A Few Words on Middle East Respiratory Syndrome Coronavirus – MERSCoV

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May 17, 2014

The latest word from the World Health Organization about MERS – a virus that is new to humans – is that there is no broad risk to the public. People are concerned because it is caused by a coronavirus, the same type of virus that caused the SARS (severe acute respiratory syndrome) outbreak in 2003 and led to 800 deaths. However, the MERS virus only spreads from one person to another with very close contact – i.e., after living with or taking care of the patient, not just from being on the same plane flight, for example.

According to the World Health Organization, “although camels are suspected to be the primary source of infection for humans, the exact route of direct or indirect [human] exposure remains unknown.”

The first human case of MERS was first reported in Saudi Arabia in September, 2012. Since then, over 500 cases in 12 countries have been reported, all originating in the Arabian Peninsula, with about a 30% death rate in those who developed symptoms. No travel warnings have been issued at this time, and in fact, the CDC specifically said last week that it is not necessary to change any travel plans. They did say, “If you are concerned about MERS, you should discuss your travel plans with your doctor,” and to be alert to any new symptoms.

People who have traveled to countries “in or near the Arabian Peninsula” and have cough and fever within 14 days should be evaluated for MERS. Patients are evidently not contagious during incubation. The countries that are considered to be in this area are Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, the Palestinian territories, Oman, Qatar, Saudi Arabia, Syria, the United Arab Emirates and Yemen. Travel-associated cases have been identified in the UK, France, Tunisia, Italy, Malaysia and Turkey.

The two known cases in the United States in Indiana and Orlando, Florida over the past month were both health care workers who cared for MERS patients in Saudi Arabia. One contact of the Indiana patient did test positive for MERS yesterday, but was not ill.  Two health care workers in Orlando taking care of the second patient were each tested this week because they developed flu-like symptoms. Neither one tested positive for MERS.

At this time, each county or state has a protocol for testing sputum, nasal, throat, and blood specimens for the MERS coronavirus. There is no vaccine or specific treatment available. Supportive care is given as for other infections. The CDC recommends usual protection against respiratory illnesses, which includes:
— wash hands often
— use tissues when coughing or sneezing
— avoid touching your face with unwashed hands
— stay away from ill people
— disinfect frequently touched surfaces (like office phones and gym equipment).

This is a work in progress that the CDC is watching carefully. At this time there does not seem to be rapid spread of this novel human virus.