Middle East respiratory syndrome coronavirus (MERS-CoV)


Updated: August 25, 2015

Travel health notice

Since April 2012, cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) have been identified in the following countries in the Middle East: Jordan, Saudi Arabia, Qatar, the United Arab Emirates, Oman, Kuwait, Yemen, Lebanon and Iran.

Several other countries have also reported cases in individuals who have travelled to the Middle East: Algeria, Austria, China, Egypt, France, Germany, Greece, Hong Kong, Italy, Malaysia, the Netherlands, the Philippines, South Korea, Thailand, Turkey, Tunisia, United Kingdom and United States.

France, Italy, South Korea, Tunisia and the United Kingdom have also reported local transmission among close contacts who have not travelled to the Middle East.

The outbreak in South Korea, which began in May 2015, was the largest outbreak of MERS-CoV outside of the Middle East. No new cases have been reported since July 4, 2015.

For the latest updates on MERS-CoV, including the total number of cases and deaths, please visit the World Health Organization's website.

The current understanding of MERS-CoV is that the virus has spread to humans from direct or indirect contact with infected camels or camel-related products (e.g. raw camel milk). Ongoing studies are underway to better understand this. Some of the infections have occurred in groups of individuals in close contact with one another (e.g. within the same household) and an increasing number of infections have occurred within health care settings among patients and health care workers, indicating the importance of following strict infection control practices. This suggests that the virus can spread between humans, however, there has been no sustained person-to-person transmission and the risk of contracting this infection is still considered to be low. 

Coronaviruses are the cause of the common cold but can also be the cause of more severe illnesses including Severe Acute Respiratory Syndrome (SARS). At this time, there is still more to learn about this coronavirus. People who have been infected with MERS-CoV have experienced influenza-like illness with symptoms fever, cough and shortness of breath. Many have also had gastrointestinal symptoms such as diarrhea.

The World Health Organization continues to work with relevant ministries of health and other international partners to support investigations to gain a better understanding of the disease and its risks. There continues to be no travel restrictions as the risk to travellers remains low.

Recommendations

Consult a health care provider or visit a travel health clinic preferably six weeks before you travel.

  1. Be aware that the risk may be higher for travellers with chronic medical conditions (e.g.: diabetes, heart disease, kidney disease, respiratory disease).
  2. Practise safe food and water precautions.
    • Avoid food that may be contaminated with animal secretions.
    • Avoid raw or undercooked (rare) camel meat. Only eat foods that are well cooked and served hot.
    • Avoid unpasteurized dairy products such as raw camel milk.
    • Avoid drinking camel urine (a practice associated with medicinal purposes in certain regions). 
  3. Avoid close contact with all wild or farmed animals, such as bats and camels.
    • If you have chronic medical conditions, your risk may be higher.
    • If you must visit a farm or market, make sure you practise good hygiene and wash your hands before and after contact with animals. 
  4. Protect yourself and others from the spread of germs and flu-like illness
    • Try to avoid close contact with people who are sick
      • There may be increased risk for travellers who require medical care in facilities where hospital-associated cases of MERS-CoV are occurring.
      • Travellers should monitor the recommendations from local authorities related to health care facilities in countries currently experiencing cases of MERS-CoV.
    • If you are sick with flu-like symptoms, delay travel or stay home:
      • Travellers should recognize signs and symptoms of flu-like illness, and delay travel or stay home if not feeling well.
      • If you are a close contact of a MERS-CoV patient, you should not travel during the time you are being monitored for the development of symptoms.
      • Travellers should note that they may be subject to quarantine measures in some countries if showing flu-like symptoms.
    • Wash your hands frequently:
      • Avoid touching your eyes, nose and mouth with your hands as germs can be spread this way. For example, if you touch a doorknob that has germs on it then touch your mouth, you can get sick.
      • Wash your hands with soap under warm running water for at least 20 seconds, as often as possible.
      • Use alcohol-based hand sanitizer if soap and water are not available. It’s a good idea to always keep some with you when you travel.
    • Practise proper cough and sneeze etiquette:
      • Cover your mouth and nose with your arm to reduce the spread of germs. If you use a tissue, dispose of it as soon as possible and wash your hands afterwards.
  5. Stay up-to-date with your vaccinations
    • There is no vaccine for MERS-CoV, however it is important to be up-to-date on all of your routine and recommended vaccinations prior to travel.
  6. Monitor your health
    • If you develop flu-like symptoms such as fever, cough and/or shortness of breath within 14 days after your return to Canada from countries in the Middle East, especially if you have a chronic medical condition, seek medical attention.
    • It is recommended that you call ahead to your health care provider or urgent care facility to inform them of your symptoms and which countries you have visited while travelling. This way, the health care provider can arrange to see you without exposing others. 

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