(Adds comments from hospital treating patient)
By Julie Steenhuysen and Sharon Begley
May 2 A healthcare worker who had traveled to
Saudi Arabia was confirmed as the first U.S. case of Middle East
Respiratory Virus (MERS), an often fatal illness, raising new
concerns about the rapid spread of such diseases, the U.S.
Centers for Disease Control and Prevention said on Friday.
The male patient traveled via a British Airways flight on
April 24 from Riyadh to London, where he changed flights at
Heathrow airport to fly to the United States. He landed in
Chicago and took a bus to an undisclosed city in Indiana.
On April 27, he experienced respiratory symptoms, including
fever, cough and shortness of breath. According to the Indiana
State Department of Health, the man visited the emergency
department at Community Hospital in Munster, Indiana, on April
28 and was admitted that same day.
Because of his travel history, Indiana health officials
tested him for MERS, and sent the samples to the CDC, which
confirmed the presence of the virus on Friday.
The virus is similar to the one that caused Severe Acute
Respiratory Syndrome (SARS) which emerged in China in 2002-2003
and killed some 800 people. It was first detected in Saudi
Arabia in 2012.
Dr. Anne Schuchat, director of the CDC's National Center for
Immunization and Respiratory Diseases, said on a conference call
the first U.S. case of MERS was "of great concern because of its
virulence," proving fatal in about a third of infections.
She said the case represents "a very low risk to the broader
general public," but MERS has been shown to spread to healthcare
workers and there are no known treatments for the virus.
Schuchat said the patient was now in stable condition and
there are no other suspected cases of MERS at the current time.
The CDC declined to identify the patient by name or say
where he was being treated. It also declined to say on which
airlines or bus line the patient traveled. Schuchat said the CDC
was working with the U.S. Department of Homeland Security to
contact individuals who may have been exposed to the patient
during his travels.
In Britain, public health officials said they were
contacting any passengers who had been sitting near the patient.
Greg Cunningham, a spokesman for the Chicago Department of
Aviation, said that the department "has been advised that there
is no reason to suspect any risk at O'Hare," Chicago's main
international airport. "There has only been one incident
confirmed to have MERS, and he is hospitalized in Indiana," he
Officials at Community Hospital in Munster confirmed that
the man was in good condition, and said the hospital is
"maintaining appropriate isolation protocols for the protection
of health care staff."
The hospital, located in northwest Indiana about 30 miles
(48 km) from Chicago, said it has been working with the CDC and
the state health department, and will be tracking the health of
the patient's family members and exposed health care workers
daily during the next two weeks to check for MERS symptoms.
"This patient was not out in the local community and,
therefore, any public exposure was minimal," the hospital said
in the statement.
The hospital stressed that transmission of MERS requires
close contact, and said the patient's activities in the United
States have been very limited, reducing the risk of widespread
transmission of the virus.
Although the vast majority of MERS cases have been in Saudi
Arabia and other countries in the Middle East, the discovery of
sporadic cases in Britain, Greece, France, Italy, Malaysia and
elsewhere have raised concerns about the potential global spread
of the disease by infected airline passengers.
With the addition of the U.S. patient, 262 people in 12
countries have been confirmed to have MERS infections and have
been reported to the World Health Organization. Of those, 93
have died, Schuchat said.
Infectious disease specialists in the United States said
that the fact the newest patient was identified quickly showed
that disease surveillance was working.
"It was only a matter of time before the United States had a
case," said virologist Dr. W. Ian Lipkin of Columbia University
in New York. "Most of us thought it was not a question of if,
but when. Am I more concerned as a result of this case? No."
"One case does not represent a reason for panic," agreed Dr.
Wayne Marasco, an infectious disease specialist at Dana-Farber
Cancer Institute in Boston.
"But the very fact that we have a virus with documented
person-to-person transmission at a fairly efficient rate and a
high mortality rate suggests we have a potentially serious
pathogen. There are no therapies out there that I'm aware of,
but I don't think we have a very big risk in the United States."
Marasco suggests that immigration agents should nevertheless
be on heightened alert for passengers arriving in the United
States after trips to the Middle East, especially Saudi Arabia.
"They should ask, where did you travel? Have you had contact
with animals, with anyone who was sick, and do you have a fever
or cough?" he said.
Marasco does not believe that thermal scanners such as those
China and other countries deployed during the 2003 SARS epidemic
would make much of a difference. That's because the incubation
period for MERS is two to 14 days, "so an asymptomatic traveler
could make it through a thermal scanner," Marasco said.
MYSTERY OF TRANSMISSION
The greatest reason for concern is that so little is known
about this coronavirus. It has been found in bats and camels,
and many experts say camels are the most likely animal reservoir
from which humans become infected.
In part, that ignorance is a result of the lack of
cooperation between Middle Eastern countries, where MERS has
been spreading, and scientists elsewhere. "One of the biggest
problems is that we haven't had any access to samples from Saudi
Arabia, Jordan or Qatar despite my efforts," Marasco said
Now that the United States has a case of MERS, there might
be political pressure for that to change, suggested Lipkin, who
pointed out that during the SARS epidemic, China was similarly
reluctant to cooperate with western scientists.
"Now the U.S. is going to be more interested. I think it
will have an impact on the number of scientists here who will be
encouraged to work on MERS and congressmen will stand up and
rail about the importance of this," Lipkin said.
(Reporting by Julie Steenhuysen in Chicago and Sharon Begley in
New York; Additional reporting by Kate Kelland in London and
Susan Guyett in Indianapolis; Editing by Michele Gershberg, Tom
Brown and Lisa Shumaker)