Middle East Respiratory Syndrome (MERS) is a mysterious viral illness, first diagnosed in Saudi Arabia in 2012. Since that time, MERS has sickened over 400 people, resulting in almost 100 deaths. All of those infected with the MERS virus either lived in the Middle East or had contact with individuals who had recently traveled to that region.
There has been a recent surge in MERS cases this past spring, with outbreaks in Saudi Arabia and the United Arab Emirates. Isolated cases have been reported in Europe from individuals who have traveled to the Middle East region.
The Centers for Disease Control and Prevention (CDC) has recently confirmed the presence of MERS in the United States. The patients have been American healthcare professionals living and working in Saudi Arabia, who became ill upon visiting the United states, and a close contact of one of the patients.n.
What is MERS?
MERS is a respiratory illness characterized by flu-like symptoms, which include fever, cough, shortness of breath and general malaise. The severity of symptoms may vary from mild to progressive, leading to pneumonia, gastrointestinal illness, kidney failure, and death.
The Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is similar to the virus that caused Severe Acute Respiratory Syndrome (SARS), a highly contagious respiratory illness that was centered in China and caused a global outbreak, killing hundreds of people, in 2003. The coronavirus family also includes viruses that cause some common colds and animal illnesses.
Although the MERS-CoV appears to be less lethal than the SARS virus, it is more lethal than the influenza virus and other common viruses. The CDC reports that MERS is associated with a 30 percent death rate.
What is the source and mode of transmission of MERS?
Although the exact source of the MERS-CoV is not well understood at this time, recent research points to dromedaries, or single-humped camels, as the potential source of the virus. In the Middle East, at the center of the outbreak, camels are commonly raised as livestock, used for hauling and racing, and kept as pets.
Researchers have suggested that the MERS-CoV may infect people through exposure to the camels’ respiratory secretions from sneezing, snorting or spitting. The virus may also be transmitted to humans by eating camel meat or drinking unpasteurized camel milk. Some of the patients infected with MERS-CoV were known to have been in contact with camels; in other instances, patients sickened with the virus have infected healthcare workers, other hospitalized patients in close proximity, and household contacts.
MERS does not appear to be as highly contagious as other communicable diseases, such as influenza and measles. Although the virus has been transmitted from human to human, it has not been shown to spread in communities. According to the CDC, because MERS does not appear to be highly contagious at this time, it probably represents a low risk to the general public.
What is the treatment of MERS?
There is currently no curative treatment for MERS. Healthcare providers treat infected patients with supportive medical care, which are measures aimed at relieving symptoms of the illness. These measures include medication to alleviate discomfort and fever, oxygen and mechanical ventilation to assist with breathing, and antibiotics to treat secondary bacterial infections. There is no vaccine for MERS-CoV.
What can I do to protect myself from MERS?
According to the CDC, individuals who are at risk of contracting MERS-CoV are those in close contact with someone who may be infected. This includes healthcare workers caring for patients with MERS, other hospitalized patients in close proximity and household contacts. Outside of close contact with infected individuals, the incidence of contracting the MERS-CoV appears low.
As with other respiratory illnesses, avoid coming into contact with infected individuals, practice good handwashing, disinfect frequently used surfaces and avoid touching eyes, nose and mouth prior to washing hands.
The CDC has guidelines in place for hospitals to minimize transmission to healthcare workers and other patients when treating patients with known or suspected MERS. Many hospitals already have these infection control measures routinely in place.
Is it safe to travel to the Middle East?
The World Health Organization (WHO) suggests that individuals visiting or living in the Arabian Peninsula who have chronic illnesses or who are immunocompromised take appropriate precautions in environments where camels are present. These precautions include avoiding contact with camels; avoiding consumption of camel meat, unpasteurized camel milk, or other food that may be contaminated by animal secretions; and washing hands frequently.
For otherwise healthy members of the general public, WHO recommends washing hands well after coming into contact with camels and other barnyard animals, avoiding contact with sick animals and practicing good food hygiene.
Last year, in an effort to avoid the spread of MERS, the Saudi government discouraged elderly, pregnant and otherwise immunocompromised individuals from making the Hajj pilgrimage. During this ritual, animals are sacrificed and the meat is shipped throughout the world to feed the hungry.
At this time, the CDC does not advise against traveling to the Arabian Peninsula or the surrounding areas. The CDC does advise anyone who develops symptoms of respiratory illness within 14 days of travel to this area to seek medical attention and to inform the healthcare provider about recent Middle-East travel.
More research is necessary to better understand this mysterious illness. The CDC, WHO and other scientists are working to determine the source of MERS-CoV and its mode of transmission.
Currently, MERS-CoV does not appear to be highly transmissible to humans. Although viruses can mutate over time and become more contagious, this has not yet been observed with MERS Co-V. At this time, the virus does not appear to be highly contagious and is probably a low risk to the general public.
Kerri Eckerling is a Highland Park resident and clinical pharmacist at Northwestern Memorial Hospital. Over the past 25 years, she has worked at the hospital, for home health care and in chemotherapy infusion clinics. She has also worked in the pharmaceutical industry, holding positions in pharmacovigilance and medical information. Eckerling writes the Your Health Matters blog to discuss medication use in matters of general healthcare and wellness, issues currently trending in the media and public health issues.
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