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Ministry Status: Routine Monitoring and Engagement

Middle East Respiratory Syndrome Coronavirus (MERS-CoV)

Frequently Asked Questions

Last reviewed June 8, 2015
Last updated November 14, 2013

The World Health Organization (WHO) has developed Frequently Asked Questions (FAQs) on the Middle East Respiratory Syndrome Coronavirus MERS-CoV.

The Ministry of Health and Long-Term Care (ministry) has developed additional FAQs on this situation as it relates to the people of Ontario. The ministry has also developed general information on MERS-CoV and Guidance for Health Workers and Health Sector Employers.

What is the latest update on the MERS-CoV situation?

The MERS-CoV situation continues to evolve, as new human cases are being reported. For the most up to date information on the MERS-CoV situation, visit the WHO's website.

What is the risk of MERS-CoV to the people of Ontario?

There have been no reports of human illness in Canada associated with MERS-CoV. The public health risk to Canada is considered low at this time.

Has anyone in Ontario or Canada been infected with MERS-CoV?

To date there are no reports of anyone in Ontario or Canada being infected with MERS-CoV.

What is MERS-CoV?

Coronaviruses are a large family of viruses that may cause a range of illnesses in humans from the common cold to Severe Acute Respiratory Syndrome (SARS). Viruses of this family also cause a number of animal diseases.

A Middle East Respiratory Syndrome Coronavirus is a new coronavirus that has not been seen in humans before. This particular coronavirus is rare but can cause serious illness.

What are the symptoms associated with MERS-CoV?

In confirmed cases of illness in humans, common symptoms have been acute, serious respiratory illness with fever, cough, shortness of breath, and breathing difficulties. Based on current clinical experience, the infection generally presents as pneumonia. It has caused kidney failure and death in some cases. It is important to note that the current understanding of the illness caused by this infection is based on a limited number of cases and may change as more information becomes available.

Is MERS-CoV the same as the SARS virus?

No. MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, both the SARS virus and the MERS-CoV are the same type of viruses (coronaviruses) and are both similar to coronaviruses found in bats.

What is the Ministry of Health and Long-Term Care doing about MERS-CoV? Has the ministry alerted health workers and health sector employers to the MERS-CoV situation?

The ministry is working with the Public Health Agency of Canada, Public Health Ontario and the Ministry of Labour to gather and analyze information on this situation and to prepare for the possibility of cases in Ontario.

The ministry has provided guidance to health workers and health sector employers on what to be on MERS-CoV in addition to laboratory testing and reporting recommendations and appropriate occupational health & safety and infection prevention & control measures. The guidance can be found at www.ontario.ca/novelcoronavirus. The ministry will continue to share information with its health system partners and the public as it becomes available and continue to take appropriate actions as necessary.

What should health care providers do if they suspect a case?

The ministry has provided health care providers with guidance on what to do if they suspect one of their patients has novel coronavirus, including laboratory testing and reporting recommendations as well as appropriate occupational health & safety and infection prevention & control measures. The guidance can be found at www.ontario/novelcoronavirus.

Can MERS-CoV be detected by laboratory tests in Ontario?

Yes. The Public Health Ontario Laboratories have the capability to detect this MERS-CoV.

What is the recommended treatment for cases?

At this time, there is no specific treatment targeting the virus. However, many of the symptoms caused by this virus can be treated and therefore treatment should be based on the symptoms of the patient. As part of its guidance on MERS-CoV, the ministry is recommending that health care providers refer to guidance from the WHO and Public Health England for more information about treatment approaches.

What should health providers tell patients who are awaiting test results for MERS-CoV and are not hospitalized?

Health providers should advise their patients to take the same steps as they would for other respiratory illnesses such as :

  • Stay home (self-isolate) until symptoms are improved, and get plenty of rest.
  • Limit contact with caregivers or visitors. Caregivers and others in the household should clean their hands frequently.
  • Clean your hands frequently with soap and water or an alcohol-based hand sanitizer, particularly after coughing or blowing your nose.
  • Practice good respiratory etiquette by covering your mouth and nose when you cough or sneeze and throw the tissue away. Throw the tissue away in a waste bin. Wash your hands with soap and water or an alcohol-based hand sanitizer after disposing of the used tissue.
  • Don't share drinks, eating utensils, toothbrushes, cigarettes, towels, washcloths or bed linen with others.

Health providers should use their judgement to assess if additional prevention messages are needed given their patient's health status and personal circumstance.

Who should call a patient back to advise them of their MERS-CoV test results?

