MERS Watch

The WHO might declare MERS an international health emergency for two main reasons: 1. The virus can cross international borders; and 2. To get the leverage needed to pressure Saudi Arabia into conducting studies on the virus that should have been done 2 years ago.

So no real reason to panic.

"Two years out we still have a poor understanding about basic facts about the virus and its transmission dynamics. It's really kind of unheard of. …People talked about information problems with SARS but we had information much faster with SARS, even though at that point there was a lot of criticism over the way China handled that.... You could make that argument that if you declared a PHEIC you could create more impetus for [the Saudi's] to actually answer these questions," [says Preben Aavitsland, Norway's former state epidemiologist and one of the drafters of the International Health Regulations].

The evidence strongly suggests that camels are MERS' source, but it's not known how people are getting infected [many victims have NOT had contact with camels, hospital infections do not explain MERS' recent rapid spread]. Supposedly, neither the virus itself nor the pattern of transmission has changed - MERS still doesn't spread well enough to transmit person to person in an ongoing fashion. However, if the virus mutates or is introduced into a health-care setting where it can't be controlled, everything could change.

Expert panel convenes to advise WHO on whether MERS is a public health emergency

The cumulative global case count, which only crossed the 200 mark in late March, is fast approaching 600 now. Of those cases, more than 150 have died. (The WHO's count lags behind the tally announced by governments; the global health agency said Saturday it had been informed of 536 cases and 145 deaths.)

Preben Aavitsland, Norway's former state epidemiologist and one of the drafters of the International Health Regulations, believes the emergency committee will advise Director General Margaret Chan to declare MERS a global emergency or PHEIC (pronounced "fake") in the jargon of the WHO.

In Aavitsland's eyes, the declaration should have come long ago. Under the International Health Regulations, a public health emergency of international concern is a disease event that poses a health risk to other states because of the potential for cross-border spread and is one that requires a co-ordinated international response.

….Aavitsland says in his view, the WHO has too infrequently used the public health emergency tool, a fact which makes it harder to unsheathe now.

"That's the problem. It's become such an extraordinary thing to do, to declare a PHEIC, that the general public will be frightened just by hearing that they are doing it," he says.

….The WHO has only declared a public health emergency twice since the International Health Regulations came into effect in 2005. The first time was the 2009 H1N1 flu pandemic. The second came last week, when the embattled polio eradication effort was declared a public health emergency.

2nd case just hit in the US...scary that is went through Atlanta...where I live.

a reply to: Vasa Croe

No real reason to panic just yet.

The important take-home messages:

1. All the crap we've dumped into our environment (and our own bodies) is forcing viruses and microbes to accelerate their evolution, way faster than we can keep up.

2. The new disease mutations we've created through our own negligence have a HUGE effect on human health.

3. Scary diseases are just a plane ride away.

It seems the two just American MERS patients just went to four. It's spreading.

Reuters reported on Tuesday that two staffers at an Orlando, Florida hospital who were exposed to a MERS patient earlier this week have started showing symptoms, and that one of the two workers has been hospitalized as a result.

rt.com...

Some news local...

Een Nederlandse man is besmet met het gevaarlijke MERS-coronavirus. Hij raakte tijdens een bezoek aan Saoedi-Arabië besmet met het potentieel dodelijke virus en wordt momenteel verpleegd in het Medisch Centrum Haaglanden (Westeinde) in Den Haag. Zijn toestand is stabiel. Dat heeft het Rijksinstituut voor Volksgezondheid en Milieu (RIVM) vandaag gemeld.

www.hln.be...
Translation :

A dutch man is infected with the dangerous MERS-Coronavirus. He might have caught his infection during a trip to Saudi Arabia. He condition is stable.

So this is spreading and getting close to home...

originally posted by: soficrow
3. Scary diseases are just a plane ride away.

Call me crazy but I don't know why people are allowed to travel into and out of areas with serious infectious disease problems. Fix that crap and then you can join the rest of us. Heck, even schools won't let kids come to school sick. LOL!

I have been thinking, so MERS started out in Saudi Arabia, the Saudi's are the players behind the rebellion in Syria, they are spending millions in funding.

Could this MERS be some kind of biological warfare?

#3

US reports third case of potential MERS virus

Washington (AFP) - A third potential case of the dangerous Middle East Respiratory Virus (MERS), has been found in the United States, health authorities said Tuesday.

"Two of the 20 team members exposed to the confirmed MERS patient are showing symptoms," said Geo Morales, spokesman for the Orlando hospital where one infected patient was treated.

"One of the two has been admitted to the hospital but is in stable condition. The other was treated and discharged and is following precautions at home. All 20 team members have been tested and we are expecting those results within the next day or two," the spokesman added.

link

a reply to: kosmicjack

What's crazy is they will never do exactly what you mentioned.

