Canadian health authorities are on red alert against the threat of MERS – Middle East Respiratory Syndrome. Since September, 2012, when the first case was reported in Saudi Arabia, more than 3,000 Canadians have been screened for the MERS coronavirus but the Public Health Agency of Canada has reported that no cases have been found. Cases of MERS worldwide remain in the low hundreds. However, more than 45 per cent of all cases have been recorded this month, prompting the World Health Organization to warn countries to be on the lookout for MERS in people returning from Middle East. The SARS-like virus can cause coughing, fever and pneumonia, but MERS is far more deadly than SARS, with a reported death rate of more than 40 per cent, compared to 10 per cent for SARS. Nevertheless, Dr. Brian Schwartz, chief of emergency preparedness for Public Health Ontario, answers questions about what Canadians need to know about MERS.
When is MERS expected to hit Canada?
Every case of the MERS coronavirus outside of the Middle East has been directly linked to a travel case. There's no predicting that we'll get one within one month, three months or six months, but the more cases there are in the Middle East, the more likelihood there is that a travel case will arrive in Canada.
How is Canada watching out for MERS?
Public Health Ontario laboratories – and it's the same in B.C. and the national medical laboratory – are conducting tests for MERS on suspect cases that are identified in the healthcare system, because we do know that some people will come back from the Middle East with a respiratory infection. [In Ontario] we've conducted dozens of tests already, all of which have been negative.
What is the treatment for MERS? Are antivirals such as Tamiflu effective?
There's no specific treatment for the MERS coronavirus. It's basically supportive treatment – making sure that people are well hydrated and have appropriate oxygenation and ventilation. I'm not an infectious diseases expert, but to my knowledge, antivirals have not been effective. For some reason, it's not easy to create a vaccine against this virus either. I'm not sure why that is.
How fast does MERS run its course?
It depends on how sick people are. Mild cases seem to resolve within a week or two. The more serious cases can be on mechanical ventilation for some time. Some of them do recover.
What can people do to avoid catching MERS?
Members of the public have no reason to be concerned about MERS. It's not a community-acquired illness like influenza, which you can get if you're standing beside someone who is coughing. MERS is either transmitted in close-contact household settings, or in hospital settings. People need to practice really good infection prevention control all the time by washing their hands and staying home when they're sick. I think that goes as far as anything to protect us from transmission of the respiratory diseases that we have here, and the ones that could be imported.
What will Ontario hospitals do in the event of MERS?
When we have a confirmed case, the Ontario Ministry of Health will open up its emergency operation centre. Healthcare workers will be wearing facial protection, gowns and gloves, and the patient will likely be in a negative pressure room. Given our experience [with SARS] in Ontario, I'd rather over-respond than under-respond. Concentrated efforts will be made to find any individuals that the person was in contact with so they can be kept under surveillance – we won't likely quarantine them. One of the things we know about MERS is it is not infectious before symptoms appear, and that was the case with SARS as well, [but] we didn't know that at the time.
This interview has been edited and condensed.