The health care provider who ordered the MERS-CoV test should contact the patient with test results. If health care providers have questions or concerns, they can contact the Ministry of Health and Long-Term Care's Health Care Provider Hotline at: 1-866-212-2272. If health care providers have questions related to laboratory tests they can contact Public Health Ontario Laboratory's Customer Service Centre at 416-235-6556/ 1-877-604-4567.

What happens if a Person Under Investigation (PUI) is identified on an airplane?

The Public Health Agency of Canada's Office of Border Health Services will be involved in the reporting and case management of arriving or departing international passengers who may be a PUI.

Is the Ministry of Health and Long-Term Care recommending that health workers take any special precautions to protect themselves against MERS-CoV?

The ministry has provided health workers and health sector employers with guidance on occupational health & safety and infection prevention & control measures for MERS-CoV. This guidance can be found at www.ontario.ca/novelcoronavirus. As part of this guidance, the ministry is recommending that health workers use Routine Practices and Contact, Droplet and Airborne Precautions by health workers at risk of exposure to a person under investigation, probable case or confirmed case and/or the patient's environment. These precautions include :

  • use of airborne infection isolation rooms when possible;
  • masking the patient with a surgical mask when outside of an airborne infection isolation room;
  • use of gloves, gowns and fit-tested, seal-checked N95 respirators and eye protection by health workers when entering the same room as, transporting, or caring for the patient.

The use of Routine Practices and Contact, Droplet and Airborne Precautions is a higher level of precaution than is being recommended by PHAC or the WHO, or that is normally recommended for coronavirus. The ministry is recommending airborne precautions based on its application of the precautionary principle to this novel virus for which little information about transmission and clinical severity is available.

Who is responsible for providing health workers with personal protective equipment?

Health sector employers are required, under the Occupational Health and Safety Act, to ensure that workers are provided with personal protective equipment (PPE) to protect them from workplace hazards, including the MERS-CoV. Employers must ensure PPE that is to be provided, worn or used is properly used and maintained, is a proper fit, is inspected for damage or deterioration and is stored in a convenient, clean and sanitary location when not in use.

Are health workers required to use personal protective equipment?

Workers must use PPE required by the employer. A worker who is required by his or her employer or by O. Reg. 67/93 to wear or use any protective clothing, equipment or device is required to be instructed and trained in its care, use and limitations before wearing or using it for the first time, and at regular intervals thereafter. Workers are required to participate in such instruction and training provided by the employer. Employers covered by the O. Reg. 67/93 are required to, in consultation with the Joint Health and Safety Committee (or Health and Safety Representative, if any), develop, establish and put into effect written measures and procedures regarding the use, wearing and care of PPE and its limitations.

What should health workers do if they are concerned they may have had unprotected exposure to a person under investigation (PUI) for MERS-CoV as part of their work duties?

Health workers may continue regular activities, and may wish to contact the Occupational Health and Infection Prevention & Control professionals in their workplace or their employer if they are concerned about unprotected exposure to a PUI for MERS-CoV. If they develop symptoms related to acute respiratory illness, they should follow relevant workplace policies and procedures. If the PUI becomes a confirmed or probable case, the Occupational Health and Infection Prevention & Control professionals will conduct a risk assessment to determine the appropriate next steps.

Workplace parties should review the exposure incident for gaps and opportunities for improvement in occupational health and infection prevention & control practices.

What should health workers do if they are concerned that they may have had unprotected exposure to a confirmed or probable case of MERS-CoV as part of their work duties?

Health workers should contact the Occupational Health and Infection Prevention & Control professionals in their workplace or their employer if they are concerned about unprotected exposure to a confirmed or probable case of MERS-CoV. For the safety of health workers, the ministry is encouraging Occupational Health and Infection Prevention & Control professionals and employers to exercise caution and to appropriately follow up.

Health workers who have been exposed to a case as part of their work duties in the last 14 days and develop symptoms of acute respiratory infection should not come to work. They should report their health status to the Occupational Health and Infection Prevention & Control professionals in their workplace or their employer.

Workplace parties should review the exposure incident for gaps and opportunities for improvement in occupational health and infection prevention & control practices.

Is it safe to travel to the Arabian Peninsula?

PHAC has posted a Travel Health Notice for Canadians planning travel. The notice provides general suggestions for how individuals can reduce their risk of being exposed to MERS-CoV, such as practicing hand hygiene and cough etiquette.

Further information MERS-CoV on this website

This information does not relieve employers from their legislated obligations.

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