An electron microscope image shows a coronavirus particle known as the… (National Institute of Allergy…)
ATLANTA — In a war room of sorts in a neatly appointed government building, U.S. officers dressed in crisp uniforms arranged themselves around a U-shaped table and kept their eyes trained on a giant screen. PowerPoint slides ticked through the latest movements of an enemy that recently emerged in Saudi Arabia — a mysterious virus that has killed more than half of the people known to have been infected.
Here at the Centers for Disease Control and Prevention, experts from the U.S. Public Health Service and their civilian counterparts have been meeting twice a week since the beginning of June to keep tabs on the Middle East respiratory syndrome coronavirus. MERS-CoV, as the pathogen is known, attacks the lungs and causes fevers, severe coughs and rapid renal failure.
Since it was first isolated in June 2012 in the city of Jeddah, MERS has infected at least 77 people and killed at least 40 of them. The number of confirmed cases has quadrupled since April, and people as far away as Tunisia and Britain have been sickened. Most troubling to health experts are reports of illnesses in patients who have not been to the Middle East.
The virus has not yet emerged in the U.S., and maybe it never will.
But when the pilgrimage season begins in July, perhaps 11,000 American Muslims will travel to the Arabian Peninsula, if past trends persist. In the meantime, millions more will fly between continents, citizens of today's globalized world.
"A person from New York could go to Saudi Arabia for business and carry the virus home on the way back," said Matthew Frieman, a virologist at the University of Maryland School of Medicine in Baltimore. "There's zero reason why that couldn't happen."
Many of the scientists working to understand MERS are veterans of the 2003 outbreak of severe acute respiratory syndrome, or SARS. A previously unknown coronavirus — a sphere-shaped virus spiked with proteins that make it look like it has a corona, or halo — jumped from its bat hosts and started infecting and killing people in China and Hong Kong.
By July 2003, more than 8,400 people around the world had become ill with SARS, which spread rapidly in hospitals. There were no fatalities in the U.S., but the World Health Organization warned travelers to avoid Toronto after 16 deaths there. The epidemic was over within a year thanks to effective infection-control practices like wearing masks, identifying patients quickly and treating their symptoms promptly. By then, more than 800 people had died and local economies suffered $30 billion in losses, according to WHO estimates.
Scientists hadn't thought coronaviruses, known for causing colds and stomach woes, could be so dangerous. After SARS, they started taking the viruses seriously. So when a coronavirus killed the patient in Jeddah, researchers pounced.
"We've always speculated that there could be another outbreak that could be as lethal as SARS," Frieman said.
Teams around the world starting sequencing the virus' genetic code. They determined that MERS must have emerged sometime in 2011.
Other researchers kept track of MERS victims. They reported sporadic cases in Saudi Arabia and Jordan, then in England, France and Italy, where sickened Middle Easterners had gone to seek medical treatment. Most of the victims were men, and many already had problems like heart disease and diabetes that may have contributed to their illnesses.
Epidemiologists started noticing clusters of MERS cases in families and in hospitals, in people who had close contact with victims. That made researchers worry that the virus might evolve to spread more easily from person to person — a prerequisite for a pandemic.
One such instance was described last month in the medical journal Lancet. It began in mid-April with a 64-year-old man who had diabetes and had received a kidney transplant in 1998.
Five days after traveling from Dubai to France, he developed a cough and breathing problems and was admitted to a hospital in Valenciennes, where he shared a room with a 51-year-old man being treated for a blood clot in his arm. After three days, the older patient was transferred to an intensive care unit, where his respiratory symptoms worsened and his kidneys began to fail.
MERS cases and deaths
First identified in 2012 in Saudi Arabia, Middle East respiratory syndrome (MERS) has caused severe illness and death as it has spread to several countries.
Source: Centers for Disease Control and Prevention
Los Angeles Times
Doctors began to suspect MERS on May 1, and their suspicions were confirmed about a week later. The patient died of multiple organ failure.