The Health Department has asked all districts to intensify the surveillance for severe acute respiratory infections (SARI) and to “carefully review any unusual patterns,” as the Middle East Respiratory Syndrome Corona Virus (MERS-CoV), which causes serious and fatal respiratory illness, could emerge as a major cause for international concern.

The directive was issued to all district surveillance officers of the Integrated Disease Surveillance Project (IDSP) following an advisory issued by the Union Health Ministry last week which asked States to be on the vigil against MERS-CoV.

MERS-CoV was first reported in Saudi Arabia in September 2012 and since then, cases were reported from countries such as U.K., Jordan, France, and Tunisia.

The infection has now emerged as a serious cause for concern, especially in India, as thousands are set to travel to Saudi Arabia in the coming days for Umrah and Haj. Emerging evidence suggests Saudi Arabia as the apparent geographic hub of the novel corona virus.

Given the potential for the MERS virus to spread from human to human through close contact and the scale of the international pilgrimage gathering during Umrah and Haj, India and Kerala in particular, is very much at risk of a potential public health emergency.

Kerala should have an increased hazard perception about a possible MER-CoV importation into the State as apart from the heavy pilgrim traffic during Haj, Kerala has a huge population of healthcare workers in Saudi Arabian hospitals. Human to human transmission of MERS-CoV is known to be high in hospital settings.

The Union Health Ministry’s advisory tells clinicians to consider the possibility of MERS-CoV in persons with respiratory illness requiring hospitalisation and who has an appropriate travel history.

As of July 12, 81 cases of MERS had been reported across the world, with 80 per cent of the cases being reported in Saudi Arabia. The mortality rate of the infection seems to be over 50 per cent. MERS-CoV infection generally presents as pneumonia or with life-threatening complications in those with underlying morbidities.

The most common symptoms observed are fever, cough, and breathing difficulties, according to WHO.

The Rajiv Gandhi Centre for Biotechnology (RGCB) here had launched MERS-CoV surveillance in May and has tested over 100 samples of bronchial lavages (fluids from the lower respiratory tract) from patients with acute respiratory illness in the intensive care units“Till now, the MERS testing was restricted to those with recent travel history to the Middle East and who did not present the clinical picture of H1N1 flu. But since last few week, all throat swab samples sent to us for H1N1 testing are also being tested for MERS-CoV, ‘ ‘R. Radhakrishnan, Head of Laboratory Medicine, RGCB, said.