On May 17, 2014, the U.S. Centers for Disease Control and Prevention (US CDC) announced they had identified evidence of apparent past Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection in a man who had close contact with the first imported case of MERS-CoV in the United States during the follow-up investigation of the imported case. It is US's first known secondary infection. He had close contact with the first imported MERS-CoV case. He has no recent travel history outside the U.S.. He experienced only mild cold-like symptoms and did not seek medical attention. His blood tests showed the presence of antibodies to the MERS virus. The case is said to be feeling well and has been on home isolation. As part of the follow-up investigation, the local health department is identifying, notifying, testing and monitoring close contacts of the first secondary infection in the nation. Thus far, secondary infections have been detected in the United Kingdom, France, and Tunisia. As there is currently no evidence that supports sustained human-to-human transmission of MERS-CoV, US CDC’s recommendations to the public, travelers, and healthcare providers have not changed. Taiwan CDC will continue to closely monitor the development of the MERS outbreak. The public is urged to pay attention to personal hygiene and physicians are advised to stay vigilant.

According to the global MERS count announced by the World Health Organization (WHO), MERS-CoV cases continue to occur in the Middle East and cases reported in other countries are also linked to the region. As of now, more than 20 countries have reported the occurrence of MERS-CoV cases and most cases occurred in the Middle East. As of May 15, there have been 572 confirmed cases of MERS-CoV, including 173 deaths. Travelers planning to visit the Middle East are advised to avoid all direct contacts with camels, avoid consuming camel meat and milk, and pay attention to personal hygiene and respiratory protection. Physicians are urged to stay vigilant and reinforce the reporting of suspected cases. Currently, Taiwan CDC has issued a travel notice of Level 2: Alert for MERS-CoV to Saudi Arabia and the United Arab Emirates (UAE) and a travel notice of Level 1: Watch for MERS-CoV to Jordan, Kuwait, Oman, Qatar, and Yemen. Since September, 2012, a total of 7 suspected MERS-CoV cases have been reported to Taiwan CDC. The possibility of MERS-CoV infection has been ruled out in all of them. To expand surveillance for MERS-CoV, 672 specimens have been collected from 378 pneumonia cases of unknown etiology for laboratory testing and none were tested positive for MERS-CoV.

Taiwan CDC advises travelers planning to visit countries in the Middle East to visit the outpatient travel medicine clinic prior to their trip to obtain any medical advice they need. Throughout the trip, travelers are urged to pay attention to personal hygiene, respiratory protection and hand cleanliness and avoid visiting any farms and all direct contact with camels, including drinking un-pasteurized camel milk, to reduce the risk of infection. If you have experienced symptoms such as fever, cough or influenza-like illness, and diarrhea upon your arrival in Taiwan, please notify the quarantine officer at the quarantine station at airports/harbors immediately and put on a surgical mask and seek immediate medical attention and inform your physician of any recent travel and exposure history. Taiwan CDC urges physicians to stay vigilant and reinforce the reporting of suspected cases to ensure prompt treatment and subsequent implementation of the relevant prevention and control measures.

For more information, please visit the Taiwan CDC website at http://www.cdc.gov.tw or call the toll-free Communicable Disease Reporting and Care Hotline, 1922 (or 0800-001922).