UMEM Educational Pearls

Title: Isolation criteria for MERS-CoV

Keywords: MERS-CoV, Viral Illness, Respiratory (PubMed Search)

Posted: 11/6/2013 by Andrea Tenner, MD
Click here to contact Andrea Tenner, MD

Case Presentation:

A 56y/o man with diabetes presents with fever, cough, and diarrhea x 2 days.

V/S: T:38.7 BP:165/88 P: 105 R:24 O2 sat:91% on room air

CXR: left lower lobe infiltrate.

On further history you learn he has just returned from visiting family in Saudi Arabia 7 days ago. While there, he visited a cousin that was ill.

Clinical Question:

Should this patient be isolated for Middle Eastern Respiratory Syndrome – Corona Virus (MERS-CoV)?

Answer:

Yes, there are 150 cases to date and 64 have died. None confirmed in the US yet but 6 confirmed in Europe.

Patients who should be isolated in an airborne iso room with N95 mask use (similar to TB) are:

Patients with fever + pneumonia/ARDS AND one of the following:

Travel to the Arabian Peninsula within 14 days of symptom onset
Close contact with a person with fever and respiratory illness within 14 days of travel to the Arabian Peninsula
Member of a cluster of patients with severe ARI being evaluated for MERS-CoV

Bottom Line:

In patients with febrile respiratory illness requiring hospitalization and recent travel to the Arabian Peninsula: isolate for MERS-CoV and contact the health department.

University of Maryland Section of Global Emergency Health

Author: Jenny Reifel Saltzberg

References

Assiri A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study. Lancet Infect Dis. 2013 Sep;13(9):752-61.

http://www.cdc.gov/coronavirus/MERS/index.html

http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6238a4.htm