Sunday 4 May 2014

MERS in the USA....

The source of all exported MERS-CoV positive people lies within the Arabian peninsula. Very limited local spread has occurred within 3 non-peninsula countries.
Click on image to enlarge.

The Middle East respiratory syndrome coronavirus (MERS-CoV) made its way to another country yesterday; the United States of America (USA).

MERS-CoV in the KSA during April.
Filled red circles mark towns and cities for general interest.
The darker sandy coloured areas indicate KSA Regions
(also Egypt and the United Arab EMirates) where
MERS-CoV detections have been located recently.
Click on image to enlarge.
This is not a big surprise and it's not the end of days, but lit up Twitter and had reporters high-five'ing like nothing the 460 cases before it, mostly around the Arabian peninsula, managed to achieve. But then MERS-CoV detections have only been accruing for 111 weeks. 

These things can take time to warm up.

The USA case was in a healthcare worker (HCW) travelling back from the Kingdom of Saudi Arabia (KSA).

What else do we know?

  • FluTrackers #456
  • The HCW who was working in Riyadh, KSA, travelled back from there to Chicago in the USA via a transfer at Heathrow airport in the United Kingdom, 24-Apr.
  • Illness became more noticeable 27-Apr (coughing, shortness of breath and fever), and the person was hospitalized 28-Apr in Indiana.
    Was less noticeable illness present first? We know little about what the earliest inklings that someone has a MERS-CoV passenger feel/look/sound like.
  • Age and sex of the patient have not been officially released.
    I should stop complaining about that from the KSA Ministry of Health data. Still important to know it, but if its not provided by one high income economy, why expect it to be provided by any other?
  • The laboratory confirmation was made 2-May (~4-days)
Because the person wasn't coughing, sneezing or noticeably wheezing on the planes, it will be unlikely that any virus was propelled towards, or impacted upon surfaces shared by, people nearby. We will of course be watching as the USA health professionals track, observe and hopefully swab and test at least some of the contacts from the planes and post-transit spaces. These people can tell us a lot about what the virus is doing among people not defined as "close" contacts; a kind of live experiment to check if MERS-CoV transmits any differently now than it did the last time it got loose from the Arabian peninsula. On those recent occasions neither Greece, Malaysia nor the Philippines saw any additions to the transmission chain.

I can remember when MERS and H7N9 cases were so rare I used to do a work up like this on each announcement. Ahh the good old (slow) days.



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