Middle East respiratory syndrome coronavirus infection primary prevention: Difference between revisions
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==Overview== | ==Overview== | ||
There is no [[vaccine]] available for the prevention of [[MERS]] [[infection]]. All individuals should implement precaution measures including washing hands with soap, avoiding personal physical contact or sharing utensils with sick individuals, and avoiding drinking raw food that may be contaminated with animal products. | |||
==Primary Prevention== | ==Primary Prevention== | ||
*Although the immediate focus should be to clarify the magnitude of human‐to‐human [[transmission]], no control will be possible until the [[transmission]] from the animal/environment source to humans is understood and interrupted. Based on current information, it is prudent for individuals at high risk of severe disease from [[MERS-CoV]], including those with [[diabetes]], chronic [[lung disease]], pre‐existing [[renal failure]], or those who are [[immunocompromised]], to take appropriate precautions when visiting farms, barn areas or market environments where camels are present. These measures might include:<ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref> | |||
:*washing [[hands]] with soap, during at least 20 seconds. Particular attention should be give to children, who should act accordingly. In case water and soap are not available, then an alcohol-based solution should be used instead | |||
:*avoiding touching the [[eyes]], [[nose]] and mouth by unwashed [[hands]] | |||
* Although the immediate focus should be to clarify the magnitude of human‐to‐human [[transmission]], no control will be possible until the [[transmission]] from the animal/environment source to humans is understood and interrupted. Based on current information, it is prudent for | :*covering the [[nose]] and [[mouth]] when [[coughing]] or [[sneezing]] with a tissue that should be disposed afterwards | ||
:*washing hands with soap, during at least 20 seconds. Particular attention should be give to children, who should act accordingly. In case water and soap are not available, then an alcohol-based solution should be used instead | |||
:*avoiding | |||
:*covering nose and mouth when | |||
:*avoiding personal physical contact or sharing of eating utensils with sick people | :*avoiding personal physical contact or sharing of eating utensils with sick people | ||
:*frequent cleaning of touched surfaces, such as doorknobs | :*frequent cleaning of touched surfaces, such as doorknobs | ||
:*avoid drinking raw milk or eating food that may be contaminated with animal secretions or products, unless they have been properly washed, peeled, or cooked. | :*avoid drinking raw milk or eating food that may be contaminated with animal secretions or products, unless they have been properly washed, peeled, or cooked. | ||
:*for the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to. | :*for the general public, when visiting a farm or a barn, general [[hygiene]] measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food [[hygiene]] practices, should be adhered to. | ||
* [[WHO]] recommends increasing efforts to raise awareness of [[MERS]] among travelers going to and traveling from [[MERS]]-affected countries, but otherwise does not advise special screening at points of entry with regard to this event nor does [[WHO]] currently recommend the application of any travel or trade restrictions. | * [[WHO]] recommends increasing efforts to raise awareness of [[MERS]] among travelers going to and traveling from [[MERS]]-affected countries, but otherwise does not advise special screening at points of entry with regard to this event nor does [[WHO]] currently recommend the application of any travel or trade restrictions. | ||
===Vaccination=== | ===Vaccination=== | ||
Currently there is no [[vaccine]] available for the prevention of [[MERS]] infection.<ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref> | Currently there is no [[vaccine]] available for the prevention of [[MERS]] [[infection]].<ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref><ref name="Abdel-Moneim2014">{{cite journal|last1=Abdel-Moneim|first1=Ahmed S.|title=Middle East respiratory syndrome coronavirus (MERS-CoV): evidence and speculations|journal=Archives of Virology|year=2014|issn=0304-8608|doi=10.1007/s00705-014-1995-5}}</ref><ref name="ArabiArifi2014">{{cite journal|last1=Arabi|first1=Yaseen M.|last2=Arifi|first2=Ahmed A.|last3=Balkhy|first3=Hanan H.|last4=Najm|first4=Hani|last5=Aldawood|first5=Abdulaziz S.|last6=Ghabashi|first6=Alaa|last7=Hawa|first7=Hassan|last8=Alothman|first8=Adel|last9=Khaldi|first9=Abdulaziz|last10=Al Raiy|first10=Basel|title=Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection|journal=Annals of Internal Medicine|volume=160|issue=6|year=2014|pages=389-397|issn=0003-4819|doi=10.7326/M13-2486}}</ref> | ||
