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PRACTITIONER SECTION  
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 231-233
Ten lessons learned from the recent outbreak of the Middle East respiratory syndrome


Health Management Research Center, Baqiyatallah (A.S.) University of Medical Sciences, Tehran, Iran

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Date of Web Publication5-May-2017
 

   Abstract 

From 2012 till the present, the name of Middle East respiratory syndrome (MERS) has been heard many a times in the mass media and many papers that have been published in different scientific journals, but one question has remained – What is the lesson learned about MERS epidemic at the present time and what can really be done in order to prevent the matter? I would like to bring your attention to what could be done at the present time, based on lessons learned from MERS outbreak in the world.

Keywords: Lesson learned, Middle East respiratory syndrome (MERS), outbreak, world

How to cite this article:
Tavana AM. Ten lessons learned from the recent outbreak of the Middle East respiratory syndrome. Ann Trop Med Public Health 2017;10:231-3

How to cite this URL:
Tavana AM. Ten lessons learned from the recent outbreak of the Middle East respiratory syndrome. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 11];10:231-3. Available from: http://www.atmph.org/text.asp?2017/10/1/231/205574

   Outbreak of Mers Top


Middle East respiratory syndrome (MERS) is a viral respiratory disease caused by a novel coronavirus (MERS-CoV) that was first identified in Saudi Arabia in 2012.[1] The disease has different signs and symptoms including abnormal chest pain, fever, and cough, shortness in breath, sore throat, myalgia, and sometimes diarrhea, vomiting, and abdominal pain.[2] Till now, the disease has been reported from different countries, shown in [Table 1].
Table 1: The list of countries with reported cases of Middle East respiratory syndrome (MERS) (8th December 2015)

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The number of outbreak of the disease in the Middle East has increased dramatically in the past 3 years.[3],[4] An outbreak of more than 180 cases occurred in South Korea in May and June 2015; the index case had recently traveled to several countries in the Persian Gulf.[5],[6],[7],[8],[9]

Lessons learned

  • Since April 2012, more than 1,610 cases of MERS-CoV infection have been reported. The actual number of cases may be more than that.[10] The surveillance system and registration must be strangled in both the infected and noninfected areas. The primary healthcare (PHC) system may be the best suggestion, at least in developing countries, in order to overcome the diseases in a longtime period.[11]
  • Second, the median age of MERS patients was 48 years and 64% of cases have been male [12] that means all age groups must be considered in health measure precautions carefully.
  • Third, the disease spread very quickly, in particular, the index case and super-spreader were present, in that situation, genetic analysis of virus must be quicker in order to find the source and preponderance of all health care workers and hospitals in many parts of the world, in particular, in developing countries when the medical care is always insufficient they need to prepare money, manpower, machine, perhaps the new rapid molecular methods must be developed in the future.
  • Fourth, the disease was seen in cases of kidney failure or in patients with pneumonia; that means the high risk group must be taken care of in similar situations in order to prevent the problems.
  • Fifth, the camel has been found as a seropositive host; that means the camels and the owners must be screened time by time in infected cases must be cured before the disease spreads.
  • Sixth, not to be forgotten that prevention is always better than cure, thus, personal hygiene precaution, safety measure (i.e., mask, eye protection) are very useful anytime and very economical and practical.
  • Seventh, nosocomial infection transmission of the disease should not be forgotten too, in particular in health care workers, and that it must be prevented by key components of an effective infection control program including the following:
    1. Standard precautions when providing patient care, especially the use of hand hygiene before and after patient care;
    2. Rapid evaluation appropriate isolation precautions for patients,
    3. The usual use of personal protective equipment [i.e., masks, especial mask (N95 respirators), eye protection, and gowns][13] that should be done as other infectious diseases (i.e., influenza).[14],[15]
  • Eighth, at the present time, there is no vaccine for MERS CorV. Therefore, the new research must be focused on that, because in some situations such as a pilgrimage with a mass gathering in Mecca and Karbala this is the best, and only way for prevention and other prevention measures may be impractical.
  • Ninth, the MERS guideline must be updated day-by-day, based on research findings and signs and symptoms of cases and its controls.
  • Tenth, the experts in different aspect of MERS control must be worked as network collaboration in order to prevent the disease properly.



