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Saturday, May 17, 2014

...Transmission risk considerations


..Most MERS infections have occurred in the Middle East or have been directly linked to a case in that region. Though sporadic imported cases have been occurring since early in the outbreak, secondary infections have been more rare but did occur after primary cases were detected in the United Kingdom, France, and Tunisia.
Global and national health officials have said the risk of secondary infections is low and limited mainly to people who had unprotected, close contact with MERS patients, such as family members or healthcare workers. Today's CDC announcement raises questions about the level of contact that puts people at risk, with a business meeting presumably reflecting a lower level of contact than a care-giving scenario involving a sick family member or hospital patient.
Swerdlow told reporters that the virus still doesn't appear to spread among humans easily in a sustained way, but he added that aggressive testing will not only help flesh out transmission patterns but also reveal more about what appears to be a broader range of severity for the disease, from no symptoms to severe and sometimes fatal pneumonia. "We don't understand a lot about how the virus is transmitting, so we're casting a wide net, hoping to learn more," he said. "Our most important point is that doctors should be vigilant."
"We don't think this changes the risk to the general public or public health practices," Swerdlow said.
The Illinois man's illness, though considered the third US infection, won't be reflected in the global MERS count, because positive serology results aren't included in the World Health Organization (WHO) case definition for MERS, Swerdlow said.
Michael T. Osterholm, PhD, MPH, director of the University of Minnesota's Center for Infectious Disease Research and Policy, publisher of CIDRAP News, said one case doesn't change the picture and the event is consistent with other examples of MERS spread.
Though the risk of transmission still appears to be low, he said there's a lot that is still not known about the disease—for example, whether some patients are "super shedders" who are more likely to transmit the disease to others.
"All of us should be more careful to describe the risk to the public," Osterholm said, adding that the message should be balanced and not "oversell" a lack of risk....  http://www.cidrap.umn.edu/news-persp...s-illinois-man