As was widely expected, the first case of Middle East Respiratory Syndrome (MERS) has been reported in the United States. According to the CDC, the infected healthcare worker traveled from Saudi Arabia to Indiana. Though the individual took two airplanes and one bus on their journey, experts say that this U.S. case poses only a low risk to the public.
Since 2012, the World Health Organization (WHO) has reported 250 cases with 93 deaths. However, in Saudi Arabia those numbers are 371 cases and 107 deaths. With no treatment, vaccine or cure, the syndrome has been able to spread throughout the Middle East and other countries as well. People in Britain, Egypt, France, Germany, Greece, Italy, Jordan, Kuwait, Malaysia, Oman, the Philippines, Qatar, Saudi Arabia, Tunisia and the United Arab Emirate have been infected by MERS.
MERS, like its predecessor SARS, is caused by coronaviruses. This type of virus belongs to the family of viruses generally responsible for the common cold. Both syndromes attack the respiratory system, causing pneumonia and renal failure.
It has recently been confirmed that the origin of the disease can be traced to the Arabian camel. The process of disease transmission from animal to man is called zoonosis and two virologists from the Institute of Virology are looking into the pathways of transmission of the MERS coronavirus. Norbert Nowotny and Jolanta Kolodziejek have found that the virus RNA differs depending on the region. They took swabs from the nasal cavities of 76 camels from Oman and the virologists found the MERS virus in five of them. When compared to the MERS coronavirus from Egypt and Qatar, they found that there are regional variations of the virus. This finding suggests that there is not one single camel strain of MERS. It also means that one virus can sicken both camels and humans alike.
While this is an important finding, it should be noted that MERS is also transmissible between humans. This is most likely how the first U.S. case of MERS was transmitted. In light of the fact that MERS is such a current concern in Saudi Arabia, it is surprising that the infected healthcare worker was allowed to travel without being screened for the virus. To be fair, it is often difficult to diagnose early as MERS as the symptoms can be quite mild and even unusual.
Also like SARS, the MERS virus seems to be able to survive on surfaces. Hospitals and other facilities for healthcare have seen the virus spread multiple times. Absolute vigilance regarding safety precautions is being recommended by both the Center for Disease Control (CDC) and WHO. Education and training are tantamount to ensuring that the U.S. does not see a major outbreak of MERS. However, it is reassuring to note that it took nearly two years for a case of the MERS virus to arrive in the U.S.
Undoubtedly, healthcare officials will be watching this development carefully. Certainly anyone traveling to or from the region of the Middle East should take precautions and be aware of the signs and symptoms of MERS. Perhaps through healthcare workers’ diligence and the public’s educated awareness, the first case of MERS in the U.S. could be the only case of MERS in the nation.
by Stacy Lamy