I'm afraid this will be a repeat of what they said about the outbreak that came out of Mexico several years ago.

Oh well, The horse is already out of the barn.

Health officials said Tuesday roughly 500 people may have been exposed to the MERS virus by flying on planes within the United States with the sick patient.

link

originally posted by: kosmicjack

originally posted by: soficrow
3. Scary diseases are just a plane ride away.

Call me crazy but I don't know why people are allowed to travel into and out of areas with serious infectious disease problems. Fix that crap and then you can join the rest of us. Heck, even schools won't let kids come to school sick. LOL!

Quarantine doesn't really work - that's why it was abandoned for disease control over a century ago. Truth is, prevailing winds can carry a lot of this stuff - doesn't much matter when climates are inhospitable but factor in a bit of warming....

Then there's the farmer's creed: No point quarantining the horses if you don't clean the barn.

Severe acute respiratory syndrome: Did quarantine help?

....Mass quarantine for disease control was essentially abandoned last century. Does it deserve a second look?

An outbreak should meet the following three criteria for quarantine to be a useful measure of disease control:

* first, people likely to be incubating the infection must be efficiently and effectively identified;
* second, those people must comply with the conditions of quarantine; and
* third, the infectious disease in question must be transmissible in its presymptomatic or early symptomatic stages.

The use of quarantine in the Toronto [SARS] outbreak failed on all three counts.

It's a conundrum.

originally posted by: MessageforAll
I have been thinking, so MERS started out in Saudi Arabia, the Saudi's are the players behind the rebellion in Syria, they are spending millions in funding.

Could this MERS be some kind of biological warfare?

I seriously doubt it. The evidence shows it's a zoonotic disease - camels definitely carry it and maybe bats. The Saudis practically worship their camels and maybe are protecting them. ....I do not support killing birds to prevent bird flu, or killing off the camels to prevent MERS - mainly because life, and disease, is much more complicated and interconnected than we know.

a reply to: MessageforAll
a reply to: MrLimpet

Great updates guys. Thank you.

S&

Mixed messages? Anti-lawsuit strategies?

World Health Organization: MERS isn't an emergency

The World Health Organization said it is very concerned about a potentially lethal virus called MERS, but it stopped short of calling the recent outbreak a public health emergency.

The Middle East Respiratory Syndrome virus, which originated in Saudi Arabia, has been spreading rapidly since March and has been transmitted recently by travelers to seven different countries, including the United States.

WHO says deadly MERS virus does not constitute global emergency

UN warns countries to bolster MERS fight

The World Health Organisation says its emergency committee, which includes global medical and policy experts, had flagged mounting concerns about the potentially fatal Middle East Respiratory Virus.

WHO's health security head, Keiji Fukuda, has told reporters their concerns have become urgent as the situation has increased in seriousness.

The agency called on countries to improve infection prevention and control, collect more data on the virus and to be vigilant in preventing it from spreading to vulnerable countries, notably in Africa.

Cases of MERS have been diagnosed across eighteen countries inlcuding two in the United States.

Denver International Airport, 21 other airports adding MERS warning signs to alert passengers

Ooops. Forgot to post this update.


Second MERS case confirmed in Netherlands

Deadly MERS Camel Virus Crosses Ocean to U.S. ….cases have nearly tripled in past two months

….MERS-CoV suddenly seems to be spreading its wings. At the end of March, the world had seen only 207 MERS cases in total, 163 of them in Saudi Arabia. By April 27, that number had doubled. It is now on the cusp of tripling. Since its April 2012 debut, roughly 600 people in 19 countries have been diagnosed with MERS. At least 175 of those patients have died, a case fatality ratio—30 percent—that gives pause to everyone who calculates it.

Fortunately, so far it seems MERS-CoV is not that easy to catch, especially if you are not in close proximity to dromedary camels—the, or at least a, source of MERS infection—or seeking care in one of the Saudi, Emirati or Jordanian hospitals that have recently seen spread among health care workers and patients. In Saudi Arabia in particular, multiple hospital outbreaks have tossed gasoline on smoldering embers: The country’s case count has soared since the beginning of April to 511 cases and 157 deaths. That is three and a half times as many deaths as Toronto recorded during its 2003 outbreak of MERS-CoV’s cousin, the SARS coronavirus.

The explosion of cases seems to have galvanized some action. …

…"….if MERS is spreading within Saudi Arabia, imagine it in a hospital in Bangladesh,” Khan says.

….There are currently no drugs to cure MERS, and no vaccine to prevent it. If one could be made, it will take years to develop and license. Meanwhile, although Saudi authorities are warning their citizens not to drink unpasteurized camel milk and to wear gloves when caring for the beasts, the ubiquity of the animals, their importance to the region’s economy and their popularity suggest camel-to-person transmission of MERS-CoV will continue to occur.

