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“How shall freedom be defended? By arms when it is attacked by arms, by truth when it is attacked by lies, by faith when it is attacked by authoritarian dogma. Always, in the final act, by determination and faith.”

― Archibald MacLeish

Thursday, April 17, 2014

Global Pinoys: Warning on Middle East Respiratory Syndrome (MERS)

From Gulf News:
President Benigno Aquino has called for strict measures to prevent the spread of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in the Philippines, following the death of a Filipino paramedic of MERS-CoV in the UAE on April 10, sources said.
The Bureau of Quarantine has reactivated, at the three terminals of the Ninoy Aquino International Airport (NAIA) in suburban Pasay City, a surveillance system that the health department started using to monitor incoming passengers for bird flu and influenza virus (H7N9 and H1N1) in 2003, the health department said in a statement.
Hospitals have been ordered to report to authorities cases of patients with severe respiratory illnesses, the statement said, adding that passengers coming from the Middle East should watch out for symptoms of respiratory ailments within 10 days of arrival.
“Even if we have no reported cases of MERS-CoV yet in the Philippines, we should remain vigilant and prevent it from spreading in our country,” said Dr Lyndon Lee Suy, head of the health department’s Bureau of Emerging and Re-emerging Diseases.
Meanwhile, authorities have decided not to send back to the Philippines the ashes of the Filipino paramedic who died of MERS-CoV in Al Ain on April 10, a foreign affairs source in Manila told Gulf News.
The body will be cremated in Al Ain, said the source, who did not give further details.
Earlier, the foreign affairs department had said it would abide by the request of his family to bring back his ashes to the Philippines.
At the same time, the labour department ordered the Overseas Workers Welfare Administration (OWWA) to provide financial assistance to his family in the Philippines. The deceased’s name has been withheld.
Meanwhile, five other OFWs who were infected with MERS-CoV remained under quarantine at a hospital in Al Ain. In coordination with the Health Authority of Abu Dhabi, a medical team of the Philippine Embassy in Abu Dhabi, reported to Manila that the infected Filipinos were in a stable condition.
Giving advice to all OFWs in the Middle East, Foreign Affairs spokesman Charles Jose said, “We are advising all Filipinos not only in the UAE but in the whole of Middle East to take precautionary measures against the deadly MERS-Cov.”
They should wash hands, follow advisories of health authorities, sleep, eat properly, and seek medical attention if symptoms of respiratory ailment are felt, said Jose. Symptoms include cough, diarrhoea, fever, shortness of breath, pneumonia, and kidney failure.
A Filipina nurse, 41, died of MERS-CoV infection in Riyadh on August 29, 2013.
Cases of MERS-CoV were also recorded in Saudi Arabia, Qatar, Kuwait, Jordan and Oman in the Middle East; and in several European countries.
There have been a total of 228 laboratory-confirmed cases of MERS-CoV infections, and 92 deaths in 10 countries since 2012, the World Health Organisation said.
The Middle East respiratory syndrome coronavirus (MERS-CoV), also termed EMC/2012 (HCoV-EMC/2012), is positive-sense, single-stranded RNA novel species of the genus Betacoronavirus.

It was first reported on 24 September 2012 on ProMED-mail by Egyptian virologist Dr. Ali Mohamed Zaki in Jeddah, Saudi Arabia.
Virology.

The virus MERS-CoV belongs to the genus Betacoronavirus and has been traced to an Egyptian tomb bat. The virus isolated from the bat was a 100% match to the virus isolated from the index-patient. The bat was found in a building in close proximity to the index-patient's house.

Origin
Dr. Ali Mohamed Zaki isolated and identified a previously unknown coronavirus from the lungs of a 60-year-old male patient with acute pneumonia and acute renal failure. Dr. Zaki then posted his findings on ProMed-mail. MERS-CoV is the sixth new type of coronavirus like SARS (but still distinct from it and from the common-cold coronavirus). Until 23 May 2013, MERS-CoV had frequently been referred to as a SARS-like virus, or simply the novel coronavirus, and colloquially on messageboards as "Saudi SARS" (e.g. The Guardian and Yahoo in the UK, CNN in the U.S., and Toronto and Ottawa media in Canada). From Wikipedia
From CDC
Middle East Respiratory Syndrome (MERS) is viral respiratory illness first reported in Saudi Arabia in 2012. It is caused by a coronavirus called MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died.
So far, all the cases have been linked to six countries in or near the Arabian Peninsula. No cases have been identified in the U.S. This virus has spread from ill people to others through close contact. However, the virus has not shown to spread in a sustained way in communities. The situation is still evolving.
Frequently Asked Questions and Answers
Q: What is MERS?
A: Middle East Respiratory Syndrome (MERS) is a viral respiratory illness. MERS is caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus” (MERS-CoV).
Q: What is MERS-CoV?

