A team of experts who traveled to Saudi Arabia have reported that the new Middle East respiratory syndrome coronavirus (MERS-CoV) is easily transmitted in healthcare settings, posing a serious public health threat.

The researchers from Johns Hopkins University studied how the virus spread in four different Saudi hospitals. They published their findings in The New England Journal of Medicine.

MERS-CoV is much deadlier than the coronavirus responsible for the severe acute respiratory syndrome (SARS) in 2003, the authors wrote. MERS-CoV has killed 38 people worldwide so far, according to WHO (World Health Organization). Thirty-two of those deaths occurred in Saudi Arabia. According to the researchers, MERS-CoV kills 60% of the people it infects.

The virus is capable of person-to-person transmission and circulate in healthcare settings with “considerable morbidity.”

Trish Perl, MD, senior hospital epidemiologist for Johns Hopkins Medicine, and member of the research team, said that the team was able to gather much information about the virus thanks to swift action by local health officials and isolation and treatment of the infected patients.

The staff at the hospitals where the patients were treated handled the situation with remarkable care, ensuring that the patients were put in private rooms, and making sure other non-infected patients nearby wore masks and gloves.

Saudi health officials invited the team to help them with the investigation of the virus. As soon as the team arrived, they reviewed numerous medical records and analyzed blood samples collected from the four sites.

Some of the key findings include:

  • MERS-CoV has a much higher death rate than SARS (65 percent versus 8 percent respectively).
  • Symptoms of the virus include: coughing, shortness of breath, fever, or vomiting.
  • The average time from exposure to the virus to initial symptoms (incubation period) was 5.2 days
  • It takes 7.6 days for the virus to spread from one person to the next

Nine of the infected patients received dialysis treatment. One dialysis patient was transferred to a different hospital where more people became infected.

A further eight infected patients were also transferred, causing even more exposure of the virus, the team believe.

Dr. Perl said:

“The story of how this outbreak occurred and how this virus was transmitted became very clear once we started to lay out the evidence and saw that one infected patient had been in the hospital at the same time as another infected patient, and this patient was transferred to another hospital, where another patient became infected shortly thereafter.”

Perl added:

“Our investigation showed some surprising similarities between MERS and SARS. Both are very deadly viruses and easily transferred between people, and even between health care facilities.”

Some people appeared to transmit the virus faster than others – similar to SARS.

It is crucial to find out MERS-CoV incubation and generation times in order to prevent future outbreaks occurring, as it gives experts an idea of know how long they have to act, says investigative team member Derek Cummings, Ph.D., an associate professor at the Bloomberg School of Public Health.

The researchers concluded that careful monitoring can detect people who have been infected, so that they may be provided with treatment as soon as possible. Although there is no cure for MERS-CoV, many of the symptoms can be relieved. The next step is to develop a test to detect MERS-CoV, said Perl.

Margaret Chan, the Director-General of the World Health Organization (WHO) said that MERS-CoV is a “threat to the entire world”.

Written by Joseph Nordqvist