More cases clinically suspected to be Middle East Respiratory Syndrome (MERS) have begun to be reported by doctors following increased surveillance of severe acute respiratory illnesses (SARI) across the State .
Hospitals should put in enhanced infection control practices and encourage the use of personal protection equipment (PPE) for all its health workers as the possibility of MERS transmission is high within hospital settings.
“The possibility of MERS transmission in the community is limited. However, hospitals need to be alert about cases with typical symptoms of respiratory illness and a history of travel to the Middle East. MERS transmission route could be via the respiratory route, aerosol or by direct or indirect contact with the patient. Apart from using PPE, frequent hand-washing or sanitising using an alcohol-based rub would have to be the most important and primary precaution that hospitals should strictly implement,” said a senior virologist at the Manipal Centre for Virus Research.
The MERS picture is quite different from that of H1N1. H1N1 resulted in widespread transmission in the community, with symptoms appearing within 48 hours of contact. MERS, however, has a long incubation period (period before patient shows symptoms) of 2-14 days and the transmission seemed to occur in the latter part of the illness when the patient was in the hospital.
The long incubation period of MERS meant that screening or surveillance and contact-tracing at airports — strategies adopted during H1N1 epidemic — were not effective, he added.
Meanwhile, on Friday, the death of a 52-year-old woman at the Thiruvananthapuram Medical College Hospital, who had returned from the Middle East with typical symptoms of MERS and severe broncho-pneumonia, has had MCH reviewing its preparedness to meet a situation when more suspect cases could be referred here.
Hospital authorities said the system of isolation and surveillance, with separate ICU facilities, would be put in place and that WHO guidelines were being circulated among doctors.
The virologic samples — throat swabs and lower respiratory tract fluids — have been sent to Manipal and the results are awaited. Health officials said that as a lab-confirmed case of MERS is yet to be reported in the country, any suspect case would be extensively investigated by NIV Pune. The confirmation, if any, will be formally announced by the Union Health Ministry.
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