MERS Coronavirus hits Middle East

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The Middle East Respiratory Syndrome Coronavirus (MERS-CoV), also termed EMC/2012 (HCoV-EMC/2012, is becoming a cause of concern worldwide after cases of infection have come up in the Middle East. Dr. Ali Mohamed Zaki first reported the virus on 24 September 2012 in Jeddah, Saudi Arabia. Recently, there has been a reported source of this infectious pathogen in a camel in Saudi which happens to be the first case cited in an animal. The animal owner also had been suffering from the viral. The source of infection is still unclear though. Oman has also witnessed its first case of the infection outbreak. In August 2013, the source was traced to a bat in an Egyptian tomb but its straight link for transmission in humans has not been established.
Symptoms: This virus causes acute respiratory problems like shortness of breath accompanied by fever and cough in the patients. Death cases have also been reported in more than half of patients. There have been 165 cases of infection reported since September 2012.
Similarity with SARS Virus: Severe Acute Respiratory Syndrome is the disease caused by SARS, another type of corona virus. The virus’ outbreak in 2003 led to many deaths due to uncontrolled infection (9% of the infected people). The symptoms are cough, dyspnea, pneumonia, chills, fever, headaches, and muscle pain. The incubation periods, appearing symptoms, and lung pathologies in the two viral diseases are more or less alike. SARS was reported to have occurred in China in 2002 and in 2003 it plagued the entire world. By April 2003, scientists were able to map a corona virus genetic sequence to that of SARS.
The Mers Co virus spreads easily with close contact with an infected person. It is being feared to undergo mutation as did the SARS virus leading to its exponential outburst as a result of which it spreads easily from one person to another. Though no vaccine has been developed so far, an anti-viral drug that curbs infection is administered.
WHO Guidelines:
WHO through its Global Alert and Response (GAR) programme mentions a protocol for infection control and detection. It has set up International Health Regulations (IHR) Emergency Committee to propose alert, response, and capacity building under it. Its 4th meet concluded in December 2013.
A few of the recommendations are:
  • Setting up of assessment teams with experience in field epidemiology, clinical assessment, laboratory specimen collection, infection control, and social mobilization and risk communication.
  • Since the virus is linked to animals, animal health specialists should also be looped in.
  • Advices on travel to Middle East and health care.
  • Recording detailed patient profile to assimilate more information.
  • Effective reporting to government/public health departments.
  • Isolation of diagnosed and probable cases.
  • Rigid infection control measures to be followed especially at airports
India’s Position:
India’s big populace (numbering in several millions) lives in Middle East and is at a potential risk. It becomes double the trouble as these countries do not offer permanent citizenship to others rendering them more vulnerable at the time of distress. The government should confront the situation (if need be) with adequate safeguards and provisions for treatment for which strategizing the case is essential. The threat of spreading of infection via travellers from Middle East lurks over our local population also, for which all incoming traffic joints (air and sea ports) should be alerted with effective security checks imposed there. Security officials should be well versed with the safety and precautionary measures. Health officials should spread concern amongst people regarding day to day safe practices like good personal hygiene, early treatment of cold and flu symptoms, etc. So far, India has not witnessed any such case but being upfront is going to pay off well.
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