Novel Coronavirus Outbreak in the Mideast

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There are periods when certain kinds of outbreaks or infectious diseases gain popularity in the media, even though mankind has never really known a time in the absence of such disease. Several years ago, SARS made a big impression in Europe and the Americas; more recently the various forms of avian and swine flu struck fear in the hearts of bird and pig lovers everywhere. Mad cow disease emerges more regularly than one might think for a disease that rarely infects humans, even while meningitis–which is more common and harder to understand and control–infects humans more often (though still rarely).

The most recent viral outbreak, however, perhaps deserves some attention, though not exactly the kind it seems to be getting. The novel respiratory disease, recently officially entitled the Middle East respiratory syndrome, or MERS, by an international Coronavirus Study Group, is a coronavirus that infects the respiratory system causing acute pneumonia, renal failure, and death. Since the outbreaks began in September 2012, there have been forty confirmed cases with 20 fatalities.

Coronavirus

The coronavirus has humble beginnings. Not only has it been with mankind for millennia, but it was proven to be responsible for a majority everyday viral infections, more commonly known as the modern “common cold.”

Much more virulent strains do exist, of course. Depending on the strain, the coronavirus will infect either the upper or lower respiratory system. SARS-CoV, or the severe acute respiratory syndrome, was particularly notable for infecting both the upper and lower parts of the respiratory system while also spreading to other organs causing gastroenteritis and renal failure. SARS had its most serious outbreak in 2003, although it had existed in China long before that. The panic was mainly restricted to the European mainland, and since then the SARS virus has been contained, identified, and prevented from further spread. Strains of the virus are kept in global medical laboratories.

This most recent strain of the MERS virus was first found in a Qatari man traveling in Saudi Arabia as a tourist. The infection then spread to dozens of people, although the World Health Organization has said that the outbreak has not reached pandemic status and that there would be no reason to restrict travel or trade with or within the Middle East. It is still suspected, though not known for sure, that the virus is of animal origin. UK scientists who have isolated and identified the virus have suggested that it came from bats.

A Titular Battle

MERS was originally entitled “Saudi SARS,” which effectively distinguished it from “Hong Kong SARS” from 2003. Neither of the titles are very relevant or accurate, since the true origins (whether animal or not, or where exactly they emerged geographically) are not particularly important or relevant to the affects or treatment of the diseases.

These kinds of labels for diseases can actual be quite harmful, as the WHO and other health organizations have said that they do nothing more than impart a significant amount of stigma to the region. This stigma generates a large amount of unnecessary fear and panic in the general population, even when travel and living in both Saudi Arabia and China continue to be completely safe.

In an effort to avoid establishing unnecessary bias, the Coronavirus Study Group of the International Committee on Taxonomy of Viruses (ICTV) was founded to label the different strains. Although part of the group’s mission was to find neutral titles for the diseases that would not infer that any country or region was to blame, it was actually the ICTV itself which came out with the title “Middle East respiratory virus.” Supporters of this name–which has not yet been made official–look at the new title as a “fine compromise.” Others disagree.

The founders of the new name argue that including the disease’s broader region of origin in the title successfully avoids identifying Jeddah specifically or even Saudi Arabia, where the first case emerged. They say that “the Middle East is a very large region,” insisting that the bigger the region the more difficult it will be to subject it to inadvertent virus-related global stigma. Many people disagree with this assessment. Science magazine has reported this week that, despite the size of the Middle East, many people resent the inclusion of Middle East in the name of the virus, saying that it ends up doing exactly that which the ICTV set out to avoid: stigmatizing the region. Many people in the Middle East have gone so far as to call it an “ethnic slur.”

The discussion got particularly heated due to the infectiousness, mysteriousness, and dangerousness of the new coronavirus. Using the Middle East, a region already erroneously targeted in various global media as a place of terrorism, disease, and backwardness, in the title could have the effect of significantly aggravating the panic already sparked by the disease. This in turn could worsen the pre-existing global
bias against the Middle East increasing unnecessary fears of Muslims and Arabs who live around the world.

But even as the debate over the name continues, it remains safe to travel and trade in the Middle East and Saudi Arabia and the MERS virus, originally called human coronavirus-Erasmus-MC, has not been categorized as a pandemic.
To Panic or Not to Panic?

Although the disease is much stronger than the original 2012 “Hong Kong” SARS and is not perfectly understood by epidemiologists at medical universities in the Netherlands or UK, panic is not necessary or wise. If the disease did in fact come from bats, or some other animal, than the true “origins” of the virus may be impossible to know and could be anywhere. If the animals still carry the disease, then the new novel coronavirus could theoretically pop up in any country.

The World Health Organization and other global medical organizations do not advise a travel warning to Saudi or Jeddah and do not foresee the new MERS virus spreading farther than SARS did in 2003 and 2004. The strain is far deadlier, however, with the WHO having released news that the disease has spread to two healthcare workers in Saudi. They state also that the forty cases and 20 deaths have taken place in France, Germany, Jordan, Qatar, Saudi Arabia, and the United Kingdom. Even as the WHO does not advise population screening for the disease, it continues to monitor the situation and suggests that healthcare workers working in infectious disease hospitals take particular precautions.

Members of the general population, however, have no reason to panic or to fear traveling to the Middle East.