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MERS-CoV: Should I be concerned?

"There have been several accounts in medical history that depict human reaction to a disease outbreak."
By: Dr. Samuel Tiglao, Army Captain and Family Medicine PhysicianMERS-CoV: Should I be concerned?

There  have been several accounts in medical history that depict human reaction to a disease outbreak. From the Spanish flu pandemic, avian flu H7N9, swine flu H1N1, Severe Acute Respiratory Syndrome (SARS), Ebola virus and most recently, the Middle East Respiratory Syndrome also known as MERS.                         

Living in Seoul, South Korea as a doctor with the United States Army, I experienced this firsthand.  I attended a medical conference in a local hospital in which a MERS-infected doctor was also in attendance. Though it was later confirmed that he was not in the same conference hall where the lectures took place, precautionary measures were taken. Myself and the other doctors in my clinic that were present that day had to report our temperature and any development of respiratory symptoms to our supervisor for 14 days. I am glad to say that we did not develop any symptoms and did not develop MERS.

At this point, you probably have so many questions about this virus. Where did it come from? What are the symptoms? How is it treated? And most importantly, how does it spread and what can YOU do to avoid getting infected?

What is MERS?

Let's start with this simple question. MERS otherwise known as the Middle East Respiratory Syndrome is a viral respiratory illness. The term MERS-CoV (CoV stands for coronavirus) is used when referring to the virus itself causing the illness.  The first case of infection was reported in Saudi Arabia in 2012.

What are the symptoms?

Typical MERS symptoms may include, but not limited to, fever, cough and shortness of breath.  Gastrointestinal symptoms including anorexia, nausea, vomiting, abdominal pain, and diarrhea have also been reported.  After infection, the symptoms may occur as early as 5 days or up to 12 days later.  Most patients that are infected are severely ill with pneumonia and acute respiratory distress syndrome often times requiring mechanical ventilation. Complications of the illness can also affect the functions of your heart, liver, and kidney.

Where did this virus come from?

The origins of the virus are not fully understood. It is believed that MERS-CoV may have originated  from bats and was transmitted to camels in the distant past.  Although bats might be a reservoir of MERS-CoV, camels serve as the major hosts for this virus and an animal source of infection in humans. The strongest evidence of camel-to-human transmission comes from a study in Saudi Arabia in which MERS-CoV was isolated from a 44-year-old man with fatal infection and from one of his camels. This man had applied a topical medicine to the nose of one of the ill camels seven days before he became ill. He died 15 days after hospital admission. 

How does it spread?

Ok, there are no camels in the Philippines, so why do I need to worry about it? It has been proven that MERS-CoV can spread from person to person, but the virus does not appear to pass easily unless there is close contact.  Close contact is defined as being within approximately 6 feet (2 meters) or within the room or care area of an infected person for a prolonged period of time while not wearing personal protective equipment (i.e. gowns, gloves, respirator, eye protection) or having direct contact with infectious secretions (e.g. being coughed on) while not wearing recommended personal protective equipment. 

Am I at risk for MERS-CoV infection in the Philippines? 

In this era of tourism, international business relations, Filipinos seeking job opportunities in other countries ( including the Middle East) and returning back to our homeland, the risk exists, but a very low risk, to the general public in this country. There are only 2 confirmed cases of MERS in the Philippines; first case was a Filipino nurse who came from Saudi Arabia earlier this year in February and the recent case was reported this July,  which involved a foreigner who arrived from the Middle East.  Both of which are contained, thanks to the protocols in placed by our Department of Health (DOH).

How is it treated? And what can I do to prevent getting infected?

Currently, there is no vaccine or specific medication or intervention against MERS-CoV.  Treatment is largely supportive and based on the patient’s clinical condition and symptoms.  Prevention is focused towards infection control, interim home care and isolation (if found to be at risk or infected), avoiding camels and check foreign travel recommendations especially in the Middle East.  But the message is quite simple, wash your hands and maintain good personal hygiene.  Should you develop a fever after returning 14 days later from a foreign country, consult your doctor or go to the nearest DOH hospital. 

No need to panic

Ok, take a deep breath. I know there are a lot of information in this article, but no need to worry.  No reason to cancel your upcoming trips and vacations.  Just like any other disease prevention, it starts with you.  By simply maintaining good personal hygiene, you are not only protecting yourself but you are doing your part in preventing the spread of a disease. 

Get out there and explore the world while you still can.

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