Getting to Know MERS-CoV

What’s Hot: MERS-CoV

Lydia is panicking. She was trying to relax by watching late-night news after a long day at work. However, instead of relaxing her, the news somewhat gave her more stress. It was about the new virus that has entered the country. MERS-CoV? This is the first time that she has ever heard of that. What is MERS-CoV? Not only is she not very familiar with it, but knowing that she is in the nursing profession and may even be able to experience having a patient with that conditions stresses her. How would she deal with a patient with MERS-CoV? What precautions are there to take? How is one who is diagnosed with MERS-CoV treated?

Her mind is filled with questions as she rummages through her textbooks and even opens her laptop to search about the virus.

MERS-Virus

Getting to know MERS-CoV

There is nothing that stresses the nurse more than not knowing what to do in certain situations. Those situations when they feel clueless and absolutely useless. They say “Knowledge is power”, how will someone, let’s say a nurse, be able to formulate interventions appropriate for the situation when doesn’t even know the background of the problem that he/she is facing?
Nowadays, the common talk of the people and headlines from the news are about MERS-CoV. A lot has been panicked, many are concerned, some afraid, but what really is MERS-CoV? Is it life-threatening? Should we be concerned or let the so-called “trend” die down?

Coronaviruses are a large family of viruses that cause a range of illnesses in humans, from the common cold to the Severe Acute Respiratory Syndrome (SARS) and they also cause a number of animal diseases.
Specifically, Middle East respiratory syndrome coronavirus (MERS-CoV) is a strain of coronavirus that was first identified in 2012 in Saudi Arabia when a man died with SARS-like symptoms. However, not all infected people have symptoms, since there may be some individuals who are infected with MERS-CoV and do not get ill or show any symptoms at all.
Usually, those infected with MERS-CoV may have the following signs and symptoms:

  •   Coughing
  •   Mucous
  •   Shortness of breath
  •   Malaise – a general feeling of being unwell
  •   Chest pain
  •   Fever
  •   Diarrhea (in some cases)
  •   Renal (kidney) failure.

In other words, it may be described as flu-like illness with signs and symptoms of pneumonia since early reports described symptoms as similar to those found in SARS-CoV (severe acute respiratory syndrome) cases. However, SARS infections did not cause renal failure, unlike MERS-CoV.

At present, there are no vaccines or treatments for patients who become ill with MERS. Risks related to MERS-CoV include pneumonia, kidney failure and death; and those with chronic diseases, such as diabetes and heart conditions; Organ transplant recipients who are on immunosuppressive medications; Other patients whose immune systems are weak (cancer patients undergoing treatment) are most susceptible in developing MERS-CoV infections and complications.
Currently, there are no specific treatments for patients who become ill with MERS-CoV infection and treatment is usually focused of providing supportive medical care to help relieve the symptoms such as providing treatment to prevent, control or relieve complications and side effects, as well as attempting to improve the patient’s comfort and quality of life.

Precautions

As it is always said, prevention is way better that cure. In this case, infection prevention and control measures are critical to prevent the possible spread of MERS-CoV in hospitals and other health care facilities. Those that provide for patients who are suspected or confirmed to be infected with MERS-CoV infection should take appropriate measures to decrease the risk of transmission of the virus not only from an infected patient to other patients, but also to health-care workers and visitors.

  1. Members of the health care team should be educated, trained and refreshed with skills on infection prevention and control.
  2. And since it is not always possible to identify patients with MERS-CoV early because some patients may only have mild or unusual symptoms, it is important that health-care workers apply standard precautions consistently with all patients no matter what their diagnosis is, in all work practices all the time.
  3. Droplet precautions should also be added to the standard precautions when providing care to all patients with symptoms of acute respiratory infection. Contact precautions and eye protection should be added when caring for probable or confirmed cases of MERS-CoV infection, while airborne precautions should be applied when performing aerosol generating procedures.
  4. Patients should be managed as potentially infected when the clinical and epidemiological clues strongly suggest MERS-CoV, even if an initial test on a nasopharyngeal swab is negative. Repeat testing should be done when the initial testing is negative, preferably on specimens from the lower respiratory tract.
  5. Health-care providers are advised to be extra aware and watchful of their patients as well as the things happening around them including their surroundings.
  6. Those travellers returning from the Middle East who develop SARI should be tested for MERS-CoV as advised in the current surveillance recommendations. They should be promptly assessed and the WHO should be notified of any new case of infection with MERS-CoV, as well as information about potential exposures that may have resulted in infection and a description of the clinical course. Investigation into the source of exposure should promptly be initiated to identify the mode of exposure, so that further transmission of the virus can be prevented.
  7. People at high risk of severe disease due to MERS-CoV should avoid close contact with animals when visiting farms or barn areas where the virus is known to be potentially circulating. For those fond of visiting farms or barns, they must practice general hygiene measures (regular hand washing before and after touching animals, avoiding contact with sick animals, and following food hygiene practices).

 

Sources:

http://www.who.int/csr/disease/coronavirus_infections/en/

http://www.who.int/csr/don/2014_04_24_mers/en/

http://www.medicalnewstoday.com/articles/262538.php

Liane Clores, RN MAN

Currently an Intensive Care Unit nurse, pursuing a degree in Master of Arts in Nursing Major in Nursing Service Administration. Has been a contributor of Student Nurses Quarterly, Vox Populi, The Hillside Echo and the Voice of Nightingale publications. Other experience include: Medical-Surgical, Pediatric, Obstetric, Emergency and Recovery Room Nursing.

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