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Middle East respiratory syndrome coronavirus

Outlines

This presentation will outline the following:

Middle East respiratory syndrome coronavirus (MERS-CoV).

Determinants.

Indicators.

Measurements.

Individual characteristics.

Outside influences

Specific example.

Conclusion.

This presentation will outline the following

Middle East respiratory syndrome coronavirus, determinants, indicators, measurements, individual characteristics, outside influences, specific examples, compare and contrast of determinants and lastly conclusion.

Middle East Respiratory Syndrome Coronavirus

MERS– CoV is a viral respiratory disease caused by a novel coronavirus which causes signs of common cold to Severe Acute Respiratory Syndrome (SARS) (World Health Organization, 2017).

Middle East respiratory syndrome coronavirus (MERS– CoV) is a global health concern identified in 2012 in Saudi Arabia (Oboho et al., 2013).

https://www.britannica.com/science/MERS

Middle East respiratory syndrome coronavirus (MERS– CoV) is a viral respiratory disease caused by a novel coronavirus which causes signs of common cold to Severe Acute Respiratory Syndrome (SARS) (World Health Organization, 2017). It is a global health concern identified in 2012 in Saudi Arabia and had mortality reported to be almost 30 to 40% (Oboho et al., 2013). MERS – CoV can have no symptoms (asymptomatic) and can have mild symptoms as such common cold symptoms. Also, it can have symptoms of severe acute respiratory disease (SARS) and cause death (World Health Organization, 2017).

MERS– CoV Determinants

http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(15)70128-3/fulltext

MERS-CoV has been found in camels in several countries including Saudi Arabia (WHO, 2017). Studies support that camels are the likely to be the source of MERS –CoV infection in humans but investigations have not yet recognized how humans got infected with the MERS virus (Adney et al, 2014; Azhar et al., 2014; Chu et al., 2014; Memish et al, 2014).

The main origin of MERS-CoV virus is not well understood but according to the analysis of diverse genomes of the virus, it is believed that MERS-CoV may have originated in bats and then was transmitted to camels in the past (WHO, 2017).

MERS– CoV Determinants

Epidemiological determinant (Mackay & Arden, 2015).

Healthcare providers determinants (Mackay & Arden, 2015).

Patient determinants:

Gender.

Age.

Multiple comorbidities.

Chronic diseases (Mackay & Arden, 2015).

Socioeconomic status (Miguel et al., 2017).

Epidemiological determinant of MERS-CoV has a wider tropism that is identified to grow rapidly in vitro, triggers distinct responses and delay the antiviral responses (Mackay & Arden, 2015). MERS – CoV is often associated with hospitals outbreaks due to lack of standard precautions which creates perfect environments of exposure, transmission and mortality (Mackay & Arden, 2015). MERS -CoV patient determinants are age, gender and health conditions. It impacts health of male patients who have chronic diseases and vulnerable people suffering from multiple comorbidities. Socioeconomic status such as those living in farms are more susceptible to MERS-CoV infection (Miguel et al., 2017).

MERS –CoV Indicators

Laboratory-confirmed cases of infection with MERS-CoV since 2012.

2,102

733

Deaths related to MERS-CoV are reported since 2012.

Countries have reported cases of MERS-CoV since 2012.

210

Laboratory-confirmed cases of infection with MERS-CoV in Saudi Arabia

210

Laboratory-confirmed healthcare workers cases of infection with MERS-CoV in Saudi Arabia (WHO, 2017)

WHO (2017), identified recent MERS –CoV indictors across the world. These figures illustrates the current MERS- CoV updates. MERS CoV cases reported in Saudi Arabia between January and September 2017 were 210 cases (WHO, 2017). Accurately, 87 of these cases were exposed to MERS CoV and 42 cases were healthcare workers (WHO, 2017). According to WHO (2017), most of MERS-CoV infected cases are 70 year old and older male patients in which some have chronic diseases.

Measurement of MERS- CoV

Measurement of MERS-CoV infection include:

History of contact with camels in the 14 days.

History of contact with an ill patient who is diagnosed to have acute respiratory in 14 days.

All suspected cases should have nasopharyngeal swabs.

Evaluation for common causes of community-acquired pneumonia (Ministry of Health, 2014).

According to Ministry of Health (MOH) (2014), measurement of MERS-CoV should include:

Investigating of history of contact with camels in the 14 days prior to the onset of illness. Also, Investigating history of contact with an ill patient who is diagnosed to have acute respiratory in the 14 days prior to the onset of illness. Nasopharyngeal swabs to be done to all suspected cases. Moreover, specific evaluation of common causes of community-acquired pneumonia to be done by clinical epidemiologist or clinical specialists (MOH, 2014)

Individual Characteristics

Individual Characteristics susceptible to get infected with MERS-CoV:

Age more than 50 year old.

Male more than female.

Living in middle east.

Healthcare workers.

Hospitalization (Alhamlan et al., 2017)

http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-MERS

Individual Characteristics susceptible to get infected with MERS-CoV as indicted in a recent study are:

Age of more than 50 years old.

Male.

Living in middle east.

Healthcare workers.

Hospitalized.

Have chronic diseases.

Have immunodeficiency diseases.

