Middle Eastern Respiratory Syndrome (MERS), which was first identified in the Middle East in 2012, is caused by the Coronavirus (therefore called Middle Eastern Respiratory Syndrome-Coronavirus or MERS-CoV). While MERS-CoV has been categorized as low-risk in the U.S., these 10 facts about MERS-CoV will help travelers in making informed judgments about travel and general precautions:

  1. Between 2012 and December 2016, 1,841 laboratory-confirmed cases of MERS-CoV have been reported to the World Health Organization (WHO), 80 percent of which have been from Saudi Arabia.
  2. The Centers for Disease Control (CDC) has issued a Level 2 Alert, signifying “Practice Enhanced Precautions,” for people traveling to the Arabian Peninsula.
  3. MERS-CoV is communicable in nature. However, it does not easily pass from human to human unless there is close contact, such as in a healthcare setting. Though we still do not know of the virus’s exact communication method, it is thought to be transmitted through an infected person’s respiratory secretions such as coughing.
  4. MERS-CoV is a zoonotic virus, which means that it is transmitted between animals and humans. Studies have shown that the virus has been transmitted to humans through direct or indirect contact with infected dromedary camels.
  5. The WHO recommends that people traveling to the Arabian Peninsula avoid contact with camels and are advised against drinking camel milk or raw camel urine and eating undercooked meat of any kind, especially camel meat.
  6. Once infected, a person shows symptoms like fever and cough with initial clinical features symptomatic of Severe Acute Respiratory Syndrome (SARS).
  7. Outside of the Arabian Peninsula, the largest known outbreak of MERS occurred in the Republic of Korea in 2015. The patient zero for this outbreak was identified as a traveler returning from the Arabian Peninsula.
  8. MERS has been categorized as a very low-risk illness in the U.S. Only two positive cases have ever been reported in the U.S., and both of these cases were among healthcare providers who had worked in the Arabic peninsula.
  9. The mortality rate for MERS-CoV patients is around 35 percent. However, those that died have been known to have an underlying medical condition. Some of the reported pre-existing conditions included cancer, diabetes and chronic lung, heart and kidney disease. In addition, people with weakened immune systems are more likely to be infected or have a severe case of the disease.
  10. Most patients without any underlying pre-existing conditions exhibited mild or no symptoms and made a full recovery.

Since its first reported occurrence in 2012, epidemiologists have been trying to understand the patterns of the virus’s transmission from animals to humans. According to the WHO, the most urgent need is to understand better and identify the risk factors for the virus’s transmission so healthcare environments can be better equipped in case of another outbreak. Regardless, educating communities regarding these facts about MERS-CoV will help in establishing better surveillance and quarantines in the future.

Jagriti Misra

Photo: Flickr

Kuwait is located on the Arabian Gulf and sits between Iraq, Iran and Saudi Arabia. According to the World Travel Guide, Kuwait has a number of tourist attractions, even though its location might hinder it from topping the list for many travelers. Kuwait sits on a beautiful coastline and has many impressive buildings and eateries. As with any other destination, travelers should take the necessary precautions to avoid contracting the top diseases in Kuwait.

The Center for Disease Control (CDC) recommends that all travelers to Kuwait get vaccinated for hepatitis A and typhoid. Both diseases can be contracted through contaminated food or water, and thus it is important for travelers to be careful when choosing where to eat. Luckily, the World Travel Guide lists many restaurants known for both safety and fine dining, including Pepper Steak House and Ayam Zaman Restaurant. The CDC recommends using available resources such as this guide to determine where it is safe to eat to avoid contracting the top diseases in Kuwait as a traveler. The CDC also warns that travelers staying with family or friends or in more rural areas are at a greater risk of catching typhoid.

Another pervasive disease in Kuwait is Middle East Respiratory Syndrome (MERS). MERS is a respiratory virus unlike any other known viruses, according to the CDC. It causes a fever, cough, shortness of breath and, in some cases, can be fatal. The first case was reported in 2012 in Saudi Arabia, and it is quickly becoming one of the top diseases in Kuwait. A fatal case of MERS was reported to the World Health Organization (WHO) in September 2015. The WHO issued a warning which states that individuals who have diabetes, renal failure, chronic lung disease or are immunocompromised have the greatest risk of contracting a MERS infection. The report cautions those at risk against contact with animals, especially camel,s and recommend good hygiene practices, along with avoiding the consumption of raw milk and undercooked meats.

