Middle East respiratory syndrome coronavirus infection diagnostic criteria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Healthcare providers should be prepared to detect persons at risk for Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection; this requires clinical judgment as information on modes of transmission of MERS-CoV and clinical presentation of MERS is limited and continues to evolve. Patients can be categorized as suspected, probable and confirmed case of MERS-CoV infection.
Diagnostic Criteria for MERS-CoV Infection
Suspected Case
For a patient to be categorized as a suspected case or patient under investigation (PUI) it should meet the following criteria, either A or B:
A. Fever (≥38°C, 100.4°F) and pneumonia or acute respiratory distress syndrome (based on clinical or radiological evidence)
- AND EITHER
- History of travel from countries in or near the Arabian Peninsula within 14 days before symptom onset
- OR
- Close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula
- OR
- Member of a cluster of patients with severe acute respiratory illness (e.g.fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments
OR B. Fever (≥38°C, 100.4°F)
- AND
- Symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath)
- AND
- Being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula in which recent healthcare-associated cases of MERS have been identified
Probable Case
According to the CDC, it is considered a probable case of MERS-CoV infection, an individual under investigation who has missing or inconclusive laboratory test results for the infection and that has been in close contact with another individual who is a "laboratory-confirmed case" of MERS-CoV infection.[1]
Confirmed Case
According to the CDC, a confirmed case of MERS-CoV infection is considered an individual who shows laboratory confirmation of infection by MERS-CoV.[1]