A deadly virus that started in the Middle East is likely to come to Australia, health authorities warn.
Almost 200 people around the world have died and 600 have become sick from Middle Eastern Respiratory Syndrome (MERS) since it was identified in 2012.
Australia’s chief medical officer Professor Chris Baggoley has just returned from Geneva where he chairs the World Health Organisation’s committees on the MERS virus.
He says the disease is likely to come here.
“There have been cases now in 11 countries,” he said. “I think we could well get a case.”
MERS started in the Middle East and has since been detected around the world. It is related to the deadly SARS virus, which killed 800 people in 2002.
The virus is considered less contagious but more deadly than SARS.
People travelling to affected areas such as the Middle East have been warned to be vigilant.
Professor Baggoley says Australian authorities are well-equipped if a case emerges on our shores.
“If we get a case, we are well prepared,” he said.
MERS virus in Australia but no human cases
To date there have been no cases of MERS in Australia, but there are samples of the virus in the CSIRO’s high-security laboratories in Geelong.
Researchers have been studying samples of MERS in their labs for the past 12 months.
They are looking at the genetic make-up of the virus and how different immune systems respond in the hope of finding screening tests.
Researchers are also screening Australian camels for the virus. The MERS virus is spread to humans through contact with camels.
There are about 300,000 camels in central Australia and some are exported to the Middle East.
CSIRO researcher in emerging zoonotic disease Gary Crameri says it is unlikely Australian camels have the virus.
“But we do have the bat species [in Australia] that were the original reservoirs of the virus,” he said.
“Although we’ve only had camels here for just over 100 years it’s unlikely, but it’s certainly a possibility.”
Mr Crameri says no Australian bats or camels have tested positive for MERS.
Virus starting to spread
The World Health Organisation says there have been 632 confirmed cases of MERS infection globally and 193 deaths.
In the Middle East, the virus has appeared in people who deal with camels and spread to health workers caring for them.
There were two unlinked cases in May in the United States. One was in Indiana and the other in Florida.
Both were healthcare workers who had been working in the Middle East.
A contact of the Indiana patient in Illinois also tested positive for the virus but only reported mild cold-like symptoms.
Cases of MERS virus have been reported in several Middle East countries including Saudi Arabia, Jordan, Qatar, Kuwait, Oman and the United Arab Emirates.
There has also been cases in Europe, Africa and Asia.
The pathogen was also found in camels in Nigeria, Tunisia and Ethiopia between 2009 and 2011, suggesting the virus is more widespread.
In Australia, some travel agents have told the ABC they are recommending that the elderly and children not travel to the Middle East.
As more Australians are travelling around the world, particularly through the Middle East, scientists say there is a risk it will come here.
Mr Crameri says the virus is not easily transmissible.
“The risk of picking it up through a loose contact or through a plane is very small,” he said.
“For people just passing through the Middle East or staying in cities, there’s very little risk whatsoever.
“It’s possible people who have contracted the disease in the Middle East may come to Australia.”
MERS less contagious but more deadly
Virologists say at this stage MERS does not appear to be as contagious as its cousin, SARS. This is because it presents as a lower-respiratory cough-like illness.
SARS, by contrast, had more cold-like symptoms such as sneezing that allowed it to spread more easily.
However among those confirmed cases of MERS, more people die compared to SARS.
Symptoms include fever, cough and shortness of breath. The death rate is about 40 per cent.
It is also said to grow more aggressively than SARS in lab conditions.
Doctors say they can only study cases that end up in hospital and that it is also possible that many people contract the virus without symptoms.
Many cases of the illness have occurred among camel herders and people who visited camel farms or consumed unpasteurised camel milk.
In some instances, the virus has spread from person to person through close contact, such as caring for or living with an infected person. However, there is no evidence of sustained spread of MERS virus in community settings.
The WHO says it is not a public health emergency given the lack of sustained human-to-human transmission.
In Australia, doctors have been reminded to watch for the illness in returned travellers.
Authorities on alert
In the United States, warnings about the potential threat of MERS are being posted at airports.
However experts suggest airport body heat screening programs, like those seen during the SARS outbreak, are likely to be useless.
Patients typically do not get a fever while a virus is incubating and can cross borders undetected.
In Australia there are six phases of pandemic preparedness: alert, delay, contain, sustain, control and recover.
The Department of Foreign Affairs Smart Traveller website advises people travelling to affected areas to avoid camels and take health precautions such as good hand hygiene.
Airlines closely monitoring virus
Australia’s national airline Qantas now flies through the Middle East.
A Qantas spokesman says it is closely monitoring the virus and following advice from the World Health Organisation.
The airline says it has made all employees and travellers aware of the virus and is warning them to take appropriate precautions.
“Whilst the illness can be serious, there have only been very small numbers of people affected by the virus,” he said.
“The situation has not been declared a pandemic.
“The WHO does not advise special screening at points of entry with regard to this event nor does it currently recommend the application of any travel or trade restrictions.”
Mecca precautions
There are also concerns about the potential for the MERS virus to spread during annual pilgrimages to Mecca in Saudi Arabia.
Saudi Arabia already suggests that pilgrims over 65 or under 12 and pregnant women do not make the journey.
Sydney community leader Bilal el-Hayek went to Saudi Arabia in April and plans to go back twice more this year.
“We’ve got a lot of families that travel to the Middle East, day in day out, whether it’s Lebanon, Saudi Arabia, Turkey, Iraq, Iran – all that part of the world,” he said.
“So we need to create awareness for these families. This is the disease and these are the precautions they need to take to avoid any catching that disease.”
He says travellers are generally unconcerned about contracting MERS while on a pilgrimage.
“To be honest, there’s more people dying of smoking every day,” he said.
The World Health Organisation suggests vulnerable people, such as the elderly, sick or pregnant, consult their doctor before travelling.
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