In 2015, the WHO did not recommend any travel restrictions for Kuwait, as there is no evidence that indicates MERS can be transferred through person-to-person contact. However, in May 2016, the CDC issued a level two alert after cases of MERS were seen in several countries around the Arabian Gulf. These cases occurred in travelers and also in people they had been in close contact with. The CDC does not discourage travel to these areas, but they recommend that travelers consult with a doctor to determine risk factors and if additional precautions are necessary.

Helen Barker

Photo: Flickr

Health_SaudiArabia MERSAn outbreak of Middle East Respiratory Syndrome (MERS) was reported in Saudi Arabia on March 21, 2016. Mers-CoV is a viral respiratory illness new to humans. The first case was reported in 2012. According to the Centers for Disease Control and Prevention, MERS has a high mortality rate, three to four of every 10 patients who become ill with MERS die.

Caused by a coronavirus and found in camels, the illness has been linked to countries near the Arabian Peninsula. Health organizations such as WHO and the CDC advise against consuming raw camel products like meat and milk that is not pasteurized.

Due to travel, outbreaks have occurred in 26 countries throughout the globe, including cases in the U.S. The largest outbreak outside of the Middle East occurred in the Republic of North Korea in 2015.

A typical case of MERS begins with a cough, fever and shortness of breath. If the virus progresses, an individual can experience pneumonia, kidney failure or septic shock.

“It is not always possible to identify people with MERS-CoV early because the early symptoms are non-specific. For this reason, all health care facilities should have standard infection prevention and control practices in place for infectious diseases,” according to the World Health Organization. “It is also important to investigate the travel history of patients who present with respiratory infection.”

Human-to-human transmission has not been common except in places where there is extremely close contact, such as health care facilities. People with diabetes, renal failure, lung disease and compromised immune systems are especially vulnerable to becoming infected with MERS and should be evaluated immediately after being in close proximity to the disease.

There is not yet a vaccine for MERS or any specific antiviral treatment. Symptoms of the illness can be relieved with medical care. Preventative actions such as hand washing, avoiding those infected and disinfecting frequently touched surfaces. These actions serve as the only forms of protection at this point.

“WHO is working with clinicians and scientists to gather and share scientific evidence to better understand the virus and the disease it causes, and to determine outbreak response priorities, treatment strategies, and clinical management approaches,” WHO said about their response to MERS.

Of the four cases reported this month in Saudi Arabia, one patient died.

Emily Ednoff

Photo: Wikipedia

The number of MERS cases is increasing. The number has risen from 575 to 688 in the worst afflicted country, Saudi Arabia, and continues to show up in pockets in areas of the world less affected, including Algeria and the United States. As of June 4, WHO reported 681 laboratory-confirmed MERS cases and 204 deaths from the disease.

Professional health care experts assure that, at this point, the general public does not need to worry about the illness. If you have traveled to the Middle East, where the disease is rampant, you are much more likely to contract the disease, which is spread person-to-person. The symptoms are flu-like, including fever, cough, shortness of breath. Those thought to have contracted the virus are put in negative-pressure rooms and masked immediately in order to prevent further outbreak.

Recent findings have discovered the virus’ possible origins: camel milk. Drinking camel milk is a widespread tradition in the Middle East, and the Qatari government is urging everyone to boil the milk before consumption.

Hospital breaches have also contributed to MERS’ spread. Saudi Arabia in particular has been highly criticized for its lack of proper care in hospitals, which allowed the virus to further spread. The Saudi health ministry has put in more strict measures, and WHO has been “diligently” following up on reports of the disease.

