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Risk for MERS-CoV importation to Canada low
While Canada’s risk for Middle East respiratory syndrome coronavirus importation is low, the acquisition of other respiratory virus infections abroad or domestically after return to Canada may be fairly high and ongoing, according to recent data.
Researchers from Ontario’s public health department evaluated 177 travelers returning to the province between November 2012 and June 2014. These individuals were deemed persons under investigation (PUIs) for MERS-CoV, based on Ontario Ministry of Health and Long-Term Care guidelines, and were recommended for isolation and screening for MERS-CoV and other pathogens. The mean age of the PUIs was 48.1 years; 56% were males, and 54.8% had returned from Saudi Arabia or the United Arab Emirates. PUI identification peaked after the October 2013 hajj and after the May 2014 importation of the first two MERS-CoV cases into the United States.
The researchers collected and analyzed nasopharyngeal swabs and bronchoalveolar lavage specimens from PUIs. The specimens were assayed with real-time reverse transcription PCR (rRT-PCR), as well as influenza rRT-PCR. Specimens positive for influenza A virus were subtyped for seasonal influenza A(H3N2) virus hemagglutinin gene and influenza A(H1N1) pdm09 virus. Respiratory samples then were tested for rhinovirus, enterovirus, influenza A and B viruses, parainfluenza viruses 1-4, respiratory syncytial virus A and B, adenovirus, bocavirus, human metapneumovirus, human coronavirus OC43 and human coronavirus 229E/NL63.
The researchers detected at least one respiratory pathogen in 50.3% of PUIs. Of these pathogens, 98% were viral only. The most prevalent virus detected was influenza, with positive tests for influenza A, 15.3%; A(H3N2), 7.9%; and A(H1N1)pdm09; 7.3%. Influenza B and rhinovirus were identified in 7.9% and 19.8% of PUIs, respectively, with a noticeable uptick for rhinovirus during the fall. Likewise, influenza A(H3N2) peaked in the fall, while influenza B and A(H1N1) pdm09 peaked in late spring. None of the samples tested positive for MERS-CoV.
“Influenza vaccination should be a priority for all persons and should be recommended by health care practitioners who advise travelers,” the researchers wrote. “In addition, surveillance should continue for other respiratory pathogens so that their effects on health systems, when they co-circulate with emerging pathogens with similar clinical presentation, can be better understood.” – by Jen Byrne
Disclosure: The researchers report no relevant financial disclosures.