Middle Eastern Respiratory Syndrome, which first hit the news in 2013, has reared its head again, this time in South Korea where 3 have so far died of the infection. How the virus spread to South Korea from its origins in Saudi Arabia is unclear, and has sparked fears that it could reach South Africa.
Colloquially known as Camel Flu, due to its presumed animal origin, MERS is a coronavirus, meaning it is similar to the common cold and, more ominously, SARS. SARS, properly named Severe Acute Respiratory Syndrome, killed 774 people in 7 months between 2002 and 2003.
MERS, however, has so far been substantially more deadly. The WHO reported in June 2015 that the virus has a fatality rate of 36%, prompting the WHO to declare it “a threat to the entire world.” With over 1 in 3 sufferers dying from the disease, it’s easy to see how fears over transmission to other countries, including South Africa, have festered and grown.
So, what are the chances that MERS will make its way to SA? Not high, but certainly possible. Indeed, a month ago it would have seemed a lot more likely that South Africa would experience an outbreak than South Korea, but 700 closed schools, as reported by the BBC, later we’re forced to re-evaluate the risk. Cases have been found as far afield as Austria, the UK and the US, though none of these cases led to widespread transmission.
MERS is not classified as a highly contagious disease as it is unable to travel large distances and is killed easily by detergents and exposure to sunlight. It is believed, though not confirmed, that transmission occurs through doplets of saliva that are spread by coughing and sneezing.
However, only 20% of lung cells are of the right type to be susceptible to the virus meaning a relatively large amount of saliva would have to be inhaled, probably over a long period of time. This is in contrast to Ebola, which provoked similar concerns last year and was transmittable by a tiny quantity of infected material.
There are, however, certain situations which greatly increase the likelihood that transmission will occur, mainly those that force people to be confined together in small spaces, such as on a plane or bus. The majority of cases so far have occurred within healthcare settings, either from one patient to another or from a patient to a healthcare worker.
Given the increasing rates of pan-African travel, the chance of an infected person travelling to South Africa is far from negligible, with those sitting around him or her on the plane or bus being at high risk of contracting the disease. The average incubation period is 5-6 days, though it can stretch up to two weeks, according to the Centers for Disease Control and Prevention rel="nofollow". There are currently no travel bans in place in South Africa to prevent the spread of MERS, nor yet is there any screening of passengers from high risk countries like Saudi Arabia, Jordan, the UAE or those returning from South Korea, though the latest update from the National Institute of Communicable Diseases rel="nofollow" says that they are monitoring the situation.
Informal travel such as busses and taxis pose the additional problem of making it near-impossible to track and quarantine everyone who could have been exposed to the diseases. Nigeria’s management of last year’s Ebola outbreak highlighted how effective an aggressive quarantining program can be, something that is being mirrored in South Korea. So far 2 300 have been quarantined for just 80 suspected cases.
MERS initially presents with cold-like symptoms, mimicking its relative, before transitioning into something much more deadly. Common symptoms of this second phase include pneumonia and kidney failure, with death a distinct possibility. The mortality rate is heightened by the fact that the disease is more easily transmittable to individuals with a weakened immune system, usually those who are old or sick with other conditions, which means they are also less likely to fight off the disease when it develops further.