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May 12, 2014 01:00 AM

MERS risk not significant despite 2nd U.S. case: CDC

Steven Ross Johnson
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    A second U.S. case of MERS was confirmed at Dr. P. Phillips Hospital, Orlando, Fla.

    Health officials on Monday said the deadly illness known as Middle East respiratory syndrome, or MERS, did not constitute a significant risk to public health, despite a second confirmed U.S. case in a patient who arrived at an Orlando, Fla., hospital May 9.

    Describing it as “another imported case” to enter the U.S., Centers for Disease Control and Prevention Director Dr. Tom Frieden said the facts are similar to those of the MERS patient confirmed May 2 in Indiana: The patient is a healthcare worker who lives and works in Saudi Arabia, where the vast majority of cases and deaths from the disease have been reported. The two U.S. cases were not related, officials said.

    “Our experience with MERS so far suggests that the risk to the general public is extremely low,” Frieden said.

    The patient, whose identity was not released, flew to London May 1 from Jeddah, which is in western Saudi Arabia on the Red Sea.

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    The patient reportedly began feeling unwell during that initial flight, complaining of fever, chills and a slight cough, but continued to Boston, Atlanta and finally Orlando to visit family. On May 9 he went to the emergency department of Dr. P. Phillips Hospital, a campus of Orlando Health, where he was admitted the next day and placed in isolation. He is “in good condition and improving,” the hospital said in a news release.

    “We are taking every precaution but believe the risk of transmission from this patient is very low since his symptoms were mild and he was not coughing when he arrived at the hospital,” Dr. Antonio Crespo, chief quality officer at Dr. P. Phillips Hospital said. Sixteen of the hospital's workers who were exposed to the patient will be off duty throughout the 14-day incubation period and will be monitored and tested, according to Orlando Health.

    More than 500 people could have been exposed to the virus during the infected patient's travels, and health officials have been tracking and notifying those who were in close proximity to him, Frieden said. None of them so far has become infected.

    As of May 12, a total of 538 confirmed global cases of MERS have been reported since the virus was first identified in 2012, resulting in 145 deaths. Of those cases, most have occurred in Saudi Arabia, which has had 450 cases reported and 118 deaths over the last two years. It is not known what causes MERS or exactly how it is spread only that it requires close contact with an infected individual such as in the case of healthcare workers. Dr. Anne Schuchat, assistant surgeon general and director of the CDC's National Center for Immunization and Respiratory Diseases, said infected healthcare workers account for approximately one-fifth of all MERS cases.

    This new case comes roughly two weeks after the first confirmed case was reported at Community Hospital in Munster, Ind., where a healthcare worker arrived in the emergency department after flying to Chicago from the Saudi Arabian capital of Riyadh to visit family. The patient was released from the hospital May 9.

    MERS is a coronavirus, similar to SARS, which was responsible for more than 700 deaths globally in 2003, more than 600 of which occurred in China. No vaccine exists for MERS, and the only treatment option is supportive care for respiratory illness.

    While Frieden emphasized the low risk of the virus spreading throughout the general public, he noted that the risk can be further diminished by washing hands often and avoiding close contact with people who are sick.

    There are no plans to raise the nation's health alert level for international travel in light of the discovery of a second confirmed case, Frieden said, but he cautioned travelers to the Arabian Peninsula to take measures to protect themselves against infection.

    Follow Steven Ross Johnson on Twitter: @MHsjohnson

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