Middle East Coronavirus

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Since the summer of last year, the perennial talk of epidemics and pandemics has focused on a novel coronavirus. A virus that belongs to a diverse group of that affects many animal species — from bats to humans. At the time the public health risks were unknown. How many could eventually possibly become infected or die? How does the virus spread? Is Human to human transmission possible?

During the summer of 2012, in Jeddah, Saudi Arabia, the unknown coronavirus was isolated from the sputum of a patient with acute pneumonia and renal failure. To date, 55 laboratory-confirmed cases have been reported to the World Health Organisation. 31 individuals with laboratory-confirmed infection have died. Directly or indirectly most cases have been linked to four countries in the middle east; Saudi Arabia, Qatar, Jordan, and the United Arab Emirates. Now known as the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), the exact scale and full parameters of a disease that the world is still understanding are slowly coming to the forefront.

Roughly two months ago a 73 year old man from Abu Dhabi died in a Munich hospital. He died on the 18th day of his infection of septic shock from the coronavirus infection he was suffering from. It is this patient, who was admitted to the Klinikum Schwabing in Munich in March, that is the subject of newly published research revealing more about the virus’ clinical features. Publishing in the Lancet, the research highlights the need for a therapeutic approach and that more data and research are needed. Little comprehensive clinical data on the new virus exists. In all, cases have been documented in Arabian Peninsula, Tunisia, Morocco, France, Italy, Germany, and the UK. Although one case in France turned out to be a false positive. Across all the documented and reported cases this is only the fifth patient for whom the virus’s progression and characteristics have been described in a medical journal.

A question early on had always been, is this the next SARS? In the spring and summer of 2003, the global outbreak of severe acute respiratory syndrome (SARS) caused more than 8000 probable or confirmed cases and 774 deaths in 25 countries across five continents. A health scare of pandemic proportions. And that is the new state of fear with every new mysterious infection. The new coronavirus (MERS-CoV) is one which Dr Margaret Chan, the Director General of the WHO, described as “my greatest concern right now.”

It seems the initial moniker of “novel” coronavirus was apt. The Lancet study shows key differences. Namely, between how the new virus circulates in the body compared with the SARS virus. This comparison to SARS, somewhat due to its initial similarities, but also because of how little we know about MERS-CoV.

“Laboratory data are crucial for diagnostic recommendations to make projections about prognosis, and to estimate infection risks. Without quantitative laboratory data from well documented cases of MERS-CoV infection, most considerations had been made on the basis of an assumed analogy to severe acute respiratory syndrome.”

This coming after recent pleas by the WHO for those working on the virus to share more information. Saudi Arabia has recently said that the development of diagnostic tests have been delayed by patent rights.

Despite the complications inherent in modern medicine and research into emerging infectious diseases, one thing is clear — only analysis of a large number of patients can be fruitful enough to really chart this virus and its disease patterns.

These types of advancements only really come from patient information. And only really comes when a patient finally succumbs to their infection.

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