Should you be worried about MERS?

Story highlights

MERS has shown limited human-to-human transmission, but cases rising in Korea

Vast majority of South Korea cases confined to hospital infections

MERS patients who died in South Korea had underlying medical conditions

Hong Kong CNN  — 

The numbers sound scary as cases and deaths of MERS mount daily in South Korea.

People are commuting with face masks in a densely crowded Asian capital, schools are shutting doors and mandatory quarantines are in effect. But what really are the risks and dangers to the general public?

As one official said, South Korea is fighting two battles: MERS and public fear.

Should I be worried about getting MERS?

Not really.

“It’s not a very contagious disease,” said Dr. Stanley Perlman, one of the authors of a comprehensive MERS review published in the journal Lancet this month. “Personally, people shouldn’t be worried, but I can understand the fear factor.”

South Koreans are being told to take basic preventative measures like keeping hands clean, covering coughs and avoiding personal contact.

Steps to prevent MERS

  • Wash your hands often with soap and water for at least 20 seconds. Use an alcohol-based hand sanitizer if soap and water are not available.
  • Cover your nose and mouth with a tissue when you cough or sneeze, then dispose of the tissue.
  • Avoid touching your eyes, nose and mouth with unwashed hands.
  • Avoid personal contact, such as kissing, or sharing cups or eating utensils, with sick people.
  • Clean and disinfect frequently touched surfaces and objects, such as doorknobs.

  • Source: CDC

    A person with MERS is estimated to infect less than one other person. It’s called a basic reproduction number that estimates the average number of people that a sick person will infect.

    Compared with the reproduction number for Ebola, (in which one infected person is likely to spread the disease to two other people) or measles (one infected person is likely to to spread the infection to 15 other people), the rate of MERS is low indeed.

    How infectious is MERS?

    Here’s what the science shows: A 2014 research looked at how many people got ill after living in the same home as MERS patients in Saudi Arabia, the country most affected by MERS, Of 280 people who lived in the same households of the Saudi patients, 4% were infected, according to the research published in the New England Journal of Medicine.

    If you haven’t been sick at a South Korean hospital, and you haven’t traveled to Saudi Arabia, you really need not panic. Experts say your risk is low.

    Read: Are we ready for the next global outbreak?

    But could the virus change?

    The MERS virus could mutate – in the same way viruses are known to undergo changes and genetic recombinations. But right now, there is no evidence of genetic mutation in what’s been found in the South Korean cases compared to the Saudi cases.

    But coronaviruses are prone to mutation, which could increase risk of a pandemic.

    So, why are more cases popping up in South Korea?

    That’s one of the most important questions right now.

    The World Health Organization has a fact finding mission this week to examine what’s happening with MERS in South Korea.

    South Korea has a modern and sophisticated health care system. And that could be one of the reasons why the country is reporting so many cases. They’re testing people who could’ve been exposed or are showing any possible symptoms of MERS.

    MERS symptoms are fairly general including cold-like symptoms, cough, fever and nausea.

    CNN asked the Ministry of Health how many people in the country have been tested for MERS, but have not gotten a number.

    Shouldn’t growing number of MERS concern us?

    The MERS count includes people with mild symptoms, and at least one of the confirmed cases has been completely asymptomatic.

    The growing case count doesn’t mean everyone with MERS is gravely ill. Several patients have been cleared and hundreds have been released from quarantine.

    How did the MERS outbreak start in South Korea?

    The first MERS patient in South Korea traveled to four Middle Eastern countries. After he developed symptoms, he visited four health care facilities back home. This means he exposed his fellow patients, their families and health care staff in several facilities before getting diagnosed.

    “I think it’s the combination of poor initial handling of the first patient,” said Perlman. “When a MERS patient came to the U.S. or Europe, they were isolated when there was hint of something going on. In this case, the patient wandered around hospitals and family members weren’t protected and that’s the reason why it’s gotten worse than other non Arabian countries.”

    Why does it matter that the MERS cases occurred in hospitals?

    The bulk of the latest MERS cases have come from two hospitals: St. Mary’s, located south of Seoul, and the Samsung Medical Center, based in Seoul’s glitzy Gangnam district.

    Similar to emergency rooms in the United States, hospitals in Korea are often crowded with sick patients waiting to get care. They are exposed to each other in close proximity.

    Also in South Korea, family members rather than nurses often stay bedside by patients, changing them and taking care of them. This also exposes them to additional risk of infection.

    Hospital-based MERS outbreaks are by no means new though.

    Saudi Arabia reported a 2013 outbreak that infected 23 patients in an intensive care unit. In that outbreak, 15 people died.

    How deadly is MERS?

    Like many viral diseases, MERS is much more lethal for people who are already severely ill. Of those who’ve died in South Korea after contracting MERS, the deceased patients had pre-existing conditions including cancer, COPD and chronic heart disease.

    “There’s a lot of illnesses that make people more prone to infection,” Perlman said. “The obvious are asthma, emphysema, lung disease might not be able to handle infection very well.”

    MERS globally has been known to carry about a 30 to 40% death rate. But the death rate in the South Korean outbreak has consistently remained been under 10%.

    Perlman says he believes the death rate could be lower because South Korean health authorities are finding more cases including mild ones that may not have been picked up before.

    Should kids stay home from school?

    Not really. Of nearly 100 cases in South Korea, only one of the MERS cases is a teenager. This doesn’t mean that children don’t get infected – but it’s worth looking at the facts that the vast majority of the MERS patients are older.

    Perlman says he doesn’t think shutting schools is ideal since the virus is not very contagious, but said he “can understand why people worry.”

    Does MERS pose a threat to the United States?

    Well, MERS has already popped up in the United States in 2014 – long before the South Korean cases.

    Both cases in the United States involved health workers who worked in Saudi Arabia and traveled to Indiana and Florida.

    The World Health Organization doesn’t recommend any travel or trade restrictions.

    Hong Kong, which grappled with SARS over 10 years ago, issued a red alert warning travelers to avoid non-essential travel to South Korea.

    Speaking of SARS, are the two related?

    MERS is in the same family of viruses as SARS (severe acute respiratory syndrome – coronavirus) as well as the common cold. However, unlike SARS, which sickened more than 8,000 people in 2003 and killed 773 worldwide, MERS does not spread easily between humans.

    SARS eventually waned because health officials quarantined people who were exposed and contained the infection.

    Are there worrying aspects of MERS?

    Yes, it comes down to the fact that scientists don’t know much about MERS. It’s a relatively new syndrome and there is no vaccine or cure. And the exact mode of how MERS is transmitted remains unknown.