Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV)

Please click the frequently asked questions below for further information and IPC precautions required:

• What is MERS?

  This is a novel coronavirus that emerged in the Middle East and is classed as a high consequence infectious disease (HCID).  It causes severe viral respiratory disease.

  

• How does it spread?

  MERS-CoV, like other coronaviruses, likely spreads from an infected person’s respiratory secretions, such as through coughing. However, we don’t fully understand the precise ways that it spreads.

  MERS-CoV has spread from ill people to others through close contact, such as caring for or living with an infected person. Infected people have spread MERS-CoV to others in healthcare settings, such as hospitals.

  Those at risk of contracting MERS-CoV include travellers to the Arabian Peninsula (or those in close contact with travellers to this region). The camel is a host species for the virus and those in contact with camels or camel products may also be at risk of contracting the disease.

• What are the symptoms of MERS?

  Symptoms include fever and cough that commonly progresses to a severe pneumonia, sometimes requiring mechanical ventilation.  Pneumonia is more likely in immunocompromised individuals, people with cardiopulmonary illnesses, as well as the elderly and young children. In some cases, a diarrhoeal illness has been the first symptom to appear.

• Why is this important?

  If NIAS staff are aware that the patient has a suspected or confirmed MERS-CoV, this should be communicated to EAC / NEAC  and the IPC Team as soon as possible. Where possible the HART team will convey patients who are a high level of suspicion or confirmed case of MERS-CoV.

  All MERS-CoV cases are notifiable to the Public Health Agency (PHA).

• IPC Precautions
  • This should be treated as a HCID.
  • The HART team should be involved in risk assessment and transfer of all suspected and confirmed cases.
  • As this is a HCID there are specific guidelines surrounding the use of PPE. Guidance should be sought for the appropriate method of donning and doffing of PPE.
  • An FFP3 mask that you are fit tested for should be used.
  • Ensure use of a buddy system for donning and doffing PPE.

  The NIAS guidance for VHF should be used and the IPC team contacted immediately for further advice.

• What cleaning is required?
  • All equipment and the ambulance should have a deep clean with a hypochlorite solution with a strength of 10,000 PPM (Same dilution as blood and body fluids).
  • Appropriate PPE should be worn when decontaminating the vehicle and the equipment.
  • Any single use equipment should be disposed of.
  • Waste should be treated as Category 4 waste and disposed of in line with the trust waste.
• Do staff need prophylaxis or follow up?

  A list of staff will be recorded of all staff who have had interaction with the suspected/confirmed case.

  All staff in contact with a case of MERS will be individually risk assessed by the multi-agency team.

• Link to guidance

  MERS-CoV: infection control for possible or confirmed cases – GOV.UK (www.gov.uk)