The news that Middle East respiratory syndrome, or MERS — a virus that by one estimate has killed roughly a quarter of the relatively small number of patients confirmed to be infected by it — is on U.S. soil quickly triggered investigations by federal and state health authorities.
“Right now we don’t have a lot of experience with this in the U.S.,” said Dr. Michael Lin, an infectious disease specialist at Rush University Medical Center. “Most of our information about how this virus spreads comes from the Middle East.”
Fortunately, MERS “does not seem to be extremely contagious,” Lin said.
The Centers for Disease Control and Prevention said there have been 401 confirmed MERS infections reported in 12 countries, including the most recent U.S. case. All reported cases have originated in one of six Arabian Peninsula countries: Saudi Arabia, the United Arab Emirates, Qatar, Oman, Jordan and Kuwait. Ninety-three of the patients have died, according to the CDC.
“It certainly has captured people’s attention because of how lethal it is,” Lin said.
CDC officials said the virus was carried here April 24 by a traveler who flew from Riyadh, Saudi Arabia, to London, then on to Chicago. The patient then boarded a bus to Indiana.
Three days later, the patient developed a cough and fever and went to Community Hospital in Munster, Ind., health officials said. Doctors tested for the MERS virus, a diagnosis confirmed by the CDC and Indiana public health officials last week.
By Friday, Indiana health officials said Community Hospital had contacted “all high-risk individuals” who might have come in contact with the patient but urged anyone who visited the facility’s emergency department between 6:30 p.m. and 9:30 p.m. April 28 to watch for signs and symptoms of the virus.
Health officials don’t consider passengers on the patient’s flights or bus to be at high risk of infection. Nonetheless, officials said the CDC was to have begun contacting passengers Saturday.
Officials have declined to release more specific information about the patient or his travels.
MERS symptoms — fever, cough and respiratory problems — resemble those of influenza. Unlike the flu, however, there is no available vaccine or specific treatment recommended for the virus. Health experts aren’t certain where MERS originated.
CDC officials said they’ve been waiting for the virus’ arrival but made clear it poses very low risk to the general public.
“In this interconnected world we live in, we expected (the virus) to make its way to the United States,” said Dr. Tom Frieden, the CDC’s director. “This case reminds us that we are all connected by the air we breathe, the food we eat, and the water we drink.”
MERS is a new type of what scientists call “coronaviruses,” a widespread group of diseases that includes the common cold and pneumonia. The highly contagious SARS virus, which killed hundreds in Asia and North America in the early 2000s, is another kind of coronavirus.
First discovered in a Saudi Arabian patient in summer 2012, some experts believe MERS originated from an animal source because it’s been detected in camels and bats in the Middle East.
But so far, Lin said MERS has a low rate of human-to-human transmission. The virus spreads from ill people to others through close contact, but federal health officials say the virus hasn’t been shown to spread “in a sustained way in communities.”
The World Health Organization says it is not always possible to identify patients with the virus early. For that reason, the WHO says, health care facilities caring for infected patients must take measures to decrease the risk of transmission to other patients, health care workers and visitors.
Dr. David Schwartz, an infectious disease specialist with the Cook County Health and Hospitals System, said MERS often targets adults with chronic health conditions and doesn’t spread via casual contact like severe acute respiratory syndrome.
“It does really seem as if you need to spend, as we say, quality time with a person who has the illness in order to catch it from them,” Schwartz said. “I think there’s a lot of reasons to be hopeful that this virus will not produce the kind of problems that the SARS coronavirus did.”
Officials say they don’t know how the Indiana patient contracted the virus, though infection may have occurred in Saudi Arabia. At this time, the CDC does not recommend anyone change their travel plans.
Though experts say the risk of infection is low, Lin said the virus’ presence in the United States should remind health care professionals to consider a MERS diagnosis if a patient is exhibiting symptoms and has recently traveled to the Middle East. Patients should also share their travel histories with doctors, Lin said.
“It’s a small world when it comes to diseases,” he said.
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