CDC Issues New MERS Infection Control Guidelines for U.S. Facilities

June 12th, 2015

With an ongoing outbreak in Korea and a substantial increase in the number of MERS cases reported worldwide since last spring, the Centers for Disease Control and Prevention has issued updated infection control guidelines on the coronavirus for U.S. health care facilities.

“This updated guidance continues to recommend standard, contact, and airborne precautions,” the CDC states. “In addition, it emphasizes additional elements of infection prevention and control programs that should be in place to prevent the transmission of any infectious agents including respiratory pathogens such as MERS in healthcare settings.”

The level of precautions is driven by three factors regarding MERS:

• Current lack of a safe and effective vaccine and chemoprophylaxis

• A possible high rate of morbidity and mortality among infected patients

• Incompletely defined modes of transmission of MERS

Given that troubling trifecta, the guideline underscore the need to rapidly identify suspect cases, having them don a mask, and separating them if possible from patients in common areas. The CDC recommendations include the following:

Upon Arrival and During the Visit

• Take steps to ensure all persons with symptoms of a respiratory infection adhere to respiratory hygiene and cough etiquette, hand hygiene, and triage procedures throughout the duration of the visit. Consider posting visual alerts (e.g., signs, posters) at the entrance and in strategic places (e.g., waiting areas, elevators, cafeterias) to provide patients and HCP with instructions (in appropriate languages) about hand hygiene, respiratory hygiene, and cough etiquette. Instructions should include how to use facemasks or tissues to cover nose and mouth when coughing or sneezing, to dispose of tissues and contaminated items in waste receptacles, and how and when to perform hand hygiene.

• Provide space and encourage persons with symptoms of respiratory infections to sit as far away from others as possible. If available, facilities may wish to place these patients in a separate area while waiting for care.

• Ensure rapid triage and isolation of patients who might have MERS infection

• Identify patients at risk for having MERS infection before or immediately upon arrival to the hospital

• Implement triage procedures to detect patients at risk for having MERS infections during or before patient triage or registration (e.g., at the time of patient check-in) and ensure that all patients are asked about the presence of symptoms of a respiratory infection and history of travel to areas experiencing transmission of MERS or contact with possible MERS patients.

• Immediately isolate those identified as at risk for having MERS infection

• Implement Respiratory Hygiene and Cough Etiquette (i.e., placing a facemask over the patient's nose and mouth) and isolate those at risk for MERS infection in an Airborne Infection Isolation Room.

• Provide supplies to perform hand hygiene to all patients upon arrival to facility (e.g., at entrances of facility, waiting rooms, at patient check-in) and throughout the entire duration of the visit to the healthcare setting.

For more on this unfolding story see the July 2015 issue of Hospital Infection Control & Prevention