The U.S. Centers for Disease Control and Prevention (CDC) recently released recommendations regarding Middle East Respiratory Syndrome Coronavirus (MERS-CoV). Critical care and emergency medicine clinicians should be alert for patients who:
- Develop severe acute lower respiratory illness within 14 days after traveling from countries in or near the Arabian Peninsula, excluding those who only transited at airports in the region; or
- Are close contacts of a symptomatic recent traveler from this area who has fever and acute respiratory illness; or
- Are close contacts of a confirmed case
Clusters of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization) without recognized links to cases of MERS-CoV or to travelers from countries in or near the Arabian Peninsula should be evaluated for common respiratory pathogens. If the illnesses remain unexplained, providers should consider testing for MERS-CoV, in consultation with state and local health departments. Healthcare professionals should immediately report to their state or local health department any person being evaluated for MERS-CoV infection as a patient under investigation.
A new bird flu virus, influenza A (H7N9), has killed or critically stricken patients in China. Genetic evaluation of the virus shows it has the ability to mutate readily.
The World Health Organization notes, “analysis of the genes of these viruses suggests that although they have evolved from avian (bird) viruses, they show signs of adaptation to growth in mammalian species.” So far, H7N9 has not been found to be transmissible from human to human; those who’ve contracted it have had contact with poultry.
The Centers for Disease Control and Prevention has developed a diagnostic test, advising clinicians to be on the lookout for H7N9 in “patients with respiratory illness and an appropriate travel or exposure history.” Most of the people identified with the new bird flu have had symptoms of severe pneumonia such as chest congestion, difficulty breathing, fever, and severe cough. The Society will continue to monitor this situation and will keep members abreast of any new information.
A new coronavirus is on the loose, and Hong Kong and world health authorities are taking notice. The virus has killed 11 of the 17 people known to have contracted it, a death rate much higher than that of severe acute respiratory syndrome (SARS). Unlike SARS, which affected the respiratory system, this new virus, dubbed “novel coronavirus,” attacks multiple organs. The most likely source of this new disease is bats, though monkeys, pigs, civet cats and even rabbits can also harbor it. To be prepared, Hong Kong officials have started conducting simulations in the event of an outbreak, including quarantines and treatment protocols. The new potential outbreak seems to be centered in the Middle East, with several cases linked to travelers who visited Qatar, Jordan and Saudi Arabia. The Society will continue to monitor this situation and will keep members abreast of any new information.