Preventing MERS-CoV from Spreading to Others in Homes and Communities

Preventing MERS-CoV from Spreading to Others in Homes and Communities
Updated Aug. 2, 2019
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The following interim guidance may help prevent Middle East Respiratory Syndrome Coronavirus (MERS-CoV) from spreading among people in homes and in communities. The interim guidance is based on what we currently know about other viral respiratory infections and MERS-CoV. CDC will update this interim guidance as additional information becomes available.

This interim guidance is for:

Prevention Steps for People Confirmed to Have, or Being Evaluated for, MERS-CoV Infection

If you are confirmed to have, or being evaluated for, MERS-CoV infection you should follow the prevention steps below until a healthcare provider or local or state health department says you can return to your normal activities.

Stay home
You should restrict activities outside your home, except for getting medical care. Do not go to work, school, or public areas, and do not use public transportation or taxis.

Separate yourself from other people in your home
As much as possible, you should stay in a different room from other people in your home. Also, you should use a separate bathroom, if available.

Call ahead before visiting your doctor
Before your medical appointment, call the healthcare provider and tell him or her that you have, or are being evaluated for, MERS-CoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected.

Wear a facemask
You should wear a facemask when you are in the same room with other people and when you visit a healthcare provider. If you cannot wear a facemask, the people who live with you should wear one while they are in the same room with you.

Cover your coughs and sneezes
Cover your mouth and nose with a tissue when you cough or sneeze, or you can cough or sneeze into your sleeve. Throw used tissues in a lined trash can, and immediately wash your hands with soap and water for at least 20 seconds.

Wash your hands
Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.

Avoid sharing household items
You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with other people in your home. After using these items, you should wash them thoroughly with soap and water.

Monitor your symptoms
Seek prompt medical attention if your illness is worsening (e.g., difficulty breathing). Before going to your medical appointment, call the healthcare provider and tell him or her that you have, or are being evaluated for, MERS-CoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department.

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Prevention Steps for Caregivers and Household Members

If you live with, or provide care at home for, a person confirmed to have, or being evaluated for, MERS-CoV infection, you should:

  • Make sure that you understand and can help the person follow the healthcare provider’s instructions for medication and care. You should help the person with basic needs in the home and provide support for getting groceries, prescriptions, and other personal needs.
  • Have only people in the home who are essential for providing care for the person.
    • Other household members should stay in another home or place of residence. If this is not possible, they should stay in another room, or be separated from the person as much as possible. Use a separate bathroom, if available.
    • Restrict visitors who do not have an essential need to be in the home.
    • Keep elderly people and those who have compromised immune systems or certain health conditions away from the person. This includes people with chronic heart, lung or kidney conditions, and diabetes.
  • Make sure that shared spaces in the home have good air flow, such as by an air conditioner or an opened window, weather permitting.
  • Wash your hands often and thoroughly with soap and water for at least 20 seconds. You can use an alcohol-based hand sanitizer if soap and water are not available and if your hands are not visibly dirty. Avoid touching your eyes, nose, and mouth with unwashed hands.
  • Wear a disposable facemask, gown, and gloves when you touch or have contact with the person’s blood, body fluids and/or secretions, such as sweat, saliva, sputum, nasal mucus, vomit, urine, or diarrhea.
    • Throw out disposable facemasks, gowns, and gloves after using them. Do not reuse.
    • Wash your hands immediately after removing your facemask, gown, and gloves.
  • Avoid sharing household items. You should not share dishes, drinking glasses, cups, eating utensils, towels, bedding, or other items with a person who is confirmed to have, or being evaluated for, MERS-CoV infection. After the person uses these items, you should wash them thoroughly (see below “Wash laundry thoroughly”).
  • Clean all “high-touch” surfaces, such as counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards, tablets, and bedside tables, every day. Also, clean any surfaces that may have blood, body fluids and/or secretions or excretions on them.
    • Read label of cleaning products and follow recommendations provided on product labels. Labels contain instructions for safe and effective use of the cleaning product including precautions you should take when applying the product, such as wearing gloves or aprons and making sure you have good ventilation during use of the product.
    • Use a diluted bleach solution or a household disinfectant with a label that says “EPA-approved.” To make a bleach solution at home, add 1 tablespoon of bleach to 1 quart (4 cups) of water. For a larger supply, add ¼ cup of bleach to 1 gallon (16 cups) of water.
  • Wash laundry thoroughly.
    • Immediately remove and wash clothes or bedding that have blood, body fluids and/or secretions or excretions on them.
    • Wear disposable gloves while handling soiled items. Wash your hands immediately after removing your gloves.
    • Read and follow directions on labels of laundry or clothing items and detergent. In general, wash and dry with the warmest temperatures recommended on the clothing label.
  • Place all used gloves, gowns, facemasks, and other contaminated items in a lined container before disposing them with other household waste. Wash your hands immediately after handling these items.
  • Monitor the person’s symptoms. If they are getting sicker, call his or her medical provider and tell him or her that the person has, or is being evaluated for, MERS-CoV infection. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask the healthcare provider to call the local or state health department.
  • Caregivers and household members who do not follow precautions when in close contact2 with a person who is confirmed to have, or being evaluated for, MERS-CoV infection, are considered “close contacts” and should monitor their health. Follow the prevention steps for close contacts below.

