Severity: Warning Alert

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

The locations affected by this alert are:

  • Turkey
  • Afghanistan
  • Pakistan
  • Algeria
  • Bahrain
  • Egypt
  • Iran
  • Iraq
  • Israel
  • Jordan
  • Kuwait
  • Lebanon
  • Morocco
  • Oman
  • Qatar
  • Tunisia
  • United Arab Emirates
  • Palestinian Territories
  • Saudi Arabia

This alert began 12 Mar 2020 01:30 GMT and is scheduled to expire 28 Mar 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 12, the following countries have identified confirmed COVID-19 cases:

Countries reporting community transmission:

  • Iran: 9,000 cases. The US CDC maintains a "Warning-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.
  • Qatar: 262 cases
  • Bahrain: 189 cases
  • Israel: 75 cases
  • Kuwait: 80 cases
  • United Arab Emirates: 74 cases
  • Iraq: 70 cases
  • Egypt: 67 cases
  • Lebanon: 66 cases
  • Palestinian Territory: 30 cases
  • Algeria: 25 cases
  • Saudi Arabia: 21 cases
  • Tunisia: 6 cases
  • Morocco: 5 cases


Countries where community transmission has not been determined:

  • Pakistan: 19 cases
  • Oman: 18 cases
  • Afghanistan: 7 cases
  • Jordan: 1 case
  • Turkey: 1 case



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.

On March 11, the WHO declared the ongoing coronavirus outbreak a pandemic. This shift in posture from an earlier briefing indicating the WHO would no longer use the term "pandemic" to describe disease transmission is reflective of the current COVID-19 global impact. Per the March 11 statement, "Describing the situation as pandemic does not change WHO's assessment of the threat posed by this virus. It doesn't change what WHO is doing, and it doesn't change what countries should do."

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

WHO: Getting your workplace ready for COVID-19

US CDC: Interim Guidance for Businesses and Employers