American health officials are reporting the first case of the Middle East respiratory syndrome in the United States, where a health-care worker who recently returned from Saudi Arabia is now being treated at an Indiana hospital.
Since first emerging in 2012, the MERS coronavirus has been spreading throughout the Middle East, killing about a third of its victims. Although infected travellers previously brought the virus to Europe, Africa and Asia, this is the first time it has been “exported” to North America.
While MERS is related to the SARS virus, it does not spread as easily so the risk to the North American public remains “very low,” said Dr. Anne Schuchat, a U.S. assistant surgeon general and director of the National Center for Immunization and Respiratory Diseases with the Centres for Disease Control.
Nevertheless, the virus’s debut on American soil is a grim reminder that new diseases “are just another plane ride away,” she told reporters in a telephone press conference Friday.
“While centred in the Arabian Peninsula, MERS is now in our heartland,” Schuchat said. “This situation is very fluid. We expect to learn much more in the coming days.”
The World Health Organization says MERS has now infected 261 people but it only counts cases confirmed through laboratory testing. The European Centre for Disease Prevention and Control puts the tally as high as 424, with 131 deaths.
The latest victim of MERS is a U.S. citizen who works in the health-care industry in Riyadh, Saudi Arabia, where most MERS cases have occurred. This person also has underlying medical conditions, according to Amy Reel, a spokesperson with the Indiana department of health; many MERS patients seem to suffer from pre-existing health issues, which may make them more susceptible to the virus.
On April 24, the patient flew out of Riyadh and transferred through London to Chicago, where he or she boarded a bus for Indiana. On Sunday, the patient began experiencing fever and respiratory symptoms and was admitted to a community hospital in Munster, a town in northwestern Indiana, the next day. The patient is in stable condition, Schuchat said.
Schuchat said health officials are now tracking people who may have come into contact with the Indiana patient. While MERS does not spread easily, patients have, in the past, infected close relatives, though in some cases they did not develop any symptoms.
MERS has also caused hospital outbreaks in the Middle East, most likely due to poor infection control practices. Schuchat said the Indiana hospital is exercising every precaution but “we should not be surprised if additional cases are identified among the health-care providers.” According to Reel, the hospital is “aggressively following up” with some 40 health-care workers.
“I think I would say it’s way too early for us to breathe a sigh of relief. But no one else is ill and we’ll be actively investigating,” Schuchat said.
The Indiana case comes on the heels of a dramatic month for MERS, with 217 cases reported in April alone, according to the European Centre for Disease Prevention and Control. That’s more than the previous two years combined.
There is no evidence the virus has recently mutated, however, and the increase could be due to a number of explanations, including more heightened surveillance or an outbreak in camels, which scientists believe could be spreading the virus to humans.
But every new infection is another opportunity to mutate, said Peter Daszak, president of the conservation group EcoHealth Alliance, which has been studying MERS. The virus’s appearance in the U.S. is concerning, he said.
“Every time this happens, it adds almost another nail in our coffin on the way to a pandemic,” he said. “The virus is still out there and it’s still getting into humans and nothing seems to be happening to break that chain.”