A: MERS-CoV is a beta coronavirus. It was first reported in 2012 in Saudi Arabia. MERS-CoV used to be called “novel coronavirus,” or “nCoV”. It is different from other coronaviruses that have been found in people before.
Q: Is MERS-CoV the same as the SARS virus?
A: No. MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. CDC is still learning about MERS.
Q: What are the symptoms of MERS?
A: Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness.
Q: Does MERS-CoV spread from person to person?
A: MERS-CoV has been shown to spread between people who are in close contact.[1] Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in several countries are being investigated.
Q: What is the source of MERS-CoV?
A: We don’t know for certain where the virus came from. However, it likely came from an animal source. In addition to humans, MERS-CoV has been found in camels in Qatar and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV, indicating they were previously infected with MERS-CoV or a closely related virus. However, we don’t know whether camels are the source of the virus. More information is needed to identify the possible role that camels, bats, and other animals may play in the transmission of MERS-CoV.
Q: Is CDC concerned?
A: Yes, CDC is concerned about MERS-CoV. Most people who have been confirmed to have MERS-CoV infection developed severe acute respiratory illness. They had fever, cough, and shortness of breath. About half of these people died. Also, the virus spreads from person to person and has spread between countries. CDC recognizes the potential for the virus to spread further and cause more cases and clusters globally, including in the United States.
Q: Has anyone in the United States gotten infected?
A: So far, there are no reports of anyone in the United States getting infected with MERS-CoV.
Q: What is CDC doing about MERS?
A: CDC works 24/7 to protect people’s health. It is the job of CDC to be concerned and move quickly whenever there is a potential public health problem. CDC is closely monitoring the MERS situation and working with WHO and other partners to understand the risks of this virus. CDC is engaged in the following ways:
CDC developed molecular diagnostics that will allow scientists to accurately identify MERS cases. CDC also developed assays to detect MERS-CoV antibodies. These lab tests will help scientists tell whether a person is, or has been, infected with MERS-CoV. CDC will evaluate genetic sequences as they are available, which will help scientists further describe the characteristics of MERS-CoV.
As part of routine public health preparedness in the United States, CDC is providing MERS-CoV testing kits to state health departments. CDC also developed Interim Guidance for Health Professionals. This includes case definitions, and guidance for evaluating patients, reporting cases to CDC, infection control in healthcare settings, preparedness, caring for MERS patients at home, and handling clinical specimens.
CDC is offering recommendations to travelers when needed. CDC is also helping to assess ill travelers returning from affected areas.
In addition, CDC participated in international public health investigations of past MERS cases in Saudi Arabia (October 2012) and Jordan (May 2013). CDC continues to provide advice and laboratory diagnostic support to countries in the Arabian Peninsula and surrounding region.
Q: Can I still travel to countries in the Arabian Peninsula or neighboring countries where MERS cases have occurred?
A: Yes. CDC does not recommend that anyone change their travel plans because of MERS. The current CDC travel notice is a Watch (Level 1) which advises travelers to countries in or near the Arabian Peninsula to follow standard precautions, such as hand washing and avoiding contact with people who are ill.
Q: What if I recently traveled to countries in the Arabian Peninsula or neighboring countries and got sick?
A: If you develop a fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries[2], you should see your healthcare provider and mention your recent travel.
Q: How can I help protect myself?
A: CDC advises that people follow these tips to help prevent respiratory illnesses:
Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
Cover your nose and mouth with a tissue when you cough or sneeze then throw the tissue in the trash.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact, such as kissing, sharing cups, or sharing eating utensils, with sick people.
Clean and disinfect frequently touched surfaces, such as toys and doorknobs.
Q: Is there a vaccine?
A: No, but CDC is discussing with partners the possibility of developing one.
Q: What are the treatments?
A: There are no specific treatments recommended for illnesses caused by MERS-CoV. Medical care is supportive and to help relieve symptoms.
Q: Is there a lab test?
A: Lab tests (polymerase chain reaction or PCR) for MERS-CoV are available at state health departments, CDC, and some international labs. Otherwise, MERS-CoV tests are not routinely available. There are a limited number of commercial tests available, but these are not FDA-approved.
Q: What should healthcare providers and health departments do?
A: For recommendations and guidance on the case definitions; infection control, including personal protective equipment guidance; home care and isolation; case investigation; and specimen collection and shipment.