Health Care Providers Advise Cautionary Measures as MERS Infections Spread

Published Jun. 26, 2014

Zoonotic diseases, which are caused by infectious organisms spreading among species (animals to humans and vice versa), are a continual source of intrigue for me as a practicing veterinarian. Although bacteria, fungi, and other organisms can make the inter-species leap, the most common pathogens to do so are viruses.

Well, now there’s a new global health concern in a new disease emerging from Saudi Arabia called MERS (Middle Eastern Respiratory Syndrome). As long-distance travel is made simple by plane, infectious organisms now make their way from isolated parts of the globe to susceptible populations through a single or series of airline flights.

What is MERS?

MERS-CoV is a contagious virus capable of causing sudden respiratory failure. More specifically it’s a coronavirus that’s similar to SARS (severe/sudden acute respiratory syndrome), which took the world by storm in 2003 across multiple continents by sickening and killing thousands of people, with Asia (China, more specifically) being most-affected.

A concerning human mortality rate of 30 percent is associated with MERS-CoV. It’s spread through direct contact with virus-shedding species, so the likelihood that infection will occur merely by living in or traveling to an area harboring MERS-CoV is low.

Where Does MERS Originate?

The first reports of MERS-CoV are from 2012 in Saudi Arabia. The virus originated in a species most pet owners don’t regularly consider as sources of zoonotic disease: camels. The New England Journal of Medicine recently published the study Evidence for Camel-to-Human Transmission of MERS Coronavirus, which traces the genetics of the current MERS outbreak to a now-deceased Saudi Arabian camel farmer and one of four calves (juvenile camels) showing respiratory tract signs (nasal discharge).

The camel farmer reportedly came into contact with the infected calf while administering medication (Vicks vaporub topical ointment) into the calf’s nasal passages. The camel acted as an intermediate host, as it showed signs of illness and passed the MERS virus onto the final host: humans. The farmer’s daughter developed symptoms of respiratory infection but survived. The study does not clarify if the daughter tested positive for MERS-CoV. If she did test positive, then MERS would have proven to be capable of transmission among members of the same species (horizontal transmission).

There’s also reportedly a genetic link to coronavirus found in an Egyptian tomb bat (Taphozous perforatus) captured in Saudi Arabia, but MERS-CoV hasn’t yet been isolated from bats.

What Are the Clinical Signs of MERS?

The New England Journal of Medicine reports the Saudi Arabian camel farmer showed the following clinical signs:

fever
rhinorrhea (nasal discharge)
cough
malaise (lethargy)
shortness of breath

Yet, other signs of illness can be seen with coronavirus infections, including:

vomit
diarrhea
anorexia (decreased appetite)
sneezing
other

Has MERS Made Its Way to the U.S.? Where Else Besides the Middle East Has MERS Been Found?

MERS-CoV has recently been reported in Egypt and found its way to the U.S. According to the Centers for Disease Control and Prevention MERS in the U.S., the first U.S. case occurred in a Saudi Arabian health care worker who traveled to Indiana via London and Chicago, fell ill, was hospitalized, and recovered.

The second U.S. case was another Saudi Arabian health care worker who traveled via London, Boston, and Atlanta to Florida, fell ill, and has since recovered. The second and first cases are not reported to be linked, so the two sickened individuals never came into contact with each other and likely brought the illness from Saudi Arabia.

The USA Today article Third U.S. MERS case brings more questions than answers tells of an additional case in an Illinois man who interacted with the Indiana patient in a business setting. He wasn’t sickened, but blood tests revealed infection with the same MERS-CoV as the Indiana man. Since the Illinois man wasn’t sickened, he’s not actually recognized as another official MERS case according to World Health Organization (WHO) guidelines.

Although the appearance of MERS in the U.S. is a scary progression of events, the good news is that none of the three patients developed life threatening illness.

Yet, I predict that there will be more cases in the U.S. and other countries in the coming months.

Could Your Pet Be Affected By MERS?

Currently, no other animal species besides camels and humans are known to harbor the MERS virus. Yet, both dogs and cats can be infected with coronavirus, which causes mild to fatal illness.

Canine Coronavirus (CCV) infects both domestic and wild dogs and is more common in juvenile pooches that are stressed, unvaccinated, and immune-compromised from other underlying illness or malnutrition than otherwise healthy adult and vaccinated dogs. CCV infection primarily occurs from exposure to an infected dog’s feces and viral strands can be transmitted through fecal material for up to six months post-infection.

Feline Infectious Peritonitis (FIP) is one of the most frustrating diseases for veterinary practitioners to treat due to its high mortality rate and difficulty in establishing a definitive diagnosis.

How Do I Protect Myself and My Pet From MERS?

I predict that if more pet owners are infected with MERS we’ll eventually have cases of the disease in dogs, cats, and other species.

Therefore, it’s important that humans take preventive measures to limit the transmission of infectious organisms among people and their pets.

My top tips are:

1. Frequently wash your hands with soap and warm water for 30 to 60 seconds.

2. Wash your hands after touching your pet and other animals.

3. Use alcohol-based hand sanitizing gel when soap and water are unavailable.

4. Avoid close contact with other people and pets when you are sick. Keep your general vicinity “germ-free” by coughing or sneezing into a tissue, cloth, or your elbow instead of into your hand or surrounding air.

5. Have you pet undergo a wellness examination with a veterinarian at least every 12 months. Resolve all abnormalities, even those that are mild, as they can leave the canine or feline body immunocompromised and potentially susceptible to more severe consequences, including periodontal disease, obesity, and other diseases.