Have comorbidities.

All of these charchterstis indictes high probilibilty of MERS-CoV infection if not well protected and standard precaution are not maintained (Alhamlan et al., 2017).

Outside Influence

It is important to investigate travel history of patients with respiratory infection (WHO, 2017)

http://www.health.gov.au/internet/main/publishing.nsf/Content/ohp-MERS

All healthcare settings should have apply standard infection precautions and infection control practices (WHO, 2017). It is important to investigate the travel history of patients with respiratory infections. Having complete travel history can determine if patients have recently visited active MERS-CoV countries (WHO, 2017).

Specific Example

In a recent study, it is identified that 17% of the 123 non-outbreak cases and 10% of the 81 outbreak cases reported data on being exposed to camels (Alhamlan et al., 2017).

http://english.alarabiya.net/en/News/2013/11/28/MERS-virus-found-in-camels-in Qatar-linked-to-human-spread.html

In a recent study, it is identified that 17% of the 123 non-outbreak cases and 10% of the 81 outbreak cases reported data on being exposed to camels (Alhamlan et al., 2017). This indicated that the patients owned or raised camels and got infected with MERS-CoV. Avoiding contact with camels and drinking camel milk are required methods of MERS –CoV prevention that all should adhere to (Alhamlan et al., 2017).

Conclusion

Infection prevention and control practices are important to prevent the possible spread of MERS-CoV. MERS –CoV Public health awareness and healthcare facilities’ awareness need to be emphasized. Health care facilities should take appropriate standard and universal precaution measures to decrease the risk of transmission and prevent infection (WHO, 2017).

Infection prevention and control practices are important to prevent the possible spread of MERS-CoV. MERS –CoV Public health awareness and healthcare facilities’ awareness need to be emphasized in continuous basis. Health care facilities should take appropriate standard and universal precaution measures to decrease the risk of transmission and prevent infection (WHO, 2017). Also, infection control committees should emphasize proper hand hygiene techniques and proper standard precautions.

References

Adney, D. R., van Doremalen, N., Brown, V. R., Bushmaker, T., Scott, D., de Wit, E., Bowen, R.A. & Munster, V. J. (2014). Replication and shedding of MERS-CoV in upper respiratory tract of inoculated dromedary camels. Emerging infectious diseases, 20(12), 1999 – 2005.

Alhamlan, F. S., Majumder, M. S., Brownstein, J. S., Hawkins, J., Al-Abdely, H. M., Alzahrani, A., Obaid, D.A., Al-Ahdal, M.N. & BinSaeed, A. (2017). Case characteristics among Middle East respiratory syndrome coronavirus outbreak and non-outbreak cases in Saudi Arabia from 2012 to 2015. BMJ open, 7(1), e011865.

Azhar, E. I., El-Kafrawy, S. A., Farraj, S. A., Hassan, A. M., Al-Saeed, M. S., Hashem, A. M., & Madani, T. A. (2014). Evidence for camel-to-human transmission of MERS coronavirus. New England Journal of Medicine, 370(26), 2499-2505.

Chu, D. K., Poon, L. L., Gomaa, M. M., Shehata, M. M., Perera, R. A., Zeid, D. A., El Rifay, A.S., Siu, L.Y., Guan, Y., Webby, R.J. & Ali, M. A. (2014). MERS coronaviruses in dromedary camels, Egypt. Emerging infectious diseases, 20(6), 1049.

References

Mackay, I. M., & Arden, K. E. (2015). MERS coronavirus: diagnostics, epidemiology and transmission. Virology journal, 12(1), 222.

Memish, Z. A., Cotten, M., Meyer, B., Watson, S. J., Alsahafi, A. J., Al Rabeeah, A. A., Corman, V.M., Sieberg, A., Makhdoom, H.Q., Assiri, A. & Al Masri, M. (2014). Human infection with MERS coronavirus after exposure to infected camels, Saudi Arabia, 2013. Emerging infectious diseases, 20(6), 1012.

Miguel, E., Chevalier, V., Ayelet, G., Bencheikh, M. N. B., Boussini, H., Chu, D. K., El Berbri, I., Fassi-Fihri, O., Faye, B., Fekadu, G. & Grosbois, V. (2017). Risk factors for MERS coronavirus infection in dromedary camels in Burkina Faso, Ethiopia, and Morocco, 2015. Eurosurveillance, 22(13).

Ministry of Health (2014). Infection prevention/control and management guidelines for patients with Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infection. Retrieved from:https://www.moh.gov.sa/en/CCC/StaffRegulations/Corona/Documents/GuidelinesforCoronaPatients.pdf

References

Oboho, I. K., Tomczyk, S. M., Al-Asmari, A. M., Banjar, A. A., Al-Mugti, H., Aloraini, M. S., Alkhaldi, K.Z., Almohammadi, E.L., Alraddadi, B.M., Gerber, S.I. & Swerdlow, D. L. (2015). 2014 MERS-CoV outbreak in Jeddah—a link to health care facilities. New England Journal of Medicine, 372(9), 846-854.

World Health Organization. (2017). Middle East Respiratory Syndrome Coronavirus (MERS- CoV). Retrieved from: http://www.who.int/emergencies/mers-cov/en/