What is Middle Eastern Respiratory Syndrome (MERS) ?

 

South Korea has reported three new cases of Middle Eastern Respiratory Syndrome (MERS), bringing the total number of people infected to 169 in the largest outbreak outside of Saudi Arabia.
The country's health ministry also reported its 25th fatality on Sunday, after the death of a patient who also had a heart condition and diabetes.

Sunday's announcement came a day after the country reported no new cases, raising hopes that Seoul was winning the battle to contain the virus.

Two of the cases newly diagnosed on Sunday involved medical workers, the AFP news agency reported.
They included a doctor who treated a MERS patient at Samsung Medical Center in Seoul, seen as the epicentre of the outbreak, where more than 80 people have been infected. The other medical worker had taken x-rays of a patient in another Seoul hospital.

A total of 43 people have so far recovered and have been released from hospital, including seven between Friday and Saturday, the ministry said.

Fourteen patients are in a critical condition, it said.

The number of new patients had been falling for three straight days from eight on Tuesday to none on Saturday.

The number of people exposed to patients and quarantined at state facilities or at home also fell to 4,035 on Saturday from a peak of more than 6,700 on Wednesday.

The outbreak began on May 20 when a 68-year-old man was diagnosed after returning from a trip to Saudi Arabia.

Since then the virus has spread at a rapid pace, sparking public alarm that prompted the temporary closure of thousands of schools and trip cancellations by more than 120,000 foreign tourists. 
Almost all patients were infected in hospitals and the World Health Organization (WHO) said it had found no evidence of transmission of the virus within communities outside hospitals.

WHO chief Margaret Chan said on Thursday that Seoul was now "on a very good footing" after an initially slow response.

Most schools reopened last week except for about 120 mostly in Seoul, Gyeonggi province surrounding the capital and Busan, the second-largest city.

There is no known vaccine for MERS, which has a mortality rate of 35 percent, according to the WHO.
The outbreak sparked alarm elsewhere in Asia, with Thailand confirming its first MERS patient on Thursday.

An Omani man, 75, who was recovering from the virus in Bangkok was "slightly better" on Saturday, a health ministry spokesman told AFP, while no other cases in Thailand had been confirmed.
 

 What is MERS?


Middle East Respiratory Syndrome (MERS) -  is a viral respiratory illness that is new to humans. It was first reported in Saudi Arabia in 2012 and has since spread to several other countries, including the United States. Most people infected with MERS-CoV developed severe acute respiratory illness, including fever, cough, and shortness of breath. Many of them have died.

Where is MERS occurring?

The following 25 countries have reported cases of MERS: Iran, Jordan, Kuwait, Lebanon, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Yemen (Middle East); Austria, France, Germany, Greece, Italy, Netherlands, Turkey, and the United Kingdom (UK) (Europe); Algeria, Tunisia and Egypt (Africa); China, Malaysia, Republic of Korea and the Philippines (Asia); and the United States of America (Americas).

What are the symptoms of MERS? How severe is the syndrome?

A typical case of MERS includes of fever, cough, and/or shortness of breath. Pneumonia is a common finding on examination. Gastrointestinal symptoms, including diarrhoea, have also been reported. Severe illness can cause respiratory failure that requires mechanical ventilation and support in an intensive‐care unit. Some patients have had organ failure, especially of the kidneys, or septic shock. The virus appears to cause more severe disease in people with weakened immune systems, older people, and those with such chronic diseases as diabetes, cancer and chronic lung disease.

Can a person be infected with the MERS virus and not be ill?

Yes. Infected persons with no symptoms have been found because they were tested for MERS‐CoV during follow‐up studies of contacts of people with MERS infection. It is not always possible to identify patients 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.

How do people get MERS-CoV?

Transmission from animals to humans

It is not yet fully understood how people become infected with MERS‐CoV, which is a zoonotic virus. It is believed that humans can be infected through direct or indirect contact with infected dromedary camels in the Middle East. Strains of MERS-CoV have been identified in camels in several countries, including Egypt, Oman, Qatar and Saudi Arabia.

