Friday, February 06, 2015

MERS: Is there reason to worry?

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MERS

Respiratory syndrome coronavirus in the Middle East (or simply MERS or MERS-CoV) is a disease transmitted by a virus. It was first described in 2012, in Saudi Arabia, when Dr. Ali Mohamed Zaki isolated the organism in a patient with severe lung disease. This virus belongs to the family of coronaviruses , a type of virus that usually causes mild cold symptoms and colds. However, this coronavirus is very aggressive and completely new, is suspected to have an animal that has mutated from a virus from bats . If the virus becomes a human being transmitted, it causes a dangerous respiratory infection that derives similar to the flu or pneumonia symptoms, which can affect all the systems of the body and can cause death in 3-5 affected in 10 cases, especially if the patient already suffering from another disease prior to contagion. since the year 2012 the majority of cases have occurred in the Middle East. Countries that have detected the most cases are: Saudi Arabia, UAE, Qatar, Oman, Kuwait, Yemen, Jordan and Lebanon. But the mobility of travelers across continents is a reality today, so there have been isolated cases of infections MERS in many other countries around the world, including: UK, France, USA, Greece, Egypt, Netherlands, Italy, Tunisia, Malaysia and one case in Spain. This makes MERS in an infectious disease of global and that has alerted all the world's governments. Currently they are studying methods of prevention, which may be similar to those established to prevent infection by Staphylococcus aureus methicillin resistant (MRSA). spite of this, fortunately the spread person to person is limited, and outbreaks only appear isolation in hospitals or work. The number of cases worldwide is still very low (the number of deaths from MERS to global round 200), which enables WHO to say that by the time this disease is kept under control and that, as of today not meet the requirements to declare an emergency of international public health.

Causes of MERS

The head of the dreaded respiratory syndrome coronavirus in the Middle East is a small virus (MERS-Cov) family of coronaviruses. These viruses are known for decades to be the main cause of the common cold or upper respiratory cold. However, the virus is much more aggressive MERS individually, but more difficult is transmitted from person to person. It is also a completely new virus for our immune system, so that the defenses of our body will fight much worse.
was suspected that this virus may have mutated from another coronavirus from bats, and found genetic similarities of more than 90 %.

How is it spread MERS

MERS virus infection is similar to other respiratory viruses. The secretions of sick people (saliva, mucus) may contain viruses that are transmitted by direct contact, cough or sneeze. As mentioned, the spread person to person is more limited than previously thought, and reported cases have caused small outbreaks are self-limiting in their immediate environment where they live or work and hospitals that were served.
was not known as arrived virus to humans, or if it still is transmitted from animals. Direct contact with bats does not seem a possibility, although that may be the source of the virus, because it is not correlated with an increase of rabies cases and this is a common animal in the Middle East. The coronavirus has been isolated in other animals, such as camels . This animal, which is very common in Arab countries, could be a vehicle of transmission to humans, but is still under study.
Once the virus reaches the human and reaches the airways begin to multiply in the epithelial bronchi. That causes an acute respiratory infection that quickly produces flu-like pneumonia or respiratory symptoms. The infection produces a global alteration of all devices and systems, and so can be fatal in up to half of cases, especially if the victim had an underlying disease.

Symptoms of Mers

The MERS-CoV can cause symptoms at various levels of the human body. His method of operation is similar to the flu and other respiratory viruses. The main symptoms of respiratory syndrome coronavirus in the Middle East (MERS) are:
  • Malaise, muscle pain and joint pain.
  • Catarrhal symptoms with pharyngeal discomfort, coughing, sneezing, etc..
  • Sensation of fatigue or shortness of breath, pneumonia happens when occupying a part of the lung is formed.
  • Fever can be very high, exceeding 39 º C.
  • Gastrointestinal problems such as diarrhea vomiting.
When symptoms of MERS is maintained over time and may have aggravated a similar systemic involvement septic shock. So, it happens that the heart can not pump enough blood because all the blood vessels are dilated. The kidneys suffer and may require dialysis and admission to intensive care units.
MERS may end with the patient's death in up to half of cases, although the latest figures indicate that only 27% of patients do not get overcome infection. Not surprisingly, the most vulnerable are those with underlying diseases (heart failure, renal failure, diabetes, cancer), immunocompromised and elderly.
should be borne in mind that the coronavirus can not cause respiratory syndrome and be completely asymptomatic. That makes seemingly healthy people are able to transmit the virus among their close contacts (family, partners, etc.). This may explain why it was not able to locate a source of infection in many cases.

Diagnosis of MERS

The clinical signs and symptoms are nonspecific MERS making it difficult to reach the right diagnosis. One should think of a possible case of respiratory syndrome coronavirus in the Middle East (MERS-CoV) in the following situations:
  • Respiratory symptoms in people who have traveled to the Middle East the past two weeks.
  • Respiratory symptoms in people who have had close contact with people who have traveled to the Middle East two weeks earlier.
  • Respiratory symptoms in people who have had contact with other sick people in the MERS was a diagnostic possibility.
Apart from clinical diagnosis, there is evidence that can be performed in humans to see if it is infected by the coronavirus responsible. You can analyze sputum or nasal secretions to search RNA virus through genetic engineering as the PCR. Blood can make a serological study looking coronavirus antibodies, but are less reliable.
As the tests take a few days to become available, the person suspected of having MERS will be isolated and you will be considered a patient under investigation ( patient under investigation , PUI). Hospitals around the world have a number of protocols that activate in these situations.

Treatment of MERS

There is no specific treatment for MERS. Mild symptoms can be treated with nonspecific drugs that relieve the patient (analgesics that reduce fever and pain, to open bronchial aerosols, etc.).
When the box is severe can be more invasive interventions such as dialysis if renal failure or intubation when respiratory failure is irreversible. exists no vaccine against this coronavirus today. As MERS overcome infection depends entirely on the state of health of the patient concerned and the symptomatic treatment and support to be provided. They are studying new drugs and vaccines against the virus, but there is not conclusive.

Prevention MERS-CoV

Precisely because of this lack of a defined and effective treatment, it is best to try to prevent the spread of MERS and prevent its spread, for which a number of measures are recommended:
  • Wash hands with soap and water for 30 seconds several times a day. If no water can be used hydroalcoholic solved.
  • Like the flu, you should sneeze and cough into a tissue or directly onto the ground covered with hands avoiding. Do not touch your eyes, mouth or nose to prevent contact with secretions.
  • Avoid kissing and sharing utensils and cups or dishes with sick people.
  • No restrictions on travel to the Middle East. If you travel there you must maintain the same hygiene measures such as hand washing and avoiding contact with people with cold symptoms.
  • The Saudi government also recommends the use of masks and avoid contact with camels until confirmed whether these animals can transmit the virus.
  • If you are a person with underlying conditions or weak immune system, you should also avoid contact with animals, eating undercooked meat or not sanitized milk.
  • If a room or house where there has been an affected or suspected of it is haunted, you should disinfect surfaces frequently touched, such as doorknobs, toys, etc..
Article contributed for educational purposes
Health and Wellness

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