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Screening of Human and Animal S era from Egypt and Hong Kong. Sampled 1343 Human, 625 animals. Perera et al. Euro Surveill. 2013;18(36):pii=20574. Treatment. SARS: definitive treatment regimen was not clearly established MERS CoV : Interferon alpha 2b + ribavirin in vitro 1
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Screening of Human and Animal Sera from Egypt and Hong Kong Sampled 1343 Human, 625 animals Perera et al. Euro Surveill. 2013;18(36):pii=20574
Treatment • SARS: definitive treatment regimen was not clearly established • MERS CoV: Interferon alpha 2b + ribavirin in vitro1 • Recent study in Macaque monkeys2 • No clear data on human treatment 1Falzarano D et al. Sci Rep 3 2013:1686 2Falzarano D et al. Nature Medicine 2013 pub online 9/8/13
Vaccines • SARS vaccines were in development • Possible MERS vaccines: • VLP/nanoparticles with S protein • Constitutive expression of S protein in cell culture • Developmental stages
Domestic Activities • Case definition and guidance developed and disseminated • 5 MMWRs published • 3 health advisories sent to state/local health departments • Investigating persons with travel link, severe respiratory illness • 100 samples/31 states: all negative • Serology developed • MERS-CoV ELISA, MERS-CoV IFA and MERS-CoV MNt • PCR diagnostics developed and distributed
CDC Case Definition Patient Under Investigation (PUI) • A person with the following characteristics: • Fever (≥38°C, 100.4°F) 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; • 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; • OR • Is a 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. http://www.cdc.gov/coronavirus/mers/case-def.html
Domestic Deployment of CDC MERS-CoV rRT-PCR Assay by LRN Approved for MERS-CoV testing (44) Kits will be sent later (6)
Infection Prevention and Control Recommendations • Standard, Contact and Airborne Precautions • N95 respirators if available • Airborne infection isolation rooms • Similar recommendations as SARS • High mortality • Human-to human transmission • Unknown modes of transmission • No vaccine or chemoprophylaxis
Infection Control: Checklists • Prompt triage and testing of patients • Prioritization of available isolation rooms • Plans for appropriate cohorting of patients and personnel • Training • Sick leave policy