On September 24, 2012, the Taiwan Centers for Disease Control (Taiwan CDC) received a notification from the World Health Organization (WHO) concerning two confirmed cases of novel coronavirus infection with travel history to the Kingdom of Saudi Arabia (KSA) and Qatar. One of the cases has since died. Both patients have acute respiratory syndrome associated with renal failure and require treatment at an intensive care unit (ICU). As of now, none of the contacts, including healthcare workers, has shown signs of illness. 

Of the two confirmed cases, one is a 49-year-old Qatari male who traveled to KSA prior to his disease onset. Four days after he developed symptoms, he was admitted to an ICU in Qatar. Later, he was transferred to the UK from Qatar for further treatment. Laboratory testing confirmed coronavirus infection in the case. The other confirmed case was a 60-year-old Saudi Arabian male who has died. A virus isolate was obtained from the lung tissue of the fatal case. Sequencing of the viruses from the two cases are genetically the same, with one nucleotide mismatch over the regions compared. According to the preliminary investigations conducted by WHO, the UK Health Protection Agency (HPA), and the health departments in KSA and Qatar, no evidence has suggested the two cases are linked. Hence, WHO has not recommended any travel restrictions.

Coronaviruses are a group of viruses that commonly cause respiratory infections in humans and animals. The incubation period is usually 7 days. In light of the severity of the illness presented in both cases, physicians are urged to increase vigilance for this virus, especially when diagnosing suspected patients that present acute respiratory infections of unknown causes and acute renal failure and have recently traveled to KSA or Qatar. Such patients should be treated in negative pressure isolation wards. Contacts of suspected patients, including healthcare workers, should monitor their health accordingly and watch for signs of respiratory symptoms such as fever and coughing for 7 days beginning on the first day of contact.

Taiwan CDC urges travelers who wish to visit the Middle East such as KSA and Qatar to increase vigilance for the virus and pay attention to personal hygiene and hand cleanliness at all times. Further, travelers are also advised to avoid visiting crowded places or places with poor ventilation. In addition, anyone who has recently traveled to KSA or Qatar and developed symptoms of respiratory infections or fever should don a surgical mask, and seek medical attention immediately and inform the doctor of the recent travel history. On the other hand, when a physician discovers acute pneumonia of unknown cause in a patient who has visited the Middle East 7 days prior to disease onset should report the case to the health authority as soon as possible and reinforce implementation of nosocomial infection control measures according to established guidelines. For more information, please call the toll-free Communicable Disease Reporting and Consultation Hotline 1922, or visit the Taiwan CDC’s website at http://www.cdc.gov.tw.