MERS COV (Middle East Respiratory Syndrome Coronavirus) first appeared in Saudi Arabia in 2012. This disease is caused by a corona-virus, much like the SARS epidemic in 2003. A great deal of work was done early in the epidemic to identify the original host for this virus. Although there is a great deal of evidence associating the virus with camels, which are also infected, it now seems that the original host may be the Egyptian tomb bat, an appropriately scary name for a disease vector. Given that many other viruses seem to have bats as their original hosts, this would be unsurprising if true. The disease is a respiratory virus, which causes difficulty breathing, coughing, and fatigue. Roughly 40% of patients die.
From its inception, scientists and public health workers have been trying to determine the extent to which this virus might prove to be a threat to global health. Initially, it seemed that the rate of human to human transmission was low. At times there was some frustration on global health and infectious disease blogs, where there was a perception that Saudi authorities were less forthcoming than their Chinese counterparts who were dealing with bird flu. These critiques have not become less intense with time. Still, after this year’s Haj (pilgrimage to Mecca) there was a sigh of relief amongst public health authorities. Sadly, this may have been too soon.
The Center for Infectious Disease and Research (CIDRAP) at the University of Minnesota has a new post stating that Saudi Arabia has announced nine new cases in the city of Jeddah. Many of the cases seem to be in the health care sector, which may be causing protests amongst health care workers. If the outbreak is spreading in a hospital setting, this would resemble the experience with SARS in Canada. There has been a similar outbreak of MERS cases in the United Arab emirates, where ten health care workers have been infected. One of these health care workers recently returned to the Philippines, where he is now in quarantine with his family, although he is asymptomatic, because he tested positive for the virus. Yemen has also just announced its first case, an engineer. In Malaysia, a man recently died after returning from Saudi Arabia for the Haj. This is the first death in Asia from the disease.
Dr. Ian Mackay posts frequently at the excellent Virology Down Under blog site. One of the most helpful resources on the blog are his charts based on reports regarding MERS, which place the quantitative data in a visual format. His most recent post shows the steep climb in reported MERS cases. To me, this seems to be a moment in some ways similar to spring in 2009, when we first became aware of a new influenza strain circulating in Mexico. This particular virus has a high fatality rate, but it still seems to have difficulty with person to person transmission. It’s too early to know if this is the start of the next pandemic, or if the disease will sputter out as we go into summer.
One great site to keep track of events is the Avian Flu Diary, which is a blog on infectious disease in general. It has frequent updates on MERS-COV, as well as avian influenza. If you are interested in infectious disease, and would like to read an article that I wrote on bird flu, vaccines and global equity, click here, and you can download the article. Let’s keep our fingers crossed that this flare in MERS cases soon dies back down.
Shawn Smallman, Portland State University