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MERS Coronavirus Outbreak




Middle East Respiratory Syndrome is a viral respiratory illness acquired by a

coronavirus named MERS-CoV. Coronaviruses are a abundant family of viruses that can breed illnesses that range from the common cold to serious respiratory illnesses. MERS-CoV was initially known to produce a human infection in Saudi Arabia in September, 2012 (Gerber, 2014). The majority of people who have been confirmed to have this virus develop symptoms such a fever, cough, and shortness of breath. Approximately 30% of people diagnosed with MERS-CoV have succumbed to this virus. The World Health Organization has reported 536 laboratory-confirmed cases as of May 12, 2014. Of the 536 cases, 145 deaths have occurred from this virus (First Confirmed Cases of Middle East Respiratory Syndrome Coronavirus, 2014). As of today, all the cases of MERS-CoV have been affiliated to countries in and around the Arabian Peninsula (Middle East Respiratory Syndrome, n.d.). To date, the highest reported outbreak occurred from April through May of 2013 in eastern Saudi Arabia and affected 23 people in four health care facilities (CDC announces first case of MERS in the United States, 2014). ! In May 2014, the CDC disclosed the first two occurrences of MERS in the United

States. Both occurrences were imported from Saudi Arabia and were not associated with each other. The first confirmed case was a male U.S. citizen from Indiana that had been working with MERS patients in a Saudi Arabian hospital as a healthcare provider (MERS in the U.S., n.d.). This patient was hospitalized and later released after symptoms resolved and testing negative for the active MERS-CoV infection after treatment. The second U.S. case was in Florida and was also a health care worker



who resided and worked in Saudi Arabia (MERS in the U.S., n.d.). Again, this patient was treated and released after no active infection was present. ! Experts can not yet explain how people acquire the MERS-CoV infection. The

virus seems to transfer from an infected person to another person in close contact in some cases but in other cases, people have become sick with no probable source that could be detected. These persons could have been sickened by exposure to an animal or another origin or person. MERS-CoV strains that parallel human strains have been found in camels from Egypt, Qatar, and Saudi Arabia (Frequently Asked Questions on Middle East MERS-CoV, 2014). ! MERS is contagious but only to a limited extent. Fortunately, it has been discovered that the virus is not readily transmitted from person-to-person except when there is close contact. Recently there has been a rise in health care-associated MERS infections which could be explained by close contact of patients and health-care workers (Frequently Asked Questions on Middle East MERS-CoV, 2014). People that are at an increased risk of becoming infected with MERS are recent travelers or coming in close proximity with a traveler from the Arabian Peninsula or healthcare workers who do not use recommended infection-control precautions. Since some MERS patients report exposure to camels, coming in contact with camels or consuming undercooked camel meat, raw camel milk or camel urine places one at a higher risk for MERS (People Who May Be at Increased Risk for MERS, n.d.). The virus seems to cause a more drastic disease in those that have a weakened immune system, chronic diseases such as diabetes, cancer, and chronic lung diseases, and older people (Frequently Asked Questions on Middle East MERS-CoV, 2014).!




If an outbreak were to occur in Clark County WA, the local government officials

would take several measures to slow the spread of the MERS virus. According to the Washington State Department of Health, state or local government officials would cancel or limit public gatherings such as concerts, meetings and church services, close schools, theaters and other places that people gather, request that people who have symptoms or have come in contact with the virus isolate themselves to home or a healthcare facility, and asking everyone to stay home for a period of time (Pandemic Flu: Questions and Answers, n.d.). The Clark County Public Heath Preparedness Unit would take the lead and work with the Public Health Director, the Health Officer, the Communicable Disease Unit, Environmental Health Units, and other programs and organizations to develop emergency plans. Due to the extraordinary demand for medical care, hospitals would have to prepare to handle a large influx of patients for extended periods of time. Local business would have to be prepared for a large number of employees missing work and prioritize critical work functions. ! The reporting protocol for Clark County is for healthcare providers, healthcare

facilities, laboratories, and local health jurisdictions to report any cases of MERS to the Washington Department of Health Office of Communicable Disease Epidemiology immediately in suspected or confirmed cases. The local health jurisdiction investigation responsibilities would be to determine exposure for the incidence, facilitate transport of specimens to the Washington State Public Health Laboratories for testing, and ensure that the right infection control measures are put into affect while testing is confirmed for the MERS virus. The data would then be entered into the Public Health Issues



Management System as a Rare Disease of Public Health Significance and the report would be faxed to the CDE (MERS-CoV Infection, n.d.). ! Reporting the outbreak of MERS to key stakeholders with timely accurate

information is essential. Disease outbreaks are often media topics. Utilizing the media to inform and update the public and key stakeholders about the outbreak is critical for successful implementation of public health activities. I would also provide information via the Internet and a variety of publications that inform the public about the MERS virus. ! Developing better public education programs is important in preventing an

outbreak of MERS. Health care professionals are first line responders in a health care crisis and educating them about the virus and precautions to take is essential. Health care providers then can help educate the public. It is also important to collaborate with community partners to educate the public through television, radio spots, newspaper inserts, press releases and interviews. Information can also be dispersed via fairs, posters and the health department website (Proactive Steps for Preventing CommunityWide Outbreaks of Cryptosporidiosis, n.d.).




CDC announces first case of MERS in the United States. (n.d.). Retrieved September 26, 2014,

from People who may be at increased risk for MERS. (n.d.). Retrieved September 26, 2014, from

First Confirmed Cases of the Middle East Respiratory Syndrome Coronavirus Infection in the


States. (2014, May 16). Retrieved September 26, 2014, from mmwr/preview/mmwrhtml/mm6319a4.htm?s_cid=mm6319a4_

Frequently asked questions on middle east respiratory syndrome coronavirus (MERS-CoV).

(2014, May 9). Retrieved September 29, 2014, from coronavirus_infections/faq/en/

Gerber, S. (2014, June 23). Be on the lookout for MERS-CoV. Retrieved September 26, 2014,

MERS in the U.S. (n.d.). Retrieved September 26, 2014, from


Middle East Respiratory Syndrome (MERS). (n.d.). Retrieved September 26, 2014, from http:// Middle East Respiratory Syndrome Coronavirus Infection. (n.d.). Retrieved September 29, 2014,


Pandemic Flu: Questions and answers. (n.d.). Retrieved September 29, 2014, from http:// QuestionsandAnswers



People who may be at increased risk for MERS. (n.d.). Retrieved September 26, 2014, from

Proactive Steps for Preventing community-wide outbreaks of cryptosporidiosis. (n.d.). Retrieved

September 29, 2014, from proactive-steps-prevention-outbreaks-cryptosporidiosis.pdf


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