MERS Death Toll Rises; CDC Funds Increased Local Monitoring

Saudi Death Toll Rises to 76:

MERS virus (image from eden.lsu.edu)

The Saudi Health Ministry has announced that 76 people have died so far from the MERS virus which has health officials on alert in the Middle East, Europe and indeed worldwide.

MERS (Middle East Respiratory Syndrome) was first reported in 2012 in isolated clusters on the Arabian Peninsula. It was still unknown if the virus could be transmitted by personal contact. At that time, there were about eleven known cases of the virus, five fatal.

Human to human transmission was confirmed in March, 2013 with the infection and death of a man in Britain. By then, the number of cases had increased to fourteen with eight fatalities. April and May saw a total of 23 infections in eastern Saudi Arabia.

The death toll rose as the disease spread, and by mid-August the numbers had jumped to nearly a hundred total confirmed cases with 46 fatalities. Saudi government officials now report the infection has claimed at least 76 lives in that country alone.

In a more optimistic sign, no new cases of MERS have been reported in Saudi since August 1, 2013 despite thousands of Ramadan pilgrims visiting the country during July and August. Countries are advised to be alert for signs of acute respiratory illness in people having recently returned from the area.

CDC Funds Efforts to Increase Local Monitoring:
The CDC (Center for Disease Control and Prevention) has awarded nearly 76 million dollars to assist state and local communities to beef up epidemiology and laboratories to better identify, track and respond to possible outbreaks of infectious disease. This is in addition to the 13.7 million dollars which was dispersed to local agencies in January, 2013.

The money will be used to hire more than a thousand full and part time epidemiologists, laboratory technicians and health information systems personnel. Noting that many outbreaks of infectious disease are first identified at the local level, the announcement states:

"The annual ELC investment provides public health officials with improved tools to respond to more outbreaks, conduct surveillance faster and prevent more illnesses and deaths from infectious diseases...This crucial CDC investment helps build a competent public health workforce, able surveillance systems, modern and efficient laboratory facilities and information networks."

More information on funding for specific states is available at this CDC website.

See MERS Watch for updated information on this topic.

Worldwide Health Groups Issue MERS Updates

Middle East Respiratory Syndrome (Middle East Respiratory Syndrome Coronavirus, or MERS-CoV; aka Novel Virus) has been quietly spreading on the Arabian Peninsula. There have been nearly a hundred confirmed cases so far, half fatal. (See Deadly New Virus Spreads Through Human Contact)

MERS Coronavirus
Photo from HO-US National Institute for Allergy and Infectious Diseases

Several health organizations, including The Center for Disease Controls (CDC), The World Health Organization (WHO) and The European Centre for Disease Prevention and Control (ECDC) have issued new guidelines or updated information regarding the dangerous MERS virus which has killed 45 people in the Arabian Peninsula and southern Europe, with the majority of deaths in Saudi Arabia.

Increased Testing for MERS Recommended:
The CDC updated its advice to health professionals, advising them to increase testing for MERS, including in those who meet specific epidemiological and clinical criteria even if those illnesses could be explained by another cause. They also recommend testing for the virus in clusters of severe acute respiratory illnesses, even when there is no apparent link to other MERS infections.

Nations Watch for Outbreaks as Ramadan Pilgrims Return From Saudi Arabia:
To date, 94 cases have been laboratory confirmed, with an additional sixteen unconfirmed.The WHO reports that new infections are still occurring in the Arabian Peninsula but there have been no known exported cases for several months. They urge vigilance however, as thousands of Ramadan pilgrims have recently returned from Saudi Arabia. Ramadan ended on August 8.

Update 08/16/2013:
In a possibly ominous sign, a forty year old man in Mumbai, India is suspected of contracting the MERS virus after returning to India from 35 days in Saudi Arabia. He is currently quarantined at Kasturba Hospital in Chinchpokli while testing for the virus is being conducted. 

Update: 08/18/2013: The suspected case from India (above) has tested negative for MERS. He is responding well to treatment and will be released soon. 

Majority of Saudi Cases Spread Through Human Contact:
In response to a recent report that camels may be spreading the virus, the ECDC issued a statement cautioning that no clear link has been found. In fact, most of those infected had no known contact with camels or other animals.

Much of the spread of the disease appears to be through human contact. According to this article from the New England Journal of Medicine, 21 of 23 confirmed cases in Saudi Arabia were caused by person to person contact in three different health care facilities and among family care givers.

See MERS Watch for updated information on this topic.

Deadly New Virus Spreads Through Human Contact

UPDATE: August 10, 2013 - Camels Suspected of Spreading the Deadly Virus

• Camels are suspected to be carriers of Middle East Respitory Syndrome (MERS, previously called Novel Coronavirus) and may be responsible for some human infections.
• MERS has sickened at least 94 people worldwide and claimed 46 lives.

MERS-CoV virus (Wikipedia article)

According to this BBC report, infected camels may be capable of passing the virus to humans. Blood samples were taken from livestock worldwide. Antibodies to the virus were discovered in camels from Oman and Spain, suggesting the virus has become widespread in that region. Antibodies were not found in sheep, goats, cattle or other animals.

Original Article:

A previously unknown virus, nicknamed the 'Novel Coronavirus' has been blamed for the deaths of eight people and is capable of being transmitted directly through person to person contact.

The new virus, known as  HCoV-EMC, is from a family of coronaviruses which are responsible for the common cold and the SARS virus which killed more than 800 people worldwide during an outbreak in 2002 and 2003. It is genetically related to a type found in bats and the unusual virus seems to have mutated to a form which is capable of not only infecting humans, but alarmingly, can be spread from human contact alone.

The international medical community has been aware of the new illness since last year when it broke out in the middle east. At that time, eleven cases were reported including five deaths. Until now, it was unclear if the outbreak clusters were due to personal transmission or if they were all exposed to the same non-human source.

Now, the death of a man in Britain has ended all doubt. The BBC has reported the first cases of transmission of the Novel Coronavirus through close contact with an infected person. An ill man returning from Pakistan infected two of his sons. One later died, possibly complicated by a previous medical condition.

Officials in the UK have located all fellow passengers on the man's flight from Pakistan and are checking to see if any of those may have also been infected.

Currently there are only 14 known cases worldwide, with limited and clustered outbreaks reported in Saudi Arabia, Qatar, Jordan, and the United Kingdom. Eight of those victims have died.

Most of those sickened experienced severe lower respiratory symptoms with one instance of a mild infection where the victim recovered without medical treatment.

There are no travel restrictions currently in place, but the Center for Disease Control (CDC) is asking health professionals to report cases of acute respiratory infection in persons who have travelled to the Arabian Peninsula within the previous 10 days, or anyone who may have had close contact with persons who have recently returned from the Arabian Peninsula or neighbouring countries. More information can be found in this FAQ from the CDC.

See MERS Watch for updated information on this topic.

Image: coronaviruses 004 lores.jpg: http://commons.wikimedia.org/wiki/File:Coronaviruses_004_lores.jpg