May 15, 2014
News Review From Harvard Medical School -- No Sign So Far of MERS Spread in U.S.
Two confirmed cases of the often deadly MERS virus have been reported in the United States. But so far there's no evidence that these patients spread the disease to anyone in this country, health officials said. And the World Health Organization affirmed May 13 that it does not consider MERS a public health emergency. That's because so far there been no "sustained human-to-human transmission." MERS stands for Middle East Respiratory Syndrome. It is caused by a type of coronavirus. More than 500 cases have been confirmed worldwide. Nearly one-third of the patients died. Most cases occurred in the Middle East. It has spread only to health care workers and others in very close contact with people who were ill. The two new cases involved health care workers who had traveled to the United States. They had cared for MERS patients in the Middle East. Two U.S. health care workers who took care of the second patient became ill with symptoms similar to those of MERS, such as fever and cough. Test results for these workers so far have been negative. Final results are still pending. HealthDay News wrote about it May 14.
By Anthony L. Komaroff, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
It has been more than 10 years since the respiratory illness called severe acute respiratory syndrome first appeared in southern China and Hong Kong. This illness came to be better known as SARS.
Caused by a type of virus called a coronavirus, SARS spread to two dozen countries. Its scope included several countries in North America, South America and Europe. It killed more than 700 people.
There have been no known cases of SARS since 2004. But this virus moved quickly enough and was serious enough that in 2012, the Centers for Disease Control and Prevention (CDC) declared that it presented a severe threat to public health and safety.
That same year, public health and infectious disease experts took note of new viral respiratory disease that was also caused by a coronavirus. This virus, however, was different from the one that causes SARS. The first cases of this illness occurred in Saudi Arabia. For this reason, it was named Middle East Respiratory Syndrome -- MERS or MERS-CoV (for coronavirus).
Symptoms of MERS include fever, cough and shortness of breath. So far, roughly one-third of the people with confirmed cases of MERS have died.
Until recently, most cases of MERS occurred in countries in the Arabian Peninsula. But this month, two cases have been confirmed in the United States. Both of the people with MERS had traveled to the United States from Saudi Arabia. One is fully recovered. The other, a health care professional who lives and practices in Saudi Arabia, is doing well.
As of now, it appears that the MERS virus doesn't spread easily from person to person. It is most likely to go from someone who has MERS to someone who lives with or cares for them. The CDC is keeping close watch on MERS along with other public health organizations. The CDC does not believe that MERS poses a serious health threat at this time.
But now there are reports that two health care workers who cared for one of the MERS patients have developed flu-like symptoms. Neither case has been confirmed as MERS yet. Final test results are still pending. Tracking the spread of MERS is critical because it is possible that the virus may start to spread more easily between humans.
The Emergency Committee on MERS-CoV has been following this outbreak for the World Health Organization. At its most recent meeting, committee members expressed growing concern about the effect of MERS on public health. However, there is still "no evidence of sustained human-to-human transmission." So the situation doesn't yet meet the criteria for a Public Health Emergency of International Concern.
Health care officials are reaching out to anyone who may have had close contact with anyone with a confirmed case of MERS. These efforts include family members and even people who may have had close contact during airline flights. The goal is to encourage them to watch for symptoms and consider seeing their doctors.
What Changes Can I Make Now?
Right now we don't have a specific antiviral drug to kill the MERS virus. Antibiotics won't help. And there is no vaccine.
However, if someone did become ill from MERS, medical care can still be life-saving. Doctors can make sure the person gets enough fluids to avoid kidney damage, provide oxygen if blood levels are low and keep blood chemicals in balance.
One of the best ways to avoid all infections is also one of the easiest: wash your hands. And wash them often.
Soap and water don't kill germs; they remove germs from your hands. Water alone does a pretty good job of germ removal. But soap increases the overall effectiveness by pulling unwanted material off your skin and into the water.
Drying your hands is an important step in the hand-washing process. Wet hands are more likely to spread germs than dry hands.
If hand washing is not possible, alcohol-based cleaners are a good alternative. They eliminate most but not all bacteria and many viruses. To be effective, alcohol-based rubs need to come into contact with all surfaces of your hands -- back, front and between the fingers.
If you are sick with any cold or flu, you can help prevent spread to others.
- Wash your hands often.
- Cough and sneeze into your elbow.
- Use disposable tissues when you sneeze or blow your nose.
What Can I Expect Looking to the Future?
The CDC right now is testing samples from the health care workers exposed to the patients with MERS. These test results and how many new cases arise during the next week will affect what we hear next from public health officials.