Middle East Respiratory Syndrome Coronavirus
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In September 2012, the World Health
Organization (WHO) announced the discovery of a novel coronavirus. This
virus has been named the Middle East Respiratory Syndrome Coronavirus
(MERS-CoV). MERS-CoV is a serious respiratory disease with common
symptoms in patients that include fever, cough, shortness of breath, and
breathing difficulties. Most patients have had pneumonia. Some patients
present with gastrointestinal illness prior to the onset of respiratory
symptoms. About half of people infected with MERS-CoV have died. The
virus has been shown to spread between people who are in close contact.
It can also spread from infected patients to healthcare personnel. No
travel warnings or restrictions have been issued related to MERS-CoV.
The U.S. Centers for Disease Control and Prevention (CDC) is
recommending surveillance and testing for individuals who have
unexplained severe respiratory illness and a history of travel to
countries in the Arabian Peninsula or neighboring countries. These
countries include: Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon,
Palestinian territories, Oman, Qatar, Saudi Arabia, Syria, the United
Arab Emirates, and Yemen*.
Information for health professionals
Interim Local Health Departments MERS-CoV investigation
Interim Infection Prevention and Control Recommendations for
Hospitalized Patients with MERS-CoV
- Testing for novel coronavirus
At present, PCR testing of specimens for the novel coronavirus
is available in Wisconsin only at the Wisconsin State Laboratory
of Hygiene (WSLH) and also at the CDC. Currently available diagnostic
tests for other corona viruses are not suitable for detecting
this new virus.
To increase the likelihood of detecting MERS-CoV, CDC
recommends collection of specimens from different sites--for
example, a nasopharyngeal swab and a lower respiratory tract
specimen such as (induced) sputum, bronchoalveolar lavage,
bronchial wash, or tracheal aspirate. Lower respiratory tract
specimens should be a priority for collection and polymerase
chain reaction (PCR) testing.
In addition, stool specimens should be collected but are of
lower priority. The Wisconsin Division of Public Health
will approve test requests to be performed at the WSLH if a
patient meets the criteria described below.
Patient under investigation (PUI)
A person with an acute respiratory infection,
which may include fever (≥ 100.4°F) and cough;
Suspicion of pulmonary parenchymal disease (e.g.,
pneumonia or acute respiratory distress syndrome based on clinical
or radiological evidence of consolidation);
History of travel from the Arabian Peninsula or
neighboring countries* within 14 days prior to illness onset.
Wisconsin State Laboratory of Hygiene - Lab requisition form
Note: Because of the need for immediate implementation and strict
adherence to infection control guidelines, the Wisconsin Division of
Public Health recommends that
patients who meet the case definition of PUI, regardless of whether
another etiology is suspected or lab confirmed, be tested for the
MERS-CoV. This recommendation differs from that of the CDC.
Influenza Surveillance Coordinator
Wisconsin Division of Public Health
Bureau of Communicable Diseases and Emergency Response
(Phone 608-266-5326) (Fax 608-261-4976)
July 09, 2013