You may have seen some pretty scary headlines in recent days relating to a new virus that has the medical community on alert. Middle East Respiratory Syndrome (MERS) is a viral respiratory illness that can be passed between people in close contact. The condition was first reported in 2012 in Saudi Arabia, and so far most of those who have been infected have been from that region of the world.
People with MERS develop severe acute respiratory illness, presenting symptoms like fever, coughing and shortness of breath. About half of the 81 reported cases— mostly older men with pre-existing health conditions—have died. However, other cases have been reported where the patient experienced just mild respiratory illness.
While MERS is not the same as the SARS virus, it has similar attributes, including how it is transmitted. Since its discovery, doctors have seen transmission from people in close contact to each other, including patients infecting health-care workers. Clusters of cases in Saudi Arabia, Jordan, the U.K., France, Tunisia and Italy all have been reported and are being closely watched by the World Health Organization (WHO).
In fact, the WHO was so concerned about the potential problems the MERS could pose, the organization called an emergency meeting—the first emergency meeting it has held in four years—to discuss what, if any, threat the virus could present to the international community. (As of now, the WHO reports that the virus is not a public health emergency of international concern.)
One of the main concerns is an upcoming Hajj pilgrimage, where up to 3 million pilgrims from around the world travel to the city of Mecca, Saudi Arabia, not far from where the virus was first reported. Considering the pilgrimage is among the largest, global gatherings, health-care workers are concerned how such a huge influx of people in the area could lead to further spreading of MERS.
To help people better understand what MERS is and what the medical community is doing to track and reduce its spread, Thriving recently spoke with Thomas Sandora, MD, MPH, of the Division of Infectious Diseases at Boston Children’s Hospital.
Thriving: What causes MERS, and how has it been spread so far?
TS: MERS is caused by a coronavirus. Previously, there had only been five known human coronaviruses, SARS being the latest to be discovered. This new coronavirus, called MERS-CoV, is the sixth. There has been person-to-person spread of the virus, and thus far all known cases seem to be directly linked back to the Arabian peninsula where the first cases were reported.
Th: Why has the WHO taken such an interest in the virus?
TS: Because the virus’ symptoms can be severe and the mortality rate is currently high, there is concern that if the condition became more widespread, it could lead to more disease and death across the world. This is especially true in the modern age, where infections can be quickly spread across great distances through all the people involved in air travel.
But it’s important for people to remember that there is much we don’t know about MERS-CoV yet, including how easily it is spread or how severe typical cases will be. These meetings and announcements are a good example of public health agencies being very cautious upfront and waiting until they have more information before making too many decisions.
Th: What is the medical community currently doing to protect people from MERS?
TS: Public health groups from all over the world have people on the ground in Saudi Arabia and surrounding areas, collecting information and trying to determine the source of the virus. Thus far, it seems to be closely related to a coronavirus usually found in bats, so there are scientists in caves as we speak, trapping bats and performing tests to pinpoint the exact origin of the virus.
Once that’s been established, it will be easier to control the virus’ source and reduce the number of human cases. They are also currently working on tests to better identify existing human cases, which will reduce its spread by earlier identification and isolation of people who are infected.
It’s also quite likely that people are already working on vaccines and other responses in the event that it should become more widespread. It’s a very similar response to what we saw with SARS and H1N1, which in time proved to be quite successful for containing the viruses on a worldwide scale.
Th: As a general rule, how can people protect themselves from communicable viruses, such as MERS?
TS: Because we don’t fully know how the disease is being transmitted from person to person, the best way to avoid infection is by following the usual steps: wash your hands with soap and water often, avoid touching your eyes, nose and mouth with unwashed hands and avoid close contact with people who are sick. Once we know exactly how the disease is transmitted, more specific information on how to avoid it will be made available. (For tips on avoiding infection see this FAQ from the CDC.)
The most important thing health care workers can do is to be aware of the disease and, if they see any patients with severe respiratory symptoms, they should take a travel history to find out if the patient has visited anywhere with reported MERS cases. If they have done such traveling, they should notify public health officials immediately so testing can be arranged and necessary precautions can be taken.