Implementing Home Care and Isolation or Quarantine of People Not Requiring Hospitalization for MERS-CoV

This interim guidance is for staff at local and state health departments, infection prevention and control professionals, healthcare providers, and healthcare workers who are coordinating the home care and isolation¹ or quarantine² of people who are confirmed to have, or being evaluated for, MERS-CoV infection (see Case Definitions). The interim guidance is based on what is currently known about viral respiratory infections and MERS-CoV. CDC will update this interim guidance as needed.

People who are confirmed to have, or being evaluated for, MERS-CoV infection and do not require hospitalization for medical reasons may be cared for and isolated in a residential setting after a healthcare professional determines that the setting is suitable. Providers should contact their state or local health department to discuss home isolation, home quarantine, or other measures for close contacts and for patients who test positive for MERS-CoV, and to discuss criteria for discontinuing any such measures. See Interim U.S. Guidance for Monitoring and Movement of Persons with Potential MERS Exposure, and Interim Guidance for Health Professionals for more information.

Assess the Suitability of the Residential Setting for Home Care

In consultation with state or local health department staff, a healthcare professional should

• assess whether the residential setting is suitable and appropriate for home care;
• assess whether the patient is capable of adhering to precautions that will be recommended as part of home care or isolation (respiratory hygiene, hand hygiene, etc.); and
• contact their local or state health department to notify them that the residential setting has been determined to be suitable for home care and that hospital discharge is planned.

Provide Guidance for Precautions to Implement during Home Care

A healthcare professional should

• provide CDC’s interim guidance for Preventing MERS-CoV from Spreading to Others in Homes and Communities to the person confirmed to have, or being evaluated for, MERS-CoV infection, and to the caregiver and household members; and
• contact their state or local health department to discuss criteria for discontinuing any such measures.

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Footnotes

1. Isolation is defined as the separation or restriction of activities of an ill person with a contagious disease from those who are well.
2. Quarantine is defined as the separation or restriction of movement of well persons who might have been exposed to a communicable disease while determining if they become ill.

References

• Memish ZA, Zumla AI, Al-Hakeem RF et al. Family cluster of Middle East respiratory syndrome coronavirus infections. N Engl J Med, 2013, 368(26):2487-94.
• Mailles A, Blanckaert K, Chaud P et al. First cases of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections in France, investigations and implications for the prevention of human-to-human transmission, France, May 2013. Euro Surveill, 2013, 18(24).
• Hijawi B, Abdallat M, Sayaydeh A et al. Novel coronavirus infections in Jordan, April 2012: epidemiological findings from a retrospective investigation. Eastern Mediterranean Health Journal, 2013, 19(Supplement 1):S12-18.
• The Health Protection Agency (HPA) UK Novel Coronavirus Investigation Team. Evidence of person-to-person transmission within a family cluster of novel coronavirus infections, United Kingdom, February 2013. Euro Surveill, 2013, 18(11):20427.
• Guery B, Poissy J, el Mansouf L et al. Clinical features and viral diagnosis of two cases of infection with Middle East Respiratory Syndrome coronavirus: a report of nosocomial transmission. Lancet, 2013, 381(9885):2265-72.
• Assiri A, McGeer A, Perl TM et al. Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus. N Engl J Med, 2013, (Epub ahead of print).
• Omrani AS, Matin MA, Haddad Q et al. A family cluster of Middle East Respiratory Syndrome Coronavirus infections related to a likely unrecognized asymptomatic or mild case. International Journal of Infectious Diseases, (2013).
• World Health Organization. MERS-CoV summary and literature update – as of 09 July 2013. WHO, 2013.

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