Sunday, May 31, 2015

Abu Dhabi: Two Asymptomatic MERS Cases Clear Virus, Leave Hospital

# 10,122

The two truck drivers (mentioned in my last blog) who tested positive for the MERS earlier this month virus after the camels they were transporting from Oman to the UAE proved infected, have been released from hospital isolation after successfully clearing the virus.

First the news report, then I'll be back with a little bit more on why this matters.

HAAD: Two MERS CoV cases test negative and leave hospital 
31/05/2015 03:02:00 PM 
ABU DHABI, 31st May, 2015 (WAM) - The Health Authority - Abu Dhabi, HAAD, have announced that the two individuals who were in isolation in hospital with MERS Coronavirus (MERS CoV) have now tested negative for the virus, and left the hospital. 
HAAD said in a statement today that the cases were confirmed positive through active case finding, and were kept in isolation at hospitals as a precautionary measure. They were able to clear the virus themselves without any treatment. 
HAAD confirmed that it is coordinating with the Ministry of Health and other authorities in the country, and has taken all necessary measures as per international standards and recommendations from the World Health Organisation, WHO. 
The Ministry of Health confirmed that it is monitoring the situation closely to ensure the health and safety of everyone. 

Both of these patients have been described as `asymptomatic' in the HAAD releases and the WHO updates, and their detection and isolation was the result of routine testing after the camels they were transporting tested positive for the MERS coronavirus.

Were it not for this rather serendipitous finding, they'd never have known they were infected, and might have passed the virus on to others. 

While it is unknown whether asymptomatic cases can spread the virus on to others, some studies have suggested it is possible (see Study: Possible Transmission From Asymptomatic MERS-CoV Case), and the lack of obvious epidemiological links between many community acquired cases certainly raises the question.

Unknown also is the extent of asymptomatic carriage of the MERS virus.

Limited contact testing of asymptomatic (or mildly symptomatic) contacts of known cases has turned up a substantial number, and in November of 2013, we looked at a study published in The Lancet that  calculated  for every case identified, there were likely 5 to 10 that went undetected. 

How many there really are?  Well, that's the $64 question. 

Until we can quantify both the risks and incidence of asymptomatic carriage of MERS, our understanding of the true transmissibility and severity of the the virus is likely to remain skewed.

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