First Case of Deadly MERS Infection Found in U.S.

A deadly virus from the Middle East has arrived in the U.S. with the first reported case of a patient hospitalized with the respiratory infection, the Centers for Disease Control and Prevention said.

The patient, an American health-care provider who visited Saudi Arabia, flew from Riyadh to London to Chicago on April 24, and then took a bus to Indiana. The person fell ill on April 27 and was hospitalized the next day, U.S. officials said. The CDC is now trying to determine who may have come into contact with the patient, now isolated and being “well cared for,” said Anne Schuchat, director of the National Center for Immunization and Respiratory Diseases, in a briefing yesterday.

The illness, known as Middle East respiratory syndrome coronavirus, or MERS-CoV, has been responsible for 401 cases in 12 countries and 93 deaths, the Atlanta-based CDC said in statement. First detected two years ago, the virus causes respiratory distress, fever and coughing.

Patients die “from the infection in their lungs,” said Debra Spicehandler, a doctor at Northern Westchester Hospital in Mount Kisco, New York. “They need ventilators, can’t breathe and get overwhelming lung infection.”

Schuchat would not say where the person is being treated or provide personal details such as age or gender.

Oxygen Support

The origin of the virus is unknown, Schuchat said, though there are theories it is linked to camels. There is no vaccine or specific treatment recommended for the virus.

“In this interconnected world we live in, we expected MERS-CoV to make it the United States and we have been preparing,” she said.

While there is no current treatment, Inovio Pharmaceuticals Inc., based in Blue Bell, Pennsylvania, is in the early stages of developing a vaccine. The company, which rose about 7 percent yesterday on the news, said in November that tests of a synthetic DNA vaccine in mice “induced robust and durable immune responses” to the virus.

Schuchat said the virus “represents a very low risk to the broader general public.” When it has spread outside the Arabian peninsula, she said, cases have been confined to family members and health-care workers who had close contact with the original patients.

There was an increase in MERS cases in March reported from Saudi Arabia and the United Arab Emirates, she said.

‘All Connected’

“This case reminds us that we are all connected by the air we breathe, the food we eat and the water we drink,” CDC Director Tom Frieden said in a statement.

Most at risk are people who are elderly or who have pre-existing health problems and weakened immune systems, Schuchat said. Reports from the Arabian peninsula “suggest there are asymptomatic patients,” which would mean the overall death rate is lower.

“If you’re living with the person you might catch it, but it’s not like it’s going to spread through the air,” Spicehandler said.

An April 24 report from the World Health Organization found that as many as 75 percent of cases appeared to be infections acquired from another infected person. Most have been health-care workers. Only four cases of transmission within households have been reported, the report said.

So far, countries in the Middle East reporting infections include Jordan, Kuwait, Oman, Qatar, Kingdom of Saudi Arabia and the United Arab Emirates; in Europe: France, Germany, Greece, Italy and the United Kingdom; in North Africa: Tunisia; and in Asia: Malaysia and the Philippines, the report said.

Camel Study

Columbia University researchers found MERS in camels in Saudi Arabia that matched the virus found in humans, making the animals “a likely source of the outbreak,” according to a May 1 statement from the university’s Mailman School of Public Health.

Researchers are investigating whether patients may have been infected through exposure to camel milk or meat.

“The way humans become infected from an animal and/or environmental source is still under investigation,” the April 24 WHO report said. “More individuals are likely to be infected until the mode of transmission is determined and preventive measures implemented to break transmission from the source to humans.”