It is unlikely but possible that a patient in primary care with respiratory
symptoms will have Middle East Respiratory Syndrome (MERS), so be
alert for the possibility of MERS in returned travellers.
Isolate
Infection control recommendations for suspected cases aim to provide the highest level of protection for
health care workers, given the current state of knowledge.
In patients with compatible symptoms and exposure history, GPs should follow standard and transmissionbased precautions (contact, droplet and airborne) for infection control, to minimise the risk of spread of
MERS. The recommendations include:
• Keep patient in a single room with the door closed
• Contact precautions, including careful attention to hand hygiene
• Encourage patient to use respiratory etiquette
• Ask patient to wear a mask
• Use personal protective equipment, including a P2 mask/respirator, gloves, and eye protection
• Single use equipment wherever possible
• Clean areas where the patient has been after they have left.
The Royal Australasian College of General practitioners (RACGP) provides infection control standards for
office-based practice, available from the RACGP website.
Inform
If transferring a patient to the emergency department, please ensure your phone call and letter of referral
includes details of relevant travel history, or known exposure to confirmed or probable cases, and include
details of any relevant treatments or investigations undertaken for the patient. Ensure the ambulance
personnel are informed so appropriate PPE can be used.
Please also remember to inform your local public health unit/communicable disease control unit about the
case urgently.
Testing for MERS
Do not collect clinical samples in a general practice setting. This is best done as part of a comprehensive
follow up plan and with ready access to appropriate PPE and reference laboratory facilities. Patients should
be referred to a hospital for investigation and management.
Reporting
Notify the relevant state and territory public health unit/communicable diseases units of any suspected (and
probable or confirmed) cases to discuss patient testing and/or referral and coordinate management of
contacts.
Confirmed and probable cases must be reported to state/territory public health authorities immediately on
being classified. State and territory authorities should notify the Commonwealth Department of Health and
Aged Care which is responsible for reporting to World Health Organization (WHO) (under International
Health Regulations 2005).