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November 6, 2013

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  1. MERS Coronavirus:The US ResponseDavid L. Swerdlow, MDCAPT, USPHSIncident Manager, CDC MERS Coronavirus ResponseAssociate Director for ScienceNational Center for Immunization and Respiratory Diseases November 6, 2013
  2. MERS Coronaviruses (MERS CoV)Outline Lessons from SARS Emergence and epidemiology of MERS The US response- domestic and global
  3. SARS Epidemic Occurred 2002-2003 8,098 probable cases, 774 deaths Estimated economic losses >$30B Super-spreading events helped seed global spread E.g., traveler at Hong Kong hotel spread virus to several countries Control strategies: Surveillance to identify cases Isolation of ill Quarantine of exposed Good infection control
  4. MERS Coronavirus- current situation as of October 29, 2013 First case reported from KSA in September 2012 Outbreak in Jordan April 2012 identified retrospectively 150 laboratory confirmed cases with 64 (43%) deaths* Gender: 91 Males (63%), 53 Females [6 Unknown] Median age (min, max) in years: 52 (2, 94) Most with underlying conditions 24 (16%) of 150 cases health care workers
  5. MERS CoV Cases and Deaths Confirmed by WHO
  6. Cases or clusters associated with returning travelers United Kingdom: 2/13- 3 cases, 2 deaths- Retuning traveler from KSA and family France: 4/13- 65 yo French traveler returning from UAE and 51 yo hospital roommate Tunisia: 5/13- Returning traveler from Qatar (died) and two adult children Italy: 5/13- Returning traveler from Jordan. Ill niece and co-worker were probable cases
  7. Possible Environmental (Animal) Source Bats: PCR testing Similar virus--Ghana and Europe1; South Africa2 Identical small DNA fragment in bat sampled near first case in KSA3 Camels: Serology Camels from Oman (100%) and Spain (14%) had antibodies to MERS, other animals neg4 Camels from Egypt (94-98%), other humans and animals in Egypt and China neg5 No direct evidence available 1Annan A, et al. Emerg Infect Dis 2013;19:456-59;2Ithete NL, et al. EID 2013;10 epub; 3Memish Z, et al, EID Ahead of Print, 8/21/13;4Reusken CBEM, et al. Lancet ID 2013;18:860-6; 5Perera RA et al. Eurosurveillance 2013;18 (36) pii 20574