The cause of the current MERS spike remains unknown - it can't be explained by hospital infections or exposure to camels.

Silently among us: Scientists worry about milder cases of MERS

(Reuters) - Scientists leading the fight against Middle East Respiratory Syndrome say the next critical front will be understanding how the virus behaves in people with milder infections, who may be spreading the illness without being aware they have it.

Establishing that may be critical to stopping the spread of MERS, which emerged in the Middle East in 2012 and has so far infected more than 500 patients in Saudi Arabia alone. It kills about 30 percent of those who are infected.

...."Asymptomatic carriers of diseases can represent a major route for a pathogen to spread," said Dr Amesh Adalja of the University of Pittsburgh Medical Center.

....there may be people with mild cases "that can serve as a way for the virus to spread to other individuals, which makes it a lot harder to control," Adalja said.

Scientists are especially concerned because a lot of recent cases of MERS are among people who did not have contact with animals such as camels or bats that are believed to be reservoirs for the virus.

"If they don't have animal contact, where do they pick it up? Potentially, asymptomatic cases," said Dr Michael Osterholm, an infectious disease expert from the University of Minnesota.

PS. imho - the existence of asymptomatic cases suggests developed immunity, which suggests integration of MERS viral DNA into the human genome of previously exposed individuals, which suggests a kind of harmonized adaptation process.

Foreign doctors, nurses in Saudi Arabia could take MERS global

NEW YORK (Reuters) - The biggest risk that Middle East Respiratory Syndrome will become a global epidemic, ironically, may lie with globe-trotting healthcare workers.

From Houston to Manila, doctors and nurses are recruited for lucrative postings in Saudi Arabia, where MERS was first identified in 2012. Because the kingdom has stepped up hiring of foreign healthcare professionals in the last few years, disease experts said, there is a good chance the MERS virus will hitch a ride on workers as they return home.

"This is how MERS might spread around the world," said infectious disease expert Dr Amesh Adalja of the University of Pittsburgh Medical Center.

It can take five to 14 days for someone infected with MERS to show symptoms, more than enough time for a contagious person to fly to the other side of the world without being detectable. Healthcare workers "are at extremely high risk of contracting MERS compared to the general public," Adalja said.

full story

There is no doubt MERS is spreading between people, and not being caught from camels or bats. The good news: It's not spreading easily or efficiently.

According to the WHO, nearly 75 per cent of recently reported cases of MERS are "secondary cases," many of whom are health-care workers who have contracted the virus within a healthcare environment.

Al Jazeera reports that MERS is airborne, but that is not confirmed by other sources. Numerous agencies are reporting possible treatments and working on vaccines. Airplanes are flagged as sources of infection - seems current cleaning standards are not effective - e. coli and MRSA (maybe MERS?) can live for days on airplanes' surfaces.

Mapping MERS as virus spreads globally

….The contagious virus spreads airborne, making it easy to spread from person to person, putting health care workers at risk in particular.

….Health care officials recommend that anybody who is suspected of having MERS be put on “total precaution.”

“That means a combination of everything we need to do to prevent illnesses from spreading in a health care setting: by contact, by blood, and most importantly and most likely in this case airborne, and that’s the hardest one to do,” Behrman said.

E.coli, MRSA can linger on airplane surfaces for days, study shows

Beautiful news since I have a coworker going to Hawaii this December.

a reply to: ketsuko

Great update and overview - worth reading.

Experts keeping a close watch on Mers coronavirus

Daniel Bardsley
May 24, 2014 Updated: May 24, 2014 20:17:00

Up until just a couple of months ago, there were just 15 or so cases a month. But then, in April alone, there were more than 200. This month scores more have been reported. The recent spread of Middle East Respiratory Syndrome (Mers) has been nothing if not dramatic.

....“We’ve seen a really sharp turn in the trajectory … [and] we’re seeing much more spillover to other parts of the world,” said Dr Kamran Khan, an associate professor at the University of Toronto and a specialist in infectious diseases at St Michael’s Hospital in Toronto. Last year he published a study on the international spread of Mers, and describes the recent rise as “very concerning on a number of fronts”.

It appears though, that the feared tipping point, when the virus mutates to become more easily passed from person to person, has not yet been reached.

....And for a disease whose homeland is Saudi Arabia, there is an ever-present concern: the huge number of pilgrims making the trip to Mecca each year from every corner of the world. That number will surge next month, as many perform Umrah during Ramadan, and again in October when millions perform Haj.

....“It’s not a greyhound virus or a highly aggressive virus like a bulldog,” he said. “It’s like a dachshund. A little dachshund with short legs is not going to get anywhere.”

....