===Pre-Travel Medical Consult=== | |||
Before traveling individuals should consult their primary care physician, at least 4 to 8 weeks prior to the due date. However, last minute consults are also beneficial. During the consult the physician will address important health risks, evaluate the need for [[vaccinations]] and/or [[antimalarial]] medication and at the same time identify medical items the person should carry with her.<ref name=CDC>{{cite web | title = MERS Prevention and Treatment | url = http://www.cdc.gov/coronavirus/MERS/about/prevention.html }}</ref><ref name=WHO>{{cite web | title = International travel and health | url = http://www.who.int/ith/updates/20140603/en/ }}</ref> | |||
===Travel Guidance=== | ===Travel Guidance=== | ||
The peak travel season to Saudi Arabia is July through November, coinciding with the religious pilgrimages of Hajj and Umrah. CDC encourages pilgrims to consider recommendations from the Saudi Arabia Ministry of Health regarding persons who should postpone their pilgrimages this year, including persons aged ≥65 years, children, pregnant women, and persons with chronic diseases, weakened immune | *Prior to travel, individuals should review [[CDC]] recommendations for [[infection control]] in endemic regions. | ||
*All individuals should monitor their health condition closely during the travel and in the weeks after their return. The peak travel season to Saudi Arabia is July through November, coinciding with the religious pilgrimages of Hajj and Umrah. | |||
*[[CDC]] encourages pilgrims to consider recommendations from the Saudi Arabia Ministry of Health regarding persons who should postpone their pilgrimages this year, including persons aged ≥65 years, children, pregnant women, and persons with [[chronic diseases]], weakened [[immune system]]s , or [[cancer]]. It is also recommended that individuals who travel to countries in the Arabian Peninsula or nearby countries, take protective measures in order to avoid [[respiratory illness|respiratory illnesses]], by practicing good [[hand]] [[hygiene]] and avoiding contact with ill patients. In case of [[symptom]] onset, including: [[cough]], [[fever]] or [[dyspnea]], anytime during the trip or in the 14 days after the return to the US, patients should seek medical attention and warn their health-care provider about the recent trip. | |||
The [[WHO]] advises persons with preexisting medical conditions to consult a health-care provider before deciding whether to make a pilgrimage.<ref name=CDC>{{cite web | title = People at increased risk for MERS | url = http://www.cdc.gov/coronavirus/MERS/risk.html }}</ref> | |||
===Infection Control=== | ===Infection Control=== | ||
Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected [[MERS-CoV]] [[infection]].<ref name="AssiriMcGeer2013">{{cite journal|last1=Assiri|first1=Abdullah|last2=McGeer|first2=Allison|last3=Perl|first3=Trish M.|last4=Price|first4=Connie S.|last5=Al Rabeeah|first5=Abdullah A.|last6=Cummings|first6=Derek A.T.|last7=Alabdullatif|first7=Zaki N.|last8=Assad|first8=Maher|last9=Almulhim|first9=Abdulmohsen|last10=Makhdoom|first10=Hatem|last11=Madani|first11=Hossam|last12=Alhakeem|first12=Rafat|last13=Al-Tawfiq|first13=Jaffar A.|last14=Cotten|first14=Matthew|last15=Watson|first15=Simon J.|last16=Kellam|first16=Paul|last17=Zumla|first17=Alimuddin I.|last18=Memish|first18=Ziad A.|title=Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus|journal=New England Journal of Medicine|volume=369|issue=5|year=2013|pages=407–416|issn=0028-4793|doi=10.1056/NEJMoa1306742}}</ref><ref name="pmid23787161">{{cite journal| author=Mailles A, Blanckaert K, Chaud P, van der Werf S, Lina B, Caro V et al.| title=First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013. | journal=Euro Surveill | year= 2013 | volume= 18 | issue= 24 | pages= | pmid=23787161 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23787161 }} </ref> | |||
===Close contacts with confirmed or probable cases of MERS=== | |||
