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New respiratory virus spreads easily, deadlier than SARS

By Maria Cheng

AP Medical Writer

LAST UPDATED: 01:31 a.m. HST, Jun 20, 2013

LONDON » A mysterious new respiratory virus that originated in the Middle East spreads easily between people and appears more deadly than SARS, doctors reported Wednesday after investigating the biggest outbreak in Saudi Arabia.

More than 60 cases of what is now called MERS, including 38 deaths, have been recorded by the World Health Organization in the past year, mostly in Saudi Arabia. So far, illnesses haven't spread as quickly as SARS did in 2003, ultimately triggering a global outbreak that killed about 800 people.

An international team of doctors who investigated nearly two dozen cases in eastern Saudi Arabia found the new coronavirus has some striking similarities to SARS. Unlike SARS, though, scientists remain baffled as to the source of MERS.

In a worrying finding, the team said MERS (Middle East respiratory syndrome) not only spreads easily between people, but within hospitals. That was also the case with SARS, a distant relative of the new virus.

"To me, this felt a lot like SARS did," said Dr. Trish Perl, a senior hospital epidemiologist at Johns Hopkins Medicine, who was part of the team. Their report was published online Wednesday in the New England Journal of Medicine.

Perl said they couldn't nail down how it was spread in every case — through droplets from sneezing or coughing, or a more indirect route. Some of the hospital patients weren't close to the infected person, but somehow picked up the virus.

"In the right circumstances, the spread could be explosive," said Perl, while emphasizing that the team only had a snapshot of one MERS cluster in Saudi Arabia.

Cases have continued to trickle in, and there appears to be an ongoing outbreak in Saudi Arabia. MERS cases have also been reported in Jordan, Qatar, the United Arab Emirates, Britain, France, Germany, Italy and Tunisia. Most have had a direct connection to the Middle East region.

In the Saudi cluster that was investigated, certain patients infected many more people than would be expected, Perl said. One patient who was receiving dialysis treatment spread MERS to seven others, including fellow dialysis patients at the same hospital. During SARS, such patients were known as "superspreaders" and effectively seeded outbreaks in numerous countries.

Perl and colleagues also concluded that symptoms of both diseases are similar, with an initial fever and cough that may last for a few days before pneumonia develops.

But MERS appears far more lethal. Compared to SARS' 8 percent death rate, the fatality rate for MERS in the Saudi outbreak was about 65 percent, though the experts could be missing mild cases that might skew the figures.

While SARS was traced to bats before jumping to humans via civet cats, the source of the MERS virus remains a mystery. It is most closely related to a bat virus though some experts suspect people may be getting sick from animals like camels or goats. Another hypothesis is that infected bats may be contaminating foods like dates, commonly harvested and eaten in Saudi Arabia.

Doctors around the world have struggled to treat patients. "We need more information from other countries to find out what the best treatment is," said Dr. Clemens Wendtner, who treated a MERS patient who later died in Munich. "Our patient got everything possible and it still didn't help him."

Other experts said there are enough worrying signs about MERS that it can't yet be written off, despite the relatively small number of cases it has caused.

"As long as it is around, it has every opportunity at the genetic roulette table to turn into something more dangerous," said Michael Osterholm, an infectious diseases expert at the University of Minnesota.

WHO Director-General Dr. Margaret Chan has previously called MERS the single biggest public health threat and acknowledged officials were "empty-handed" regarding prevention measures.

"We understand too little about this virus when viewed against the magnitude of its potential threat," she said last month in Geneva.

At a meeting this weekend in Cairo, WHO will meet with other experts to discuss MERS and to possibly develop guidelines for next month's Ramadan, when millions of Muslim pilgrims will be visiting Saudi Arabia.


Journal: http://www.nejm.org
WHO: http://www.who.int
CDC: http://www.cdc.gov/coronavirus/mers/overview.html

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TLehel wrote:
What if we don't know the source because it was engineered? Could be a man-made virus based off of SARS.
on June 19,2013 | 11:24AM
Slow wrote:
Could be lots of things. I just want some one to blame Obama.
on June 19,2013 | 12:44PM
localgirl2 wrote:
Oh well, why not?
on June 19,2013 | 01:31PM
inverse wrote:
Not likely. This is what virus and bacteria naturally do, transform into ways that allow their propagation despite the development of anti-viral and anti-bacterial drugs. Was in the news Hawaii has it share of superbugs like MRSA or some super Gonorhea strain that is very drug resistant but they don't spread as easily as this MERS. If you are talking about engineered biological weapons like the movie Outbreak with Dustin Hoffman or a couple of old Hawaii 5-0 episodes with Jack Lord during the post Vietnam: cold war era, the US probably was, and still is the leader in biological weapon research amd development. However why would Islamic extremists go that route when nuclear weapons or a dirty bomb is a much more effective weapon of mass destruction that might become available to them when countries like Iran are starting to ramp up their nuclear program. Would worry more about a Sum of All Fears scenario (Ben Affleck/ Morgan Freeman) where a nuclear weapon is smuggled into the US and set off at a piblic event like a football game.
on June 20,2013 | 02:46AM
bekwell wrote:
Wow! Now I have something to worry about; and all I wanted to do was go surfing today.
on May 12,2014 | 03:28AM
Hapa_Haole_Boy wrote:
it's Allie's fault
on June 19,2013 | 02:38PM
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