Until then, the virus continues to increase in the Middle East. With a 30% mortality rate, the disease is spreading rapidly in other, more malnourished parts of the world. While there is still not a vaccine for the virus, the CDC has released prevention methods against contracting the disease, including washing your hands with soap and water often, covering your mouth and nose with a tissue when you cough and/or sneeze, avoiding touching your eyes, nose and mouth, and avoiding intimate contact with sick persons.

– Nick Magnanti

Sources: ECDC, Health Map, NY Daily News, Science Mag, Seacoast Online
Photo: Science News

MERs Virus, Mecca
The MERS (Middle East Respiratory Virus) appeared this week in Mecca, the Muslim holy capital in Saudi Arabia. Officials confirmed 11 new cases of the virus within the nation this Wednesday; four surfaced in the capital of Riyadh, six appeared in Jeddah and one case was identified as MERS in Mecca. The outbreak has sparked significant concern as Ramadan approaches in July, with millions expected to travel to the holy city for the fasting holiday, and in October during the annual Haj.

This case illustrates the virus’ potential to travel far and wide. These cases increase the amount of identified MERS cases in Saudi Arabia to 272. Of the 272 cases, 81 of those afflicted have died.

The first case of MERS surfaced two years ago in the Middle East. It is related to the SARS virus, and causes heavy coughing, pneumonia and high-temperature fevers.

As public alarm increases, King Abdullah of Saudi Arabia has replaced Saudi health minister Abdullah al-Rabeeah with Labor Minister Adel Fakieh, who visited King Bahd hospital in Jeddah to observe those receiving treatment at the facility.

The virus’ deadly spread demands a race for a cure or vaccine. “Multiple vaccine developments are under way,” said Philip Dormitzer, the global chief of virology at Novartis Vaccines. However, experts say that though developing vaccines for the virus are feasible, “neither the market economy nor the vaccine development process is likely to report it.”

MERS is a serious threat to public health, not only in the Middle East, but on a global scale as well. The risk of its spread to other continents is deadly and very possible. Saudi Arabian officials must make efforts to quarantine those afflicted so as to reduce its expansion.

– Arielle Swett

Sources: National Geographic, Reuters
Photo: The West Side Story

The U.S. has seen its third case of the MERS virus this past month. Despite showing no symptoms, an Illinois man was diagnosed with the virus on May 2, his infection proving unique: he is the first person to have contracted the virus in the U.S., which is already prevalent in the Middle East.

The Center for Disease Control and Prevention (CDC) has already begun to issue public warnings regarding the virus and its prevention methods. Yet while CDC response team leader, Dr. David Swerdlow, sees no immediate threat as the disease has had “no sustained transmission” in the U.S. like other viruses such as the flu, MERS is proving to spread rapidly overseas. According to Reuters, about 30 percent of those infected with the virus have died.

While we still know little regarding the origin of the MERS virus, it is characterized as a “severe, acute viral respiratory illness caused by MERS-CoV, a beta coronavirus,” meaning that, according to the CDC, most people will at some point in their life contract the virus. Spread person-by-person, the illness — for which there is still no vaccine  — is on the rise, and while it has not yet been characterized by the CDC as a global health emergency, the virus is continuing to result in an increasing number of fatalities.

While cases of the virus have emerged in nations of varying degrees of wealth, including Egypt, the Netherlands and Jordan, by far the worst-hit country has been its originator, Saudi Arabia. Deaths in Saudi Arabia as a result of the MERS virus have hit a whopping 163 as of May 17. Yet while the country — known for its vast oil wealth and a relatively strong GDP placement compared to other nations  — may not be the most prime example of impoverishment, a startling 20 percent of the nation’s population is still, almost secretly, living in poverty. Crippled by impoverished conditions, the world’s poor may be among those most at risk of contracting the severe virus.

While the future for the virus is still relatively unknown, appropriate actions by the CDC are being put into place in order to ensure proper combativeness in case of a pandemic. Forced now to wait and see the true effects of the virus characterized as a “deadlier, less transmissible cousin of the SARS virus,” the CDC ensures that they are prepared for whatever the outcome.

– Nick Magnanti

Sources: CNN, Al Jazeera, TIME 1, Washington Post, Public News Service, AL, Boston, TIME 2
Photo: ICCS