Is MERS The Next Pandemic?

The latest scare in international health is Middle East Respiratory Syndrome, also known as MERS, which is caused by the Middle East Respiratory Syndrome Coronavirus, also known as MERS-CoV. Not in any way related to Methicillin-Resistant Staphylococcus Aureus, or MRSA, which is caused by staph bacteria, not a virus, MERS has been followed by public health officials around the world since 2013 and in the Western press since 2014, when the first cases were reported in the United States.

What Is MERS?

MERS is a coronavirus, a relatively large virus inside a protective capsule. Other coronaviruses cause many cases of the common cold, and when they get into the lungs, they can weaken the immune system so that there is increased susceptibility to bacterial pneumonia. The virus does not come out of its protective protein coating until it is inside a target cell, where it attaches to the protein-making ribosomes to code them to make copies of itself. In 2002, a coronavirus known as SARS emerged in eastern Asia, and in 2012, the coronavirus MERS was first detected in Saudi Arabia.

Every infection occurred in Saudi Arabia, although some of the infected people have traveled outside the Kingdom. Not everyone who is infected with the virus develops symptoms, but most infectees eventually show fever, cough, and shortness of breath. About 25% of people who are infected with the virus show no symptoms at all, but about 30% die.

How Is MERS Transmitted?

In 2012, when MERS was known as "Novel coronavirus," the World Health Organization issued a world-wide alert to public health agencies and immigration officials to be on the alert for new cases.

At first, all cases were linked to contact with camels infected with the virus; however, by May 2014, 75% of all cases occurred in people who had close personal contact with someone else who was infected by the virus.

The MERS virus is believed to have an incubation period of 2 to 14 days. People who are infected with the virus do not infect other people until they develop their own symptoms. While there have been approximately 100 camel-to-human transmissions of the disease and approximately 300 secondary infections with the disease (from a person infected by a camel to another person), there have been only 2 confirmed cases in which someone who caught MERS from someone who caught the virus from a camel passed it on to another person. The first case in the US involved a healthcare worker returning to the US after doing nursing in Saudi Arabia.

See Also: First US MERS Case: Should You Be Scared?

What Is the Treatment for MERS?

Currently there are no treatments for MERS itself. There are only supportive treatments to relieve cough, fever, and low oxygen levels. There are no known effective antiviral medications for the disease, and there is no vaccine. Diagnostic tools, however, have been developed for confirmation of the infection--allowing for other treatments if MERS is not the actual cause of symptoms.

What To Do If You Think You Have Been Exposed To MERS

While there are no specific treatments for MERS, there are reasonably good diagnostics. The US Centers for Disease Control recommend the use of molecular diagnostic methods that identify the virus as well as an antibody test. To make sure the virus is detected, the CDC recommends collection of the virus at multiple sites in the respiratory tract. One sample should come from the lungs, but testing should also involve swabs of the nose and throat. The antibody testing supplies have to come from state health departments, which get them from the CDC.

Currently, MERS testing is only recommended for people who have returned from Bahrain, Iran, Iraq, Israel, Jordan, Kuwait, Lebanon, the Palestinian territories, Oman, Qatar, Saudi Arabia, Syria, the United Arab Emirates, or Yemen in the last 2 to 14 days. People who do not develop symptoms during the first 14 days after their return from the Middle East (symptoms usually would show up sooner) are assumed not to have been exposed to the virus.

There is no need to test their family members and close personal contacts because the virus is not spread when there are no symptoms.

There is also an orderly progression of symptoms in MERS.

The more severe respiratory symptoms follow. But it's important to remember that as of the third week of May 2014, there have been only three total cases in the USA.

Frequently asked questions about MERS:

Q. Does MERS have the potential to become a global pandemic?

A. Not yet. The virus has not mutated into a form that is easily spread from person to person. Many cases have occurred in health care workers who had direct exposure to respiratory secretions containing the virus.

Q. But hasn't the number of cases in Saudi Arabia greatly increased since March 2014?

A. Yes, but this is due to improvements in testing. The antibody test, allowing quick diagnosis of the infection, only recently became available. Virologists from the European Centre for Disease Prevention and Control (ECDC) did not find in changes in the DNA of the virus even after the number of diagnosed cases in Saudi Arabia greatly increased in March 2014.

Q. Is it safe to travel to the Middle East?

A. The CDC advises that there is no reason to postpone travel plans for the Middle East, although people traveling to the Kingdom of Saudi Arabia for contracts as healthcare workers should make themselves familiar with CDC guidelines for preventing MERS infection.

See Also: Swine Flu Pandemic Sweeping Through Britain Even Though 70% Vaccinated Last Year

Q. What can be done to prevent catching MERS?

Commonsense precautions apply. Wash you hands frequently with warm water and soap, soaping them thoroughly and holding them under the tap for 15 seconds (long enough to sing "Row, Row, Row Your Boat" or "Happy Birthday to You" twice). Wash your hands both before (to protect yourself) and after (to protect others) touching your mouth, nose, or face. See a doctor for diagnosis at the very first signs of MERS infection or if someone with whom you are in close personal contact contracts the virus.