CDC reopens SARS playbook from 2003

The Centers for Disease Control is using its playbook from the 2003 SARS virus scare to handle a new pandemic that has killed 173 people in the Middle East.

SARS, the severe acute respiratory syndrome, killed 774 people, but the new Middle Ease Respiratory Syndrome (MERS) is seen as even more dangerous because it has killed one in three people who have come into contact with it, compared to one in 10 for the 2003 virus.

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More than 500 people have been infected with the virus in the Middle East, though there have been only three cases so far in the United States.

Altogether the CDC has 300 workers involved in trying to prevent MERS from spreading in the U.S.

To keep it from spreading further, the CDC is taking the following steps.

Quickly identify patients

The first step to preventing a pandemic from spreading is to identify those with the virus and keep them from spreading it further.

In the case of the Middle East virus, two of the cases known so far in the U.S. have been in healthcare workers who recently worked in Saudi Arabia. One patient in Indiana has now been released from the hospital, while the second patient in Florida is under care but recovering. A third case confirmed Saturday was an Illinois business associate of the victim from Indiana.

The pattern of a virus hitting people working in healthcare is similar to SARS.

“A lot of the transmission in SARS was in healthcare settings and healthcare workers who were providing care to people who got sick and that is what we’re seeing with MERS,” said CDC spokesperson Thomas Skinner.

After the SARS outbreak the CDC knew it was only a matter of time before something similar would challenge the agency and the CDC has been preparing for a new virus that might affect healthcare workers.

“Over the past couple of years we’ve been working with state health departments and hospital associations to prepare for the arrival of this virus,” said Skinner. “We’ve been emphasizing to healthcare workers…of the need to quickly identify patients, test them, properly diagnose them, isolate them, and for healthcare workers to take the necessary steps to protect themselves so hopefully this is going to pay off.”

Ready test kits

As soon as the first cases of MERS emerged in 2012, the CDC got their hands on the virus so they could develop a test kit to help detect it.

By 2013 the agency had distributed the test kits to most state health departments and those that don’t have the tests can ship their samples to the CDC for analysis.

The test kits look for strands of the MERS coronavirus in the sputum of patients suspected of having contracted the disease.

In the Illinois case, the victim had been initially cleared with the test kit but later blood work showed MERS anti-bodies that suggested he had recently infected with the virus.

Emergency Operations Center activated

Immediately after the CDC confirmed the first case of MERS in Indiana it activated its Emergency Operations Center to coordinate a response.

Six officials were sent to the Hoosier State to begin tracking down everyone the patient had come into contact with. Hundreds of other CDC staff around the country also helped with the efforts.

The agency spent over a thousand man-hours tracking down all the passengers and crew the Indiana victim had come across on his flight between London and Chicago.

The agency has also tracked down most of the people he came across on his bus trip from Chicago to Indiana. In some cases, the CDC was able to use credit card information to track people down and ensure they had not been infected.

Because some people paid their fares with cash, however, the agency hasn’t been able to track down everyone.

The second case of MERS in the U.S. detected in Florida is even more complicated as the victim flew three flights between London to Boston to Atlanta and finally Orlando.

Skinner says the CDC is still tracking down well over 500 passengers the carrier came into contact with but those passengers have dispersed to approximately 33 different states.

Continuing vigilance

Amesh Adalja, a University of Pittsburgh physician and member of the Infectious Diseases Society of America, says its lucky the U.S. hasn’t had more cases of MERS and sooner.

He notes that unlike SARS, MERS has not been as good at jumping person to person outside of healthcare settings but if it did it would be a major red flag the disease could become an epidemic.

Adalja also notes in the past few months there’s been a spike of MERS infections in the Middle East, which could explain why there have been more cases in the U.S. and elsewhere.

Skinner says considering the recent rise in MERS cases abroad he wouldn’t be surprised to see more cases popping up in the U.S. as well.