A Saudi man who died from the MERS virus probably caught it after caring for one of his sick camels, the most conclusive evidence so far that the humped mammals can infect humans.
The 44-year-old man died in November with Middle East respiratory syndrome, about a month after treating a dromedary camel with nasal discharge, researchers from King Abdulaziz University in Saudi Arabia wrote in the New England Journal of Medicine. Samples taken from both patient and camel found a genetically identical virus, the authors said.
Previous studies found the bug in camels from the Canary Islands to Ethiopia, along with signs that many of the people infected had contact with the animals. But there was no conclusive evidence of transmission until now.
“Camels may act as intermediate hosts that transmit the virus from its reservoir to humans,” the authors wrote. “The exact reservoir that maintains the virus in its ecologic niche has yet to be identified.”
The man in the study kept nine camels in a barn about 75 kilometers (47 miles) south of Jeddah, the authors wrote. The patient and three of his friends visited the camels daily. The owner fell ill about 7 days after applying a topical medicine in the nose of one of the four sick camels, his friends told scientists. The friends, who had no direct contact with the animals’ secretions, remained free of the virus.
The man first developed fever, a runny nose and a cough, followed by severe shortness of breath that caused him to be hospitalized. He died two weeks later.
Saudi Arabia yesterday increased its estimate of the death toll from the virus to 282 from 190 and the total number of cases to 688 from 575 after a review of cases stretching back to 2012. The government also fired deputy health minister Ziad Memish, six weeks after relieving health minister Abdullah al-Rabeeah of his duties.
MERS first came to light when a 60-year-old Saudi man died with severe pneumonia and kidney failure in Jeddah in June 2012. Since then the virus has spread globally, with cases reported in Europe, Africa, Asia and the U.S.
The virus belongs to the same family of pathogens as SARS, which killed about 800 people worldwide after first appearing in China more than a decade ago.
MERS causes fever, cough and shortness of breath, leading in severe cases to respiratory failure, organ failure and death. People with weakened immune systems such as the elderly and those with diabetes, cancer or chronic lung disease are most at risk. There’s no vaccine and no specific treatment.
The World Health Organization’s emergency committee last month decided against declaring MERS a global health emergency, citing the lack of evidence for sustained human-to-human transmission. Most of the infections have been because of poor infection-control practices in hospitals, the WHO said.
Saudi Arabia expects millions of Muslims from around the world to perform the annual Hajj pilgrimage to Mecca and Medina in early October. The WHO doesn’t recommend any travel restrictions related to MERS, though Saudi Arabia has suggested that pilgrims over 65 years or under 12, and pregnant women, refrain from the journey.