Middle East respiratory syndrome coronavirus infection diagnostic criteria: Difference between revisions
YazanDaaboul (talk | contribs) |
m (Changes made per Mahshid's request) |
||
(4 intermediate revisions by one other user not shown) | |||
Line 6: | Line 6: | ||
MERS-CoV infection is suspected when patients with a recent travel to the Arabian peninsula, exposure to infected patients, or exposure to healthcare settings develop fever, pneumonia, or ARDS. Once suspected, patients should undergo lab testing to confirm or rule out MERS-CoV infection. | MERS-CoV infection is suspected when patients with a recent travel to the Arabian peninsula, exposure to infected patients, or exposure to healthcare settings develop fever, pneumonia, or ARDS. Once suspected, patients should undergo lab testing to confirm or rule out MERS-CoV infection. | ||
==Diagnostic Criteria for MERS-CoV Infection== | ==Diagnostic Criteria for MERS-CoV Infection== | ||
MERS-CoV infection is suspected when patients with a recent travel to | MERS-CoV infection is suspected when patients with a recent travel to endemic regions, exposure to infected patients, or exposure to healthcare settings develop fever, pneumonia, or ARDS. Once suspected, patients should undergo lab testing to confirm or rule out MERS-CoV infection. | ||
===Suspected Case=== | ===Suspected Case=== | ||
Line 14: | Line 14: | ||
: ''AND EITHER''<br> | : ''AND EITHER''<br> | ||
:: History of travel from countries in or near | :: History of travel from countries in or near endemic regions within 14 days before symptom onset<br> | ||
: ''OR''<br> | : ''OR''<br> | ||
:: Close contact with a symptomatic traveler who developed [[fever]] and acute [[respiratory illness]] (not necessarily [[pneumonia]]) within 14 days after traveling from countries in or near | :: Close contact with a symptomatic traveler who developed [[fever]] and acute [[respiratory illness]] (not necessarily [[pneumonia]]) within 14 days after traveling from countries in or near endemic regions<br> | ||
: ''OR''<br> | : ''OR''<br> | ||
:: Member of a cluster of patients with severe acute [[respiratory illness]] (e.g.[[ fever]] and [[pneumonia]] requiring hospitalization) of unknown [[etiology]] in which [[MERS-CoV]] is being evaluated, in consultation with state and local health departments<br> | :: Member of a cluster of patients with severe acute [[respiratory illness]] (e.g.[[ fever]] and [[pneumonia]] requiring hospitalization) of unknown [[etiology]] in which [[MERS-CoV]] is being evaluated, in consultation with state and local health departments<br> | ||
Line 25: | Line 25: | ||
:: Symptoms of respiratory illness (not necessarily pneumonia; e.g., [[cough]], [[shortness of breath]]) <br> | :: Symptoms of respiratory illness (not necessarily pneumonia; e.g., [[cough]], [[shortness of breath]]) <br> | ||
: ''AND''<br> | : ''AND''<br> | ||
:: Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near | :: Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near endemic regions in which recent healthcare-associated cases of MERS have been identified | ||
===Probable Case=== | ===Probable Case=== | ||
Line 32: | Line 32: | ||
===Confirmed Case=== | ===Confirmed Case=== | ||
According to the [[CDC]], a ''confirmed case'' of [[MERS-CoV]] [[infection]] is defined as an individual who demonstrates laboratory confirmation of [[infection]] by [[MERS-CoV]].<ref name="MMWR">{{cite web | title = Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection and Guidance for the Public, Clinicians, and Public Health Authorities, 2012–2013 | url = http://www.cdc.gov/coronavirus/mers/case-def.html }}</ref> | According to the [[CDC]], a ''confirmed case'' of [[MERS-CoV]] [[infection]] is defined as an individual who demonstrates laboratory confirmation of [[infection]] by [[MERS-CoV]].<ref name="MMWR">{{cite web | title = Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection and Guidance for the Public, Clinicians, and Public Health Authorities, 2012–2013 | url = http://www.cdc.gov/coronavirus/mers/case-def.html }}</ref> | ||
==CDC Guidelines== | |||
According to [[CDC]] guidelines:<ref name=MMWR>{{cite web | title = Updated Information on the Epidemiology of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Infection and Guidance for the Public, Clinicians, and Public Health Authorities, 2012–2013 | url = http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a4.htm }}</ref> | |||
*Investigations of [[MERS-CoV]] and other [[respiratory]] [[pathogens]] may be conducted simultaneously and additionally, positive results for another [[respiratory]] [[pathogen]] should not hinder testing for [[MERS-CoV]]. | |||
*Health-care providers in the United States should continue to evaluate patients for [[MERS-CoV]] [[infection]] if they develop [[fever]] and [[pneumonia]] or [[acute respiratory distress syndrome]] within 14 days after traveling from countries in or near the Arabian Peninsula. | |||
*Providers should also evaluate patients for [[MERS-CoV]] [[infection]], in the presence of [[ARDS]], [[fever]] or [[pneumonia]] and if they have been in close contact with recent travelers from the Arabian Peninsula who have [[fever]] and acute [[respiratory illness]]. | |||
*Clusters of patients with severe acute [[respiratory illness]], such as [[fever]] and [[pneumonia]] that requires hospitalization, must be evaluated for common [[respiratory]] [[pathogens]] and reported to local and state [[public health]] departments. In case a diagnosis isn't reached, particularly if the cluster includes health-care providers, testing for [[MERS-CoV]] should be considered, in consultation with state and local health departments. In this situation, all patients should be tested, even if they haven't had travel-related exposure. | |||
*If [[symptoms]] have started more than 14 days prior, [[CDC]] guidelines recommend additional testing of a [[serum]] specimen via the ''[[CDC]] [[MERS-CoV]] serologic assay'' | |||
