When should patients be considered for testing for Middle East Respiratory Syndrome (MERS) by the Connecticut State Public Health Laboratory (SPHL)?

Testing for MERS-CoV by the SPHL requires approval by the Connecticut Department of Public Health (DPH) Epidemiology and Emerging Infections Program (EEIP). Approval for testing by the SPHL will be granted if the patient meets the Centers for Disease Control and Prevention’s (CDC) case definition of a MERS Patient Under Investigation (PUI). A patient is considered a PUI if they have both clinical features and an epidemiologic risk based on the following:   

1. A patient admitted with fever and pneumonia or acute respiratory distress syndrome (ARDS), or a fever and symptoms of respiratory illness like cough or shortness of breath but not necessarily pneumonia;   

AND

2. within the last 14 days:

1. had close contact with a confirmed MERS case while case was ill, OR;
2. was a patient, visitor or worker in a health care facility in or near the Arabian Peninsula where recent healthcare-associated cases of MERS were identified, OR;
3. traveled from countries in or near the Arabian Peninsula.

Healthcare providers with possible PUI should call the EEIP at 860-509-7994 on weekdays or 860-509-8000 after hours, weekends, and holidays as soon as possible to discuss the case with the Epidemiologist on-call. If testing is approved, the healthcare provider must complete the MERS PUI Case Investigation form as soon as possible and fax it to the EEIP at 860-509-7910.  

The following specimen types* should be collected and submitted to the SPHL via courier: 

1. Lower respiratory tract: bronchoalveolar lavage, tracheal aspirate, pleural fluid, or sputum;
2. Upper respiratory tract: nasopharyngeal swab (NP) and oropharyngeal swab (OP), or a NP wash/aspirate or nasal aspirate;
3. A serum specimen 

*For additional information about specimen type and priority visit the CDC ‘s Interim Guidance. 

Specimens should be submitted in a cold pack for travel via courier to the SPHL, accompanied by a completed Clinical Test Requisition form (OL-9B).   

FOR HOSPITALIZED PATIENTS: Standard, Contact, and Airborne Precautions must be followed, until the MERS-CoV test results are available.