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Int J Infect Dis. 2016 Jun;47:10-4. doi: 10.1016/j.ijid.2016.04.016. Epub 2016 Apr 23.

Active screening and surveillance in the United Kingdom for Middle East respiratory syndrome coronavirus in returning travellers and pilgrims from the Middle East: a prospective descriptive study for the period 2013-2015.

Author information

1
Public Health England Birmingham Laboratory, National Infection Service, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK. Electronic address: Sowsan.Atabani@phe.gov.uk.
2
Public Health England Birmingham Laboratory, National Infection Service, Heart of England NHS Foundation Trust, Birmingham B9 5SS, UK.
3
Department of Virology, University College London Hospitals NHS Foundation Trust, London, UK.
4
Aarhus University, Aarhus, Denmark; The Royal Hospital, Muscat, Oman.
5
Division of Infection and Immunity, University College London, London, and UK National Institute for Health Research Biomedical Research Centre, UCL Hospitals National Health Service Foundation Trust, London, UK.

Abstract

BACKGROUND:

Over 25000 pilgrims from the UK visit Saudi Arabia every year for the Umrah and Hajj pilgrimages. The recent outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) in South Korea and the continuing reports of MERS-CoV cases from Saudi Arabia highlight the need for active surveillance for MERS-CoV in returning pilgrims or travellers from the Middle East. Public Health England Birmingham Laboratory (PHEBL) is one of a few selected UK public health laboratories responsible for MERS-CoV screening in travellers returning to the UK from the Middle East who present to hospital with severe respiratory symptoms. The results of the PHEBL MERS-CoV screening and surveillance over the past 3 years is presented.

METHODS:

UK travellers/pilgrims who returned from the Middle East and presented to a hospital with respiratory symptoms were studied over the period February 1, 2013 to December 31, 2015. Patients with respiratory symptoms, who satisfied the Public Health England MERS-CoV case algorithm, were tested for MERS-CoV and other respiratory tract viruses on admission to hospital.

RESULTS:

Two hundred and two patients suspected of having MERS-CoV were tested. None of them had a laboratory-confirmed MERS-CoV infection. A viral aetiology was detected in half (50.3%) of the cases, with rhinoviruses, influenza A (H1N1 and H3N2), and influenza B being most frequent. Peak testing occurred following the annual Hajj season and in other periods of raised national awareness.

CONCLUSIONS:

Respiratory tract infections in travellers/pilgrims returning to the UK from the Middle East are mainly due to rhinoviruses, influenza A, and influenza B. Whilst MERS-CoV was not detected in the 202 patients studied, heightened awareness of the possibility of MERS-CoV and continuous proactive surveillance are essential to rapidly identify cases of MERS-CoV and other seasonal respiratory tract viruses such as avian influenza, in patients presenting to hospital. Early identification and isolation may prevent outbreaks in nosocomial settings.

KEYWORDS:

Mass gatherings; Middle East respiratory syndrome coronavirus (MERS-CoV); Pilgrimage; Respiratory viruses; Surveillance

PMID:
27117200
DOI:
10.1016/j.ijid.2016.04.016
[Indexed for MEDLINE]
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