Concerns Rise Over MERS
By June 11, 2015, nine deaths were attributed to Middle East Respiratory Syndrome (MERS) in South Korea, where 130 cases had been confirmed. It is the largest outbreak of the viral disease recorded outside the Arabian Peninsula so far.
So just what is MERS? Does the airborne virus causing it pose a greater global health threat?
The mortality experienced in the wake of the 2003 Severe Acute Respiratory Syndrome (SARS) outbreak has led the World Health Organisation (WHO) and other national agencies to take the threat from MERS very seriously.
MERS is a close relative of SARS. Both illnesses are the result of infection with coronaviruses, which are widespread - some strains even cause the common cold. MERS-CoV is the coronavirus responsible for MERS. But unlike the common cold, infection with MERS-CoV can lead to life-threatening complications including respiratory and kidney failure.
As of June 1, the WHO had reported 1,150 laboratory-confirmed cases and 450 deaths in the current MERS outbreak although the real number could be much higher. It is worth noting there were 8,098 probable cases of SARS between 2002 and 2003, resulting in 774 deaths.
The MERS outbreak has progressed slowly. The first new case was reported in Saudi Arabia in 2012, and since then incidents have been reported in many other countries, most recently and most significantly in Asia, far from where MERS has mostly been reported.
There are some major differences between MERS and Ebola – the other virus responsible for causing an outbreak in the past year. Not only is Ebola confined to West Africa, it is also spread via direct contact with an infected individual. MERS is spread through the air.
People of all ages are at risk of getting MERS. The incubation period is typically two to five days but may extend to 14 days. The virus spreads by close contact among family members or those caring for people with the infection. Most of those infected in South Korea have been health workers at a single hospital. Wider community spread hasn’t occurred but its potential is a concern. More than 3,000 people in South Korea were reportedly quarantined early June in an attempt to stop the spread.
Some people are wearing face masks to protect themselves. To be effective, it must be a standard N95 mask (because it filters 95% of the particles). However, it isn’t clear whether wearing any type of mask can prevent the inhalation of airborne coronaviruses. As of June 11, there were no restrictions on travel to countries because of MERS, but Hong Kong and Taiwan have warned against travel to South Korea.
Identifying who is at risk is difficult because the outbreak isn’t isolated geographically. In theory, anyone disclosing a respiratory illness of an unexplained origin could harbour MERS. Those who have had contact with an infected individual are advised to monitor their temperatures twice a day for at least two weeks after exposure and report any fever, coughing or breathlessness.
No vaccination or antiviral treatment exists. Observed mortality ranges from 10% to 30%, but it is highest in people with other conditions.
However, because there is little data on the number of people with subclinical infection, it is likely that mortality attributed to MERS-CoV infection alone may be overestimated.
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