A second case of deadly MERS in the US

I’d written previously about the first case of MERS (Middle East Respiratory Syndrome) found in the US.  Now a second US case of MERS has been documented.

The first US case of MERS was an American health care worker who returned from Saudi Arabia. He traveled through London and Chicago, then took a bus to Indiana, where his symptoms caused him to seek medical care in a local hospital. There he was diagnosed with MERS and placed in isolation. He did well and was released from the hospital (MERS has proved fatal in 30+ % of cases that have been treated in the Middle East and other areas.)

So far none of those with whom he came in contact have developed MERS. MERS is spread human-to-human via close contact (e.g. taking care of someone with MERS) but the risk of transmission from casual contact (like traveling on a bus or plane with a MERS patient, is very low.) MERS usually develops within about two weeks of initial exposure. So far none of the people exposed to the first case are known to have become infected. The first case was diagnosed in early May, so, presumably, if none of those he traveled become ill with MERS within the next few days, they should be safe.

The second US case of MERS is also an American male health care worker who returned from Saudi Arabia.

Infection by Shutterstock

Infection by Shutterstock

The second patient started to experience some mild respiratory symptoms en route, but dismissed them. The symptoms continued to worsen, and he went to a local emergency department when he arrived home in Florida. Because of his respiratory symptoms, occupation and history of travel to the Middle East, he was admitted and placed in isolation in the hospital. People who were on flights with him are being contacted and told to watch out for any respiratory symptoms. The CDC reports that these two cases are not linked.

In other MERS news, two hospital workers who were exposed to the second US MERS case in an Orlando, FL, hospital have developed fever and respiratory symptoms. Both were tested, and came up negative.  Though AP reports that another 18 health care workers are awaiting test results.

The World Health Organization (WHO) is conducting an emergency meeting to see if this outbreak of MERS, should be classified as a public health emergency that is of concern throughout the world. If the consensus it that it is a significant problem, WHO can recommend that flights from affected areas, like Saudi Arabia, be halted, they may send WHO teams in to the area to beef up investigstions of cases, and/or send in investigators to get hands on clinical information and do some basic research. They can call on other agencies (like the CDC) to assist, they may ask governments to ban travelers from affected areas, and can take other measures to limit the spread of the disease.

When SARS (Severe Acute Respiratory Syndrome) struck in China, causing deaths and disase, the WHO, other agencies and governments put pressure on the Chinese government to destroy the caged marketable animals that were the source of SARS. The Chinese government did so and there have been no additional cases of SARS since then. Like SARS, MERS is also a coronavirus that can cause severe lung disease and show a high mortality rate. Some camels have been shown to have been infected with MERS and may be a reservoir for the disease.

Mark Thoma, MD, is a physician who did his residency in internal medicine. Mark has a long history of social activism, and was an early technogeek, and science junkie, after evolving through his nerd phase. Favorite quote: “The most exciting phrase to hear in science... is not 'Eureka!' (I found it!) but 'That's funny.'” - Isaac Asimov

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