Risk assessment: Severe respiratory disease associated with a novel coronavirus, 26 September 2012

Risk assessment

Following the identification of a novel coronavirus in two patients, both having been in Saudi Arabia albeit three months apart, ECDC has prepared a rapid risk assessment to consider the risk to the public in the EU.

Executive summary

No additional cases have been confirmed at this point and there is no evidence of person-to-person transmission of this novel coronavirus to date. An infection transmitted by contact with animals cannot be ruled out at this stage.

ECDC is working with the UK Health Protection Agency (HPA) and the World Health Organisation (WHO) to develop an appropriate definition to be used by national public health authorities for investigating patients and identifying possible and confirmed cases. An interim case definition has been agreed and is under ongoing review.

Preliminary molecular tests show that the viruses identified in the two confirmed cases are very closely related. Further investigations are needed to better understand the epidemiology of this novel coronavirus and refine ECDC’s assessment of the public health implications. This requires coordinated international surveillance and laboratory testing. The value of laboratories has been demonstrated by the excellent work done by the HPA laboratories in the UK and the Erasmus University Medical Centre in Rotterdam, the Netherlands.

Until more information becomes available, all cases should be managed strictly according to national infection control guidelines for respiratory viruses. ECDC recommends the HPA infection control advice for suspected or confirmed novel coronavirus case or the WHO interim guidelines on infection prevention and control of acute respiratory diseases in health care (WHO/CDS/EPR/2007.6) in the absence of appropriate national guidelines.

Based on the available information, ECDC assesses the current risk as low. Information for visitors to The Kingdom of Saudi Arabia for the pilgrimage to Mecca (Hajj) can be found through WHO website and The Kingdom of Saudi Arabia website.


Event background

The first case associated with this novel coronavirus is a 60 year old patient in Jeddah, Saudi Arabia. He was admitted to hospital on 13 June with severe pneumonia seven days after having developed symptoms. He later developed acute renal failure and died on 24 June 2012.

The second case was reported on Saturday 22 September, by the Health Protection Agency (HPA), UK. The patient is a 49 year old from Qatar with no underlying health conditions who had travelled to Saudi Arabia prior to onset of disease. He developed respiratory symptoms on 3 September, and was admitted to an intensive care unit in Doha, Qatar, on 7 September, where he subsequently developed renal failure. He was transferred by air ambulance to a hospital in the UK on 11 September.