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First U.S. MERS case confirmed


By Sabriya Rice
Posted: May 2, 2014 - 5:15 pm ET
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A healthcare worker who returned from a trip to Saudi Arabia in April has imported the first case of

Middle East Respiratory Syndrome (MERS) into the U.S., the Centers for Disease Control and Prevention announced Friday. The patient is now isolated and in stable condition at an Indiana hospital, the agency said, and there are no other confirmed cases of the illness in the country.

MERS is a viral respiratory disease first reported in Saudi Arabia in 2012. Little is known about the condition, but it tends to spread from person to person through close contact, and patients develop fever, a cough and shortness of breath. More than 400 people in 12 countries have been reported with the condition and 93 have died, according to the CDC. All reported cases have originated in six countries in the Arabian Peninsula.

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The disease is of “great concern”, said Dr. Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases in a press conference today. It is highly virulent, she said, and can be fatal in up to two-thirds of cases. There is no available vaccine or treatment, and although there are theories linking MERS to camels, specifics about its origin and pathology are still being investigated.

Health officials say MERS has not demonstrated that it spreads quickly within the community setting. The primary focus for monitoring the syndrome has been in the healthcare setting, particularly among patients whose immune systems are compromised, and hospital workers who handle potentially infected patients pre-diagnosis.

The American patient was in Saudi Arabia working in a healthcare setting. On April 24, the patient flew from the Saudi-Arabian capital of Riyadh to London and then to Chicago, followed by bus travel from Chicago to Indiana. A few days later, the patient started to experience severe respiratory symptoms, and on April 28 went to the emergency room at Community Hospital in Munster, Ind., and was admitted to the hospital the same day. Laboratory tests confirmed the condition as MERS this afternoon.

When the possibility of a MERS infection was recognized, staff quickly instituted isolation protocols and began working cooperatively with the CDC and the state health department, a hospital statement indicated.

In an abundance of caution, the hospital said, the exposed family members and healthcare workers will be monitored daily throughout the 14-day incubation period to watch for any signs or symptoms of MERS.

“Diseases are just a plane ride away,” Schuchat warned. The names of the air and bus lines the patient took were not revealed, however the CDC says it has been working closely with those companies, and had proactively provided information to state health departments in the event the disease reached the U.S.

In July 2013, the CDC posted resources to assist U.S. healthcare facilities and providers. Health officials recommend that physicians test individuals for MERS who develop shortness of breath within 14 days of travel to Saudi Arabia, or who have been exposed to someone who has traveled to the region. The patient should immediately be reported to the state or local health department, with accompanying information provided in a “patient under investigation” form, available on the CDC website.

“This is a rapidly evolving situation,” Schuchat said, noting that guidance may change as more details become available.

Indiana health officials said Community Hospital had contacted "all high-risk individuals" who might have come in contact with the patient but urged anyone who visited the facility's emergency department between 6:30 p.m. and 9:30 p.m. April 28 to watch for signs and symptoms of the virus, the Chicago Tribune reported.

The CDC said it would begin contacting passengers on the patient's flights and bus trip Saturday, though they don't consider them to be at high risk.

CDC officials said the virus' arrival poses very low risk to the general public.

Dr. David Schwartz, an infectious disease specialist at the Cook County Health and Hospitals System, said MERS often targets adults with chronic health conditions and doesn't spread via casual contact like severe acute respiratory syndrome, the Tribune reported.

The New York Times reported that a CDC team will travel to Indiana to assist in treatment and to retrace the patient's contacts.

Follow Sabriya Rice on Twitter: @MHSRice


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