In case of contact with a confirmed or probable case of [[infection]] by [[MERS-CoV]], immediate consult with an health-care provider should be made. Depending on the findings on the evaluation, the physician may request additional laboratory or auxiliary tests and provide additional recommendations. Likely, the person will be asked to monitor their health during the following 14 days and monitor for [[Middle East respiratory syndrome coronavirus infection primary prevention #History and symptoms]] of MERS-CoV | |||
==Submission of Lab Specimens to the Public Health Laboratory== | |||
Among patients suspected of being [[infected]] with the [[MERS-CoV]], the following [[Laboratory specimen|specimens]] should be collected, by health-care providers, for submission to a [[public health laboratory]] or to the [[CDC]]: | |||
*[[Nasopharyngeal]] swab | |||
*[[Oropharyngeal]] swab (might be placed in the same container, in [[viral]] transport medium, as the [[nasopharyngeal]] swabs) | |||
*[[Sputum]] | |||
*[[Serum]] | |||
*Stool/rectal swab. | |||
During the collection of the [[Laboratory specimen|specimens]], it is recommended the use of [[infection]] control precautions and the health-care practitioners, involved the collection of these [[Laboratory specimen|specimens]], should wear recommended personal protective equipment, such as: | |||
*Gloves | |||
*Gowns | |||
*[[Eye]] protection | |||
*[[Respiratory]] protection | |||
==References== | ==References== | ||
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{{WS}} | {{WS}} | ||
[[category:disease]] | [[category:disease]] | ||
[[category:virology]] | [[category:virology]] | ||
[[Category:Up-To-Date]] | [[Category:Up-To-Date]] | ||
Latest revision as of 18:05, 18 September 2017
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Middle East Respiratory Syndrome Coronavirus Infection Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: João André Alves Silva, M.D. [2]
Overview
There is no vaccine available for the prevention of MERS infection. All individuals should implement precaution measures including washing hands with soap, avoiding personal physical contact or sharing utensils with sick individuals, and avoiding drinking raw food that may be contaminated with animal products.
Primary Prevention
- Although the immediate focus should be to clarify the magnitude of human‐to‐human transmission, no control will be possible until the transmission from the animal/environment source to humans is understood and interrupted. Based on current information, it is prudent for individuals at high risk of severe disease from MERS-CoV, including those with diabetes, chronic lung disease, pre‐existing renal failure, or those who are immunocompromised, to take appropriate precautions when visiting farms, barn areas or market environments where camels are present. These measures might include:[1]
- washing hands with soap, during at least 20 seconds. Particular attention should be give to children, who should act accordingly. In case water and soap are not available, then an alcohol-based solution should be used instead
- avoiding touching the eyes, nose and mouth by unwashed hands
- covering the nose and mouth when coughing or sneezing with a tissue that should be disposed afterwards
- avoiding personal physical contact or sharing of eating utensils with sick people
- frequent cleaning of touched surfaces, such as doorknobs
- avoid drinking raw milk or eating food that may be contaminated with animal secretions or products, unless they have been properly washed, peeled, or cooked.
- for the general public, when visiting a farm or a barn, general hygiene measures, such as regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices, should be adhered to.
- WHO recommends increasing efforts to raise awareness of MERS among travelers going to and traveling from MERS-affected countries, but otherwise does not advise special screening at points of entry with regard to this event nor does WHO currently recommend the application of any travel or trade restrictions.
Vaccination
Currently there is no vaccine available for the prevention of MERS infection.[1][2][3]
Pre-Travel Medical Consult
Before traveling individuals should consult their primary care physician, at least 4 to 8 weeks prior to the due date. However, last minute consults are also beneficial. During the consult the physician will address important health risks, evaluate the need for vaccinations and/or antimalarial medication and at the same time identify medical items the person should carry with her.[1][4]
Travel Guidance
- Prior to travel, individuals should review CDC recommendations for infection control in endemic regions.
