TIME Infectious Disease

Deadly Middle East Virus in U.S. For First Time

Officials have confirmed a case of Middle East Respiratory Syndrome in Indiana, the first known incident of the virus in the U.S. There have been more than 400 cases worldwide, a third of which have been fatal, since the virus was first discovered in 2012

Update: May 3, 10:18 p.m.

A hospital in northern Indiana is treating a patient infected with Middle East Respiratory Syndrome, marking the first time a case of the deadly virus has appeared in the U.S., state and federal health officials confirmed.

The Indiana State Department of Health said the patient at Community Hospital in Munster is a male health care provider who had recently returned from a trip to Saudi Arabia, where cases of the virus have been most prevalent since it was first identified in 2012.

Researchers have been largely stumped by the origin and transmission patterns of the virus, which looks like the flu, as it has gradually spread around the Middle East. It has been linked to both bats and, increasingly, camels but the reservoir remains elusive.

There have been more than 400 cases of the SARS-like virus scattered among a dozen countries, nearly a third of which have been fatal. Saudi Arabia has seen the bulk of the cases—more than 320 with some 94 deaths—but others have also appeared in Jordan, Britain, France and Italy.

Representatives from the Centers for Disease Control and Prevention and Indiana’s state health department released details about the case in a briefing with reporters on Friday after a positive laboratory result was confirmed.

The man had arrived in Chicago from Saudi Arabia and then took a bus to Indiana. (Public Health England later said it was advised of a passenger, now confirmed to have MERS, who was on British Airways Flight 262 when it arrived at London’s Heathrow Airport on April 24. The man then boarded American Airlines Flight 99 to Chicago.)

On April 27, the man began experiencing respiratory symptoms like shortness of breath, coughing and a fever. He went to the emergency room the next day and was admitted as a patient to Community Hospital, where he received immediate care and was placed in isolation.

Hospital officials said in a statement on May 3 the patient remained hospitalized “in good condition” and is improving each day. “The swift diagnosis and precautionary measures taken have undoubtedly greatly helped reduce the risk of this potentially serious virus spreading,” said State Health Commissioner William VanNess II.

Staff at the hospital who had direct contact with the man before he was isolated were taken off duty and placed in temporary home isolation, the statement added. They will be allowed to return to work once the incubation period is over—it could take up to two weeks for symptoms of MERS to appear—and their laboratory results are negative. No additional cases of MERS have been identified.

It remains unclear how the man became infected, how many people he was in close contact with and whether those people became ill. British and U.S. health officials said they had contacted other passengers on the flights but asserted the risk of infection between them appears low.

(MORE: A Deep Look Inside the Battle Against MERS)

Public health experts have warned for months that it could be only a matter of time before a case appeared in the states. “It’s something we’ve predicted and expected,” said Peter Daszak, president of EcoHealth Alliance, a New York-based organization that patrols the animal-human health border and has worked closely with researchers looking for MERS’ origin.

Daszak said he remains concerned the virus is widespread in camels in Saudi Arabia and that it’s likely more rampant across the region where camels are common. While the virus doesn’t pose a “high risk” to the public yet, he said, “people continue to get infected and travel with this virus. That’s the concern for something that may have the ability to evolve into a pandemic risk.”

Dr. Ian Lipkin, an epidemiology professor at Columbia University and a leading researcher in the hunt for the virus’ origin and pattern of transmission, said he wasn’t surprised either that a case has appeared in the U.S. and originated in Saudi Arabia.

Officials in Egypt just diagnosed their first case and other infected people have recently traveled from either Saudi Arabia or the United Arab Emirates to the Philippines, Malaysia and Greece. But the caseload in the Kingdom jumped 89 percent in April, highlighting whether its Ministry of Health is doing enough to find the reservoir and warn the public about any threat.

In a rare move in late April, King Abdullah dismissed the health minister without an official explanation. The position was quickly filled by Labor Minister Adel Faqih, who immediately promised “transparency and to promptly provide the media and society with the information needed.”

Saudi Arabia has come under fire for its handling of MERS, as months pass with little or no progress made on nabbing its origin or how it spreads to people. “It’s a difficult place in which to work,” Lipkin said, “but there’s optimism that the change in leadership may be productive.”

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