There used to be joke among physicians when I was a doctor in training that anytime the cause of an illness could not be established, ‘throw it in the virology dustbin’! We have surely come a long way since then. With the tools at our disposal, any new syndrome, in this case an acute respiratory infection i.e. flu like illness in the Middle East, a virus was sought, quickly found and described. And no surprises here, it was named MERS-CoV: Middle Eastern Respiratory Syndrome Corona Virus.
The newspapers love new viruses and this became the front page news not only in the region but worldwide and horrors of SARS Outbreak in the Far East were revisited. This obviously put everyone on alert.
So where do we stand now?
Till date globally lab-confirmed cases of MERS-CoV infection 836 , including at least 290 deaths (case fatality rate: 34.7 % meaning about a third of patients are dying due to this infection) since it was first described in Saudi Arabia in September 2012, followed by 11 more countries, with all reported cases originating in the Arabian Peninsula. Most patients developed severe acute respiratory illness, with fever, cough, and shortness of breath, just like a bad attack of Flu.
Where did this newest kid on the block come from?
Although camels are suspected to be the primary source of infection for humans, the exact routes how it infected humans remains unknown. Investigations to find the source of this infection and how it got into humans are still ongoing, maybe through air or direct contact with the animal’s secretions. Worrying is the lack of known high risk exposures in the recent cases. So has the virus changed to establish a foothold in the humans? The month of Ramadan is ongoing and with it lesser pilgrimage Umrah increases to the holy lands. Three months later will be the biggest congregation for Hajj. It remains to be seen if there will be significant spread of MERS-CoV during this period or if the apparent decrease in numbers of late show that the transmission is slowing down already.
So what does one do?
At this time, all treatment is supportive, and no specific antiviral drug therapy or vaccine is available. Remember 75% of secondary cases occurred in healthcare workers or family contacts of the patients. So sensible advice is to avoid close contact with anyone with flu like illness and wash your hands frequently. No need to change any travel plans to the region fearing the spread of the virus.