Issue: June 2014
June 01, 2014
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CDC: No person-to-person spread of MERS among Midwest cases

Issue: June 2014

The CDC has concluded that the Indiana patient with Middle East respiratory syndrome, or MERS, coronavirus did not spread the virus to an Illinois resident during a business meeting that occurred before the patient became ill and hospitalized.

The Illinois resident tested negative for active MERS coronavirus infection by PCR assay just days after his interaction with the Indiana patient. CDC serology testing by immunofluorescent assay (IFA) and enzyme-linked immunosorbent assay (ELISA) showed that the Illinois resident was positive for MERS coronavirus antibodies.

“The initial ELISA and IFA serology results indicated the possibility that the Illinois resident had been previously infected with MERS coronavirus,” David Swerdlow, MD, incident manager for MERS coronavirus response activities for the CDC, said in a press release. “This compelled us to notify and test those people with whom he had close contact in the days following his interaction with the Indiana MERS patient.”

The patient underwent an additional, more definitive neutralizing antibody test. Based on those results, the CDC has concluded that the Illinois resident was not previously infected with MERS coronavirus.

“While we never want to cause undue concern among those who have had contact with a MERS patient, it is our job to move quickly when there is a potential public health threat,” Swerdlow said. “Because there is still much we don’t know about this virus, we will continue to err on the side of caution when responding to and investigating cases of MERS in this country.”

To date, no active MERS coronavirus infection has been identified in any contacts of the two people in the United States confirmed to have the disease. However, the CDC is continuing investigations, including voluntary serology testing of contacts.

According to Peter Hotez, MD, PhD, dean of the National School of Tropical Medicine at Baylor College of Medicine, person-to-person transmission of MERS seems to be confined to the Arabian Peninsula, where the level of person-to-person transmission still is not very high and typically requires close personal contact.

Peter Hotez

“So far, the threat of MERS developing into a global pandemic appears to be low,” Hotez told Infectious Disease News. “Having said that, coronaviruses have a propensity to mutate. Anything we say about MERS today, in a few months, could be a very different story.”

In terms of risk to Americans, CDC has not recommended any travel restrictions to the Arabian Peninsula, Hotez said, but WHO has suggested that people with certain underlying diseases or immune deficits should exercise more caution. — by Emily Shafer