Middle East Respiratory Syndrome: Being Prepared

Middle East Respiratory Syndrome (MERS) was first reported less than a year ago by a virologist in Saudi Arabia. Since then, it has infected 81 people in eight countries; 44 of these cases have been fatal. So far, no cases have been reported in the U.S., but the possibility exists that hospitals and health care providers here may need to treat patients infected with MERS.

Potential for Public Health Emergency

Like severe acute respiratory syndrome (SARS), MERS is a coronavirus that produces fever, an upper respiratory tract infection, and a cough. With the severe form, individuals may require mechanical ventilation. Even though MERS has not yet migrated to the U.S., it poses a significant threat for a public health emergency that could affect national security or the health and security of U.S. citizens living abroad. Recent reports do describe limited transmissions of MERS with some cases having occurred among health care professionals in international settings. The reports point to the need to quickly identify infected patients and for strict adherence to infection prevention procedures to stop any potential transmission in its tracks.

In June, Health and Human Services Secretary Kathleen Sebelius issued an emergency determination of the potential for a public health emergency involving MERS. In response, the Centers for Disease Control and Prevention (CDC) issued guidelines and resources to help prepare health care facilities that may need to care for patients infected with MERS and to prevent and control the coronavirus. No cure exists for MERS. The World Health Organization (WHO), however, has recently announced that MERS does not amount to a global health emergency, so no travel restrictions will be issued now.

Getting Ready

According to the CDC, all hospitals should be ready to care for a limited number of MERS-infected patients. Potentially, they may also need to care for a larger number of patients if transmission escalates. Key points outlined by the CDC include:

  • Ensure that your facility’s infection control policies are consistent with CDC MERS guidelines and that triage activities can be implemented based on public health guidance.
  • Review policies and procedures for rapidly implementing appropriate isolation and infection practices for potential MERS-infected patients and for submitting laboratory specimens for MERS testing; also review plans to implement surge capacity procedures and crisis standards of care.
  • Assess your facility’s effectiveness for environmental cleaning procedures; provide education, if needed. Also provide education, as needed, on diagnosis, appropriate personal protective equipment (PPE) use, triage procedures, and procedures regarding unprotected exposures.
  • Develop plans to restrict visitors if MERS begins circulating in your community.
  • Check negative-pressure airborne infection isolation rooms to be sure they are functioning and correctly monitored for airflow and exhaust handling.
  • Be sure that PPE is on hand and initiate plans if demand for PPE or other supplies exceeds supply; ensure that any personnel who will provide patient care have been medically cleared, fit-tested, and trained for respirator use.
  • Confirm your local or state health department contact information for reporting MERS cases and confirm reporting requirements with these officials; ensure that specific persons have been assigned to communicate with public health officials and disseminate information throughout your facility.

For the latest information on MERS, including case definitions and infection control guidance for health care providers, visit www.cdc.gov/coronavirus/mers.

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