MERS (Middle East Respiratory Syndrome) update

Some news on the MERS (Middle East Respiratory Syndrome) front.

1. Direct transmission from infected camels to humans has been documented in the Middle East. It was reported in the New England Journal of Medicine recently.

Briefly, a man who had a small herd of camels developed an upper respiratory infection that proceeded to get worse causing him to be hospitalized.

His friends stated that several of his camels had recently had respiratory symptoms and that the patient had tried to treat them. A veterinarian went to the patient’s home and got samples from the camels. Identical strains of MERS were found in the camels and in the patient. The patient continued to deteriorate and died.

Camel via Shutterstock.

Camel via Shutterstock.

Additionally, the patient’s daughter developed a respiratory illness at approximately the same time. She reported being ill for about three days but recovered and is now fine. Specimens taken from her showed the same strain of MERS virus that killed her father and sickened the camels.

Previous to this, camels were known to be infected with MERS, but camel-to-human transmission had never been documented.

2. Good news about a treatment for MERS.

Three different studies have shown that there may be several drugs that could be effective against MERS.

These are only preliminary studies, and will require additional work. Interestingly, some of these drugs may also work against SARS (Severe Acute Respiratory Syndrome), as well.

In one study, investigators looked at about 300 different drugs already approved for use in the US. They found almost 30 that seemed to be effective against both MERS and SARS.

In a different study, scientists screened about 350 drugs that are available in the US, and found four that worked against SARS and MERS (two of those drugs also were found in the first study, as well.)

A third study found an experimental drug that could work against MERS.

These drugs will have to undergo testing in animals before they could be recommended to be used in humans. However, it could be possible that, in the case of a patient close to death from MERS that one or more of these drugs could be used “off label.” “Off label” means that the drug can be given to treat a disease for which its use wasn’t intended. For example, aspirin was originally used to reduce fever and relieve mild pain. Until studies were done showing that aspirin could reduce the risk of heart attacks, using aspirin for that reason was an off label use. When a drug is used in that manner, the patient needs to be made aware that there is no research evidence that the drug will help, and it is unknown if the drug might make the patient worse or have unintended consequences.

But, at least, this may be a start at finding anti-MERS (and anti-SARS) drugs, just the way things started off finding the first drugs that showed promise against HIV.

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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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