Wednesday, April 30, 2014

MERS in Saudi Arabia … by gimleteye

Middle East Respiratory Syndrome (MERS)
There has been heightened public awareness about virulent viral epidemics since SARS alarmed the world in 2002 and then the scare about the H1N5 virus called bird flu. Why am I writing about this? I just returned from Japan with a family sitting behind me who all were coughing and hacking through the 10 hour flight. It is no surprise that airports are vectors for easily transmissible diseases. On that count alone, Miami needs to pay attention.

SARS, a decade ago, and outbreaks of flu in chicken processing plants and markets -- again, mostly in Asia -- have sharpened the expertise of WHO epidemiologists who track highly infectious diseases, especially those that shows signs of becoming easily transmissible between humans.

Now there is a nasty virus called MERS has been percolating in Saudi Arabia. It is believed to have originated in bats or camels and can infect people. There is evidence the virus is now transmissible between people.

On April 29, the Wall Street Journal reported, "Thirty new cases in the kingdom since Saturday—at least 11 of them among health workers—brought Saudi Arabia's total confirmed instances of Middle East Respiratory Syndrome, or MERS, to 345, with 105 fatalities, since the disease was identified in September 2012. Egypt became the latest of five countries—including Malaysia, the Philippines, Greece and Yemen—to confirm its first cases in April, all in travelers from the Gulf."
Distribution of confirmed cases of MERS-Cov by month of onset and probable place of infection (Source: European Centre for Disease Prevention and Control)

Helen Branswell, the Canadian journalist who has done outstanding reporting on the science and on-the-ground policy makers on emerging viruses, writes that -- so far -- the MERS virus has not gone through the genetic changes that make easy human-to-human transmission.

But her most recent report was qualified, since the entire genomic sequence of the virus had not yet been untangled to compare to earlier versions. Moreover, Branswell notes that the late April spike in viral cases in Saudi Arabia, including many health care workers tending to the ill, was uncharacteristic of what had been to that point in time a relatively slow spread of MERS. The geographical distribution of cases has widened. This obviously puts a stressed medical response effort at risk as well.

Few are aware of the intense, dangerous work by policy makers, health care professionals and law enforcement -- really a miracle of modern technology and heroic, individual initiatives -- to contain the SARS epidemic in 2002. SARS was highly contagious with tragic consequences mostly in Asia, although the disease did spread to Canada before it was contained. MERS is also proving to be lethal, with fatalities reported in about 30 percent of reported cases.

With MERS, the World Health Organization and its dedicated first responders have not had any easy time in the secretive Saudi kingdom. According to Branswell, the Saudi government is gradually elevating the MERS problem to a public health emergency requiring significant international cooperation.

The world needs full transparency because there will be very little time to react, if a virulent virus like MERS does become easily transmittable.
Distribution of confirmed cases of MERS-CoV by reporting country, March 2012 - April 2014 (Source: European Cenre for Disease Prevention and Control)
With world economies and industrial supply lines dependent on uninterrupted flow of goods and services across national boundaries, think of the impacts of a tornado or hurricane but on a global scale.

The best course for people is to stay informed. It would also help, if people would do a better job of separating paranoia about our enemies, founded or unfounded, from the need for real cooperation between all nations to protect peoples' health from dangerous viruses, wherever and whenever they pop up. Today, for example, polio has re-emerged in Syria and Pakistan because military conflicts, intransigent generals and political officials are preventing doctors from administering to the ill and providing easily available vaccines.

To paraphrase, people are entitled to their own politics, but they are not entitled to stupidity when it comes to dealing with a killer virus.


Anonymous said...

Half the cases are fatal. Better buy some masks.

Anonymous said...

Geeze, just had a friend come back from Dubai.

Anonymous said...

If we all just started to wear berkas, this wouldn't be a problem.

Anonymous said...

Well, it's here in America now.