Photo Credit WHO
UPDATED : Not unexpectedly, the suspected cases in France referenced below have reportedly tested negative for the MERS coronavirus, and will be released from the hospital. A h/t to Pathfinder on FluTrackers for the update.
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The inevitable result of the emergence of a pair of novel viruses (H7N9 & MERS-CoV) - and the call by the World Health Organization for all member nations to `continue their surveillance for severe acute respiratory infections (SARI) and to carefully review any unusual patterns’ - is that anyone with a recent travel history to the Middle East or to China, and who presents to a hospital with fever and/or flu-like symptoms, is going to probably be tested, and isolated, until these viruses can be ruled out.
Over the past several months, we’ve seen Hong Kong’s CHP announce the isolation, and testing, of more than a dozen cases recently arrived from the Middle East – none of whom tested positive for the virus.Last week we saw similar negative tests announced by both France and Egypt (see France: MOH Statement On Negative MERS-CoV Case & Egypt Testing Suspected MERS-CoV Case).
Similarly, Hong Kong reported a number of negative H7N9 tests over the summer.
As we’ve seen with suspected cases of H5N1 over the years, many are tested, but very few actually prove positive for the virus.
And the reason is fairly simple: The early symptoms for MERS-CoV, H5N1, H7N9 ; Fever, malaise, respiratory symptoms, even pneumonia . . . are virtually identical to a host of other (far more common) viral infections like influenza and rhinoviruses.
If MERS or Avian flu is even a possibility, then prudence dictates immediate isolation and testing – at least until the cause of the illness can be identified, and novel viral infections ruled out. And since these viruses pose a potential larger public health threat - testing for them is newsworthy – even though most of these tests will prove negative.
Yesterday, reports began to emerge (see FluTrackers Thread) of a family in Toulouse, France – with recent travel history to Saudi Arabia - who are being tested for the MERS coronavirus. This morning, an update from Le Parisien.
Despite the headline, we still don’t know if any of these people have the MERS virus.
Coronavirus: three people hospitalized in Toulouse
Published on 03.11.2013, 12:13 PM | Updated: 12:58
Seven people, including six of the same family were hospitalized Friday in Toulouse (Haute-Garonne) for a hint of coronavirus MERS. This Sunday, three of them are still under observation at the Purpan Hospital. | (DR)
Seven people, including six of the same family were hospitalized Friday in Toulouse (Haute-Garonne) for a hint of coronavirus. This Sunday, three of them are still under observation at the Purpan Hospital. Two had flu-like symptoms after a trip to the Middle East.
These are the grandparents who showed signs of difficulty breathing and fever over 38 degrees, tells France 3 Midi-Pyrenees .
Both were returned on October 28, a trip to Saudi Arabia and suffered samples to identify a potential novel coronavirus MERS-CoV. Their children and grandchildren have had to meet the same tests but showed no signs of the disease. Most have also been released from the hospital on Saturday but were forced into isolation at the moment. Only the son of the two travelers, the father of two children, remained in hospital. In parallel, a seventh person, a septuagenarian, was hospitalized after a pilgrimage to Mecca but emerged immediately.
Mild infections have sometimes required more than one test to obtain a positive result, but we should have a better idea on whether this family Toulouse, France have the virus in the next 24 hours or so.
With cold & flu season upon us, it is going to be even harder for clinicians to differentiate between common respiratory viruses and the more dangerous, but far rarer, MERS-COV and H7N9 avian flu viruses. So we can expect to see a steady stream of news items, like this one, alerting us to cases being tested.
All of which highlights the need for an accurate and rapid test for both of these viruses (see Referral: Dr. Mackay On MERS-CoV Testing). Something that is being worked on, but that so far, remains elusive.
