Although MERS (Middle East Respiratory Syndrome) seems to have faded to the back off international consciousness after the troubling Ebola outbreaks in Africa and Measles outbreaks in the United States, it has continued to infect and kill individuals in the Middle East.
Beginning in 2012, this mysterious virus emerged in Saudi Arabia and has spread to the neighboring countries in the region. Over 1,000 individuals have had confirmed cases of the illness with over 300 deaths resulting from illness related complications. At a genetic level, the virus originated from the family of coronaviruses and is similar in structure to the SARS virus that caused an epidemic throughout China and Southeast Asia earlier in the decade.
Many of the crucial factors and elements of the disease are currently unknown. Researchers currently believe the disease to be zoonotic, meaning the natural source is some sort of animal; however, only theories exist now and the exact source has not been pinpointed. Due to the wide range of symptoms, and range in the quality of record keeping, the exact course of the disease is not fully understood. The median time between onset and death is 12 days and it is not fully clear why some patients survive and others do not. Patients present with a wide range of symptoms related to respiratory illnesses and DNA matching of the virus is often needed to confirm a diagnosis.
The virus is transmitted via person-to-person contact with infected individuals. All cases have been linked in some way to travel or residence in the Middle East and further investigation is needed to better understand how exactly the disease is transmitted from humans-to-animals and from person-to-person.
Of particular concern and risk are individuals who have come into contact with Camels (MERS-CoV virus has been found in camels), who have traveled to the Middle East and have developed symptoms within 14 days of traveling, and health care providers who have treated patients with the MERS virus. At the present moment, WHO and UN researchers have been unsuccessful in tracing the origins of the disease clusters and are worried about continued transmission. Currently, there is no cure for the disease and all treatment options work to manage the disease related symptoms.
There are further worries that the number of cases is actually much higher than has been reported. Civil unrest, conflict, and weak health care reporting infrastructure in many areas of the Middle East may have contributed to a significant number of cases going unreported. The actual number of cases and associated deaths may be significantly higher than currently estimated.
As health care providers with a global patient base, it is necessary to become familiar with and prepared for the MERS virus. To accomplish this, continuing education and proper forward planning will be necessary in order to help organizations be prepared for the possible encounter with the virus.
The Centers for Disease Control and Prevention and the World Health Organization have already issued up to date articles and guides for both health care providers and individuals in regards to the virus. Further, there are a variety of online nursing CE providers who have prepared evidence based nursing courses on the handling of a MERS patient. The novelty of the virus is not an excuse for unpreparedness – in the current world of global travel and commerce the possibility of several US cases is very real and very timely.
