Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was confirmed in a traveler to the United States. This virus is relatively new to humans and was first reported in Saudi Arabia in 2012.
“We’ve anticipated MERS reaching the US, and we’ve prepared for and are taking swift action,” says Centers for Disease Control and Prevention (CDC) director Tom Frieden, MD, MPH. “We’re doing everything possible with hospital, local, and state health officials to find people who may have had contact with this person so they can be evaluated as appropriate. This case reminds us that we are all connected by the air we breathe, the food we eat, and the water we drink. We can break the chain of transmission in this case through focused efforts here and abroad.”
On April 24, the patient traveled by plane from Riyadh, Saudi Arabia to London, England then from London to Chicago. The patient then took a bus from Chicago to Indiana. On the 27th, the patient began to experience respiratory symptoms, including shortness of breath, coughing, and fever. The patient went to an emergency department in an Indiana hospital on April 28 and was admitted on that same day. The patient is being well cared for and is isolated; the patient is currently in stable condition. Because of the patient’s symptoms and travel history, Indiana public health officials tested for MERS-CoV. The Indiana state public health laboratory and CDC confirmed MERS-CoV infection in the patient this afternoon.
“It is understandable that some may be concerned about this situation, but this first U.S. case of MERS-CoV infection represents a very low risk to the general public,” says Dr. Anne Schuchat, assistant surgeon general and director of CDC’s National Center for Immunizations and Respiratory Diseases. In some countries, the virus has spread from person to person through close contact, such as caring for or living with an infected person. However, there is currently no evidence of sustained spread of MERS-CoV in community settings.
CDC and Indiana health officials are not yet sure how the patient became infected with the virus. Exposure may have occurred in Saudi Arabia, where outbreaks of MERS-CoV infection are occurring. Officials also do not know exactly how many people have had close contact with the patient.
So far, including this U.S. importation, there have been 401 confirmed cases of MERS-CoV infection in 12 countries. To date, all reported cases have originated in six countries in the Arabian Peninsula. Most of these people developed severe acute respiratory illness, with fever, cough, and shortness of breath; 93 people died. Officials do not know where the virus came from or exactly how it spreads. There is no available vaccine or specific treatment recommended for the virus.
“In this interconnected world we live in, we expected MERS-CoV to make its way to the United States,” says Frieden. “We have been preparing since 2012 for this possibility.”
Federal, state, and local health officials are taking action to minimize the risk of spread of the virus. The Indiana hospital is using full precautions to avoid exposure within the hospital and among healthcare professionals and other people interacting with the patient, as recommended by CDC.
In July 2013, CDC posted checklists and resource lists for healthcare facilities and providers to assist with preparing to implement infection control precautions for MERS-CoV.
As part of the prevention and control measures, officials are reaching out to close contacts to provide guidance about monitoring their health.
While experts do not yet know exactly how this virus is spread, CDC advises Americans to help protect themselves from respiratory illnesses by washing hands often, avoiding close contact with people who are sick, avoid touching their eyes, nose and/or mouth with unwashed hands, and disinfecting frequently touched surfaces.
The largest reported outbreak to date occurred April through May 2013 in eastern Saudi Arabia and involved 23 confirmed cases in four healthcare facilities. At this time, CDC does not recommend anyone change their travel plans. The World Health Organization also has not issued Travel Health Warnings for any country related to MERS-CoV. Anyone who develops fever and cough or shortness of breath within 14 days after traveling from countries in or near the Arabian Peninsula should see their doctor and let them know where they travelled.