Lebanon News

Hospitals on high alert, ready for MERS virus

BEIRUT: Lebanese hospitals are on “high alert” and ready to deal with any potential future cases of the highly contagious Middle East Respiratory Syndrome, health experts told The Daily Star Friday, after the country’s first case was confirmed a day earlier.

“Up until now, there are no other cases,” said Dr. Naji Aoun, an infectious disease specialist at the Clemenceau Medical Center, but added, “we are all on high alert.”

Aoun stressed that the CMC and other hospitals in Lebanon were well-equipped to handle patients with the viral respiratory illness, which appears to be spreading through the region after first being reported in Saudi Arabia in April 2012.

“The standards for precaution are applied everywhere,” said Aoun.

Health Minister Wael Abu Faour announced Thursday that the country’s first MERS case had been detected in a Lebanese man that had traveled to Saudi Arabia and several other Gulf countries. The Health Ministry is monitoring the safety measures being taken by the unidentified hospital that treated the patient, who has now been discharged, and is following up his treatment, according to Abu Faour.

He said Lebanese hospitals were ready to handle patients who had the virus, and that the ministry was monitoring epidemiological investigations to ensure it did not spread within Lebanon.

MERS is caused by a coronavirus, a virus that leads to illness in humans and animals, called MERS-CoV, according to the U.S. Centers for Disease Control and Protection (CDC). It produces symptoms very similar to the flu in those who contract it, with around 30 percent eventually dying from the virus, the CDC says.

To prevent its spread, individuals are advised to follow some basic precautions such as abstaining from coughing in public, washing their hands often, using hand sanitizer gels, not touching their face with unwashed hands, and avoiding close contact with infected people. Those with the virus should also be quarantined and kept away from others until they recover.

Echoing the health minister, Dr. Sleiman Haroun, head of the Association of Private Hospitals, told The Daily Star that local hospitals were “instructed and equipped” to deal with MERS.

“They have the know-how,” he said, explaining that treatment of the virus required more medical knowledge than equipment.

According to the general director of the Health Ministry, Walid Ammar, all hospitals already received training last year from the World Health Organization on combating viruses in general and would be getting a refresher course this month on how to handle MERS.

The training consists mostly of infection prevention and control measures to avoid any possible spread of the MERS virus as well as sessions to improve knowledge of the disease, Ammar said.

According to Dr. Hassan al-Bushra, WHO’s representative in Lebanon, a full plan to begin training hospital staff to treat MERS would be put in place “as early as next week.”

WHO announced Friday that it would hold a worldwide emergency meeting Tuesday at its headquarters in Geneva to discuss the virus.

According to Aoun, MERS came from camels and was initially restricted to the Arabian Peninsula.

“The transmission first occurred from camels to humans,” Aoun told The Daily Star. “Then it was transmitted from human to human, which was very rare [before].”

“The only way to get the virus is through exposure while on the Arabian Peninsula or to someone coming from there.”

Symptoms include a high fever, coughing, shortness of breath and diarrhea, and can lead to more serious conditions such as renal failure, pneumonia and even death. The virus has an incubation period of up to 14 days.

While in approximately 70 percent of the cases patients will eventually recover, some complications of MERS can be deadly, Aoun said.

MERS can lead to death in the case of individuals with very low immunity, such as children under 2 years old, the elderly, cancer patients and diabetics, among others, as they were more likely to experience complications, according to health professional. This makes it absolutely necessary that such individuals be quarantined in the event of contracting the virus.

According to infectious disease specialist Dr. Zahi Helou, the virus itself was “very contagious” and was transmitted “very quickly.”

“Our problem is there are planes coming in from Saudi Arabia every day,” Helou said. “There needs to be more control at the airport.”

Abu Faour gave an order to activate thermal scanners at Beirut airport Thursday in order to detect fevers among travelers.

A source at the airport said only those suspected of having the disease were being scanned. If they appear to have a high temperature, “they are then being transferred to local hospitals to go through a full examination and confirm if they really have the MERS virus,” the source added.

As to whether there might be other cases already in the country, Haroun admitted there was a possibility but said that several previously suspected cases had turned out to be false alarms.

“When in doubt, the patient can take the tests at the Rafik Hariri University Hospital and be put in isolation,” he said.

Lab tests, in particular the polymerase chain reaction test specific to the coronavirus, can determine whether an individual is infected within one to four days. However, the PCR test is only available at Rafik Hariri University Hospital.

Although there are no vaccinations or anti-viral treatments to prevent people from becoming infected, there are ways to control the symptoms, such as quarantining the patient, prescribing drugs to lower fever, alleviating coughing and treating shortness of breath and diarrhea.

As of May 3, 489 cases, including 126 deaths, had been reported to the World Health Organization globally. Some 406 cases, including 101 deaths, were from Saudi Arabia. There are recent reports of three cases in Jordan and one case each in Egypt, the United States and Yemen, according to WHO.

Cases have also been reported in Qatar, Kuwait, Jordan, United Arab Emirates, Oman, Tunisia, France, Germany, Italy, Greece, Britain, Malaysia and the Philippines.

According to the WHO’s findings in the Saudi city of Jeddah, the majority of the human-to-human infections have occurred in health care facilities, and one-quarter of all cases have been health care workers.

Three-quarters of all “primary community cases” have been male, the majority of whom were over 50 years old.

Current evidence also does not suggest that a recent increase in numbers reflects a significant change in the transmissibility of the virus, according to WHO. The upsurge can instead be explained by an increase in the number of primary cases amplified by several outbreaks in hospitals due to breaches in infection prevention and control measures.

While caring for an infected patient, doctors are advised to wear N95 respirator face masks that filter most of the airborne particles, according to specialists.

Individuals traveling to the Arabian Peninsula, and Saudi Arabia in particular, should wear face masks too. People would also need to do so if they are around individuals who have recently returned from the kingdom or are frequent travelers to the region.

According to Helou, as long as individuals are cautious and follow basic hygiene precautions, there is no need to fear the virus.

“There is an exaggerated panic, there is no need for it.” – Additional reporting by Jana El Hassan

A version of this article appeared in the print edition of The Daily Star on May 10, 2014, on page 3.




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