MERS-CoV: What It Is and How Do We Protect Ourselves From It?(Special Report)

Manila — What exactly is MERS-CoV or the so-called Middle East Respiratory Syndrome-Coronavirus? Where it came from? How do we protect ourselves from this so-called “new threat to the entire world”?

These are among the most frequently asked questions after the World Health Organization (WHO) said it has recorded 254 confirmed cases of the MERS-CoV, including 93 deaths.

“It all started with one case, a 60-year-old male patient who died with complications due to acute pneumonia and acute renal failure and was diagnosed with corona virus infection who passed away in Jeddah, Saudi Arabia on June 12, 2012,” said Dr. Mario Panaligan, founding member of the ASEAN Federation of Internal Medicine (AFIM) and member of the International Society of Internal Medicine (ISIM).

Dr. Panaligan, who was invited to talk on MERS-CoV in a health forum held Tuesday at the Annabel’s Restaurant in Quezon City, said that a second case was recorded in September 2012, when a 49-year-old male living in Qatar was found with similar flu symptoms and a sequence of the virus nearly identical to that of the first case.

In November 2012, there were similar cases reported in Qatar and Saudi Arabia. As additional cases were noted, some associated with deaths, rapid research and monitoring of the virus was undertaken.

“So they term it MERS-CoV. It behaves similarly with the Severe Acute Syndrome (SARS). They are both corona virus, they belong to the same family, and so with the manifestations which are usually cough, fever and then shortness of breath. If there’s a difference, it is very slight in transmissibility, but it is hard to predict now,” Panaligan said.

According to him, scientists have found strong evidence of the MERS-CoV in a bat from Saudi Arabia, suggesting that bats are the virus’s natural reservoir. However, scientists have yet to know how the virus is transmitted from animals to humans.

Panaligan also cited a report about a Malaysian man, 54, who traveled to Saudi Arabia with a group of 18 pilgrims and was away from March 15 to 28, 2014. While visiting a camel farm on March 26, he drank camel milk. The man fell ill after returning home and died on April 13.

Researchers found that MERS-CoV could survive in camel milk for at least 72 hours. But they didn’t examine whether the virus is actually found in the milk of infected camels.

Further studies have suggested that MERS-CoV is fairly common in camels in Saudi Arabia and neighboring countries, and one or two human MERS patients were found to have had contact with infected camels.

It is reported that countries like Saudi Arabia and the United Arab Emirates produce and consume large amounts of camel meat; and the possibility exists that African or Australian bats harbor the virus and transmit it to camels. Imported camels from these regions might have carried the virus to the Middle East.

“If you are a traveller or you know somebody who travelled and just passed the Arabian Peninsula, make sure that you monitor yourselves; that you don’t develop the symptoms. It is very critical when you are exposed to somebody who got sick (of MERS-CoV),” Panaligan said.

“Basically, we still don’t know how it is going to be transmitted, how easily it is going to be transmitted, but what they found out, of course, is SARS is easily transmissible compared to this one,” Panaligan said.

At present, both SARS and MERS—CoV have no treatment… The biggest complications include pneumonia and acute respiratory distress syndrome (ARDS)… There are, of course, patients who would develop kidney failure and, of course, when there is multiple organ involvement, there is high incidence of mortality, he added.

In the same line, Panaligan said most patients who died and most patients who got sick with complications were elderly individuals, obese, pregnant women, those with underlying medical problems, including diabetes mellitus, cancer, Panaligan said.

He also said that the public should make the habit of knowing what is happening, “so you won’t be surprised and will know what to do especially with MERS virus,” Panaligan said, noting that “we have so many country fellowmen working in Saudi Arabia, Dubai, and other areas in the Middle East where corona virus was found.”

Noting that an average of 23 plane flights arrive at the Ninoy Aquino International Airport (NAIA) every day coming from the Middle East countries that are carrying 6,000 passengers, Panaligan stressed the importance of constantly monitoring such arriving passengers.

He said that on top of the exposure to the virus and may need immediate medical attention are around 300,000 overseas Filipino workers (OFWs) in the Middle East Region, specifically Oman, Dubai, Jeddah, and Qatar.

Panaligan is also reminding the public about the importance of seeking immediate medical attention if one develops a fever and symptoms of lower respiratory illness such as cough and shortness of breath after a known exposure within 14 days to a seriously sick patient, or within 14 days after travelling from countries in the Arabian Peninsula or neighboring counties.

To date, WHO said more study is required to better understand the mechanisms of MERS virus transmission to humans – the intermediate vehicle—animal, food, or something else — that channel the virus from bats to humans.

In the Philippines, Health Secretary Enrique T. Ona said that there is a need to be vigilant and aware with emerging diseases like MERS-CoV, which is yet to be fully understood with only about 200 cases all over the world in the past two years.

It can be recalled that a Filipino male nurse based in Abu Dhabi was initially tested positive for MERS-CoV while still in the United Arab Emirates. He was placed under quarantine immediately upon his return to Manila on April 15 aboard Etihad Airways Flight EY 0424 from Abu Dhabi.

On April 19, he tested negative 11 days after being exposed to the virus in a hospital where he worked in Abu Dhabi through a Filipino patient who died there due to MERS-CoV.

Meanwhile, Dr. Lyndon Lee Suy, DOH Emerging Infectious Disease program manager and spokesman for the Task Force MERS-CoV, said that despite the entry of the virus in the country through the returning OFW, “there is no MERS-CoV in the Philippines.”

By Lady Marie Dela Torre (PNA) SCS/SDT/JSD