Interim Infection Prevention and Control Recommendations for Hospitalized Patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV)
Standard, contact, and airborne precautions are recommended for management of hospitalized patients with known or suspected MERS-CoV infection, based on CDC's case definition for patient under investigation. Note that additional infection prevention precautions or considerations may be needed if a MERS-CoV patient has other conditions or illnesses that warrant specific measures (e.g., tuberculosis,Clostridium difficile, multi-drug resistant organisms).
Though these recommendations focus on the hospital setting, the recommendations for personal protective equipment (PPE), source control (i.e., placing a facemask on potentially infected patients when outside of an airborne infection isolation room), and environmental infection control measures are applicable to any healthcare setting.
In this guidance healthcare personnel (HCP) refers all persons, paid and unpaid, working in healthcare settings who have the potential for exposure to patients and/or to infectious materials, including body substances, contaminated medical supplies and equipment, contaminated environmental surfaces, or contaminated air. HCP include, but are not limited to, physicians, nurses, nursing assistants, therapists, technicians, emergency medical service personnel, dental personnel, pharmacists, laboratory personnel, autopsy personnel, students and trainees, contractual personnel, home healthcare personnel, and persons not directly involved in patient care (e.g., clerical, dietary, house-keeping, laundry, security, maintenance, billing, chaplains, and volunteers) but potentially exposed to infectious agents that can be transmitted to and from HCP and patients. This guidance is not intended to apply to persons outside of healthcare settings.
As information becomes available, these recommendations will be re-evaluated and updated as needed. These recommendations are based upon available information (as of May 14, 2014) and the following considerations:
- Suspected high rate of morbidity and mortality among infected patients
- Evidence of limited human-to-human transmission
- Poorly characterized clinical signs and symptoms
- Unknown modes of transmission of MERS-CoV
- Lack of a vaccine and chemoprophylaxis
Key Components of Standard, Contact, and Airborne Precautions Recommended for Prevention of MERS-CoV Transmission in U.S. Hospitals
For full details of these precautions, see 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Setting.
Aerosol Generating Procedure
Personal Protective Equipment (PPE) for Healthcare personnel (HCP)
Environmental Infection Control
Duration of Infection Control Precautions
Monitoring and Management of Potentially Exposed Personnel
Monitoring, Management, and Training of Visitors
To aid providers and facilities, CDC has developed two checklists that identify key actions that can be taken now to enhance preparedness for MERS-CoV infection control.
Interim Home Care and Isolation Guidance
CDC has developed interim guidance for local and state health departments, infection prevention and control professionals, healthcare providers, and healthcare workers who are coordinating the home care and isolation of ill people who are being evaluated for MERS-CoV infection.