10:59 AM EDT
Biomedical researchers and virologists are learning more genomic information about this virus, on an almost daily basis. The Atlanta-based CDC has taken blood samples from the two hospitalized U.S. patients infected with MERS Co-V and sent these samples to a testing laboratory where the MERS-CoV RNA has been genetically sequenced, with results made public.
The two U.S. MERS patients who came from Saudi Arabia--one from Riyadh and the other from Jeddah--have MERS-CoV with two different genetic sequences, and both were physicians working in hospitals in their respective cities.
The Saudi doctor who is now a patient in Florida is infected with the novel Jeddah MERS sub-clade, as are patients who left Saudi Arabia and who flew to Jordan (two cases), Malaysia, Greece (where the 60-year-plus patient is still in critical condition), UAE, Egypt, and the Netherlands--the news about the patient in the Netherlands breaking only yesterday, although his MERS symptoms presented several weeks ago.http://www.recombinomics.com/News/05151 ... lands.html
The virologist most knowledge about these cases and who has a website with daily updates (link immediately above) is Henry L. Niman, who heads the Pittsburgh company, Recombinomics. Niman also tweets and yesterday's tweet about the genomic changes within a short period of time within the Jeddah MERS-CoV sub-clade should warrant everyone's attention: the Jeddah sub-clade is undergoing "rapid supercharged evolution."
Niman believes that these rapid mutations are leading to the virus being more easily transmissible, much like the SARS-CoV more than a decade ago. Whether the virus can now spread more easily AND becomes more (or possible less) virulent remains to be seen.
Concerns should be focused within Saudi Arabia on departing passengers on international flights and pilgrimages into the country for religious observances of umrah and hajj.
11:04 AM EDT
Note, in the post by Niman today at his website (same link above), that Niman is not afraid to challenge the decision made earlier this week by the World Health Organization, that public health emergency of international concern.
The cases within Saudi Arabia this spring are "h2h," meaning human-to-human transmission, occurring in hospitals in the Kingdom of Saudi Arabia. This evidence of transmission is irrefutable.
12:11 PM EDT
"The two U.S. MERS patients who came from Saudi Arabia--one from Riyadh and the other from Jeddah--have MERS-CoV with two different genetic sequences, and both were physicians working in hospitals in their respective cities. "
If these doctors knew they had been exposed and were infected, why were they traveling anywhere? Was this a deliberate effort to spread the virus?
12:53 PM EDT [Edited]
If this first question of yours is not the question of the week, then it certainly must be the question of the month or this spring for Saudi Arabia, when the MERS-CoV virus is amplified. Your second question not so much, as I think it unlikely that there was deliberate attempt to spread the virus overseas.
I think the questions that need to be asked are what are the names of the hospitals in Jeddah and Riyadh where these two doctors were employed, respectively. The question of which hospitals takes on even more importance if the hospital in Jeddah was the King Fahd Hospital, whose own administrator was hospitalized with MERS in his own King Fahd Hospital (I understand after reading from Henry L. Niman's numerous and highly informative posts at his website that there is a youtube video of this administrator in his hospital bed--I believe he has subsequently been canned), as well as four physicians who contracted MERS Co-V in this same Fahd hospital.
If the U.S. patient contracted MERS in another Jeddah hospital--Wiki has a list of Saudi hospitals--then that raises additional concerns. At one point, paramedics in Jeddah attempted to refuse to transport patients with MERS-like symptoms--until their short-lived strike was quashed.
Perhaps most importantly, these Jeddah cases, particularly because human-to-human transmission is occurring within Jeddah hospitals, raises many critical and timely questions: about information sharing/ contagious disease alerts by the inept Saudi Ministry of Health, educational training programs in health-care settings, lack of accurate news coverage of the outbreak by Saudi media, Saudi health-care leadership (not putting an engineer in charge of hospital administration), lack of cooperation by Saudi political leadership, the nature of Saudi leadership and control, the level of scientific expertise within Saudi Arabia. You can probably come up with other important questions as well.
10:33 AM EDT
"A large share of the responsibility for this black hole must fall on Saudi Arabia, a closed society where the disease was not met with sufficient urgency for more than a year."
This is an extremely dangerous disease because the survival rate is so low. So far, about 30% of those infected have died. The fatalism that permeates Saudi Arabia and other Muslim countries contributes to the mismanagement of this outbreak. Until proper treatment options are developed, travel to and from Saudi Arabia should be very closely regulated.
8:53 AM EDT
Anyone who has lived in the middle east and seen how the people there organize things knows that MERS is going to turn into a run away problem.
11:27 AM EDT [Edited]
MERS = major crisis requiring immediate response after 2 cases found in U.S.
cigarette smoking = known carcinogen causing slow death sold everywhere daily, no problem
12:02 PM EDT
Bote: And so? I fail to see the connection. Smoking is the main cause of lung cancer. It contributes to 80 percent and 90 percent of lung cancer deaths in women and men, respectively. MERS is a highly contagious disease; lung cancer is not.
12:56 PM EDT
Smoking--putting a tobacco product between one's lips or into one's mouth--is a matter of choice. MERS CoV is not a matter of choice.
'Rik' Alan Camerik Heller
7:00 AM EDT
SARS Singapore in 2003 has been studied as their response was the most effective in extinguishing SARS in their nation. The most signficant benefit came from screening ALL nonPatients for fever 2x daily. From this you can surmise that that hospitals can be the source of MOST societal epidemics. This is not because of thier collection of acutely ill patients but because of the subactue nonpatients who transit between the hospital and the community. Health care workers, guests, companions are the successful virus' main transport. I find no reports that Saudi Arabia instituted this established technique and a 25% rate of health care workers infected leave me fairly sure they did not. Simple technology exists to do this unattened and automatically. It should be a prerequisite to calling yourself a hospital. Only one kind of contagious person should be in a hospital because hospitals know how to manage contagious patients. in Orlando, the MERS infected person took another person to a medical procedure. The hospital observed his symptoms, offered help and it was denied. He should have never entered to spread MERS if they were fever screening.
6:54 AM EDT
Don't rule out terrorist as a possible source.
8:10 AM EDT
As far as "ruling out" is concerned, most such acts these days are linked to terrorism. Sometimes terrorism is "ruled out"; other times it "cannot be ruled out". Gone are the days when things could (or could not be) "ruled out" other than terrorism