A deadly relative of the SARS virus, first detected in 2012 in Saudi Arabia, has made its way from the Middle East to the Mid-West. So far there is no evidence it has been transmitted within the United States, and the patient is in isolation. However, the announcement serves as a reminder of how quickly diseases can move in a world connected by air travel.
Middle East Respiratory Syndrome Coronavirus (MERS-CoV) is known to have infected more than 400 people since September 2012, 111 of whom died and 60% required hospitalization. In November 2013 a bat living near one of the sites where infection has occurred was found to carry the same virus. Although the infection rate in the nearby bat colony seems to be low, it is likely the disease spread to humans from bats, probably via other animals such as camels.
Although MERS' symptoms of pneumonia, fever and kidney failure, are similar to SARS, it has not achieved the infamy of its relative. SARS affected healthy people in the prime of life, while MERS has mainly been fatal people who are already sick from other things.
"We've anticipated MERS reaching the U.S., and we've prepared for and are taking swift action," said Dr Tom Frieden, director of the Centers for Disease Control, "We have been preparing since 2012 for this possibility.".
The patient traveled to Indiana from Saudi Arabia via London and Chicago, started experiencing respiratory symptoms on April 27 and has been hospitalized there. He is reported to be improving "We're doing everything possible with hospital, local and state health officials to find people who may have had contact with this person so they can be evaluated as appropriate,” said Frieden. However, since the virus' method of transmission is not known it will be a challenge to identify who is in danger. It is still possible that human-to-human transmission is difficult and most infections occur from animals, as is the case with some varieties of flu.
In the absence of more information about MERS the CDC have repeated their general advice on avoiding infection by other respiratory diseases – frequent hand washing and avoiding touching eyes, nose and mouth. Even the transmission of much better known diseases such as influenza A remains debated, but are thought to often be picked up by shaking hands or touching surfaces on which the virus has fallen and then touching parts of the face whose moisture and lower temperature makes them suitable entry points to the body. The CDC does not recommend wearing face masks for reducing viral spread.
The identification of antibodies against MERS, published last week, has inspired hope for a therapy or vaccine.