1. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) Update April 29, 2014

2. Major Increase in MERS CoV 2 *Source: ECDC 163 new cases since April 2014* At least 43 are reported to be HCWs Cluster in UAE involving 16 HCWs/paramedics Case Counts* 133 cases in KSA 25 in UAE 2 in Jordan 1 in each (Greece, Malaysia, Philippines)

3. Additional Information 75% of cases due to secondary spread (source: WHO) Total of 345 cases, 107 deaths (as of 4/25) (Source: ECDC) Reason for increase still unclear  Seasonality?  Nosocomial transmission?  Better case detection?  Changes in virus? 3

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6. Requests for Testing Form on THAN https://home.tnhan.tn.gov/default.aspx Requires approval by Central Office  Marion Kainer, Tim Jones, John Dunn, Kelly Moore Specimen submission guidelines on back of form  Coordinate with state lab 6

7. MERS Testing Preferred specimens:  Broncheoalveolar lavage, tracheal aspirate, pleural fluid or sputum Other specimens:  Nasopharyngeal swabs, oropharyngeal swabs State lab can perform PCR 7

8. Person Under Investigation (PUI) http://www.cdc.gov/coronavirus/mers/case-def.html Acute respiratory infection (fever, cough) AND suspicion of pulmonary parenchymal disease (e.g. ARDS, pneumonia) AND (one of the following)  History of travel to affected area within 14 days  Close contact with symptomatic traveler who developed fever and acute respiratory illness within 14 days of travel  Member of a cluster of patients with severe acute resp. illness Clusters of SARI HCW who have cared for patients with SARI 8

9. Questions marion.kainer@tn.gov 9