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Dec 2017 ( Volume -11 Number -12)

Article 2
MERS-CoV: A New Challenge
Latif Ahmed Khan, MBBS; MD; MRCP(UK); FRCP(E)
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MERS-CoV: A New Challenge

Latif Ahmed Khan, MBBS; MD; MRCP(UK); FRCP(E)

Middle East Respiratory Syndrome-Corona Virus (MERS-CoV) is the name of a new disease that is caused by a Corona virus. It appeared for the first time in Saudi Arabia in 2012, but has been since reported from many countries in the Arabian Peninsula and other countries. Center for Disease Control (CDC), USA has reported 2 patients from the USA, both of whom had travelled from Saudi Arabia.

This new disease is considered to be common in camels. Humans contact the disease from infected camels. Corona viruses in general cause a mild flu like. However MERS Corona virus causes a severe illness with predominantly respiratory symptoms. Fever, cough, breathlessness are the initial symptoms. Patients rapidly develop respiratory distress and need ventilator support. Mortality rate is 30 to 40% and the disease is highly infectious and contagious. Secondary spread in healthcare institutions and hospitals is common. Many healthcare workers, who were exposed to Corona virus patients, are testing positive. Most of the healthcare workers have remained asymptomatic but illness and even deaths have been reported.

The CDC does not recommend cancelling any trips to Middle East because of MERS-CoV. However it recommends the citizens to take level 2 precautions, which means to follow standard precautions like hand washing and avoiding healthcare institutions that have reports of positive cases. The World Health Organization (WHO) recommends surveillance for any severe acute respiratory infections (SARI) cases returning from Middle East and to carefully review any unusual pattern of SARI and to pass on the information to the WHO as soon as possible.

There was a major outbreak of a MERS-CoV infection in the month of June 2017 in Riyadh region and the hospitals had reported 35 new cases with 5 fatalities. These cases were reported to have occurred in three different clusters, where cluster 1 and cluster 2 were related but cluster 3 was reported to have occurred separately. The WHO also declared details of another hospital outbreak of 13 new cases on the 17th of August 2017 that occurred in the city of Dumah Al Jindal, Al-Jouf. The Ministry of Health, Government of Saudi Arabia have a command and control center and they issue regulations and guidelines regarding case definition of Corona virus infection and regarding the precautions and management of any suspected and confirmed cases.

The WHO has advised all member countries to be vigilant of any new cases and pass on the information regarding their exposure to this organization. WHO also recommends that people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS-CoV infection. These people should avoid contact with camels, drinking raw camel milk or camel urine, or eating meat that has not been properly cooked. However WHO is silent on its guidelines regarding Hajj pilgrims. General guidelines for all travelers apply to them also.

References:

 

1.    CDC Novel Corona Virus  https://www.cdc.gov/features/novelcoronavirus/index.html

2.    WHO MERS-CoV Fact Sheet http://www.who.int/mediacentre/factsheets/mers-cov/en/

3.    WHO MERS-CoV in Saudi Arabia http://www.who.int/csr/don/13-june-2017-mers-saudi-arabia/en/

4.    Ministry of Health, Saudi Arabia Corona Virus

http://www.moh.gov.sa/en/CCC/StaffRegulations/Corona/Pages/StaffRegulations.aspx,

5.    WHO details recent Saudi MERS hospital outbreak, Center for infectious diseases research policy. University of Minnesota.

http://www.cidrap.umn.edu/news-perspective/2017/08/who-details-recent-saudi-mers-hospital-outbreak

 

Author Information: Dr. Latif Ahmed Khan, MBBS; MD; MRCP(UK); FRCP(E) is Consultant Internal Medicine and Endocrinology, King Saud Medical City, Riyadh, Kingdom of Saudi Arabia.

Mobile: +966552149232 Email: khanlatifahmed@gmail.com

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