The Hype Surrounding MERS-CoV: Should We Be Worried?

By Tyler Wolford, MS, Specialist, Laboratory Response Network, APHL

If this is your first time seeing a virus up close you probably weren’t aware of their unnerving appearance: their outer membranes fortified with menacing protrusions built for one thing, to get you sick. Of the thousands of viruses known to exist, one in particular has been of interest lately: the Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV). MERS-CoV is a novel coronavirus closely related to the Severe Acute Respiratory Syndrome (SARS) Coronavirus that was responsible for 774 deaths (9.6% fatality) in south China back in 2002 and 2003. Within a few months, SARS had spread to over 37 countries with a final count of over 3000 cases. All coronaviruses present similar symptoms (e.g., fever, cough, and shortness of breath), but unlike SARS, MERS-CoV transmission is not known to transmit person to person, giving some relief to public health officials. However, viruses are known to evolve quickly, causing concern for the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC). If MERS-CoV secures a foothold and a source isn’t found, the world could be facing another outbreak eerily similar to that of SARS in the early 2000s.

As of September 25, 2013, the global count for MERS-CoV cases has risen to 130. You may be thinking that doesn’t sound like a big deal considering there are over 6 billion people in the world, which results in one case for every 60 million people. The staggering fact to keep an eye on is the close to 50% case-fatality rate. Furthermore, health officials still aren’t able to narrow down the source of the virus. Several virologists have suggested bats to be a host, noting that bats are carriers of a number of coronaviruses and nucleotide sequencing of bats in the area has shown promising matches to the virus found in patients. However, there is a high chance these positive matches could just be a related coronavirus and not specifically MERS-CoV.

Rest assured that no cases have been reported in the United States…yet. Most have been isolated to the Arabian Peninsula with few reports in Europe associated with people who have recently traveled to those countries on the peninsula. Although there is little you can do to protect yourself, public health organizations are diligently working to prepare in the event that cases present in the United States. Currently, CDC has issued guidance to health care providers who suspect a MERS-CoV infection. The CDC has also implemented polymerase chain reaction (PCR) testing capabilities at their headquarters. Since there were no FDA approved tests at that time, CDC was approved for emergency use authorization (EUA) to perform testing immediately. Since CDC began testing, 46 public health laboratories and four Department of Defense (DOD) laboratories have implemented such testing. The CDC utilized the Laboratory Response Network to efficiently implement testing across the United States. The use of the LRN to respond to emerging public health threats is nothing new – the network was leveraged for responses to anthrax, West Nile virus, H1N1, SARS and other recent threats such as ricin. The WHO and CDC continues to monitor this emerging virus.

For more information of MERS-CoV, please visit the CDC’s MERS-CoV information page.

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