How to investigate the first few X cases and contacts of human infection with Middle East respiratory syndrome coronavirus: protocol, tools and implementation guidance

Overview

Middle East respiratory syndrome coronavirus (MERS-CoV) is considered an emerging zoonotic virus with dromedary camels serving as the animal reservoir. The emergence of a new virus means that we have a limited understanding of transmission patterns, severity, clinical features and risk factors for infection. To address these unknowns, the World Health Organization (WHO) has provided several MERS-CoV investigation protocols. This protocol describes a prospective case-ascertained study of all identified close contacts of laboratory confirmed or probable MERS-CoV infections. This study would ideally be implemented within the first few days that a MERS case is reported in a specific region. It will accomplish many objectives including, but not limited to: identifying further MERS cases, reducing onward transmission (and morbidity and mortality), determining key characteristics of MERS (e.g. transmissibility, severity), and determining the geographic area of the MERS-CoV outbreak.

Within this protocol there are detailed study procedures (e.g. recruitment, follow-up, laboratory), other study-specific guidance (e.g. ethical considerations, statistical analysis), and “Implementation tip” boxes which include further helpful details and/or considerations for adaptation of the protocol for the local context.