WHO issues MERS travel advice; new case reported

The World Health Organization (WHO) advised today that people who have chronic medical conditions and want to go on a pilgrimage to Saudi Arabia, epicenter of MERS-CoV (Middle East respiratory syndrome coronavirus), should talk with their healthcare provider about the risks.

Saying the risk to travelers is "very low," the WHO recommended no travel restrictions or border screening during the Muslim Umrah and Hajj pilgrimages, which are expected to draw millions of people to Saudi Arabia. The recommendations focus on awareness and routine precautions to prevent travel-related infections.

Meanwhile, Saudi Arabia today reported another MERS case and the death of a previously reported case-patient, according to a translated government statement posted on FluTrackers, an infectious disease message board.

The new case is in an 83-year-old man in the southwestern region of Asir, the report said. It gave no other details about the man or about the deceased patient. If confirmed, the additional case and death will raise Saudi Arabia's MERS count to 71 cases and 39 deaths.

Pilgrims flock to Saudi Arabia for Umrah during the Muslim holy month of Ramadan (Jul 9 to Aug 7 this year), and far more travel there for the Hajj, which this year falls in October (Oct 13 to 18).

Two weeks ago, the Saudi Ministry of Health (MOH) advised the elderly (over 65), the chronically ill, children, and pregnant women not to go on the pilgrimages this year, citing the risk of MERS. Media reports have said the government is not issuing visas to those groups. The government also advised travelers to wear face masks in crowded places.

Today's WHO statement fulfills a promise made last week, when the agency announced that its special emergency committee on MERS-CoV concluded that the disease did not yet constitute an international public health emergency. The WHO guidance, framed as advice for governments of countries from which pilgrims will be coming, does not go as far as the Saudi advisory.

"At this time, the risk to an individual pilgrim of contracting MERS-CoV is considered very low," the WHO said in a statement e-mailed to reporters.

The guidance recommends caution, however, for those with chronic health problems: "Countries should advise pilgrims that pre-existing major medical conditions (eg, chronic diseases such as diabetes, chronic lung disease, immunodeficiency) can increase the likelihood of illness, including MERS-CoV infection, during travel; thus, pilgrims should consult a health care provider before travelling to review the risk and assess whether making the pilgrimage is advisable."

The WHO also says that governments should provide departing pilgrims and travel organizations with guidance on general travel precautions, including hand washing, food safety, personal hygiene, and avoiding unnecessary contact with animals. Health advisories should be placed at key locations such as travel agent offices and airports, the agency says.

Among other recommendations, the WHO also advises that:

  • Healthcare practitioners and facilities should be provided with WHO guidelines (or their national equivalents) on infection control and clinical management for MERS-CoV
  • Medical personnel accompanying pilgrims should be up to date on MERS-CoV information and guidance
  • Returning pilgrims should seek medical attention if they experience a respiratory illness with fever and cough within 2 weeks after returning home
  • Persons who experience a significant respiratory illness after having contact with a returning traveler with such an illness should report to local health authorities so they can be monitored for MERS-CoV
  • Countries should make sure routine measures are in place for assessing sick travelers on airplanes and ships and at ports of entry

See also:

Jul 25 WHO recommendations

Jul 25 FluTrackers report of new MERS case

Jul 12 Saudi MOH statement about health regulations for pilgrims

Saudi MOH health regulations for pilgrims

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