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Is the MERS Virus just a Fleeting New Story?

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A newly discovered virus has made headlines recently in the news. Called the Middle East Respiratory Syndrome (MERS), it is a cousin of the better known coronavirus, SARS. Two recent studies have proven that camels are infected by this MERS virus and that humans who contracted the disease also had the exact same version of the virus in their bloodstream.

To paraphrase a recent article in the BBC by Matt McGrath: However, the lead author of that report, Dr. Thomas Briese from Columbia University in New York, believes that there are many unanswered questions about the disease. He points to the fact that if camels were the sole route of infection, then the illness should be more prevalent among those who work with or are in close contact with the animals. Plus, there have been a small number of cases of people dying from MERS who have no known relationship with camels. “We do have these sporadic cases where there is no known exposure to known cases and we question where do they catch the virus. In some cases there was animal contact or camel contact but in others not, so there is no clear definitive picture yet.”

Dr Briese says that other species, including goats and sheep, have been tested but haven’t shown antibodies indicating exposure. In addition, the disease in camels is far more widespread than previously thought, with significant reservoirs in Nigeria, Ethiopia and Tunisia. Ironically, there have been no reports of people dying from the respiratory infection in these areas.

This unexplained fact, noted Dr. Briese, is making research question if a MERS viral reservoir could be found in domestic pets such as cats and dogs. “We are looking into or are trying to look into are cats, dogs – where there is more intimate contact – and any other wild species we can get serum from that we are not currently getting.”

The real question is if an animal viral reservoir is now even needed for the spread of the disease. There is one hypothesis that the virus subtly mutated and became transmissible from camels to humans. Once this occurred, the main contagious source of the disease became human to human contact—as evidenced by the recent case of a hospital worker in the United States. Again, another important question emerges. Will the virus hypothetically mutate again and make human to human transmission easier? Fortunately, researchers are looking into this problem right now, and hopefully MERS will prove nothing more than a fleeting news story.

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MERS cases Triple in Last Month and a Half

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To quote a recent MedPage report by Michael Smith, the total number of cases of the Middle East coronavirus has nearly tripled in the past month and a half, according to the European Centre for Disease Control and Prevention (ECDC).

But those cases do not include new cases reported today from Saudi Arabia, which recorded another six patients and three deaths. That brings the nation’s own totals to 520 cases with 163 deaths, up nine and three respectively. Also, it does not include the Illinois hospital worker who contracted the virus without showing signs of infection.

Saudi Arabia is followed in number of cases — although not closely — by the United Arab Emirates, which has recorded 67 cases and nine deaths, according to the ECDC. Seven other countries in the region have a total of 24 cases and 12 deaths.

Other regions — Europe, Africa, Asia, and the Americas — have seen a total of 19 cases and seven deaths and all patients have had primary epidemiological links to the Middle East.

The exact number of cases is a moving target and has been dogged by delays in reporting. The World Health Organization, for instance, reported Thursday it had been officially informed of just 572 laboratory-confirmed cases, with 173 deaths.

While the virus continues to cause several cases a day in Saudi Arabia, the risk for people outside the Middle East is said to be extremely low. However, 22 U.S. airports are now displaying signs that warn of the virus.

Returning travelers, the agency says, should monitor their own health and see a doctor if they have respiratory symptoms within 2 weeks of coming home. Importantly, they should call first and mention the travel history so the doctor’s office can ensure that proper precautions are taken.

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Second US Case of MERS

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Health officials have confirmed a second U.S. case of the Middle East Respiratory Syndrome (MERS) in Florida this week. Not a native of the states, the victim was visiting from Saudi Arabia. Health officials say this case is unrelated to the other recent one diagnosed in Indiana.

“The risk to the public remains very low,” said Dr. Anne Schuchat of the Centers for Disease Control and Prevention.

However, health officials are trying to contact all the passengers on the planes the man took to inform them to watch out for early signs of the MERS virus.

This virus has been found in camels, but officials don’t know how it is spreading to humans. It can spread from person to person, but officials believe that happens only after close contact. Not all those exposed to the virus become ill.

But it appears to be unusually lethal – some estimates have suggested it has killed nearly a third of the people it sickened. The estimate has been dropping as health officials have begun diagnosing more and more cases with less severe illness. But the estimated fatality rate for MERS still is far higher than what’s seen with seasonal flu or other routine infections.

Are we looking at the beginning of a new pandemic? As a physician, I seriously doubt it. However, what if this virus mutates into something more contagious? Though slim, the possibility is there. Like all viruses, MERS is prone to frequent mutations, and does have the potential to become more infectious. And what makes this scary is that we still have no treatment, prevention or source for this virus.

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When is the next Pandemic- Could it be MERS?

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People ask me as a physician if a new, incurable virus or bacteria could spread across the world, causing a massive pandemic. Unfortunately, I tell them the answer to this question is “When, not if.”

The truth is that bacterial and viral pathogens have been around for millions, if not billions of years. While modern antibiotics, on the other hand, have only been around for around for less than a measly hundred years. Plus, with worldwide travel, people not taking their full prescription of antibiotics, and the rapid mutation rate of diseases, it is just a matter of time before one of these bugs causes real problems.

In my book The New Reality, I write of such a scenario. Unfortunately, this situation may be more plausible than fictional in nature. With the recent disassembly of the American healthcare system, rising national debt, and deteriorating research grant funds, we may be financially unable to handle a massive pandemic—making this scenario more likely by the day.

I’m not a fear monger, but a recent article caught my attention about a deadly virus that was brought back from Saudi Arabia. It is called the Middle East Respiratory Syndrome (MERS) and carries a 25-30% mortality. The virus comes from the same family as the severe acute respiratory syndrome, or SARS, coronavirus, which killed almost 800 people worldwide in 2003. The incubation period of the virus — the time between exposure and development of symptoms — is about five days, similar to SARS.

The patient who contracted MERS was returning home to Indiana. Upon arrival, he began to have shortness of breath, coughing and fever. Officials do not know the origin of the virus or how it spreads. The MERS virus has been found in camels, but officials don’t know how it is spreading to humans. There is no vaccine or treatment available. In some countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. However, it is unknown how the patient became infected.

“MERS is now in our heartland,” said Anne Schuchat, assistant surgeon general and director of the CDC’s National Center for Immunizations and Respiratory Diseases, during a briefing Friday.

The scary thing is what happens if this MERS virus mutates into something more deadly. By nature, virus routinely mutate—making treatment of such illnesses as the common cold and HIV very difficult to treat. So what happens if it mutates into something more deadly or possibly something more easily spread?

It is certainly a reasonable question to ask. And the only true answer is to be prepared. But as our ability to prepare is under serious jeopardy as a direct result of Obama’s new domestic policies and the Affordable Care Act, we may all be caught someday off-guard for such an event.

For more information please refer to: http://www.washingtonpost.com/national/health-science/cdc-confirms-first-case-of-deadly-mers-virus-in-indiana-man-who-traveled-to-saudi-arabia/2014/05/02/b27673b4-d233-11e3-a6b1-45c4dffb85a6_story.html