In 2003, the whole
world was fretted by the emergence of SARS epidemic. Severe acute respiratory
syndrome (SARS) was caused by SARS-CoV virus, which originally originated from
Hong Kong and spread over 37 countries worldwide . According to WHO, a total of
8,098 people got infected with the virus, of these 774 people died worldwide.
It was much talked about because, the emergence of the epidemic coincided with
invasion of Afghanistan by United States, and many people feared Bioterrorism
with this virus. That didn’t happen, and since 2004 no cases of SARS infection
has been reported anywhere in the world.
However, a new
infectious outbreak has emerged in Middle east, especially Saudi Arabia. A few
cases have been reported in African and European countries too. The outbreak,
Known as Middle east respiratory syndrome (MERS), is caused by a virus similar
to Corona virus that caused SARS (SARS-CoV) a decade back. Caused by the
infection of MERS-CoV, MERS patient was first identified in Saudi Arabia in
September 2012. Since then, 144 cases of human infection have been reported
worldwide, with 62 deaths. Lion's share of these deaths and infections have
been reported in Saudi Arabia (121 cases of infection with 51 reported deaths).
MERS Coronavirus
patients develop severe acute respiratory illness with symptoms of fever,
cough, and shortness of breath. In the later stages of infection, pneumonia and
renal failure has been reported. MERS Coronavirus is a zoonotic virus,
originating from Bats. Since the chances of transmission from Bat to Human
route is significantly low in realistic world, many scientists, including
Stanley Perlman, believes that indirect route of infection through domesticated
animals might have been followed in most of the cases reported so far. It is
noticeable, that in April this year, WHO rejected the chances of Human to Human
transmission of the viruses. However come August, cases of human to human
transmission (in close proximity) have been documented. This leads to only one
conclusion, the virus is adapting in human cells.
We have seen the
world wide newspapers and news portals covering the news about MERS Coronavirus
outbreak. In Fact, Margaret Chan, Director general of WHO went on to say,
"MERS-CoV is a global threat". Yet, hardly more than a hundred people
are infected with it. Then why is everyone talking about it?
First of all, people
are just talking. No significant steps has been deployed to contain the
infection in the country of its origin, Saudi Arabia, and it has already
travelled to Europe, Africa and many countries of the Middle east. Now that the
virus has already spread to Europe and Africa, it is likely to spread throughout the world as people
continue to travel throughout the world.
If we remember the
SARS outbreak, the SARS virus (SARS-CoV) adapted to human cells to such an
extent that it was unable to infect bat cells. In the case of MERS, human to
human transmission was considered a minor component of disease development
process, but human to human transmission has been documented in both
attenuated and healthy persons. Consider
this, there are more than half a million migrant Nepali workers in Middle east
(I didn’t stretch myself to find the exact number), imagine how hard it will
hit Nepal if corona virus infection ever reach epidemic proportions.
Until this day, the
infection of MERS coronavirus hasn’t reached any alarming state, and much like
H7N9 infection, it can be controlled too. A close relation between, WHO, People
where the virus is found and the government is required. However, so far, no
substantial steps has been taken in controlling this outbreak. Focus needs to
be on identifying the unique features of the virus, finding the source of the
virus, quarantining the infected and those on close proximity among other. We
aren't ready with the vaccines, neither do we have necessary medications to
cure MERS, preventive approach is what we should be looking too.
Moreover, we from
Nepal should be monitoring the situation with close eye, and be alert for any
such infections happening in Nepal. I won't be amazed, if next case of MERS
coronavirus is reported in Nepal, in a migrant worker coming to celebrate
Dashain/Tihar. We need to be prepared for the worst.
(Data used here is
from CDC and WHO)
