Healthcare Workers and Hospital Patients Are at Risk from MERS

[Laidback Al]

In June I made an allnurses' post about the hospital transmission of the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) (link). At that time about 55 cases had been reported from around the world. Now, 4 months later, more than 80 additional cases have been reported, most from Saudi Arabia.

MERS-CoV is a novel infectious disease that was first recognized in 2012. The coronavirus is similar to the coronavirus responsible for the SARS outbreak in 2002-2003, which infected more than 8000 people. Although less than 150 people have been infected with MERS-CoV around the world, the frequency has been increasing since March of this year. At least 50 people with MERS-CoV have died and many patients require extensive care in ICUs. While sustained human-to-human transmission has not occurred, human-to-human transmission is prevalent as evidenced by clusters of cases and nosocomial infections among healthcare workers and hospital patients.

Although official information is limited, about half of all MERS-CoV cases have occurred in clusters. Many of those clusters of infection occurred in health care facilities. A number of patients were infected during their hospital stay. Importantly, at least 30 healthcare workers, including nurses and possibly doctors, were infected while treating patients in hospitals and other healthcare facilities.

The fact that human to human transmission is occurring in healthcare facility settings among both patients and healthcare workers, including nurses, means that special care should be taken by healthcare workers when treating and caring for suspected and confirmed MERS-CoV cases.

[Laidback Al]

Why Should I care about MERS?

Let me preemptively respond to a question that might be posted in this thread--

"Why should I care about MERS, it's only infected about 140 and people and most of the nosocomial infections are taking place in Saudi Arabia on the other side of the world?"

Here is why readers at allnurses should be concerned about MERS.

We don't know how extensively MERS is circulating in the general population in Saudi Arabia. Official reports from the Saudi Arabia Ministry of Health are limited and probably do not provide an accurate picture of the MERS outbreak in that country.

We do know that in the next several weeks almost 2 million international visitors will travel to Saudi Arabia to participate in the annual Hajj pilgrimage. These visitors will be mingling with more than 1 million local citizens of Saudi Arabia. Additional human-to-human transmission could occur if the disease is circulating in the local Saudi Arabia population. Infected international Hajj travelers could bring the disease back to their home country when they return.

The fact is, international travelers to the Middle East have already become infected and brought the coronavirus back to their home countries. Cluster outbreaks from international travelers have occurred in France, Italy, Tunisia, and the United Kingdom earlier this year. So the spread of MERS by Hajj pilgrims around the world is a very real possibility in the coming weeks when these travelers return to their home countries.

It is important that healthcare workers all around the world be vigilant and consider MERS as the infectious agent for individuals who developed fever and pneumonia or other respiratory illnesses and have recently traveled to the Middle East or have had contact with sick individuals who have recently traveled to the Middle East.