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 The World Health Organization convened an emergency meeting in
Geneva on Tuesday to decide whether the rising rate of confirmed
cases, most of them in Saudi Arabia, constitutes a "public health
emergency of international concern."
Florida officials said they were monitoring the health of 20
healthcare workers who had been in contact with the patient,
including a doctor who had already left for Canada. They also were
trying to track down nearly 100 people who may have overlapped with
the patient at two Orlando medical facilities he visited.
"We're not going to see the last of this," said Dr. Kevin Sherin,
director of the Florida Department of Health for Orange County. "We
are going to see more cases coming to our community. ... All of the
emergency departments in the United States, to be perfectly honest,
need to become very familiar with the Middle East Respiratory
Syndrome, and making sure the protocols are in place."
The Florida MERS case is the second on U.S. soil. Both involved
healthcare workers who spent time in Saudi Arabia before "importing"
the infection to the United States.
 The Transportation Security Administration, at the request of the
U.S. Centers for Disease Control and Prevention, is posting MERS
warning signs at 22 major U.S. airports, including all three in the
New York City area, a U.S. official said.
The warning notes that the risk to most travelers is low but that
people who get sick within 14 days of being in the Arabian Peninsula
should call a doctor.
Disease experts say it is crucial that hospitals ask anyone who
presents with fever or respiratory illness the person has recently
been to the kingdom.
"Travel history is very important to ask about," said Dr. Amesh
Adalja of the University of Pittsburgh Medical Center.
The virus, which causes coughing, fever and sometimes fatal
pneumonia, has been reported in more than 500 patients in Saudi
Arabia alone and has spread to neighboring countries and in a few
cases, to Europe and Asia. It kills about 30 percent of those who
are infected.
The CDC "is taking the current situation very seriously and is
working in close coordination with local health authorities," said
White House spokesman Jay Carney, who added that President Barack
Obama had been briefed on the confirmed cases.
The WHO said its conclusions would be announced at a news conference
on Wednesday. The last time the agency set up an emergency committee
was in response to the 2009 H1N1 "swine flu" pandemic.
EMERGENCY DEPARTMENT
MERS is a virus from the same family as SARS, or Severe Acute
Respiratory Syndrome, which killed around 800 people worldwide after
it first appeared in China in 2002. Like SARS, MERS spreads from
close contact with an infected person.
Officials at the Dr. P. Phillips Hospital in Orlando said on Tuesday
the two local healthcare workers exposed to the MERS patient in the
emergency department became ill, with one developing symptoms within
24 hours of being exposed to the patient and one within 72 hours of
exposure.
One of the workers has been hospitalized and the other is being
isolated in his home and monitored.
Hospital officials said the workers' symptoms developed a bit
earlier than would be expected for MERS, which typically takes five
to 14 days to develop into symptoms. The hospital said it did not
yet know if the workers had MERS, but they were put in isolation as
a precautionary measure.
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The Orlando patient's case highlights concerns over how to prevent
the spread of infection, particularly among healthcare workers who
are vulnerable because of close contact with the sick. After
working in a hospital in Jeddah, Saudi Arabia, which has been
treating MERS patients, the healthcare worker flew to London and
reached the United States on May 1.
Although he had already begun to experience symptoms on the flight,
they were mild, and he did not seek treatment at the Orlando
hospital until last Thursday.
Last week, he visited with family and accompanied someone to another
Orlando medical facility for a procedure. Even when he reached the
emergency department close to midnight at Dr. P. Phillips Hospital,
it was not until mid-morning the next day that he was placed in
isolation.
'IN GOOD SPIRITS'
Since the hospital is less than 10 minutes from the Universal
Orlando and Walt Disney World theme parks, the staff is on alert to
diseases from other countries. It conducted a drill last year that
involved a fictitious case of MERS.
Orlando hospital officials said the MERS patient was doing well and
had a low-grade fever and a slight cough.
"He's in good spirits. He's cooperating ... we have not decided yet
when he will go home," said Dr. Antonio Crespo, chief quality
officer at the hospital.
Crespo said the patient started experiencing muscle aches on his
flight from Jeddah to London on April 30. He developed a fever
during his flight from London to Boston, where he took connecting
flights to Atlanta and finally Orlando.
Because of his travel history, the hospital suspected MERS and
contacted the health department. An initial MERS test on Friday was
"equivocal," but a test sample taken on Saturday confirmed the
virus.
Even so, healthcare workers in the emergency department who attended
to the patient were not wearing masks before it became clear that it
might be a case of MERS.
The first U.S. MERS patient, who was admitted to a hospital in
Indiana late last month, has been discharged.
(Additional reporting by Kate Kelland in London , Sharon Begley in
New York, and Mark Hosenball in New York; Editing by Michele
Gershberg, Dan Grebler, Peter Cooney and Cynthia Osterman)
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