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MERS Mystery

MERS Patient Is Well, Does Not Seem to Have Infected Others

Image: Handout transmission electron micrograph shows particles of the Middle East respiratory syndrome (MERS) coronavirus

Middle East respiratory syndrome (MERS) coronavirus. The first US patient with MERS is doing better, hospital officials say. National Institute for Allergy and Infectious Diseases / Reuters

The first patient in the U.S. infected with the mysterious MERS virus continues to improve and does not so far seem to have infected anyone else, health officials said Monday.

The patient, at Community Hospital in Munster, Indiana, is a health care worker in his 60s who had traveled from Saudi Arabia, where the virus was first seen. He is a U.S. citizen, the World Health Organization said.

"All of the tests in close contacts have been negative," Don Fesko, CEO of the hospital, told a news conference. Officials said about 50 health workers had contact with the patient before they began taking extreme measures — wearing masks, gloves, gowns and eye protection.

"All of the tests in close contacts have been negative."

The patient is in good spirits, has been taken off supplementary oxygen, has been walking around and is cooperating with isolation precautions, officials said. Family members have been asked to isolate themselves and to wear face masks when they go out in public, just in case they are infected and haven't begun to show any symptoms yet.

The incubation period for MERS is usually about five days but it's been known to take as long as 14 days to cause symptoms, so the doctors are taking the most cautious approach.

Middle East Respiratory Sydrome (MERS) virus was first seen in 2012 and most cases are linked to the Middle East, although it’s now been seen in more than a dozen countries around the world. Many of those who are sick enough to show symptoms have had other conditions, such as cancer, diabetes or kidney disease.

It spreads from person to person, but usually only with close and prolonged contact. But Centers for Disease Control and Prevention experts and state health officials are testing health care workers and other close contacts of the patients, and will continue to test them for 14 days, just to be sure.

"It appears MERS picked the wrong hospital, the wrong state, and the wrong country to take hold," said Indiana state health commissioner Dr. William VanNess.

Officials are tracking down about 100 passengers from an airplane the patient traveled on and 10 bus passengers to make sure they don't have any symptoms. But experts say MERS has not been known to pass from casual contact such as sitting next to someone on public transport.

Health officials are releasing very little information about the patient but say he lives and works in Saudi Arabia. "He was working at a hospital in Saudi Arabia," said Dr. Daniel Feikin, CDC's medical epidemiologist at the hospital.

"He does not recall directly working with a patient who had MERS although he did work in a hospital that had cases of MERS."

He came to the U.S. on April 24 and went to the emergency department at the hospital on the 28th. "He began feeling unwell on or around 14 April 2014 with a low-grade fever without any respiratory symptoms. On 27 April 2014, he developed shortness of breath, cough, increasing fever, and mild runny nose," WHO says in a statement on its website.

"It would not be surprising if we had another importation."

CDC officials had been predicting that someone might eventually come to the United States with a MERS infection.

The virus has been found in people in Jordan, Kuwait, Oman, Qatar, Saudi Arabia, Egypt, the United Arab Emirates, France, Germany, Greece, Italy, Britain, Tunisia, Malaysia and the Philippines. There’s no specific treatment, no cure and no vaccine for MERS.

"If this virus continues to infect people in the Middle East, it would not be surprising if we had another importation," Feikin said.

MERS worries health experts because it’s related to severe acute respiratory syndrome, or SARS, which swept around the world in 2003, infecting around 8,000 people and killing close to 800 before it was stopped. Both conditions are caused by coronaviruses, members of a family of viruses that usually cause common cold symptoms and that infect a wide range of mammals.

While MERS kills a higher percentage of patients — about 30 percent — it is not nearly as infectious as SARS was. And with MERS, most people with serious infections have been either elderly, or sick with something else such as asthma or diabetes.