¿Están los estadounidenses en riesgo de MERS?

El virus MERS se está propagando pero ¿llegará a los Estados Unidos?

A principios de junio de 2015, los funcionarios surcoreanos pusieron en cuarentena a miles de personas por temor a una infección por MERS. Anteriormente, este virus respiratorio era generalmente aislado en la Península Arábiga . Sin embargo, a fines de mayo de 2015, un hombre coreano de 68 años que regresaba de Arabia Saudita logró exponer a los trabajadores de la salud de 3 hospitales a este virus potencialmente mortal antes de ser diagnosticado y aislado adecuadamente. Ahora, personas de países de todo el mundo temen el potencial de otro brote de tipo SARS alrededor del año 2003.

¿Qué es MERS?

El Síndrome Respiratorio de Oriente Medio, o MERS, es un coronavirus que se transmite por el aire y que las personas infectadas expulsan. En otras palabras, las personas con MERS liberan gotas respiratorias que contienen el virus. Estas gotitas infectan directamente a los que están en contacto cercano o se unen a fomites u objetos como teléfonos y platos, e infectan a otros de esta manera. Curiosamente, los camellos también han estado implicados en la propagación del MERS, y se advierte a las personas que visitan el Medio Oriente que eviten interactuar con estos animales, tomar su leche y comer carne de camello poco hecha. (Sí, la gente come carne de camello.)

El MERS se diagnosticó por primera vez formalmente en Arabia Saudita en septiembre de 2012. (Aunque nunca se diagnosticó formalmente, se cree que el MERS apareció por primera vez en Jordania en abril de 2012). a personas mayores. Desde 2012, el MERS ha matado a unas 400 personas en Arabia Saudita.

In some people, MERS causes no or mild disease. In others, however, the MERS virus causes fever, chills, and shortness of breath. Other possible symptoms include nausea, vomiting, pneumonia, and kidney failure. In about 30 to 40 percent of those infected, MERS results in loss of life. MERS is especially dangerous in those with weakened immune systems, or people who have co-morbid (medical jargon for pre-existing) diseases like diabetes, lung cancer or kidney dysfunction. 

How Is MERS Diagnosed?

MERS is diagnosed using a combination of history, physical exam and laboratory testing. In particular, if you have recently traveled to the Middle East and are experiencing respiratory symptoms, then your physician should consider this diagnosis and order a reverse transcription-PCR assay. (In 2013, after the FDA issued and Emergency Use Authorization, the CDC supplied the hardware for MERS testing to major hospital centers throughout the world.)

In those infected, MERS usually takes about five to six days to incubate. However, in some, the disease has shown up as early as two days or as late as 14 days post exposure.

How Is MERS Treated?

Although the CDC is considering the development of a MERS vaccine, no specific treatment for MERS currently exists. Instead, people with this illness are provided supportive care which includes fluids, ventilation and so forth. Furthermore, people in areas where MERS is prevalent are encouraged to wear a face mask around those possibly infected. At-risk people should also judiciously disinfect, keep their hands clean and avoid close personal contact like kissing and sharing utensils with people who may have MERS.

Although people with MERS nave apparently been quarantined and treated at home, if this disease ever becomes a real problem in the United States and other developed nations, we’re probably looking at a SARSesque scenario.

Specifically, people with MERS will need to be isolated in a hospital room equipped with independent aeration. Moreover, healthcare workers caring for patients with MERS will need to wear masks and take other barrier precautions. Finally, strict procedural protocols will also be needed in order to keep ventilators, nebulizers and so forth thoroughly sterilized.

Are You at Risk for MERS?

Before the recent outbreak in South Korea, people outside of the Middle East were considered at low risk for exposure to MERS. For example, in mid-2015, there had been only two cases of MERS in the United States, both among healthcare workers returning from the Middle East. Typically, people with MERS had gone on only to at most infect one other person. However, the rapid spread of MERS in South Korea has public health officials and epidemiologists the world over reconsidering the threat of this virus. 

Experts are wondering whether the cases in South Korea were caused by a mutated and more virulent or deadly strain of the disease. Experts also wonder whether patient zero in the South Korean outbreak, the 68-year-old businessman, is a “supercarrier” because he has gone on to infect several people (including his son). In other words, this man may carry higher viral loads in the respiratory droplets he breathes out. Furthermore, this man went on to infect a 35-year-old man who then went on to infect 82 people! Finally, some experts postulate that Koreans themselves have increased susceptibility to the disease.

Although the vast majority of Americans and Europeans are likely still at little risk for MERS, the CDC and other health and government agencies are on alert for possible spread among people traveling to Western countries from the Middle East and now South Korea. Most importantly, however, the CDC is not recommending that anybody alter their travel plans. Of note, returning travelers with respiratory symptoms could be quarantined for up to two weeks. 

All things considered, you’re likely at little risk for being infected with MERS especially if you haven’t traveled abroad.

If you or someone you love is experiencing respiratory symptoms and has just returned from the Middle East, South Korea or any country that’s experienced a recent MERS outbreak, it’s important to inform a physician immediately. Additionally, it’s imperative that you inform clinic or hospital staff that you suspect this illness so that healthcare personnel can take necessary precautions, and other patients can be cleared from the area before you come in. 

Please note that as soon as you suspect MERS, you should travel only to the hospital and steer clear of other public places. Public exposure can result in a healthcare crises. For instance, South Korea had to shut down thousands of schools and hospitals for fear of rampant spread of MERS.

Bone Marrow Transplantation at | 832-533-3765 | [email protected] | Website

I am Dr. Christopher Loynes and I specialize in Bone Marrow Transplantation, Hematologic Neoplasms, and Leukemia. I graduated from the American University of Beirut, Beirut. I work at New York Bone Marrow Transplantation
Hospital and Hematologic Neoplasms. I am also the Faculty of Medicine at the American University of New York.