Hospital trust says ‘no significant risk to public health’ as two patients are isolated, suspected to be suffering from respiratory virus

The accident and emergency department at Manchester’s main hospital was closed for more than two hours on Monday afternoon after two patients were suspected to be suffering from Middle Eastern respiratory virus syndrome (Mers), a deadly viral respiratory disease caught from camels.



Manchester Royal Infirmary (MRI) reopened after both patients were isolated for ongoing clinical treatment and management of their condition, Central Manchester University hospitals NHS foundation trust said.

An MRI spokesperson said test results were still pending and that one patient had been relocated to North Manchester general hospital.

“Manchester Royal Infirmary A&E is now open to the public,” the spokesperson said. “We would like to reassure our patients and the general public that there is no significant risk to public health.”

Mers is passed between animals – usually camels – and humans. First identified in Saudi Arabia in 2012, it is caused by a coronavirus (Mers‐CoV), a large family of viruses that can cause diseases ranging from the common cold to severe acute respiratory syndrome (Sars). Most recent cases of Mers in Saudi Arabia were in patients who had a history of drinking raw camel milk and close contact with camels.

Public Health England said there is currently no risk of catching Mers from another human. Dr Rosemary McCann, north-west deputy director of health protection, said on Monday: “We are aware of two individuals being tested for Middle East respiratory syndrome [Mers-CoV] in Manchester.

“Although cases continue to be reported from the Middle East, no new cases of Mers-CoV have been detected in the UK since February 2013. There is presently no evidence of sustained person-to-person transmission of Mers-CoV, and the risk of contracting infection in the UK remains very low.

Facebook Twitter Pinterest A thin section of Mers-CoV. Photograph: Disease Control and Prevention/PA

“The risk to UK residents travelling to Middle Eastern countries may be slightly higher than within the UK but is still very low. Limited onward transmission in South Korea has been associated with healthcare settings, and the risk to UK tourists visiting South Korea is also considered to be very low.”

The World Health Organisation (WHO) said it is not yet fully understood how people become infected with Mers, but at least 449 people have now died from the virus. “It is believed that humans can be infected through direct or indirect contact with infected dromedary camels in the Middle East. Strains of Mers-CoV have been identified in camels in several countries, including Egypt, Oman, Qatar and Saudi Arabia,” said the WHO.

A typical case of Mers includes of fever, cough, and/or shortness of breath and gastrointestinal symptoms, including diarrhoea. Severe cases can cause respiratory failure that requires mechanical ventilation and support in an intensive-care unit.

Some patients have had organ failure, especially of the kidneys, or septic shock. The virus appears to cause more severe disease in people with weakened immune systems, older people and those with chronic diseases such as diabetes, cancer and lung disease.

Last year, PHE issued a warning to travellers to and from the Middle East urging them to avoid contact with camels.

According to the WHO, Mers has so far been detected in 26 countries, including the UK. They are:

In 2012, Germany, Jordan, Saudi Arabia, the UK.

In 2013, France, Germany, Italy, Kuwait, Oman, Qatar, Saudi Arabia, Tunisia, United Arab Emirates, the UK.

In 2014, Algeria, Austria, Egypt, Greece, Iran, Jordan, Kuwait, Lebanon, Malaysia, the Netherlands, Oman, Qatar, Saudi Arabia, Turkey, UAE, the US, Yemen.

To date in 2015, China, Germany, Iran, Oman, Philippines, Qatar, South Korea, Saudi Arabia, Thailand, UAE.

Dr Derek Gatherer, a virologist at Lancaster University, said Mers belonged to the same family of viruses as Sars, which caused a brief global panic in 2003, but was not a close relative.

“In the Middle East it has mostly been associated with the camel breeding industry with many cases in farm workers, and has also spread within Saudi hospitals with 466 deaths in total,” he said. “There is no treatment for Mers other than a general symptomatic support for pneumonia, perhaps involving steroid drugs to widen airways and assist breathing. There is no vaccine at present.

“The World Health Organisation defines Mers risk as being confined to those hospital workers not wearing appropriate personal protective equipment and working within two metres of a case in a ward, or those patients in the same room or ward as a confirmed case, or those who have contacted respiratory secretions from a case. Outside hospitals, the risk to the general public is extremely low and the outbreak ought not to cause concern.”

Gatherer said the Manchester cases came just as a Mers outbreak in South Korea was officially declared over – with the last of the 16,000 people under quarantine being released from movement restrictions. The outbreak killed 36 of the 186 people officially confirmed as infected, and spread principally within the country’s hospital system after a traveller returned from the Middle East with a pneumonia that was not diagnosed as Mers until he had infected several others.