Nosocomial MERS outbreak shows more ‘intense transmission’ of disease.

An investigation of a large outbreak of Middle East respiratory syndrome, or MERS, coronavirus at a hospital in Saudi Arabia revealed a more “intense transmission” of the infection than previously recorded in other outbreaks. “Since the first diagnosis of [MERS] … in the Kingdom of Saudi Arabia in 2012, sporadic cases and clusters have occurred throughout the country,” the researchers said. “This large MERS outbreak in a major tertiary-care hospital in Riyadh was thought to be related to emergency department overcrowding, uncontrolled patient movement and high visitor traffic. The outbreak required institution of multiple measures to interrupt transmission, including almost complete shutdown of the hospital.” A man aged 67 years was admitted to the 1,200-bed hospital in June 2015 with a history of fever and cough. Despite no identified exposure to camels, reverse transcription PCR of a nasopharyngeal swab revealed the presence of MERS coronavirus (MERS-CoV). The patient died 31 days after admittance, and had no identified contact with any subsequent cases. Three weeks after the index patient was admitted to care, a second case of MERS was confirmed. After the hospital’s infection control program initiated an outbreak investigation to identify risk factors and exposures, 81 confirmed and 49 probable cases of MERS were identified at the hospital over approximately 2 months. One-third of these cases occurred among health care workers (HCWs), and the majority of all cases were linked to the hospital’s ED. Nearly three-quarters of patients required hospitalization, 16% were asymptomatic and 53% died. During the outbreak, the hospital initiated a pre-existing Infectious Disease Epidemic Plan developed from CDC and WHO guidelines. Despite strict enforcement of infection control practices, including hand hygiene and isolation of cases, more patients and HCWs continued to be infected, leading the hospital to close its ED, postpone elective surgical procedures and suspend all outpatient appointments and visits. These measures were associated with a rapid decline in new cases, and eventually led to the outbreak’s conclusion. culled from healio.com

MERS VACCINE !!!

An effective vaccine to protect against the Mers virus is a step closer,european scientists genetically modified a version of the smallpox vaccine to display Mers virus protein on its surface. The vaccine was able to protect camels - the animal reservoir for the virus - from developing Mers virus symptoms. Experts hope the vaccine might stop the virus spreading in camels and may also protect humans at risk from infection. Infections have been reported in 26 countries around the world with the outbreak epi-centre located in the Arabian Peninsula.There are no treatments for Mers but scientists are trying to develop an effective vaccine. One such scientist is Prof Bart Haagmans, who is based at the Erasmus Medical Centre in the Netherlands. He has been busy developing and testing vaccines in camels. A team of scientists drawn from the Netherlands, Spain and Germany, genetically engineered a pox virus called Modified Vaccinia Ankara -MVA - to display Mers virus spike protein on its surface. MVA, related to the virus used to eradicate smallpox, was used to eradicate smallpox and is currently being used to develop vaccines to a variety of viruses like influenza, Ebola and hepatitis C. Importantly it can produce antibodies and killer cells.The Mers spike protein is thought to be a major target for the immune response. The team hoped that by cloaking MVA with this spike they would train the immune system to recognize and kill Mers. The team took the engineered MVA, sprayed it up the noses of camels and injected it into their muscle, and then four weeks later they repeated the vaccination again. When the team exposed the vaccinated animals to the Mers virus the camels developed very mild symptoms. Crucially they didn't develop a runny nose and the amount of virus they produced was very low. Camels that hadn't received the vaccine produced very large amounts of virus and suffered a very runny nose. This indicates that even though the vaccine didn't prevent infection it did reduce the amount of virus that the vaccinated camels produced. story credit BBC news.

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