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Australian health professionals are being warned of the continued risk of Middle East Respiratory Syndrome (MERS) infection for workers in the Kingdom of Saudi Arabia, especially during times of mass gatherings like the Hajj.

MERS is a viral respiratory illness caused by MERS coronavirus (MERS-CoV) and has a high fatality rate (approximately 35%). Saudi Arabia is experiencing an ongoing outbreak of MERS with approximately 80% of cases worldwide reported from that region. Other Middle Eastern countries are also still reporting cases.

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Australia’s Chief Medical Officer, Professor Brendan Murphy, has advised health professionals travelling to Saudi Arabia to be vigilant and protect themselves from MERS.

“Direct and indirect contact with dromedary camels are risk factors for infection. If you decide to travel to the Saudi Arabia at this time, I urge you to avoid visiting farms or markets where there may be camels and to avoid close contact with camels, raw camel milk, undercooked camel meat and anything contaminated with camel secretions.” Professor Murphy said.

Professor Murphy also urged vigilance in providing patient care. “Human-to-human transmission of MERS has been observed in health care settings where there have been failures in infection prevention and control. You should protect yourself by practising appropriate infection control at all times, including the use of personal protective equipment and hand hygiene. When treating a patient who is suspected or confirmed to have MERS, or who has a history of contact with camels, additional infection control recommendations for airborne transmission may be required and you should speak with your employer or recruitment agency about these”.

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Health professionals who feel unwell upon their return from the Middle East should see their doctor and tell them where they have been working and if they have been in contact with someone who may have had MERS or with camels or camel products. If they feel unwell while still working in the Middle East, they should not wait until they arrive back in Australia to seek medical assistance. They should see a doctor or go to the local emergency department as soon as possible.

There is no vaccine for MERS-CoV. MERS symptoms include fever, cough and breathing difficulties. A variety of other symptoms have been reported in a smaller number of cases, including muscle pain, diarrhoea, vomiting and nausea.

Health professionals should be aware that patients with pre-existing medical conditions such as chronic lung disease, diabetes, chronic renal disease and immunodeficiency are more likely develop the severe form of MERS.

“It is also important for health practitioners in Australia to be vigilant to identify MERS-CoV infection in returning travellers. We encourage clinicians to test travellers who present with signs and symptoms of MERS and have recently returned from the Middle East for MERS-CoV and ensure suspected cases are managed appropriately,” Professor Brendan Murphy said.

Health professionals should report all suspected, probable and confirmed cases to the state or territory public health unit. MERS-CoV is a nationally notifiable disease.

The Department of Health publishes information for clinicians and health professionals including countries affected and national guidelines for testing and prevention at www.health.gov.au/MER-coronavirus.

Around 3,000 Australians travel to Saudi Arabia each year to participate in the annual Muslim pilgrimage to Mecca (Hajj), including a number of health professionals who support them. The 2017 Hajj period runs from 30 August to 4 September.

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