Transmission from humans to humans

The virus does not appear to pass easily from person to person unless there is close contact such as providing clinical care to an infected patient while not applying strict hygiene measures. This has been seen among family members, patients, and health‐care workers. The majority of cases have resulted from human-to-human transmission in health care settings.

Is MERS-CoV contagious?

Yes, but apparently only to a limited extent. The virus does not seem to pass easily from person to person unless there is close contact, such as occurs when providing unprotected care to a patient. There have been clusters of cases in health‐care facilities, where human‐to‐human transmission appears to be more efficient, especially when infection prevention and control practices are inadequate. Thus far, no sustained human-to-human transmission has been documented.

What is the source of the MERS virus—bats, camels, domestic animals?

The source of the MERS-CoV is not yet fully clear. A coronavirus very similar to the one found in humans has been isolated from camels in Egypt, Oman, Qatar, and Saudi Arabia. . It is possible that other reservoirs exist. However, other animals, including goats, cows, sheep, water buffalo, swine, and wild birds, have been tested for MERS‐CoV, but so far none have been found in these animals. These studies combined support the premise that dromedary camels are a likely source of infection in humans.

Should people avoid contact with camels or camel products? Is it safe to visit farms, markets, or camel fairs?

In countries in the Middle East affected by MERS-CoV, as a general precaution, anyone visiting farms, markets, barns, or other places where animals are present should practice general hygiene measures, including regular hand washing before and after touching animals, and avoid contact with sick animals.
The consumption of raw or undercooked animal products, including milk and meat, carries a high risk of infection from a variety of organisms that might cause disease in humans. Animal products processed appropriately through cooking or pasteurization are safe for consumption, but should also be handled with care to avoid cross‐contamination with uncooked foods. Camel meat and camel milk are nutritious products that can continue to be consumed after pasteurization, cooking, or other heat treatments.
Until more is understood about MERS, people with diabetes, renal failure, chronic lung disease, and immunocompromised persons are considered to be at high risk of severe disease from MERS‐CoV infection. Especially in the Middle East people should avoid contact with camels, consuming raw camel milk or camel urine, as well as eating meat that has not been properly cooked.
Camel farm and slaughterhouse workers in the affected areas should practice good personal hygiene, including frequent hand washing after touching animals, facial protection where feasible, and the wearing of protective clothing, which should be removed after work and washed daily. Workers should also avoid exposing family members to soiled work clothing, shoes, or other items that may have come into contact with camels or camel excretions. Sick animals should never be slaughtered for consumption. People should avoid direct contact with any animal that has been confirmed positive for MERS‐CoV.

Is there a vaccine against MERS‐CoV? What is the treatment?

No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient’s clinical condition.

Are health‐care workers at risk from MERS‐CoV?

Yes. Transmission of MERS-CoV has occurred in health‐care facilities in several countries, including from patients to health‐care providers. It is not always possible to identify patients with MERS‐CoV early or without testing because symptoms and other clinical features may be non‐specific.
For this reason, it is important that health‐care workers apply standard precautions consistently with all patients.
Droplet precautions should be added to standard precautions when providing care to all patients with symptoms of acute respiratory infection. Contact precautions and eye protection should be added when caring for suspected or confirmed cases of MERS‐CoV infection. Airborne precautions should be applied when performing aerosol‐generating procedures.

Does WHO recommend any travel or trade restrictions related to this new virus?

WHO does not recommend the application of any travel or trade restrictions at this point. Based on countries’ risk assessment, precautions aimed at raising awareness of MERS-CoV and its symptoms among travellers to and from affected areas, can be taken.

How is WHO responding to the MERS-CoV outbreak?

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 is working with affected countries and international technical partners and networks to coordinate the global health response, including providing updated information on the situation, conducting risk assessments and joint investigations with national authorities, convening scientific meetings, and developing guidance and training for health authorities and technical health agencies on interim surveillance recommendations, laboratory testing of cases, infection prevention and control, and clinical management.





Info:-
1. http://www.aljazeera.com/news/2015/06/south-korea-reports-mers-cases-150621044938952.html
2. http://www.who.int/csr/disease/coronavirus_infections/faq/en/