MERS Virus Found in United States for First Time

Friday, May 2, 2014

4:27 PM

By Unknown

In: 2014, News, Top story, Update

MERS Virus Found in United States for First Time - New York Times

Health |First U.S. Case of MERS Virus Is Found in Indiana Man Who Visited Mideast

A virus that has killed more than 100 people in the Middle East has been found in the United States for the first time, in an Indiana health care worker who recently returned from Saudi Arabia, federal health officials said on Friday.

The man, whose name, age and exact occupation have not been released, is in stable condition in an Indiana hospital, said Dr. Anne Schuchat, director of respiratory diseases at the Centers for Disease Control and Prevention. He is in isolation and receiving oxygen.

A single American case of the virus — called MERS, for Middle East respiratory syndrome — is “a very low risk,” Dr. Schuchat said. The C.D.C. is not recommending that anyone change travel plans to the Middle East.

But a team from the agency will travel to Indiana to assist in treatment and to retrace the patient’s contacts. He flew to Chicago from Riyadh, Saudi Arabia, via London on April 24, then took a bus to Indiana. He fell ill on April 27 and was hospitalized the next day.

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The typical incubation period for MERS is five days, and the patient is not known to have infected anyone else. Airline passenger lists will be used to contact everyone who sat near him.

But because bus companies often do not know who bought tickets or who sat where, “that bus ride may be a challenge,” said Tom Skinner, a C.D.C. spokesman.

MERS is a coronavirus similar to SARS, or severe acute respiratory syndrome, which killed hundreds of people, mainly in China, in 2002 and 2003.

The newer virus was first reported in 2012 in Saudi Arabia. Since then, about 400 cases have been reported to the World Health Organization; about a third have been fatal. (The numbers are inexact because of delays in laboratory confirmations.)

The virus is thought to have originated in bats, but it is also widespread in camels. While it has not spread easily between humans, there have been outbreaks within families and in hospitals, where patients have infected paramedics, nurses and doctors.

For unknown reasons, cases began surging in Saudi Arabia in March. Some experts fear that mutations made the virus more transmissible, while others believe that more camels are transmitting it and that carelessness in hospitals has helped it spread.

The classic symptoms are fever and shortness of breath, which indicates pneumonia, but there have been mild cases and unusual symptoms. The W.H.O. suggests that hospitals test any patient who has returned from the Middle East within 14 days.

There have been large recent outbreaks in Saudi Arabia and in Abu Dhabi, United Arab Emirates, and the first case in Egypt was just reported.

There is no cure. Patients may be put on ventilators and given antibiotics to prevent secondary bacterial infections, in the hope that their immune systems will slowly defeat the virus.

Scientists going through libraries of antibodies, which can prevent a virus from invading new cells, have found two that attach to MERS. But antibody treatments take time to produce, and so far there is no vaccine.

Travelers to the Middle East have been warned to stay away from farm animals, and camels in particular. Camels are raised for meat and milk, for racing, and to haul goods. So-called beauty camels are kept as pets and entered in beauty contests.

Experts suspect that raw camel milk and meat transmit the virus. The Saudi government has warned its citizens against consuming either.

Michael T. Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, said cases might have surged in March because camels are born between November and March. Young camels are most susceptible to the virus and could spread it to their mothers, who are still being milked then.

The W.H.O. is investigating how long the virus can live on surfaces like bedsheets and hospital equipment.

Health authorities advise any hospital with what is suspected to be a case of MERS to have all personnel wear masks, gowns, gloves and face shields to prevent breathing in respiratory droplets or contact with bodily fluids.

Cases have also been reported in Jordan, Kuwait, Oman, Qatar, Tunisia and the United Arab Emirates, and there have been isolated cases in travelers returning to European countries.

Although the W.H.O. has not issued travel warnings, Saudi Arabia suggested last year that older Muslims, young children and people with chronic diseases put off their pilgrimage to Mecca.

The next hajj week is in October, but some Muslims also visit Mecca at other times.

The worst recent outbreak of cases has been in Jidda, Saudi Arabia’s second-largest city, which is the gateway for pilgrims arriving by ship or air, but also a commercial center in its own right. A W.H.O. team is investigating cases there.

Only a few strains of the virus can jump to humans from camels, but those strains appear to grow best in deep lung tissue, said Dr. W. Ian Lipkin, who heads a disease-hunting lab at Columbia University’s Mailman School of Public Health. That suggests that it is mostly easily transmitted in hospitals with respirators or other machines that aerosolize coughs.