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  1. Case Definitions/

Open Syndrome Middle East Respiratory Syndrome (MERS)

Authors: Ministry of Health Command and Control Center, Ministry of Health

Location: Saudi Arabia

Purpose #

MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS

The definition #

Acute febrile illness (T ≥380 C) with/without respiratory symptoms OR IV. Gastrointestinal symptoms (diarrhea or vomiting), AND leukopenia (WBC≤3.5x109 /L) or thrombocytopenia (platelets < 150x109/L)

Machine-readable definition #

The definition is available in JSON format following the Open Syndrome v1.0 specification:

{
   "authors": [
     "Ministry of Health Command and Control Center"
   ],
   "category": "suspected",
   "definition_type": "case_definition",
   "description": "MIDDLE EAST RESPIRATORY SYNDROME CORONAVIRUS",
   "exclusion_criteria": [],
   "human_readable_definition": "Acute febrile illness (T ≥380 C)\nwith/without respiratory symptoms\nOR\nIV. Gastrointestinal symptoms\n(diarrhea or vomiting), AND\nleukopenia (WBC≤3.5x109 /L) or\nthrombocytopenia (platelets \u003c\n150x109/L)",
   "inclusion_criteria": [
     {
       "logical_operator": "OR",
       "type": "criterion",
       "values": [
         {
           "name": "fever with/without respiratory symptoms",
           "type": "syndrome"
         },
         {
           "logical_operator": "AND",
           "name": "Gastrointestinal symptoms with blood count abnormalities",
           "type": "criterion",
           "values": [
             {
               "logical_operator": "AT_LEAST",
               "logical_operator_arguments": [
                 1
               ],
               "name": "gastrointestinal symptoms",
               "type": "criterion",
               "values": [
                 {
                   "name": "diarrhea",
                   "type": "symptom"
                 },
                 {
                   "name": "vomiting",
                   "type": "symptom"
                 }
               ]
             },
             {
               "logical_operator": "OR",
               "name": "Blood count abnormalities",
               "type": "criterion",
               "values": [
                 {
                   "description": "WBC ≤ 3.5x10⁹/L",
                   "name": "Leukopenia",
                   "type": "diagnostic_test"
                 },
                 {
                   "description": "Platelets \u003c 150x10⁹/L",
                   "name": "Thrombocytopenia",
                   "type": "diagnostic_test"
                 }
               ]
             }
           ]
         }
       ]
     }
   ],
   "keywords": [
     "MERS",
     "Asia"
   ],
   "language": "English",
   "location": "Saudi Arabia",
   "notes": [
     "Usage of Suspected case definition (section 4.1 - children and adults)."
   ],
   "open_syndrome_version": "1.0.0",
   "organization": "Ministry of Health",
   "published_at": "2025-01-29T01:18:47Z",
   "published_by": [
     "Open Syndrome Initiative"
   ],
   "published_in": "https://opensyndrome.org",
   "references": [
     {
       "citation": "Saudi Ministry of Health. (2018). Middle East respiratory syndrome coronavirus: Guidelines for healthcare professionals (Version 5.1)",
       "url": "https://www.moh.gov.sa/ccc/healthp/regulations/documents/mers-cov%20guidelines%20for%20healthcare%20professionals%20-%20may%202018%20-%20v5.1%20%281%29.pdf#page4"
     }
   ],
   "scope": "broad",
   "status": "draft",
   "target_public_health_threats": [
     "MERS"
   ],
   "title": "Open Syndrome Middle East Respiratory Syndrome (MERS)",
   "version": "1.0.0"
 }

Using the Definition #

Healthcare organizations can implement this definition through:

  • Direct integration with surveillance systems
  • API endpoints for real-time validation
  • Manual case verification processes

Next Steps #

We encourage:

  • Clinical feedback on the definition criteria
  • Technical feedback on the implementation format
  • Suggestions for additional symptoms or signs
  • Reports of implementation experiences

Get Involved #

We welcome contributions and feedback from the community.