Screening

Contact screening

Contact screening identified secondary infection in only 4% of 280 close family contacts and 2% of 5065 healthcare facility contacts.[115][116]

People who may have been exposed to the virus are advised to monitor their health for 14 days from the last day of possible contact and seek medical attention if they develop symptoms, especially fever, cough, or dyspnoea. Isolation or quarantine is not currently warranted.

With an effective reproductive number of less than one, the epidemic potential of the infection is considered low at present unless the virus mutates. Although there has been considerable concern over the potential global spread of infection during the annual Hajj pilgrimage to Mecca, where millions of pilgrims from many countries travel to Saudi Arabia, surveillance studies have not identified infection in pilgrims while in Saudi Arabia or after returning home.[117][118][119][120][121][122]

Asymptomatic patients who test positive

Patients may be asymptomatic but test positive for infection on real-time reverse transcription polymerase chain reaction (RT-PCR) as part of active case monitoring or contact investigations. These patients may go on to develop symptoms during the course of the infection. The potential for transmission from these patients is unknown, and until more is known, patients should be isolated (hospital or home), followed up daily to see whether symptoms have developed, and tested at least weekly. The choice of isolation location depends on numerous factors including hospital bed capacity, the hospital's ability to monitor patients at home, conditions of the household and its occupants, and patient risk factors for developing severe infection. Isolation should continue until 2 consecutive upper respiratory tract specimens taken at least 24 hours apart test negative on RT-PCR. Further specific guidance for managing the patient in each location is available from the World Health Organization (WHO).[123]

Surveillance

The aims of surveillance are to detect early, sustained human-to-human transmission and determine the geographic risk area for infection. The WHO has produced detailed guidance on surveillance for human infection with Middle East respiratory syndrome coronavirus (MERS-CoV) infection:

World Health Organization (WHO): surveillance for human infection with Middle East respiratory syndrome coronavirus (MERS-CoV) external link opens in a new window

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