HLTB21H3 Lecture Notes - Lecture 11: Middle East Respiratory Syndrome, Case Fatality Rate, Multiple Organ Dysfunction Syndrome

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2 Dec 2013
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HLTB21- Lecture 11- November 28, 2013
MERS: Middle East Respiratory Syndrome (quite new)
Novel coronavirus infecting humans
First reported in Sept. 2012 (Zaki 2012)
Incubation 5-12? days; cough, fever, breathing difficulties (we really don’t know
much about MERS)
Zoonotic in origin (bats; camels?)
Unlike SARS, it damages many types of human cell lines (killing cells rapidly) and
different organs in body; as well as many different animals
Could be more virulent than SARS
• Patients suffer multiple organ failure, esp. renal failure; pneumonia
Novel SARS-like Coronavirus in the Middle East
Mar. 2013: 17 cases, 11 dead (since Sept 2012); 65% case fatality rate
Nov. 2013: 160 cases,68 deaths: 43% case fatality rate
(SARS:~11%overall)
Qatar, Saudi Arabia, United Arab Emirates, Oman, Kuwait,
Jordan, Pakistan; probable - Germany, UK, France, Spain, Italy, Tunisia
WHO: not as easily spread between people as SARS
MERS Transmission
Person-to-person transmission observed
Via: healthcare settings & close family contact
Most cases in men (why?), and individuals with co-morbidities -> because it
was mostly men doing pilgrimages; they were also older
> Imp. factors: pre-existing conditions (esp. diabetes, kidney disease) and a
degree of immunosuppression
> resulted in a lower case rate than SARS
SARS vs. MERS
Greater Case Fatality Rate with MERS (40-50% vs. 11%)
Much fewer health-care workers have been infected with MERS
Probably due to changed practices: improved infection control in hospitals,
increased surveillance, public awareness campaigns, epidemiological investigations,
and greater collaboration with international experts
However, some have been critical about the relatively slow rate of knowledge
gathering compared to SARS: we still don’t know much about MERS
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