Friday, June 12, 2015

APHA: MERS Information For Clinicians & The Public

# 10,197

Although we've only seen two MERS cases show up unannounced in the United States over the past three years, and we've been fortunate not to see any secondary cases, the reality it that MERS could arrive in an infected traveler at anytime, and just about anyplace in the country.

Between an outbreak in an international travel hub like Seoul Korea, the ongoing outbreaks in the Middle East, and the start of Ramadan in less than a week which will see tens of thousands of religious pilgrims descend on to Saudi Arabia, there is an understandable movement to promote MERS awareness. 

Yesterday the CDC released updated guidelines for healthcare providers (see CDC Releases HAN #380 On MERS) and held a COCA Call (see Updated Information & Guidelines For Evaluation Of MERS) to help bring clinicians up to speed on this potential threat.

Today the APHA (American Public Health Association)  weighs in with a summary report (see below) on the CDC's MERS guidelines, along with a handy poster for the public on how they should deal with the MERS threat (much of which would be applicable for almost any infectious disease).

Download PDF of fact sheet

This from the APHA Public Health Newswire:

CDC updates guidelines for MERS as Outbreak continues 

by Dan on Jun 12, 2015 • 10:14 am No Comments
As a response to the ongoing threat posed by the Middle East Respiratory Syndrome coronavirus, or MERS, the Centers for Disease Control and Prevention on Thursday released updated guidelines and information on the evaluation and testers for the disease. 
The Republic of Korea’s Ministry of Health has identified 107 laboratory-confirmed cases of MERS since June 10, which CDC calls “the largest single outbreak of MERS-CoV outside of the Arabian Peninsula.” David Kuhar, MD, medical officer from the Division of Healthcare Quality Promotion’s National Center for Emerging and Zoonotic Infectious Diseases at the CDC, discussed the updates in an audio conference for health professionals. 
“For eye protection, a disposable face shield can be used that should be discarded after patient contact,” Kuhar said. “Reusable goggles are also acceptable as long as cleaned and disinfected as per manufacturer’s instructions. The idea here is that droplets could enter the eyes through coughing. The eye protection is an added measure of safety to minimize the risk of transmission. 
“There are no case reports of transmission occurring because of a lack of eye protection, but this is just to (err) on the side of caution.” 
MERS is a viral respiratory disease that was first reported in 2012 in Saudi Arabia. Symptoms include fever, coughing, shortness of breath and respiratory illness. 
CDC recommends that health care providers ask patients about their history of travel exposure to health care facilities if they meet the revised considerations for patient under investigation. The updated criteria for patients under investigation are now available on CDC’s website
According to Susan Gerber, MD, team lead for the Division of Viral Diseases at CDC’s National Center for Immunization and Respiratory Diseases, cooperation between health care providers and local and state public health departments is vital in addressing MERS, especially considering the current lack of information. 
“Decisions should be made with public health departments,” Gerber said. “I can’t emphasize that enough. It’s very important to have that engagement in potentially diagnosing a patient. 
“We are missing some important data on the natural history of infection for MERS-CoV. We do not have precise data to guide decision making. It is known to have evidence of MERS-CoV RNA that could go on for weeks. We don’t know if it’s important for the transmission of the virus.” 
Check out APHA’s Get Ready fact sheet on MERS to protect yourself and others.

Although MERS doesn't currently appear to have what it takes to spark a major epidemic - there are a lot of unanswered questions about this virus.   Questions that, quite frankly, we shouldn't still be asking after three years (see WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps).

Hopefully what we learn from the Korean outbreak will fill in some of those gaps. 

But whether or not MERS is ready for prime time, the smart money says - one of these days an emerging virus will show up at our doorstep that is a major public health threat.

And we need to be using every opportunity between now and then to get ready to deal with it. 

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