Middle East Respiratory Syndrome – Coronavirus: What We Should Know

by Janess Ann J. Ellao

MANILA — Details about the Middle East Respiratory Syndrome – Coronavirus have remained scarce as “there is still very limited information regarding its transmission, severity and clinical impact with only a small number of cases reported thus far,” the World Health Organization (WHO) reported.

The WHO said coronaviruses are a large family of viruses that could cause several illnesses to both animals and humans. But Mers-CoV is a strain of coronavirus that has not been previously identified with humans, first detected in April 2012.

How the virus was transmitted to humans, in fact, could still not be verified even by the WHO, as of this writing.

“It is unlikely that the transmission of the Mers-CoV to people occurs through direct exposure to an infected camel, as very few of the cases have reported camel exposure. More investigations are needed to look at the recent exposures and activities of infected humans,” the WHO said.

The WHO, however, noted in its Risk Assessment report that, “the occurrence of new cases seems to follow a seasonal pattern, with increasing incidence from March to April onwards. The number of cases sharply increased since mid-March 2014, essentially at the KSA (Kingdom of Saudi Arabia) and UAE (United Arab Emirates), where two important healthcare-associated outbreaks are occurring.”

From September 2012 to present, the WHO recorded 254 laboratory-confirmed cases of Mers-CoV, including 93 deaths.

The latest laboratory-confirmed case is that of a 25-year-old man from Al Grayat City in Saudi Arabia, WHO said in its website.

“He became ill on 9 April, was admitted to a hospital in Saudi Arabia on 10 April and discharged from the hospital on 15 April, against medical advice. As his condition did not improve, he sought medical care at another hospital in Zarka City, Jordan on 19 April, where he was tested positive for Mers-CoV,” the WHO said.

“The patient has underlying medical conditions and has a history of travel to Abha Mecca and Jeddah, Saudi Arabia from 3 to 8 April. He has a history of contact with camels and is also reported to have consumed camel milk,” the reported added.

A Filipino paramedic also contracted the virus and died on Apr. 10, 2014.

Symptoms and how it is spreading

The reasons for the spread and how it is transmitted are still unknown.

Affected countries in the Middle East include Jordan, Kuwait, Oman, Qatar, Saudi Arabia and the United Arab Emirates. Though there are also cases in Europe and in North Africa, WHO noted that these “cases have been imported from the Middle East with some secondary transmission.”

Common symptoms of the Mers-CoV, according to the WHO, include “acute, serious respiratory illness with fever, cough, shortness of breath and breathing difficulties. Most patients have pneumonia. Many have also had gastrointestinal symptoms, including diarrhea.”

“Some patients have had kidney failure. About half of the people infected with Mers-Cov have died. In people with immune deficiencies, the disease may have an atypical presentation. It is important to note that the current understanding of illness caused by this infection is based on a limited number of cases and may change as we learn more about the virus,” the WHO said.

Based on available information, WHO encouraged its member states to continue monitoring respiratory infections and review any unusual patterns as, “it is not always possible to identify patients with Mers-CoV early because some have mild or unusual symptoms.”

The WHO also recommended safety precautions to medical workers and are advised to “maintain vigilance” when treating patients who contracted the virus.

Advisories

The Ministry of Health of Saudi Arabia recently confirmed that there were 20 people who contracted the virus, with deaths of two persons in Jeddah. The United Arab Emirates, on the other hand, raised an “Orange” alarm, which meant that their constituents and expatriates are required to wear masks when going to public places.

Migrante Middle East, in a statement sent to the media, said the “sacking of its Health Minister (in Saudi Arabia) conveys an indication that Mers-CoV is spreading fast.”

On Apr. 16, 2014, the Ministry of Health in Saudi Arabia sent a text blast to its constituents, warning the public and recommending ways to avoid contracting Mers-CoV.

In its Official Gazette website, the Philippine government has come up with the following recommended safety precautions to avoid contracting Mers-CoV:

1. Wash hands often with soap and water
2. Cover one’s nose and mouth with tissue paper when one coughs or sneezes. Dispose used tissue paper immediately and properly.
3. Avoid touching one’s face with unwashed hands, especially in the areas of the eyes, nose and mouth.
4. Regularly clean frequently touched surfaces such as door knobs and handles.
5. Avoid close contact with people who tested positive for the virus.
6. Make sure that children would follow the precautions.

“Upon the President’s instructions, the Department of Health has mobilized Task Force Mers-CoV to create heightened awareness among our people about the Middle East Respiratory Syndrome – Coronavirus and prevent the spread of this communicable disease,” Health secretary Enrique Ona said in a statement.

Ona said that while there has been no epidemic or outbreak of Mers-CoV in the Middle East or the Arabian Peninsula, given that the WHO has not imposed travel restrictions in the said areas, the Department of Health has approved the “issuance of a Bureau of Quarantine alert bulletin to those traveling from the Middle East through our international airports” as a health precaution.

Ona said the Bureau of Quarantine would provide assistance to those who may be infected by the virus.

“As there are tens of thousands of Filipinos working in the Middle East and hundreds who travel to the Middle East or return home from their jobs there daily, it is important that their families, relatives, friends, neighbors and all members of their local communities fully understand all that must be known from Mers-CoV,” Ona said.

As of this writing, the Department of Health is still tracking more than 400 passengers of the Etihad Airlines flight EY 0424 because one male Filipino nurse in the said flight might have been infected with Mers-CoV. Though the said passenger tested negative, the Department of Health maintained that he might still be a carrier of the virus and his fellow passengers were at risk of the infection.

Calls to government

Migrante International chairperson Garry Martinez, in an interview with this Bulatlat.com, said overseas Filipino workers in the Middle East are well aware of the virus and were informed by their respective employers of what to do to avoid contracting the virus.

“There are 1.3 million Filipinos there. While there is still no ‘outbreak,’ we are asking the government to look after our nationals. The Saudi government would, of course, look after their constituents first,” Martinez said.

Earlier this week, Migrante International called on the government to send a medical team to provide assistance to overseas Filipino workers in the Middle East, adding that a mere warning is not enough.

“Even before Mers came along, Filipinos in the Middle East, especially the undocumented and the stranded, have been complaining about the lack of medical attention given to them by the government. Sending a medical team to look after them is a way of giving back to OFWs for their contributions that keep the economy afloat,” Martinez said.

In its website, the Department of Health said they are sending an epidemiologist and infectious disease specialist to the United Arab Emirates, following the death of a Filipino paramedic on Apr. 11, 2014 and reports of six other cases.

Recently, reports revealed that four persons in the United Arab Emirates have contracted the Mers-Cov virus, two of whom are Filipinos working as medical staff in a hospital, Migrante – Middle East said in a statement.

The migrants’ rights group based in Saudi Arabia said old and sick Filipino migrant workers are susceptible to the deadly virus.

“We are urging President Aquino to issue clear marching orders to the DFA and DoH to urgently attend to the medical needs of the distressed and stranded OFWs in Saudi Arabia and other mid-east countries, form a medical team and deploy them in MERS-hit countries where there are large concentrations of OFWs, who are distressed and stranded,” John Leonard Monterona, regional coordinator of the Migrante Middle East, said.

Monterona added that apart from conducting an information dissemination campaign on how to avoid Mers-CoV, medical missions are important to monitor the health conditions of OFWs, especially stranded Filipino migrant workers who are staying in shelters in Jeddah.

“We need action from this administration not just mere words of praises to OFWs who the government hails as ‘modern-day heroes’ due to their economic contributions through billions in dollars of remittances,” Monterona said. (bulatlat.com)

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(Photo grabbed from the WHO website)

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