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Data Collection

Health departments should immediately report patients under investigation (PUIs) to CDC using the MERS PUI short form below.

Health departments should send completed investigation short forms by FAX to CDC at 770-488-7107 or attach the short form to an e-mail to (subject line: MERS Patient Form).

Summary of Changes, MERS Patient Under Investigation (PUI) Short Form Version 6.0 issued July 23, 2014
CDC revised the short form based on comments from public health partners, healthcare providers, professional organizations, and others, as well as analysis of data collected from the short form. CDC will continue to update the document as necessary to incorporate new information that increases our understanding of MERS-CoV.


  1. Aligned with the newly revised PUI case definition.
  2. Collect additional information on healthcare worker status, comorbid conditions, and other respiratory pathogens such as rhinovirus and/or enterovirus, coronavirus (not MERS-CoV), influenza PCR / influenza rapid test, Chlaymdophila pneumoniae, and Mycoplasma pneumoniae.
  3. Added whether a serum specimen was collected for serologic testing.
  4. Overall, the form was simplified, and the sections on infection control and personal protective equipment were deleted.