Tuesday, August 13, 2013

MERS-CoV virus connects bats, camels and humans. Is a global outbreak possible?

Health authorities around the world will have to be extra vigilant before, during, and after the pilgrimage to Mecca to contain this new virus since many of the patients suffering from this disease have had no animal contact, pointing to a possible human to human transfer.

Dromedary Camels. Courtesy Andrea Kirby. Flickr PhotoStream.
Measles, mumps, encephalitis, pneumonia, influenza, and now MERS all have something in common. They are all infections caused by viruses of the Paramyxoviridae family, and it appears that the source of these viruses are bats. [1] But it is the dromedary camel that is believed to be serving as the intermediary in finding new hosts, such as humans, for this new virus that has hospitalized 94, and killed 46 of the patients.

In the case of the MERS-CoV ( Middle East respiratory syndrome coronavirus) the primary host is thought to be an insect eating bat, Neoromicia Zuluensis. This makes the camel connection even more puzzling since a blood sucking vampire bat would have been easier to connect to the camels. [2], [3].

MERS Cases and Deaths, [2] April 2012 – Present.
12, 2013. Source: CDC
At this point only dromedary, or single hump, camels are known to be carrying antibodies to MERS-CoV. Bactrians, or two hump camels, llamas, and guanacos tested along with cattle, domestic goats and sheep livestock tested were free of MERS antibodies. [4]

Since majority of the deaths have occurred in Saudi Arabia, the annual pilgrimage to Mecca can be a testing ground for how far and widely MERS-CoV will likely travel this year after the Hajj, as devotees return to their home countries. Adding to the possibility of a massive pandemic outbreak is the fact that majority of the pilgrims are elderly people, and a large number may be immuno-compromised.

The World Health Organization is advising pilgrims that are planning to undertake Umra, or Hajj to use caution and minimize contact with those who may be suffering from respiratory illnesses, and if already contracted keeping away from others to avoid infecting them. [5]
-When coughing or sneezing cover their mouth and nose with a tissue and dispose of the tissue in the trash.
-If disposable tissues are not available to cough or sneeze into upper arm sleeves of their clothing, but not in their hands.
-Wash hands after coughing or sneezing, and report their condition to the medical staff accompanying the group or to the local health services.

[1]- Institut de Recherche pour le Développement (IRD) (2012, July 24). Bats, a reservoir of resurgent viruses. ScienceDaily. Retrieved August 12, 2013, from http://www.sciencedaily.com/releases/2012/07/120724104258.htm
[2]- Centers for Disease Control and Prevention. "CDC-MERS-Frequently Asked Questions." Accessed August 13, 2013. http://www.cdc.gov/coronavirus/mers/faq.html.
[3]- Ithete NL, Stoffberg S, Corman VM, Cottontail VM, Richards LR, Schoeman MC, et al. Close relative of human Middle East respiratory syndrome coronavirus in bat, South Africa [letter]. Emerg Infect Dis [Internet]. 2013 Oct [date cited]. http://dx.doi.org/10.3201/eid1910.130946External Web Site Icon
DOI: 10.3201/eid1910.130946
[4]- TheLancet.com. "Middle East respiratory syndrome coronavirus neutralising serum antibodies in dromedary camels: a comparative serological study : The Lancet Infectious Diseases." Accessed August 13, 2013. http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(13)70164-6/abstract
[5]- "WHO World travel advice on MERS-CoV for pilgrimages." Accessed August 13, 2013. http://www.who.int/ith/updates/20130725/en/

#MERS-CoV #MERS #measles #mumps #SaudiArabia #dromedarycamels #NeoromiciaZuluensis #Hajj
#Umra #virus #bats

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