| 26 Juin 2014
On 19, 20, 22 and 23 June 2014, National IHR Focal Point of Saudi Arabia  notified WHO of 4 additional laboratory-confirmed cases of infection  with Middle East respiratory syndrome coronavirus (MERS-CoV). 
 
 Details of the cases are as follow:
 
- A 38 year old woman from Riyadh city, Riyadh Region. The patient was admitted to a hospital for another illness on 20 April. She developed respiratory symptoms on 11 June, and was laboratory-confirmed with MERS-CoV on 18 June. She is currently in a stable condition. Investigation on the source of infection is ongoing.
 - A 45 year old man from Riyadh city, Riyadh Region. The patient became ill on 6 June and was admitted to a hospital on 19 June and was laboratory-confirmed with MERS-CoV on 20 June. The patient is reported to have no history of contact with a previously laboratory-confirmed MERS CoV case. He does not have a history of travel or a history of contact with animals. The patient is currently in a stable condition.
 - A 57 year old man from a village located 50 km away from Umluj city, Tabuk Region. He was admitted to a hospital on 16 June and was laboratory-confirmed with MERS-CoV on 22 June. The patient was air-ambulanced to Jeddah on 24 June and is currently in a critical condition. He has a history of exposure to camels on a daily basis. He is reported to have an underlying medical condition.
 - A 85 year old man from Jeddah city, Makkah Region. He became ill on 15 June, was admitted to a hospital on 21 June and was laboratory-confirmed with MERS-CoV on 22 June. The patient has an underlying medical condition. He is currently in a stable condition. The patient is reported to have no history of contact with animals.
 
 Investigation and follow up of contacts of the laboratory-confirmed cases are ongoing.
 
 In addition, two additional deaths were reported among previously laboratory-confirmed cases of infection with MERS-CoV.
 
 Globally, 707 laboratory-confirmed cases of infection with MERS-CoV,  including at least 252 related deaths have officially been reported to  WHO.
 
 WHO advice
 Based on the current situation and available information, WHO encourages  all Member States to continue their surveillance for acute respiratory  infections and to carefully review any unusual patterns.
 
 Infection prevention and control measures are critical to prevent the  possible spread of MERS-CoV in health care facilities. It is not always  possible to identify patients with MERS-CoV early because like other  respiratory infections, the early symptoms of MERS-CoV are non-specific.
 
 Therefore, health-care workers should always apply standard precautions  consistently with all patients, regardless of their diagnosis. Droplet  precautions should be added to the standard precautions when providing  care to patients with symptoms of acute respiratory infection; contact  precautions and eye protection should be added when caring for probable  or confirmed cases of MERS-CoV infection; airborne precautions should be  applied when performing aerosol generating procedures.
 
 Until more is understood about MERS-CoV, people with diabetes, renal  failure, chronic lung disease, and immunocompromised persons are  considered to be at high risk of severe disease from MERS‐CoV infection.  Therefore, these people should avoid close contact with animals,  particularly camels, when visiting farms, markets, or barn areas where  the virus is known to be potentially circulating. General hygiene  measures such as regular hand washing before and after touching animals  and avoiding contact with sick animals, should be adhered to.
 
 Food hygiene practices should be observed. People should avoid drinking  raw camel milk or camel urine, or eating meat that has not been properly  cooked.
 
 WHO does not advise special screening at points of entry with regard to  this event nor does it currently recommend the application of any travel  or trade restrictions.









