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Respiratory Syndrome Coronavirus

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C228 Task II Respiratory Syndrome Coronavirus
Susan K. Fendley
Western Governors University

C228 Task II Respiratory Syndrome Coronavirus
Communicable Disease Outbreak
Respiratory Syndrome Coronavirus is also known as MERS CoV which stands for Middle Eastern Respiratory Syndrome Coronavirus. According to the World Health Organization, Middle Eastern Respiratory Syndrome (MERS) is a viral respiratory illness that is caused by a novel coronavirus (CoV). MERS CoV was first identified in Saudi Arabia. In 2012, the Jordan Ministry of Health began investigating an outbreak of a lower respiratory illness in a Jordanian hospital. In this initial outbreak, there were nine (9) confirmed cases with two (2) fatalities. Globally, since September 2012, the World Health Organization has been notified of 1,365 laboratory-confirmed cases of infection with MERS-CoV, including at least 487 related deaths. (“WHO,” 2015). Since the first case identified in 2012, there have been new cases yearly in Oman, Republic of Korea (2015), United Arab Emirates, Jordan, Saudi Arabia (2012), the Philippines (2014), United Kingdom (2015), Kenya (2016), Kuwait, Qatar, China, Iran, Germany(2014), Turkey and Austria (2014) and two isolated cases in the United States (2014). (“MERS CoV Outbreak,” n.d.).
MERS CoV Route of Transmission
Based on several studies, the MERS CoV has been traced to Dromedary Camels. One study revealed extremely high titer levels of neutralizing antibodies to MERS CoV in the blood serum of the camels. Further studies show MERS CoV isolated from nasal swabs from camels. It is unclear exactly how the virus is transmitted from camels to humans but the World Health Organization has warned against touching or direct contact with camels, avoiding drinking camel milk or camel urine and only eating fully cooked camel meat. It is also advised that people who are in direct contact with camels should wear a mask. It is believed that human to human transmission occurs with close, personal contact of those severely ill with the virus and by contact with respiratory secretions. (“Transmission of MERS CoV” n.d.). On May 3rd, 2015 a 68 year old man from South Korea went on a business trip to Barhain, Saudi Arabia and returned to South Korea the next day---May 4th, 2015. Within 7 days, he began to exhibit symptoms of MERS CoV. The initial symptoms were described by his family as merely those of a common cold. Because the symptoms were not unusual and the threat of MERS CoV was not suspected by the South Korean government, the man went about as usual without any restrictions and certainly without being quarantined. Between the flights to and from Saudi Arabia, interaction with family, co-workers and medical staff, the transmission of the MERS CoV organism was being spread from person to person without anyone’s knowledge. By June, 14th, 2015 there were 78 confirmed cases in South Korea and the cases continued to increase from there. (“South Korean Outbreak,” 2015)
Risk Factors
Traveling to a foreign country, especially one in or around the Arabian Peninsula is a definite risk factor as the outbreak began there and has continued to spread in that region. Small children, the elderly, people with immunosuppression or those in poor health would be at highest risk for contracting the virus. Also, close contact with camels would put someone at a much greater risk. (“Risk Factors,: n.d.)
Outbreak Effect on the Community
An outbreak of MERS CoV would have an enormous negative impact on a community. First, there would be panic among the people, as there always is with any type of disease outbreak. Doctor’s offices and local Emergency Departments would be filled with those people who are fearful of becoming sick or dying. The symptoms of MERS CoV closely resemble those of any other acute respiratory infection so there would be a lot of lab testing to differentiate between the two. Most physician’s offices, hospitals and laboratories would need extra staff or the available staff would be working extra hours. Also, a large outbreak would be difficult to contain because of a limited number of isolation rooms in each facility. There would be lots of absences from work and school resulting in lost work productivity and the stress of having to make up schoolwork for students. The local Health Department would be impacted as they would be responsible for keeping up with the number of current cases, number of new outbreaks and continuous reporting to the CDC and WHO. Local businesses like stores, pharmacies and funeral homes would likely be affected with increased demand for medications, supplies for cleaning and disinfecting and funeral arrangements for the fatalities.
Community Reporting Protocol
With a confirmed diagnosis of MERS CoV through blood testing, the hospital would need to report this to the local health department who would in turn report it to the CDC.
Plan
The most important step in the plan would be to isolate or quarantine anyone with the virus to prevent the chance of spreading the virus. The public would need to be made aware of the virus and educated on how the virus is spread and how to prevent it. Local health department officials would need to be in contact with all healthcare providers for information regarding new cases of the illness.
Strategies for Outbreak Prevention
Educating the public would be the most valuable tool in preventing the spread of the illness. The public should be taught to see their doctor if they have a fever of 100.4 F degrees or higher along with cough and difficulty breathing----especially for anyone who has recently traveled to, or near, the Arabian Peninsula. Also good personal hygiene and frequent, adequate handwashing techniques should be taught to the public. Also education about avoiding close personal contact with sick people and covering their mouth with a tissue when coughing or sneezing would be very important. The local TV stations would need to carry information keeping the public informed about the virus, number of cases, precautions and areas to avoid. Written materials like information sheets and pamphlets could be distributed to schools, places of business, restaurants, churches and any other public places to educate and inform the public.
(“Outbreak Prevention,”n.d.).
REFERENCES

MERS CoV Outbreak. Retrieved on March 2, 2016 from https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome Outbreak Prevention, n.d. Retrieved on March 2, 2016 from http://www.who.int/emergencies/mers-cov/en/
Risk Factors, n.d. Retrieved on March 2, 2016 from http://www.cdc.gov/coronavirus/mers/index.html
South Korean Outbreak, 2015. Retrieved on March 5, 2016 from https://en.wikipedia.org/wiki/2015_Middle_East_respiratory_syndrome_outbreak_in_South_Korea Transmission of MERS CoV retrieved on March 2, 2016 from https://en.wikipedia.org/wiki/Middle_East_respiratory_syndrome
WHO. 2015 Retrieved on March 2, 2016 from
http://www.who.int/csr/don/03-july-2015-mers-korea/en/

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