A dangerous new respiratory disease known as Middle East Virus, or MERS-CoV, has spread from the Middle East to Europe. Cases have now been reported in Jordan, Qatar, Saudi Arabia, the UAE, Tunisia, Britain, Germany, and Italy.
This virus has killed 30 of the 54 people with confirmed infections, meaning that it has a mortality rate well over 50%. To put this number in perspective, smallpox, a feared and deadly disease, historically killed only 30% of those infected.
Health and disease experts are working to understand this new virus, but at this time not enough is known about it to contain an epidemic. It is not well understood how the virus spreads. MERS-CoV causes a respiratory disease, with coughing and sneezing. Scientists believe that the virus probably spreads through the wet droplets produced when people cough or sneeze. However, it seems like not everyone exposed catches the virus. In one large family only a few people became infected, even though everybody in the family lived and ate together. One infection is known to have occurred without direct physical contact.
French scientists suspect the virus may be able to hide in the body for 9-12 days before the infected person becomes sick. An incubation period of this length is unusual for a respiratory virus, with most causing illness in 2-4 days.If MERS-CoV can hide undetected for such a long time the virus will prove very difficult to contain. People who do not know they are infected will travel and spread the virus in new areas, as is already happening. All current cases in Europe have been traced to direct or indirect contact with travelers from the Middle East.
Most respiratory viruses can be detected by tests after swabbing a patient’s mouth or nose. This sort of quick, easy test has not proven a reliable way to detect MERS-CoV. So far, the only reliable way to prove the presence of the virus is through an invasive test known as bronchial lavage, which can only be done after a person is dead. These facts may indicate that the virus causes diseaseat a very low density. Bronchial lavage results in a large sample of fluid, while mouth and nose swabs give a very small amount. If there were not a lot of viral particles present even in lethally infected patients, then we would not expect swab tests to be reliable. Unfortunately, if this is true, it means that it will be extremely difficult to screen people for the disease.
There are currently no travel restrictions in place related to the MERS-CoV outbreak. However, if you are traveling to the Middle East, there are things you can do to protect yourself. If the virus is spread through droplet transmission, practicing good hygiene will greatly reduce your chance of infection. Do not touch your face, especially not your nose or your mouth, without washing your hands first when you have been in a public place. If you are concerned about breathing recirculated air on a plane, consider wearing a surgical mask. This precaution will protect you from being exposed to potentially infectious droplets.