Guidelines for Handling and Processing Specimens Associated with Middle East Respiratory Syndrome Coronavirus (MERS- CoV) — Version 2. It is important for healthcare professionals working with


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MERS patients to inform laboratory professionals when such an infectious disease is suspected. While MERS testing may not have yet occurred, routine testing, such as CBC and chem- istries, may have been sent to the lab. Medical laboratories must follow the safety guidelines for these samples as outlined in the CDC’s Biosafety in Microbiological and Biomedical Laboratories (BMBL), 5th Edition. Healthcare professionals seeking information concerning MERS-


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CoV specimen testing, handling and shipping should contact the CDC’s Emergency Operations Center at 770-488-7100.


Treatment There are no specific drug treatments for MERS, and severe MERS- CoV is associated with poor overall survival. Therapy is supportive and based on the patient’s clinical condition. Some patients have required ECMO and mechanical ventilation. Ribavirin (Virazole, Rebetol, Copegus), interferon, protease inhibitors, immunoglobu- lin, corticosteroids, and cyclosporine (Gengraf, Neoral) are under investigation as potential treatments.21 In February 2016, a Phase 1 clinical trial was initiated on


humans for a MERS-CoV vaccine at the Walter Reed Army Institute of Research.25


Prevention The outbreak of MERS infections in South Korea demonstrates the importance of early identification, isolation and infection control in healthcare settings. In South Korea, only one infected person led to an outbreak among household and hospital contacts that eventually numbered 185 confirmed MERS cases and 36 deaths. In December 2015, the CDC issued interim infection preven-


tion recommendations for hospitalized patients with MERS-CoV in the U.S.23 The following is a brief condensation of the guideline; for the


complete guideline, see the Interim Infection Prevention and Control Recommendations for Hospitalized Patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV).


Guidelines


1. Minimize Chance for Exposures Ensure rapid triage and isolation of patients who might have MERS-CoV infection. • Identify patients at risk for MERS infection before or im- mediately upon arrival to the hospital; immediately isolate those patients


• Place a facemask over the patient’s nose and mouth and isolate those at risk for MERS-CoV infection in an airborne infection isolation room


• Provide supplies for hand hygiene to all patients upon arrival to facility


2. Ensure Adherence to Standard, Contact and Airborne Precautions


Since early symptoms of MERS-CoV are similar to other viral pneumonias, healthcare workers should use standard precautions with all patients, regardless of diagnosis.


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