains unknown, but person-to-person transmission has been documented, particularly in healthcare settings. There is increasing evidence of a possible role of camels in disease transmission.

WHO advises travellers to practice normal hygiene measures, including frequent hand washing and avoiding close contact with animals and people who are suffering from acute respiratory infections.

The WHO advises that people at potentially higher risk of severe disease due to MERS-CoV should take appropriate precautions when visiting farms, barn areas or market environments where camels are present in MERS-affected countries. Appropriate precautions might include avoiding contact with camels, good hand hygiene, and avoiding drinking raw milk or eating food that may be contaminated with animal secretions or products unless they are properly washed, peeled or cooked.

Seek immediate medical attention if you feel unwell with symptoms similar to MERS-CoV infection while travelling or on your return to New Zealand. Be sure to tell your healthcare provider that you have travelled to a region where MERS-CoV cases have been reported.

Healthcare settings
Many confirmed cases have occurred in healthcare facilities. The particular conditions or procedures that lead to transmission in hospital are not well known. However, lapses in infection control are known to be important in increasing the risk of infection in healthcare settings. Therefore, the WHO emphasises the importance of infection control strategies and practices in healthcare in affected countries, not only when caring for suspected MERS-CoV patients but also when caring for patients in all circumstances.

More information
For more information about MERS-CoV, see the following websites:

WHO has provided some travel advice on MERs-CoV for pilgrimages. This advice is available here

Associated Advisories:

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