*Laboratory confirmation of [[infection]] by [[MERS-CoV]] now requires a positive [[PCR]] test of ≥2 specific genomic targets or, a single positive target followed by successful sequencing of a second. | |||
* Laboratory tests, such as the [[PCR]] for [[MERS-CoV]] are available at state health departments, [[CDC]] and some international laboratories. Otherwise, [[MERS-CoV]] tests are not routinely available, despite the existence of a limited number of non-[[FDA]]-approved commercial tests. | |||
==References== | ==References== | ||
Line 39: | Line 51: | ||
{{WS}} | {{WS}} | ||
[[category:Disease]] | [[category:Disease]] | ||
[[category:virology]] | [[category:virology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] |
Latest revision as of 18:04, 18 September 2017
Middle East Respiratory Syndrome Coronavirus Infection Microchapters |
Differentiating Middle East Respiratory Syndrome Coronavirus Infection from other Diseases |
---|
Diagnosis |
Treatment |
Case Studies |
Middle East respiratory syndrome coronavirus infection diagnostic criteria On the Web |
American Roentgen Ray Society Images of Middle East respiratory syndrome coronavirus infection diagnostic criteria |
FDA on Middle East respiratory syndrome coronavirus infection diagnostic criteria |
CDC on Middle East respiratory syndrome coronavirus infection diagnostic criteria |
Middle East respiratory syndrome coronavirus infection diagnostic criteria in the news |
Blogs on Middle East respiratory syndrome coronavirus infection diagnostic criteria |
Directions to Hospitals Treating Middle East respiratory syndrome coronavirus infection |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Alejandro Lemor, M.D. [2]
Overview
MERS-CoV infection is suspected when patients with a recent travel to the Arabian peninsula, exposure to infected patients, or exposure to healthcare settings develop fever, pneumonia, or ARDS. Once suspected, patients should undergo lab testing to confirm or rule out MERS-CoV infection.
Diagnostic Criteria for MERS-CoV Infection
MERS-CoV infection is suspected when patients with a recent travel to endemic regions, exposure to infected patients, or exposure to healthcare settings develop fever, pneumonia, or ARDS. Once suspected, patients should undergo lab testing to confirm or rule out MERS-CoV infection.
Suspected Case
Patients with the following findings (either A or B) are suspected to have MERS-CoV :[1]
A. Fever and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence)
- AND EITHER
- History of travel from countries in or near endemic regions within 14 days before symptom onset
- History of travel from countries in or near endemic regions within 14 days before symptom onset
- OR
- Close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near endemic regions
- Close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near endemic regions
- OR
- Member of a cluster of patients with severe acute respiratory illness (e.g.fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments
- Member of a cluster of patients with severe acute respiratory illness (e.g.fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments
OR
B. Fever
- AND
- Symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath)
- Symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath)
- AND
- Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near endemic regions in which recent healthcare-associated cases of MERS have been identified
Probable Case
According to the CDC, a probable case of MERS-CoV infection is defined as an individual under investigation who has missing or inconclusive laboratory test results for the infection and who has been in close contact with another individual with a "laboratory-confirmed case" of MERS-CoV infection.[1]
Confirmed Case
According to the CDC, a confirmed case of MERS-CoV infection is defined as an individual who demonstrates laboratory confirmation of infection by MERS-CoV.[1]
CDC Guidelines
According to CDC guidelines:[1]
- Investigations of MERS-CoV and other respiratory pathogens may be conducted simultaneously and additionally, positive results for another respiratory pathogen should not hinder testing for MERS-CoV.
- Health-care providers in the United States should continue to evaluate patients for MERS-CoV infection if they develop fever and pneumonia or acute respiratory distress syndrome within 14 days after traveling from countries in or near the Arabian Peninsula.
- Providers should also evaluate patients for MERS-CoV infection, in the presence of ARDS, fever or pneumonia and if they have been in close contact with recent travelers from the Arabian Peninsula who have fever and acute respiratory illness.
- Clusters of patients with severe acute respiratory illness, such as fever and pneumonia that requires hospitalization, must be evaluated for common respiratory pathogens and reported to local and state public health departments. In case a diagnosis isn't reached, particularly if the cluster includes health-care providers, testing for MERS-CoV should be considered, in consultation with state and local health departments. In this situation, all patients should be tested, even if they haven't had travel-related exposure.
- If symptoms have started more than 14 days prior, CDC guidelines recommend additional testing of a serum specimen via the CDC MERS-CoV serologic assay
- Laboratory confirmation of infection by MERS-CoV now requires a positive PCR test of ≥2 specific genomic targets or, a single positive target followed by successful sequencing of a second.
- Laboratory tests, such as the PCR for MERS-CoV are available at state health departments, CDC and some international laboratories. Otherwise, MERS-CoV tests are not routinely available, despite the existence of a limited number of non-FDA-approved commercial tests.