Saturday, September 21, 2013

WHO Reports Changing MERS Demographics; Rise in Sporadic Cases

MERS Corona virus
The World Health Organization issued an update on the MERS virus which has infected scores in the middle east with a few cases in Europe and Tunisia. 37 new cases have been confirmed since the last update.

130 cases in nine countries have been laboratory confirmed and 17 are considered 'probable', including two from the Italian cluster which had previously been considered 'confirmed'. 58 of those have died or about 45%. About 63% are male and the median age is now 50, down significantly from the 59.5 years in the last report.

The new numbers reflect a change in the demographics of the reported cases. Before July 2013, 83% of MERS victims were men, but the latest victims are increasingly female, including many from the health care field. Others caught the illness from family members and, in about one in four cases, the method of exposure is unknown.

Nine of the newest cases are considered 'sporadic' or having no known prior contact with another infected person. 63% of these sporadic infections have been in women. These cases tend to be more deadly and most victims have underlying medical conditions. 89% of these recent sporadic cases were severe or later died.
"The recent upsurge in case reporting is of concern and represents both an increase in sporadic cases and several coincident clusters of infection in contacts. ...The reason for the increase in sporadic cases is unknown but could be the result of increased surveillance, an expansion of the virus in the unknown reservoir, seasonal variation, or a change in exposure patterns."
Genetic research on samples from 30 victims of the virus has shown it has passed between humans and animals and through human to human contact several times since it first emerged around July of 2011. They suspect an 'unknown reservoir' of the virus exists which has repeatedly infected humans. 
"The analysis supports a geographically dispersed reservoir of MERS-CoV with movement of virus among geographic locations through movement of an animal reservoir, animal products, or possibly infected humans, though movement of animals was thought to be the most likely explanation."
The search for this unknown reservoir for the virus continues with studies of domestic and wild animals ongoing in the region. Possible genetic matches were found among bats and some camels have antibodies indicating possible exposure, but neither of these clues have led to the source of this deadly corona virus.

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