Two cases of Middle East respiratory syndrome (MERS) in travellers returning to France from the Arabian Peninsula

French authorities are implementing response measures and monitoring the situation. (More information from the French Ministry of Health)

European public health authorities should continue surveillance of acute respiratory infections and maintain preparedness for potential travel-related MERS cases entering the EU/EEA. Information about the recent cases, case definitions and diagnostic approaches should be shared with clinicians to maintain increased awareness for early identification, isolation and diagnosis of possible MERS cases. Adherence to strict infection control protocols during contact with patients that may have a Middle East respiratory syndrome coronavirus (MERS-CoV) infection – including hand hygiene and respiratory measures – is critical to prevent further spread of the virus in healthcare settings.

Countries should also advise travellers returning from areas where MERS-CoV may be circulating to seek medical attention if they develop a respiratory illness with fever and cough or diarrhoea during the two weeks following their return and to disclose their recent travel history to their healthcare provider. Travellers to the Arabian Peninsula are also advised to avoid contact with dromedary camels and consumption of camel products. When visiting markets or places where dromedary camels are present, strict hygiene measures should be followed. These include hand hygiene before and after touching animals and avoiding any contact with sick animals. Further information can be found in the World Health Organization’s MERS-CoV factsheet.

Although sporadic MERS cases in travellers returning to the EU/EEA can be expected, the probability of sustained human-to-human transmission among the general population in Europe remains very low and the impact of the disease in the general population is considered low. The current MERS situation poses a low risk to the EU/EEA, and recommendations from the Rapid Risk Assessment published by ECDC on 29 August 2018 still apply.

ECDC published a technical report, ‘Health emergency preparedness for imported cases of high-consequence infectious diseases’, in October 2019 that is still useful for EU/EEA countries wishing to assess their level of preparedness for a disease such as MERS. ECDC also published ‘Risk assessment guidelines for infectious diseases transmitted on aircraft (RAGIDA) – Middle East respiratory syndrome coronavirus (MERS-CoV)’ on 22 January 2020.

MERS-CoV is a zoonotic virus transmitted mostly from infected dromedary camels and via consumption of raw or undercooked camel products, including milk. Human-to-human transmission is possible, with documented events occurring mostly in hospital settings. Since April 2012, and as of 1 December 2025, a total of 2 640 cases of MERS, including 958 deaths, have been reported by health authorities worldwide. The majority of these have been reported in the Middle East. Excluding these two recent cases, the latest imported case in Europe occurred in 2018.