You surely have heard about the recent cases of Middle East Respiratory Syndrome (MERS) coronavirus reported in the United States, including the suspected exposure of a person in Illinois as a result of a meeting with a person who was infected in Saudi Arabia, met with the patient in Illinois and then went to Indiana, where he was diagnosed. Those cases were the second and third reported in the nation, with the first being a medical worker who had flown to Florida and became symptomatic there.
While it was initially believed that the Illinois patient had been infected by the Indiana patient, on May 28 the CDC reported the Illinois patient had tested negative for MERS-CoV, and that while the Illinois person may have been exposed to the virus by the Indiana patient, the virus had NOT spread to the Illinois patient.
This is very good news, but does not mean public health professionals shouldn’t maintain their vigilance when dealing with respiratory patients who have recently traveled to Saudi Arabia, or have had close dealings with recent travelers. A test for MERS has been developed and is widely available.
This evolving matter is something to be aware of and the CDC urges healthcare professionals to evaluate for MERS-CoV infection all patients in the U.S. who meet the following criteria:
1) Fever and pneumonia or acute respiratory distress syndrome (based on clinical or radiologic evidence) AND EITHER:
- history of travel from countries in or near the Arabian Peninsula within 14 days before symptom onset OR
- close contact with a symptomatic traveler who developed fever and acute respiratory illness (not necessarily pneumonia) within 14 days after traveling from countries in or near the Arabian Peninsula) OR
- is a member of a cluster of patients with severe acute respiratory illness (e.g., fever and pneumonia requiring hospitalization) of unknown etiology in which MERS-CoV is being evaluated in consultation with state or local health department (more details below).
OR
2) Close contact of a confirmed or probable case of MERS.
Patients with lower respiratory illness should also be evaluated for common causes of community-acquired pneumonia, guided by clinical presentation and epidemiologic and surveillance information, according to the CDC. For these patients, testing for MERS-CoV and other respiratory pathogens can be done simultaneously. Positive results for another respiratory pathogen (e.g., influenza) should not necessarily preclude testing for MERS-CoV, because co-infection can occur.