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Having been a film critic at a newspaper in a former life, a cinematic analogy struck me after a recent interview with Allison McGeer, MD, FRCPC, a microbiologist and infectious disease consultant at Mount Sinai Hospital in Toronto.
It is the scene in The Exorcist where the frail but iron-willed Father Merrin stares at an ancient statue of a demon at a wind-blown archeological dig in Iraq. He is soon called from the field to face his recurrent enemy, much as SARS veteran McGeer recently traveled to the Middle East to get a first hand look at the novel Middle East Respiratory Syndrome (MERS) coronavirus. Though there are some distinctions, MERS is something of a pathogenic cousin to the SARS (Severe Acute Respiratory Syndrome) coronavirus that emerged dramatically in 2002-2003. An outbreak that began in China spread globally, eventually causing more than 8,000 infections and some 775 deaths. Then, like some violent squall at sea, SARS vanished as rapidly as it arose.
Only a smattering of SARS cases occurred in the U.S., but Toronto was hit particularly hard with some 400 infections and 44 deaths in patients and health care workers. Thus, McGeer has now seen the grim handiwork of both viruses, having battled SARS in her own hospital and helped investigate a MERS hospital outbreak in Saudi Arabia. With MERS capable of causing high mortality in chronically ill patients, McGeer and other infection preventionists in Canada and the U.S. are watchful for any incoming cases from the Middle East.
“We know what rules this virus lives by," she says. "But we are having that discussion here in Ontario – are we prepared to identify the first case of MERS? I think our ability to detect travel-associated cases in hospitals – which is the critical issue – is probably pretty good. If it presents in a household contact of a traveler – which is how we got into trouble with SARS – then that will be more difficult.”
For more on this story see the next issue of Hospital Infection Control & Prevention