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COMMENTARY |
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Year : 2016 | Volume
: 9
| Issue : 5 | Page : 637-638 |
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The emergence of Middle East respiratory syndrome during Hajj 2012: A personal experience
Banyameen Mohammad Iqbal
Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, Maharashtra, India
Date of Web Publication | 13-Oct-2016 |
Correspondence Address: Banyameen Mohammad Iqbal Department of Pathology, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune - 411 018, Maharashtra India
Source of Support: None, Conflict of Interest: None | Check |
DOI: 10.4103/0975-2870.192147
How to cite this article: Iqbal BM. The emergence of Middle East respiratory syndrome during Hajj 2012: A personal experience. Med J DY Patil Univ 2016;9:637-8 |
The authors have highlighted a very important topic which has the potential of blowing out exponentially if not contained properly. Middle East respiratory syndrome (MERS) has been recognized as a major global public health threat by the WHO.
[1] The virus appears to be circulating throughout the Arabian Peninsula, primarily in Saudi Arabia, where the majority of cases (>85%) have been reported since 2012. Most of these infections are believed to have been acquired in the Middle East and then exported outside the region.[1] Several cases have been reported outside the Middle East also. The ongoing outbreak in the Republic of Korea (2015) is the largest outbreak outside of the Middle East.[2]
In the year 2012, I happened to be working in Mecca, Kingdom of Saudi Arabia (KSA), which being the epicenter for more than 2 million Hajj Pilgrims annually and more than 6 million around the year for Umrah (small pilgrimage). For a city of slightly more than 700 km 2 of area with 2 million native population and more than thrice the number of pilgrims during Hajj and Umrah times, we were literally on our toes in the hospitals and camps which were set for the pilgrims. A maximum number of patients which got admitted to hospitals during Hajj times were suffering from fever, respiratory symptoms ranging from mild respiratory problems to severe respiratory disease to pneumonia. Some of them even landed into renal failure. These patients tested negative for influenza virus A, influenza virus B, parainfluenza virus, enterovirus, and adenovirus. The entity MERS was still not known. This was the beginning of MERS. Some of these patients would later be diagnosed as MERS. Later on in September 2012, an Egyptian virologist working in Jeddah (KSA) announced the first culture of a new coronavirus to the world and described the first reported case of MERS in a 60-year-old man from Bisha (KSA).[3] As of now, Saudi Arabia accounts for the maximum number of confirmed cases of MERS (close to 1500). Approximately 36% of reported patients with MERS died.[1]
MERS is caused by coronavirus (MERS-CoV). Coronaviruses are a large family of viruses that can cause diseases ranging from common cold to severe acute respiratory syndrome. Majority of human cases of MERS have been attributed to human-to-human infections. Camels are likely to be a major reservoir host for MERS-CoV. It is believed that it originated in bats and was transmitted to camels, sometime in the distant past. Strains of MERS-CoV that are identical to human strains have been isolated from camels in several countries, including Egypt, Oman, Qatar, and Saudi Arabia.[1] The virus does not seem to pass easily from person to person unless there is close contact, such as occurs when providing unprotected care to a patient.
It is not always possible to identify patients with MERS-CoV early or without testing because symptoms and other clinical features may be nonspecific. Patients to health-care provider transmission have been reported from several countries. Infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in health care facilities.
No vaccine or specific treatment is currently available. Treatment is supportive and based on the patient's clinical condition. As a general precaution, anyone visiting camel farms should practice general hygiene measures, including regular hand washing before and after touching animals, and should avoid contact with sick animals. Camel meat and camel milk should be consumed after pasteurization and proper cooking, respectively.
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3. | Zaki AM, van Boheemen S, Bestebroer TM, Osterhaus AD, Fouchier RA. Isolation of a novel coronavirus from a man with pneumonia in Saudi Arabia. N Engl J Med 2012;367:19:1814-20. |
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