On Tuesday morning in Florida, Orlando Health physicians and a state public health official spoke with reporters about the second MERS (Middle East Respiratory Syndrome) case at Dr. Phillips Hospital, where the patient is currently being treated.
The patient with MERS initially came to Orlando Regional Medical Center to bring a relative in for testing, according to Dr. Ken Michaels, the health system’s medical director for occupational health. The care team admitted him to the hospital on May 8, when Dr. Michaels said the patient came to the emergency room at Dr. Phillips Hospital displaying possible symptoms of pneumonia. (The physicians continued to use the pronoun “he” in the news conference, although neither the patient’s gender or age have been confirmed.)
The patient was not initially tested for MERS until the staff interviewed him, said Dr. Antonio Crespo, the hospital’s chief quality officer. He said the patient wasn’t coughing initially, so they waited to conduct tests until Saturday, May 10, and the case was announced to the public on Monday.
“Both hospitals are cooperating and efforts are underway to contact people to see if they’re okay,” said Dr. Kevin Sherin from the state department of public health. “It’s a couple dozen people between hospital workers and extended family contacts who might have been exposed, and between the waiting room at ORMC and Orlando Health it would be under 100 for potential exposure.”
It was reported yesterday that the patient flew on May 1 from Saudi Arabia to Orlando, Fla., making stops in London, Boston, and Atlanta before reaching his final destination. The patient is a resident of Saudi Arabia.
The mortality rate from the MERS infection, a coronavirus from the same family as SARS (Severe Acute Respiratory Syndrome), is 30 percent, according to the Centers for Disease Control and Prevention. Symptoms of the respiratory infection include coughing, fever, and shortness of breath, which can lead to fatal pneumonia. The treatment for MERS at this point is symptomatic: providers administer IV fluids and medication to control fevers and muscle aches from the infection. There is no cure for MERS.
The World Health Organization is holding an emergency meeting on the MERS virus Tuesday as more cases are reported in the Middle East, Europe, and the United States. At this point, two MERS cases have been confirmed in Indiana and Florida. In Saudi Arabia, the Associated Press reported today that 152 people have died out of the 495 confirmed hospitalized cases.
Last week, scientists tied the human contraction of the virus to camels, and in Saudi Arabia, where the two confirmed U.S. cases contracted the virus, authorities are instructing camel handlers to wear masks and gloves.
The WHO today will discuss whether the MERS virus that emerged in 2012 qualifies as a “public health emergency of international concern” (PHEIC). This categorization would label the outbreak of MERS as an extraordinary event that threatens other WHO member states and may require an international response.
Dr. Crespo said that two non-physician team members from the Orlando Health Emergency Department have come to the hospital displaying flu-like symptoms after being exposed to the MERS case.
One team member has been admitted to the hospital with symptoms 24 hours after being in contact with the confirmed MERS case, but hospital officials this morning said that it’s too soon to call based on information from the CDC. The hospital has placed the admitted person in isolation while he undergoes tests. The second employee has been sent home with isolation instructions.
UPDATE: A spokeswoman the Orlando hospital Wednesday said two employees tested negative for the rare MERS virus days after coming into contact with the second confirmed case.
The 15 team members, including three physicians, who were in contact with the confirmed MERS case without a mask before the hospital’s isolation standards were initiated, have been identified, said Dr. Michaels. Those individuals are currently in isolation at their homes. The physicians said they are following up with these people daily with a phone call, symptoms survey, and instructions on what to do in case symptoms develop. They’ve been asked to remain at home and all were provided with surgical masks to wear.
The confirmed MERS patient’s family members have also been asked to remain at home and to wear masks to prevent the spread of possible infection.