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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9 Responses to “MERS (Middle East Respiratory Syndrome) update”

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  2. Naja pallida says:

    If you’re working around bat roosts, MERS is probably not highest among possible concerns. Bats are ideal reservoirs for all kinds of different zoonotic viruses. Thousands upon thousands of warm little bodies all crammed tight together in one spot, pooping and peeing all over. Not that one should be scared or anything, but you should be taking every step possible to keep clean, wear gloves, and avoid direct contact with feces or downed bats. If there’s digging going on, wear something to avoid inhaling dust.

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  4. annetteboardman says:

    The idea of being able to catch it from bats makes me very happy I am not actually doing fieldwork in Egypt at the moment, but preparing a site report for publication. There were an awful lot of bats on our site in Egypt, as there were a lot of caves.

  5. BeccaM says:

    Ever play ‘Six Degrees of Kevin Bacon’s Camel’? ;-)

  6. emjayay says:

    It’s the world McEcosystem.

  7. Naja pallida says:

    A partial sequencing of the genome has shown that MERS has much in common with coronaviruses that are native to bats, and not those found in other more ‘domestic’ animals, like cats, dogs or camels. Which makes it highly likely that camels are just an intermediary species, just like the civet was with SARS – which also originated in bats. Testing of many species of domestic animals hasn’t yet shown a definitive path of transmission from bats to humans, though they have found the virus in Egyptian tomb bats near the homes of some of the earliest victims, so it seems likely that they are the reservoir.

  8. emjayay says:

    If my camel doesn’t have a cold, am I safe?

  9. Indigo says:

    Good to know. These days, all medicine is global medicine. We need to cast a wide net over ailments and disorders and viruses and medical hobgoblins of all sorts to stay on the preventively holistic side of medicine as transportation puts camel herders and stock brokers and just plain folks all over the world on the same playing field of possible infections.

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