Emerging Respiratory Pathogens, e.g. COVID-19: Coronavirus Disease-19; Middle East Respiratory Syndrome Coronavirus Infection: MERS COV
Description General Measures Management Referral Note: notifiable medical conditions. Consult the most recent guidelines from the National Department of Health or NICD. DESCRIPTION Viral respiratory illness caused by coronaviruses, including Middle East respiratory syndrome (MERS-CoV), severe acute respiratory syndrome (SARS), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS
Note: notifiable medical conditions.
Consult the most recent guidelines from the National Department of Health or NICD.
DESCRIPTION
Viral respiratory illness caused by coronaviruses, including Middle East respiratory syndrome (MERS-CoV), severe acute respiratory syndrome (SARS), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 causes coronavirus infectious disease-2019 (COVID-19).
Individuals present with a wide spectrum of clinical presentations ranging from asymptomatic infection to acute upper respiratory illness, and rapidly progressing lower respiratory illness; respiratory failure, septic shock and multi-organ failure resulting in death.
A typical presentation includes:
- fever (>38°C), chills or rigors, cough, shortness of breath
Presentation may include:
- hemoptysis, sore throat, myalgias, diarrhoea, vomiting, abdominal pain
Complications:
- severe pneumonia
- acute renal failure
- acute respiratory distress syndrome (ARDS)
- refractory hypoxaemia
GENERAL MEASURES
All suspected, probable cases and contacts must be discussed and managed in consultation with the regional virologist or infectious diseases specialist at the referral centre.
Transfer of patients will only occur once all relevant arrangements have been made to limit further exposure to a potential contagious and life threatening agent.
Droplet precautions should be added to the standard precautions. Airborne precautions should be applied when performing aerosol-generating procedures.
Isolate suspected symptomatic cases at all times.
MANAGEMENT
Treatment
- Treatment is supportive.
- No antiviral agents are currently available.
- Management of contact: consult with NICD and isolate contact.
- Record and follow-up all patient contacts.
Prevention
- Handwashing and the careful disposal of materials infected with nasal secretions.
- Antiseptic/disinfectant solutions: choroxylenol, benzalkonium chloride, and cetrimide.
- Chlorhexidine has been shown to be ineffective.
REFERRAL
All cases, after consultation with infectious diseases and NICD.
See: COVID-19: Corona Virus Disease-19
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2020-2024_Version 1.1_20 January 2025
Chapter 10: Infections and Related Conditions_10.19 Emerging Respiratory Pathogens, e.g. COVID-19: Coronavirus Disease-19; Middle East Respiratory Syndrome Coronavirus Infection: MERS COV