Introducing the Brand New "Threat to the Entire World," MERS!

A new virus, known as MERS, has recently captured the attention of health organizations around the globe. MERS, which stands for Middle East respiratory syndrome, was discovered for the first time in humans in April 2012, and has the potential to cause a deadly epidemic. As of July 26, MERS has killed 45 out of the 90 people it has infected, giving the virus a 50% mortality rate (yikes!). Interestingly, being a male is a risk factor, for the majority of MERS patients are middle-aged men. Little is known about MERS because of its novelty, but what scientists have found raises concerns.

MERS belongs to the Coronavirus family - a.k.a. the troublesome family of viruses responsible for SARS and the common cold. MERS, like SARS, erupted onto the world stage rather abruptly. In a little over a year, the virus has already spread to eight different countries: Jordan, Qatar, Saudi Arabia, United Arab Emirates, Tunisia, France, Italy, and the United Kingdom. All known cases of MERS are either directly or indirectly connected to the Arabian peninsula, hence its name. Luckily, there have been no reported MERS cases in the U.S. thus far.

MERS is chillingly similar to SARS, short for Severe Acute Respiratory Syndrome, the virus responsible for a frightening epidemic during the years 2002 and 2003. SARS spread like wildfire, reaching 31 countries in under one year! Over 8,000 people were infected, 774 of whom perished. Mers "looks for all the world like SARS," says Dr. Trish Perl, a pathologist and epidemiologist at Johns Hopkins in regards to their resemblance. Both viruses are "easily" spread within hospital settings and can be "readily transferred" between hospitals, a dangerous combination. MERS's tendency to spread throughout hospitals has created challenges for health care providers trying to contain the outbreak. The SARS Epidemic, which died down in 2004, featured highly infectious people who were especially likely to spread a virus to many others, more commonly described as super-spreaders. Super-spreaders now appear to be an aspect of MERS too. Super-Spreaders are not a new phenomenon. In fact, there is a very notorious historical figure that is a prime example of a super-spreader: Typhoid Mary. Typhoid Mary was a carrier of Salmonella typhi, the bacteria responsible for typhoid fever, and directly infected 51 people although she herself was immune to it. SARS and MERS's effects on humans are also comparable. Patients are most frequently afflicted with fevers and coughs, which can progress into life threatening pneumonia. Other symptoms include vomiting, shortness of breath, and severe diarrhea. Unique to MERS is the appearance of kidney failure in patients. Even the viruses' incubation periods, the time it takes from the initial infection to the onset of symptoms, are roughly the same. Symptoms of SARS appear anywhere from two to seven days after infection, while MERS's average incubation period is five days - an ample amount of time for a carrier to spread MERS before becoming sick.

Despite their similarities, two distinctions between the viruses have arisen. First, SARS spread faster than MERS and second, MERS is 6.25 times deadlier than SARS*. These differences are a mixture of both good and bad. The good news is that MERS doesn't spread as efficiently as SARS. This means that MERS will most likely be easier to contain. On the other hand, if MERS does cause an epidemic then it will be even more destructive than SARS due to its higher fatality rate.

The epicenter of the MERS outbreak is Saudi Arabia, an important destination for Muslims. Each year millions of people journey to Mecca in Saudi Arabia for the Hajj, the sacred pilgrimage all Muslims who are able-bodied and financially capable are expected to make at least once in their lifetime. Because MERS spreads from person-to-person, the influx of millions of pilgrims to Mecca this October is concerning. According to International Business Times, the Hajj pilgrimage will present the "perfect breeding ground" for MERS. Health officials are worried that the MERS outbreak could explode and morph into an epidemic if the virus is spread amongst the masses. If a pilgrim were to contract MERS, then he or she could possibly start a chain reaction that could infect hundreds, if not thousands of other pilgrims. On top of that, when an infected person returns home, he or she exposes his/her homeland to MERS. Matthew Frieman, a virologist at the University of Maryland School of Medicine in Baltimore, believes that there is no reason why a person traveling to Saudi Arabia from the U.S. could not bring the virus back to America. In response to the growing health risks, The Embassy of Saudi Arabia has recommended that the elderly, the terminally ill, pregnant women, and children postpone their Hajj plans this year for their own safety. Saudi Arabia advises pilgrims to wear surgical masks covering their mouths while in crowded areas as well. The CDC has also set guidelines to help prevent people from becoming sick. They recommend regularly washing one's hands with soap and disinfecting frequently touched objects such as door handles. Scientists advise avoiding close contact such as kissing, sharing utensils or drinks with sick people since MERS is transmitted from person to person.

In this crazy world we live, new perils are hurled our way everyday, including lethal viruses. I think that in the case of MERS the world will have to wait and see what havoc this virus will bring about. In the meantime, if you are travelling to the Middle East any time soon remember to your wash your hands frequently and contact health care officials if you begin to exhibit any symptoms.

*Note: SARS's mortality rate is 8% while MERS's is 50%

References:

Abdullah, Assiri. et al. Hospital Outbreak of Middle East Respiratory Syndrome Coronavirus. New England Journal of Medicine, (2013)

Ball, J. "New Mers-Coronavirus Continues to Smoulder." BBC. June 22, 2013

Centers for Disease Control and Prevention. Hajj and Umrah (2013).

Centers for Disease Control and Prevention. Middle East Respiratory Syndrome (2013).

Falco, M. "New SARS-like Virus Poses Medical Mystery." CNN. September 24, 2012

Fox, M. "New Middle East Virus Spread in Hospitals." NBC News. June 19, 2013.

Hayes, A. "5 Things to Know about New Coronavirus." CNN. May 30, 2013.

Knox, R. "Outbreak in Saudi Arabia Echoes SARS Epidemic 10 Years Ago." NPR. June 20, 2013.

Kramer, M. "Possible Pandemic: Is MERS the New SARS?" National Geographic. May 30, 2013

PHE. Key Facts - MERS-CoV (2013).

Reuters. "New Death in Saudi Arabia from SARS-like Coronavirus MERS." Yahoo News. June 22, 2013.

Webster's New World Medical Dictionary. Super Spreader (2008).

WHO. Coronavirus Infections (2013).

WHO. MERS-CoV Summary and Literature Update - as of 20 June 2013 (2013).

Image Credits:

1. ABC7

2. NIAID.