Middle East respiratory syndrome coronavirus infection diagnostic criteria
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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 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.
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 the Arabian Peninsula within 14 days before symptom onset
- History of travel from countries in or near the Arabian Peninsula 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 the Arabian Peninsula
- 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 the Arabian Peninsula
- 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 the Arabian Peninsula 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]