Why a deadly virus in the

Middle East has the entire

world on alert
A recent spike in MERS cases could be the beginning of a global outbreak
LINDSAY ABRAMS

(Credit: xrender/Shutterstock)

A deadly new virus for which there is no cure and about which little is understood could
present a global threat, officials say. Its called Middle Eastern Respiratory Syndrome
Coronavirus or MERS-CoV and a recent upswing in cases has health officials on
high alert.
MERS, which was first reported in 2012 in Saudi Arabia, has since spread across the
country; lab-confirmed cases linked to travelers in the Gulf have also cropped up in
France, Italy, Jordan, Kuwait, Oman, Qatar, Tunisia, the U.K. and the U.A.E. Last week,
new cases were reported in Yemen, Malaysia, the Philippines and Greece. In the
U.S., according to NPR, the CDC has been preparing for the possibility that a MERS
case could walk off an airplane onto American soil.
On Thursday, the Saudi Arabian health ministry confirmed 36 new cases and four
deaths. According to Ian MacKay, an associate professor at the Australia Infectious
Diseases Research Centre at the University of Queensland, the country this month has

been seeing more than 10 reported cases each day, up from two or three daily. So far
this year, he wrote on his blog, there have been more cases detected than in 2012 and
2013 combined.
Anything thats compared to SARS which in 2003 spread globally and killed almost
800 people is going to be disconcerting. While MERS is in the same family as that
virus, its believed to be easier for otherwise healthy individuals to fight off; according
to PopSci, its far less likely to cause a pandemic. Experts, nonetheless, see a number of
reasons to be concerned:
Theres no way to prevent or treat it
Since MERS first emerged, its infected at least 250 people and killed 93. The
virus causes coughing, fever and pneumonia and has a death rate of about 30 percent.
The World Health Organization warns that more needs to be done to prevent its spread
in healthcare facilities, noting that the presence of mild and unusual symptoms can
make the virus difficult to identify at its early stages.
While officials in Saudi Arabia say theyre racing to develop a vaccine, experts counter
that immunizing an entire population against a virus thats so far killed only several
hundred would be a waste of time and money. Most say that the best course of action
would be to vaccinate animals, which are believed to be spreading it to humans. Which
leads to the next problem
We know almost nothing about it
Very little is understood about how the virus is transmitted from animals or the
environment to humans, or about what form human-to-human transmission may be
taking. Scientists first linked MERS to bats, and have since found that signs of it are
widespread in camels. According to WHO, urgent investigations are required in order
to better understand whats going on.
Saudi Arabia, meanwhile, has been accused of obscuring information about the
outbreak, making it that much harder for the international health community to answer
important questions.
Its already spreading and theres a chance its evolving

Used to be, MERS was (believed to be) transmitted to humans from camels it often
appeared in people who worked directly with the animals, or who ate their meat or
drank their milk. But now, healthcare workers are getting sick, which could indicate that
the virus is undergoing genetic changes that will allow it to spread more easily between
humans. So far, asNPR explains, there hasnt been much to indicate sustained
transmission the chain of infection appears to stop after the virus moves to a second
person but the possibility of that happening has health workers on edge. When
humans readily transmit [a virus] to humans, thats what will cause a worldwide
outbreak, Michael Osterholm, who directs the Center for Infectious Disease Research
and Policy at the University of Minnesota, told NPR earlier this week. We are very
concerned that with what weve seen over the last two weeks we may be at that
point now.
According to ScienceInsider, however, theres no indication of genetic changes in the
virus yet the increase in cases could just be the result of more widespread testing.
And virologist Christian Drosten of the University of Bonn in Germany added that there
might be a seasonal effect in play, too. It certainly seems that April and May are bad
months for MERS, he said. Then again, about 1 million Muslims are expected to travel

to Saudi Arabia in early October, for the Hajj once again presenting the potential for
a global spike in infections.

Lindsay Abrams is an assistant editor at Salon, focusing on all things sustainable.

Follow her on Twitter @readingirl, email labrams@salon.com.
Follow

MORE LINDSAY ABRAMS.