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Understanding Middle Eastern Respiratory Syndrome

MERSDiseases and IllnessesU.S. Centers for Disease Control and PreventionSevere Acute Respiratory Syndrome

The U.S. Centers for Disease Control and Prevention and the Indiana State Department of Heath announced the nation's first case of Middle Eastern Respiratory Syndrome on May 2. Public health officials are keeping tabs on the virus, which has infected more than 800 people in more than a dozen countries, killing at least 310 of them, according to Reuters. But the officials don't believe the general public is at great risk.

Dr. Peter Kadlecik, chief of infectious diseases with Kaiser Permanente, answers questions about this emerging virus.

What is MERS and when was it first identified?

Middle Eastern Respiratory Syndrome (MERS) is a viral respiratory illness causes by coronavirus that was first identified in the Arabian Peninsula in 2012. The origin of the MERS virus is not known, though it is probably related to an animal source — bats and camels have tested positive for the virus. MERS is rare but has high death rate of about 30 percent, similar to that of Severe Acute Respiratory Syndrome (SARS).

How is it transmitted, and has it spread across the globe particularly fast?

The MERS infection source and exact mode of transfer are not known at this time. There are patients who have no known sick contacts and there are others who can identify possible exposure. Transmission does occur from human to human through close contact such as caring for or living with an infected person, both in family clusters and in hospitals.

Most cases of MERS are in Saudi Arabia, United Arab Emirates and Jordan. All reported individuals with MERS lived, recently traveled or have other identifiable links to countries in the Arabian Peninsula, including cases in Western Europe and Northern Africa (travel to Saudi Arabia is expected to increase during June and July for the Muslim holiday of Ramadan).

Currently there are two confirmed cases of MERS in the United States, in Indiana and Florida. Both confirmed cases are individuals who worked in the health care field in Saudi Arabia and recently returned to the United States.

What are the symptoms, and are U.S. doctors and public health officials prepared to recognize such a new virus?

For most people, MERS symptoms develop between two and 14 days of exposure and include severe respiratory viral illness with fever, cough and shortness of breath. This can progress to pneumonia and renal failure. In addition, a minority of patients may develop gastrointestinal disease with nausea, vomiting and diarrhea. Some patients have mild cold-like symptoms with muscle aches or no symptoms at all. Patients that exhibited cold-like symptoms with muscle aches recovered. All confirmed cases in the United States are doing well and are recovering.

The Centers for Disease Control is closely monitoring MERS and working with global partners to better understand the virus.

Are some people more vulnerable, and are there precautions they can take?

People with pre-existing medical conditions may be at higher risk for getting infected, having severe disease or death. In addition, a slight majority of the cases of MERS are men above age 50. Most of the patients who have died of MERS have had other underlying medical conditions.

There are several things individuals can do to prevent and protect themselves from respiratory illnesses such as MERS. The CDC recommends frequent hand washing with soap and water; covering your nose and mouth with a tissue when coughing or sneezing; avoiding touching your eyes, nose and mouth with unwashed hands; avoiding close contact with sick people; and cleaning and disinfecting surfaces frequently.

Are there effective treatments for MERS?

Currently there is no specific vaccine or treatment for MERS. As MERS symptoms develop within 14 days of exposure, all individuals returning from travel from the Middle East/Arabian Peninsula with symptoms of respiratory infection or fever should alert their physician and seek medical care.

meredith.cohn@baltsun.com

Copyright © 2014, The Baltimore Sun
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MERSDiseases and IllnessesU.S. Centers for Disease Control and PreventionSevere Acute Respiratory Syndrome
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