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Prevention Steps for Close Contacts

If you have had close contact2 with someone who is confirmed to have, or being evaluated for, MERS-CoV infection, you should:

  • Monitor your health starting from the day you were first exposed to the person and continue for 14 days after you were last exposed to the person. Watch for these signs and symptoms:
    • Fever3. Take your temperature twice a day.
    • Coughing.
    • Shortness of breath.
    • Other early symptoms to watch for are chills, body aches, sore throat, headache, diarrhea, nausea/vomiting, and runny nose.
  • If you develop symptoms, follow the prevention steps described above, and call your healthcare provider as soon as possible. Before going to your medical appointment, call the healthcare provider and tell him or her about your possible exposure to MERS-CoV. This will help the healthcare provider’s office take steps to keep other people from getting infected. Ask your healthcare provider to call the local or state health department.
  • If you do not have any symptoms, you can continue with your daily activities, such as going to work, school, or other public areas.

You are not considered to be at risk for MERS-CoV infection if you have not had close contact2 with someone who is confirmed to have, or being evaluated for, MERS-CoV infection. CDC advises that people follow prevention steps to help reduce their risk of getting infected with respiratory viruses, like MERS-CoV. For more information, see CDC’s MERS Prevention.

Footnotes

  1. For this guidance, a person being evaluated for MERS (considered a person under investigation) is someone with the with the following characteristics:
    1. Fever3 AND pneumonia or acute respiratory distress syndrome (based on clinical or radiologic evidence) AND EITHER:
      • history of travel from countries in or near the Arabian Peninsula4 within 14 days before symptom onset, OR
      • close contact2 with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula4, OR
      • a member of a cluster of patients with severe acute respiratory illness (e.g., fever3 and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated, in consultation with state and local health departments,

      OR

    2. Fever3 AND symptoms of respiratory illness (not necessarily pneumonia; e.g., cough, shortness of breath) AND being in a healthcare facility (as a patient, worker, or visitor) within 14 days before symptom onset in a country or territory in or near the Arabian Peninsula4 in which recent healthcare-associated cases of MERS have been identified.
      OR
    3. Fever3 OR symptoms of respiratory illness (not necessarily pneumonia; e.g. cough, shortness of breath) AND close contact2 with a confirmed MERS case while the case was ill.
  2. Close contact is defined as a) being within approximately 6 feet (2 meters), or within the room or care area, of a confirmed MERS case for a prolonged period of time (such as caring for, living with, visiting, or sharing a healthcare waiting area or room with, a confirmed MERS case) while not wearing recommended personal protective equipment or PPE (e.g., gowns, gloves, NIOSH-certified disposable N95 respirator, eye protection); or b) having direct contact with infectious secretions of a confirmed MERS case (e.g., being coughed on) while not wearing recommended personal protective equipment. See CDC’s Interim Infection Prevention and Control Recommendations for Hospitalized Patients with MERS. Data to inform the definition of close contact are limited; considerations when assessing close contact include the duration of exposure (e.g., longer exposure time likely increases exposure risk) and the clinical symptoms of the person with MERS (e.g., coughing likely increases exposure risk). Special consideration should be given to those exposed in healthcare settings. For detailed information regarding healthcare personnel (HCP) please review CDC Interim U.S. Guidance for Monitoring and Movement of Persons with Potential Middle East Respiratory Syndrome (MERS-CoV) Exposure. Transient interactions, such as walking by a person with MERS, are not thought to constitute an exposure; however, final determination should be made in consultation with public health authorities.
  3. Fever may not be present in some patients, such as those who are very young, elderly, immunosuppressed, or taking certain medications. Clinical judgement should be used to guide testing of patients in such situations.
  4. Countries considered in the Arabian Peninsula and neighboring include: Bahrain; Iraq; Iran; Israel, the West Bank and Gaza; Jordan; Kuwait; Lebanon; Oman; Qatar; Saudi Arabia; Syria; the United Arab Emirates (UAE); and Yemen.

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