MERS comes to Malaysia

mers

You may have come across these recent news reports:

First there was a fatality

The Middle East Respiratory Syndrome-coronavirus (MERS-CoV) has killed its first victim in Asia, a Malaysian man who developed respiratory complications after returning from Mecca.

The 54-year-old man, from Batu Pahat, Johor, had arrived in Malaysia on March 29 after performing the umrah.

He died on Apr 13 after being admitted to the Hospital Sultanah Nora Ismail for three days, following complaints of fever, cough and breathing difficulties.

Passengers onboard the Turkish Airlines flights TK93 and TK60 on the Jeddah-Istanbul-Kuala Lumpur route on March 29 are urged to contact the Health Ministry for a health screening, said Health Minister Datuk Seri Dr S. Subramaniam.

The MERS-CoV was first detected in the Middle East in 2012, but researchers have yet to determine its cause.

The World Health Organization has recorded 238 cases of the disease and 92 deaths related to the MERS-CoV globally to date.

Then there was this report MERS suspected in Johor village, 64 quarantined

BATU PAHAT: As many as sixty-four residents in Kampung Bintang here will be quarantined for a week after some showed symptoms of the Middle East Respiratory Syndrome-coronavirus (MERS-CoV).

Some 100 villagers from the village, where the first Malaysian victim who succumbed to the virus came from, underwent a special screening to detect the virus here Thursday.

Johor Health and Environment executive committee chairman Datuk Ayub Rahmat said that a special screening centre has been set up in the village to screen the villagers for the virus.

“This is the first such case in Malaysia, and we take this matter seriously. That is why we are taking steps to screen the villagers to prevent the virus from spreading,” he said in a press conference here.

This is a concern which the health authorities are surely tracking as MERS or Middle East respiratory syndrome is a virus originally traced to bats but is now capable of human-human transmission. It is SARS-like in the reported high case fatality rate.

Here are some FAQs from the CDC

Q: What is MERS?
A: Middle East Respiratory Syndrome (MERS) is a viral respiratory illness. MERS is caused by a coronavirus called “Middle East Respiratory Syndrome Coronavirus” (MERS-CoV).
Q: What is MERS-CoV?
A: MERS-CoV is a beta coronavirus. It was first reported in 2012 in Saudi Arabia. MERS-CoV used to be called “novel coronavirus,” or “nCoV”. It is different from other coronaviruses that have been found in people before.
Q: Is MERS-CoV the same as the SARS virus?
A: No. MERS-CoV is not the same coronavirus that caused severe acute respiratory syndrome (SARS) in 2003. However, like the SARS virus, MERS-CoV is most similar to coronaviruses found in bats. CDC is still learning about MERS.
Q: What are the symptoms of MERS?
A: Most people who got infected with MERS-CoV developed severe acute respiratory illness with symptoms of fever, cough, and shortness of breath. About half of them died. Some people were reported as having a mild respiratory illness.
Q: Does MERS-CoV spread from person to person?
A: MERS-CoV has been shown to spread between people who are in close contact.[1] Transmission from infected patients to healthcare personnel has also been observed. Clusters of cases in several countries are being investigated.
Q: What is the source of MERS-CoV?
A: We don’t know for certain where the virus came from. However, it likely came from an animal source. In addition to humans, MERS-CoV has been found in camels in Qatar and a bat in Saudi Arabia. Camels in a few other countries have also tested positive for antibodies to MERS-CoV, indicating they were previously infected with MERS-CoV or a closely related virus. However, we don’t know whether camels are the source of the virus. More information is needed to identify the possible role that camels, bats, and other animals may play in the transmission of MERS-CoV.
Q: Can I still travel to countries in the Arabian Peninsula or neighboring countries where MERS cases have occurred?
A: Yes. CDC does not recommend that anyone change their travel plans because of MERS. The current CDC travel notice is a Watch (Level 1) which advises travelers to countries in or near the Arabian Peninsula to follow standard precautions, such as hand washing and avoiding contact with people who are ill.
Q: What if I recently traveled to countries in the Arabian Peninsula or neighboring countries and got sick?
A: If you develop a fever and symptoms of lower respiratory illness, such as cough or shortness of breath, within 14 days after traveling from countries in the Arabian Peninsula or neighboring countries[2], you should see your healthcare provider and mention your recent travel.
Q: How can I help protect myself?
A: CDC advises that people follow these tips to help prevent respiratory illnesses:
Wash your hands often with soap and water for 20 seconds, and help young children do the same. If soap and water are not available, use an alcohol-based hand sanitizer.
Cover your nose and mouth with a tissue when you cough or sneeze then throw the tissue in the trash.
Avoid touching your eyes, nose, and mouth with unwashed hands.
Avoid close contact, such as kissing, sharing cups, or sharing eating utensils, with sick people.
Clean and disinfect frequently touched surfaces, such as toys and doorknobs.
Q: Is there a vaccine?
A: No, but CDC is discussing with partners the possibility of developing one.
Q: What are the treatments?
A: There are no specific treatments recommended for illnesses caused by MERS-CoV. Medical care is supportive and to help relieve symptoms.
Q: Is there a lab test?
A: Lab tests (polymerase chain reaction or PCR) for MERS-CoV are available at state health departments, CDC, and some international labs. Otherwise, MERS-CoV tests are not routinely available. There are a limited number of commercial tests available, but these are not FDA-approved.

The MOH Malaysia has a page on the Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in BM only.

Doctors who wish to know and discuss more can track this thread MERS Comes to Malaysia in the Malaysian Doctors forum, Dobbs. Membership in Dobbs is free for all Malaysian doctors. Not a member? Register here.

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