Three New Cases Of MERS-Coronavirus Confirmed In Italy
June 3, 2013

Three New Cases Of MERS-Coronavirus Confirmed In Italy

Lawrence LeBlond for - Your Universe Online

In a statement released over the weekend, the World Health Organization (WHO) said the Middle East Respiratory Syndrome-Coronavirus (MERS-CoV) is continuing to spread, with three new cases now confirmed in Italy.

Italy´s Ministry of Health notified the WHO via the EU´s Early Warning Response System (EWRS) on Saturday about the first confirmed case of MERS-CoV in that country. The patient is a 45-year-old man who recently returned from a trip to Jordan on May 25 with symptoms of cough and fatigue. He was hospitalized on May 28 after his condition deteriorated.

Then on Sunday, the Ministry reported two new cases to the WHO, both of whom were close contacts of the first man. The new patients are a two-year-old girl and a 42-year-old woman. Both new victims are in stable condition.

There are conflicting reports among the media on the number of cases and deaths from MERS-CoV since the outbreak was first reported last fall, but the WHO places global cases at 53 and deaths at 30 as of June 2, 2013.

While the virus has been detected in several Europeans countries and in Africa, the majority of the cases remain in the Middle East, particularly Saudi Arabia. ABC News reported that at least 38 cases have so far been confirmed in that country with 24 deaths.

Nearly all of the cases of MERS-CoV found in Europe and Africa were in people who had recently returned from travel from the Middle East or had been transferred from there for better care. Limited local transmission has been observed in cases found in France, Italy, Tunisia and the UK among patients who had not been to the Middle East but were in close contact with patients who had been laboratory-confirmed to have the disease.

The WHO encourages all Member States to continue surveillance for symptoms of MERS-CoV, which include cough, trouble breathing and kidney ailments. While MERS-CoV is similar to the SARS disease that killed 774 people a decade ago, it is unique in the fact that it is known to cause kidney failure. Health experts are encouraged to maintain vigilance and anybody traveling from the Middle East and showing signs of severe acute respiratory infections (SARI) are urged to seek medical attention as soon as possible.

The WHO is also urging healthcare facilities to isolate patients who are suspected to have, or known to have, the MERS-CoV for a period of at least 9 to 12 days to avoid spread of the disease. This is an update from a previous alert to isolate patients for 7 to 9 days, after health experts found the disease remains contagious longer than previously thought.

It is important that all Member States promptly notify the WHO of any new cases as well as offering information about potential exposures that may have resulted in infection and a description of the clinical course and a list of people who may have been in contact with the infected patient.

The international health organization currently does not advise special screening at points of entry with regard to MERS-CoV and it also does not recommend application of travel and trade restrictions at this time. The WHO will continue to monitor the situation closely.

Nathan Wolfe, a National Geographic Emerging Explorer, founder and executive chair of Global Viral, a visiting professor at Stanford University and author of the book ℠The Viral Storm,´ is working to create an early-warning system to help forecast and contain new viruses before they can cause massive outbreaks like the current MERS-CoV.

In an interview with NatGeo´s Melody Kramer, Wolfe explained that experts have yet to gain a “definitive understanding of how the virus spreads, but human-to-human transmission has been reported for several clusters, particularly in cases with sustained contact such as health-care workers. SARS, also a coronavirus, was spread through respiratory droplets from coughing or sneezing.”

He told Kramer that there is still much that needs to be discovered about the new virus strain. He noted that it is not known how MERS-CoV originated, but the common theory right now is that it comes from animals, likely bats or perhaps camels. And while there are some instances of human-to-human transmission, experts still do not known the exact mechanism of transmission.

He said although more than 50 percent of the patients who have been confirmed to have this virus have died, he explained that it is likely only those who are the most sick are being identified and diagnosed. Those with milder symptoms may forgo seeking medical help, passing it off as a common cold.

For those who have underlying medical conditions, it is likely there will be higher death rates from this disease. So, Wolfe said, it is possible the 50+ percent mortality rate could be an overestimate.

When asked by Kramer what officials are doing to combat this disease, and what they plan to do if it spreads, Wolfe said: “We're living in a remarkable time. While the risks of pandemics have increased dramatically, so too has the global level of scientific and public health expertise. Among the exciting trends that we've seen in both the recent outbreaks of H7N9 and MERS is a high level of international collaboration and transparency. Viruses don't respect borders between countries, and our efforts to combat them must truly be global.”