- All individuals should monitor their health condition closely during the travel and in the weeks after their return. The peak travel season to Saudi Arabia is July through November, coinciding with the religious pilgrimages of Hajj and Umrah.
- CDC encourages pilgrims to consider recommendations from the Saudi Arabia Ministry of Health regarding persons who should postpone their pilgrimages this year, including persons aged ≥65 years, children, pregnant women, and persons with chronic diseases, weakened immune systems , or cancer. It is also recommended that individuals who travel to countries in the Arabian Peninsula or nearby countries, take protective measures in order to avoid respiratory illnesses, by practicing good hand hygiene and avoiding contact with ill patients. In case of symptom onset, including: cough, fever or dyspnea, anytime during the trip or in the 14 days after the return to the US, patients should seek medical attention and warn their health-care provider about the recent trip.
The WHO advises persons with preexisting medical conditions to consult a health-care provider before deciding whether to make a pilgrimage.[1]
Infection Control
Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection.[5][6]
Close contacts with confirmed or probable cases of MERS
In case of contact with a confirmed or probable case of infection by MERS-CoV, immediate consult with an health-care provider should be made. Depending on the findings on the evaluation, the physician may request additional laboratory or auxiliary tests and provide additional recommendations. Likely, the person will be asked to monitor their health during the following 14 days and monitor for Middle East respiratory syndrome coronavirus infection primary prevention #History and symptoms of MERS-CoV
Submission of Lab Specimens to the Public Health Laboratory
Among patients suspected of being infected with the MERS-CoV, the following specimens should be collected, by health-care providers, for submission to a public health laboratory or to the CDC:
- Nasopharyngeal swab
- Oropharyngeal swab (might be placed in the same container, in viral transport medium, as the nasopharyngeal swabs)
- Sputum
- Serum
- Stool/rectal swab.
During the collection of the specimens, it is recommended the use of infection control precautions and the health-care practitioners, involved the collection of these specimens, should wear recommended personal protective equipment, such as:
- Gloves
- Gowns
- Eye protection
- Respiratory protection
References
- ↑ 1.0 1.1 1.2 1.3 "MERS Prevention and Treatment".
- ↑ Abdel-Moneim, Ahmed S. (2014). "Middle East respiratory syndrome coronavirus (MERS-CoV): evidence and speculations". Archives of Virology. doi:10.1007/s00705-014-1995-5. ISSN 0304-8608.
- ↑ Arabi, Yaseen M.; Arifi, Ahmed A.; Balkhy, Hanan H.; Najm, Hani; Aldawood, Abdulaziz S.; Ghabashi, Alaa; Hawa, Hassan; Alothman, Adel; Khaldi, Abdulaziz; Al Raiy, Basel (2014). "Clinical Course and Outcomes of Critically Ill Patients With Middle East Respiratory Syndrome Coronavirus Infection". Annals of Internal Medicine. 160 (6): 389–397. doi:10.7326/M13-2486. ISSN 0003-4819.
- ↑ "International travel and health".
- ↑ Assiri, Abdullah; McGeer, Allison; Perl, Trish M.; Price, Connie S.; Al Rabeeah, Abdullah A.; Cummings, Derek A.T.; Alabdullatif, Zaki N.; Assad, Maher; Almulhim, Abdulmohsen; Makhdoom, Hatem; Madani, Hossam; Alhakeem, Rafat; Al-Tawfiq, Jaffar A.; Cotten, Matthew; Watson, Simon J.; Kellam, Paul; Zumla, Alimuddin I.; Memish, Ziad A. (2013). "Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus". New England Journal of Medicine. 369 (5): 407–416. doi:10.1056/NEJMoa1306742. ISSN 0028-4793.
- ↑ Mailles A, Blanckaert K, Chaud P, van der Werf S, Lina B, Caro V; et al. (2013). "First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013". Euro Surveill. 18 (24). PMID 23787161.