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Man ‘MERS positive’ without becoming sick Medics may take virus global

CHICAGO, May 18, (Agencies): An Illinois resident tested positive for Middle East Respiratory Syndrome after being in contact with an infected patient, though he did not show signs of illness, US health officials said on Saturday. The man likely contracted MERS from a man in Indiana who was hospitalized in late April with the first known US case of the illness.

The Illinois resident’s lack of symptoms may shed light on milder forms of the deadly virus, which emerged in the Middle East in 2012 and has infected more than 500 patients in Saudi Arabia alone. It kills about 30 percent of those who are infected. Researchers at the forefront of the global MERS response said this week they were investigating whether people infected with MERS who have no symptoms could still pass the virus on to others. “There is evidence there is a broader spectrum of MERS” than first expected, said Dr. David Swerdlow of the US Centers for Disease Control and Prevention, who is leading the US response to MERS.

The Illinois resident did not seek or require medical care and is reported to be feeling well, but officials involved in investigating the first case have been monitoring his health since May 3. A blood test on Friday showed he had developed antibodies to MERS. CDC officials explained that the blood test is not sufficient to consider him a confirmed case of MERS because it detected only antibodies, not the live virus. Swerdlow said the agency would discuss with the World Health Organization its system of classifying MERS cases to account for milder cases.

On April 25, the Illinois man had a 40-minute face-to-face meeting with the Indiana patient, a business associate, Swerdlow said. The two men shook hands but the Indiana patient did not have a cough at the time. The Illinois resident has been instructed to avoid other people or wear a face mask. While the Indiana patient was a healthcare worker who had recently arrived in the United States from Saudi Arabia, the Illinois resident had no recent history of travel outside the country, Swerdlow said.

The first case of MERS was confirmed in Indiana in early May and the second, in Florida, on May 11. Swerdlow said 50 people who came into contact with the Indiana patient have tested negative for MERS but are undergoing more tests. Health officials are now trying to identify and monitor close contacts of the Illinois resident. “It’s possible that as the investigation continues, others may also test positive for MERS-CoV infection but not get sick,” Swerdlow said. The disease causes coughing, fever and sometimes fatal pneumonia and reported cases have tripled in the past several weeks. The virus is moving out of the Arabian peninsula as infected individuals travel from the region. Dutch officials reported their first two cases this week. Infections have also turned up in Britain, Greece, France, Italy, Malaysia and elsewhere.

Meanwhile, Saudi Arabia has reported five new deaths from the MERS respiratory virus, bringing the death toll in the world’s worst-hit country to 168. In its latest tally, issued on Saturday, the health ministry said the total number of infections in the kingdom from the coronavirus since it first appeared in 2012 now stood at 529 people. Among the latest fatalities were two men aged 67 and 55 and an 80-year-old woman in Jeddah, the port city where a spate of cases among staff at King Fahd Hospital last month led to the dismissal of its director and the health minister. In addition, a 71-year-old man and another aged 77 died in Riyadh and Medina respectively, the ministry website reported. Other nations including Egypt, Jordan, Lebanon, the Netherlands, the United Arab Emirates and the United States have also recorded cases, mostly in people who had been to the desert kingdom. The biggest risk that Middle East Respiratory Syndrome will become a global epidemic, ironically, may lie with globe-trotting healthcare workers.

From Houston to Manila, doctors and nurses are recruited for lucrative postings in Saudi Arabia, where MERS was first identified in 2012. Because the kingdom has stepped up hiring of foreign healthcare professionals in the last few years, disease experts said, there is a good chance the MERS virus will hitch a ride on workers as they return home. “This is how MERS might spread around the world,” said infectious disease expert Dr Amesh Adalja of the University of Pittsburgh Medical Center. It can take five to 14 days for someone infected with MERS to show symptoms, more than enough time for a contagious person to fly to the other side of the world without being detectable.

Healthcare workers “are at extremely high risk of contracting MERS compared to the general public,” Adalja said. The threat has attracted new attention with the confirmation of the first two MERS cases in the United States. Both are healthcare workers who fell ill shortly after leaving their work in Saudi hospitals and boarding planes bound west. About one-third of the MERS cases treated in hospitals in the Saudi Red Sea city of Jeddah were healthcare workers, according to the World Health Organization. Despite the risk, few of the healthcare workers now in, or planning to go to, Saudi Arabia are having second thoughts about working there, according to nurses, doctors and recruiters interviewed by Reuters.

Michelle Tatro, 28, leaves next week for the kingdom, where she will work as an open-heart-surgery nurse. Tatro, who typically does 13-week stints at hospitals around the United States, said her family had sent her articles about MERS, but she wasn’t worried. “I was so glad to get this job,” she told Reuters. “Travel is my number one passion.”

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