Countries in Middle East, North Africa, and West Asia report COVID-19 cases, some with local disease transmission. Use basic precautions.

Severity: Informational Alert

The locations affected by this alert are:

  • Afghanistan
  • Pakistan
  • Algeria
  • Bahrain
  • Egypt
  • Iran
  • Iraq
  • Israel
  • Kuwait
  • Lebanon
  • Oman
  • United Arab Emirates
  • Saudi Arabia

This alert began 03 Mar 2020 07:23 GMT and is scheduled to expire 04 May 2020 23:59 GMT.

  • Event: Imported cases of coronavirus disease (COVID-19), limited local transmission
  • Location(s): Middle East, North Africa, West Asia (map)
  • Date: February - March 2020

Summary
Several countries in the Middle East and North Africa region and West Asia have identified imported cases of coronavirus disease (COVID-19) and, in some instances, local human-to-human transmission from those imported cases. As of March 3, the following countries have identified confirmed COVID-19 cases:

  • Afghanistan: Single imported case. No local transmission.
  • Algeria: Three imported cases; location details not yet published. No local transmission.
  • Bahrain: 49 imported cases. No local transmission.
  • Egypt: Two imported cases in Cairo. No local transmission.
  • Iran: 1,501 cases reported nationwide, including Qom, Tehran, Babol, Arak, Isfahan, and Rasht. Additional cities are likely. Most cases are residents of Qom or persons with recent travel to that city. The US CDC maintains an "Alert-Level 3" travel health notice due to local transmission of COVID-19 in Iran. This is the highest warning level and indicates authorities recommend avoiding non-essential travel. Older adults and those with chronic medical conditions are at increased risk of developing severe complications.
  • Iraq: 21 imported cases. No local transmission.
  • Israel: 12 imported cases. No local transmission.
  • Jordan: Single imported case. No local transmission.
  • Kuwait: 56 imported cases. No local transmission.
  • Lebanon: 13 imported cases. No local transmission.
  • Morocco: Single imported case; location details not yet published. No local transmission.
  • Oman: Six imported cases. No local transmission.
  • Pakistan: Five imported cases. Islamabad, Karachi, and Gilgit Baltistan are reporting cases. No local transmission.
  • Saudi Arabia: Single imported case; location details not yet published. No local transmission.
  • Tunisia: Single imported case; location details not yet published. No local transmission.
  • United Arab Emirates: Total of 21 cases reported nationwide. Limited local transmission.



Background and Analysis
Health authorities expect imported cases of this disease as disease surveillance continues globally. Older individuals, infants, and those with chronic illness are more susceptible to infection and are at increased risk for severe complications. Human-to-human transmission is occurring, though it remains unclear how easily the virus spreads between people. Preliminary investigations indicate the course of illness is not as severe as seasonal influenza, nor as contagious.

Coronavirus disease 2019 (COVID-19) is a viral respiratory disease caused by infection with the SARS-CoV-2 virus (previously known as 2019-nCoV). Symptoms occur 1-14 days following exposure (average of 3-7 days). These symptoms include fever, fatigue, cough, difficulty breathing, sometimes worsening to pneumonia and kidney failure - especially in those with underlying medical conditions.

Advice
Emphasize basic health precautions, especially frequent handwashing with soap and water, or an alcohol-based hand sanitizer if soap and water are unavailable. Practice good coughing/sneezing etiquette (i.e., covering coughs and sneezes with a disposable tissue, maintaining distance from others, and washing hands). There is no evidence that the influenza vaccine, antibiotics, or antiviral medications will prevent this disease, highlighting the importance of diligent basic health precautions.

Resources
WHO advice for international travel

WHO coronavirus knowledge base

US CDC Travel Health Notice for Iran

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