Tuesday, June 17, 2014

ALERT: CDC Alters Emergency MERS Testing To Target Asymptomatic Individuals

The CDC has had the Emergency Use Authorization for the experimental MERS-Cov test changed so that they may now test individuals without any direct probable cause that they are infected.
"The amendments authorize the expanded use of the CDC assay to include testing persons who may not be exhibiting signs and symptoms associated with MERS-CoV infection, but who meet certain epidemiological risk factors (e.g., contact with a probable or confirmed MERS-CoV case, history of travel to geographic locations where MERS-CoV cases were detected, or other epidemiologic links for which MERS-CoV testing may be indicated as part of a public health investigation)" 
The obvious rationale for this Emergency Use change is to support a broad scope MERS testing campaign of all individuals returning from Saudi Arabia after the 2014 Hajj. CDC has been upgrading its capabilities at Quarantine Stations across the country for just such an eventuality. However, there are other indications that this Emergency Use alteration has to do with un-released test results from people exposed to the most recent USA MERS cases. In that regard, we have been expecting some sort of MERS shift out of the CDC.

The first clue something was afoot was when the CDC recently went against its own MERS case definition to declare an individual who had met with a known MERS case and who had tested positive for MERS-CoV as not really having a MERS-CoV infection. The CDC followed that action by withholding MERS test results from exposed persons in Missouri and Virginia; and probably more locations we don't yet know about.

Our suspicion is that out of the recent USA MERS cases there were multiple exposed asymptomatic individuals who have tested positive for MERS, and that these people may be capable of spreading MERS. Given the CDC's timing of the Emergency Use change, relative to the CDC's suppression of MERS test results, it is difficult to discount that the CDC's new found interest in asymptomatic MERS cases confirms our suspicions of unusual test results.

While we still hold to the opinion that MERS has a low risk of ongoing chain transmissions outside of the Muslim and Eastern World, CDC's activities regarding MERS testing may indicate otherwise. Moreover, given Saint Louis's bookending of MERS cases in Chicago and testing in Springfield Missouri, we have to admit that the spread of a Zoonotic Bronchitis in our family after a trip to Six Flags did bring thoughts of a readily spread but low impact MERS back to the forefront. Had the CDC acted a few weeks earlier in expanding the Emergency Use Authorization for MERS testing, we could have been tested.

Obviously the CDC can't find what it is not looking for, but with their new expanded Emergency Use criteria it is possible the reports of wide spread Bronchitis in locations common to known USA MERS infections may just lead to further MERS positive test results.


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