   Conclusion Top


Risks of MERS infection can be minimized by healthcare workers and any individual in different parts of the world by considering the ten lessons learned above. I wish a world without disease, in particular, MERS.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
   References Top

1.
ProMed Mail: Novel Coronavirus – Saudi Arabia: Human Isolate; Archive Number: 20120920.1302733. Available from: http://www.promedmail.org/direct.php?id=20120920.1302733. [Last Accessed on 2013 Apr 22].  Back to cited text no. 1
    
2.
Assiri A, Al-Tawfiq JA, Al-Rabeeah AA, Al-Rabiah FA, Al-Hajjar S, Al-Barrak A, et al. Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: A descriptive study. Lancet Infect Dis 2013;13:752-61.  Back to cited text no. 2
[PUBMED]    
3.
World Health Organization. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Summary of Current Situation, Literature update and Risk Assessment – As of 5 February 2015. Available from: http://www.who.int/csr/disease/coronavirus_infections/mers-5-february-2015.pdf?ua=1. [Last accessed on 2015 Mar 4].  Back to cited text no. 3
    
4.
Rha B, Rudd J, Feikin D, Watson J, Curns AT, Swerdlow DL, et al. Update on the epidemiology of Middle East respiratory syndrome coronavirus (MERS-CoV) infection, and guidance for the public, clinicians, and public health authorities – January 2015. MMWR Morb Mortal Wkly Rep 2015;64:61-2.  Back to cited text no. 4
[PUBMED]    
5.
World Health Organization. MERS-CoV in the Republic of Korea at a Glance. Available from: http://www.wpro.who.int/outbreaks_emergencies/wpro_coronavirus/en/. [Last accessed on 2015 Jul 28].  Back to cited text no. 5
    
6.
World Health Organization. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – Republic of Korea. Available from: http://www.who.int/csr/don/24-may-2015-mers-korea/en/. [Last accessed on 2015 May 26].  Back to cited text no. 6
    
7.
Zumla A, Hui DS, Perlman S. Middle East respiratory syndrome. Lancet 2015;386:995-1007.  Back to cited text no. 7
    
8.
World Health Organization. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – Thailand. Available from: http://www.who.int/csr/don/20-june-2015-mers-thailand/en/. [Last accessed on 2015 Jun 22].  Back to cited text no. 8
    
9.
World Health Organization. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – Saudi Arabia. Available from: http://www.who.int/csr/don/13-november-2015-mers-saudi-arabia/en/. [Last accessed on 2015 Nov 16].  Back to cited text no. 9
    
10.
Cauchemez S, Fraser C, Van Kerkhove MD, Donnelly CA, Riley S, Rambaut A, et al. Middle East respiratory syndrome coronavirus: Quantification of the extent of the epidemic, surveillance biases, and transmissibility. Lancet Infect Dis 2014;14:50-6.  Back to cited text no. 10
    
11.
Al Shehri AM. A lesson learned from Middle East respiratory syndrome (MERS) in Saudi Arabia. Med Teach 2015;37(Suppl 1):S88-93.   Back to cited text no. 11
    
12.
World Health Organization. Middle East Respiratory Syndrome Coronavirus (MERS-CoV): Summary of Current Situation, Literature Update and Risk Assessment-as of 5 February 2015. Available from: http://www.who.int/csr/disease/coronavirus_infections/mers-5-february-2015.pdf?ua=1. [Last accessed on 2015 Mar 4].  Back to cited text no. 12
    
13.
Weber DJ, Rutala WA, Schaffner W. Lessons learned: Protection of healthcare workers from infectious disease risks. Crit Care Med 2010;38(Suppl):S306-14.   Back to cited text no. 13
    
14.
Tavana AM. Pandemic influenza A H1N1 in Iran and lessons learnt. Ann Trop Med Public Health 2012;5:295-7.   Back to cited text no. 14
  [Full text]  
15.
Mehrabi Tavana A. Avian and swine flu infections in human need more care in national and international levels. IRCMJ 2010;12:82-3.  Back to cited text no. 15
    

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Correspondence Address:
Ali Mehrabi Tavana
Health management Research Center, Bagiyatallah (A.S.) University of Medical Sciences, Tehran
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.205574

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