Mers: Latest killer in a family of deadly viruses

Saudi medical staff leaving the emergency department at a hospital in the centre of the Saudi capital Riyadh on April 8, 2014. Two cases of Mers among health workers prompted the authorities to close the emergency department at the city's King Fahd H
Saudi medical staff leaving the emergency department at a hospital in the centre of the Saudi capital Riyadh on April 8, 2014. Two cases of Mers among health workers prompted the authorities to close the emergency department at the city's King Fahd Hospital. -- FILE PHOTO: AFP

A Malaysian man from Johor who developed respiratory complications after returning from Mecca died on April 13, 2014, becoming the first person from Asia to die from the Middle East Respiratory Syndrome (Mers) coronavirus. Mers is the latest health scare to hog headlines as modern international travel has increased the speed in which viral diseases can spread across vast distances. We take a closer look at Mers and other recent viruses that have caused severe health problems and even death.

1) Middle East Respiratory Syndrome (Mers)

As its name suggests, Mers was first detected in 2012 in Saudi Arabia and the Middle Eastern state is the worst-hit country, with more than 60 deaths so far. As of April 16, 2014, the World Health Organisation has recorded 238 cases of the disease and 92 deaths globally. 

Singapore has not seen any case of Mers, but the Ministry of Health said in a statement that "given today's globalised travel patterns, the possibility of an imported case here cannot be ruled out".

This is why hospitals here are testing all patients with severe respiratory illness and who have been to the Middle East recently. 

The statement added that the "risk of an outbreak in the community here is low as sustained human-to-human transmission of the virus has not been reported". Still, "all suspected and confirmed cases will be isolated and managed under strict airborne infection control precautions".

Although there is no travel advisory against going to the Arabian Peninsula, the ministry has issued a list of precautions to take, such as getting vaccinations against influenza and meningitis.

The Islamic Religious Council of Singapore will work with travel agents to make sure umrah and Haj pilgrims receive the health advisory. 

2) Different strains of bird flu

Chickens awaiting delivery to a market in Guizhou Province. FILE PHOTO: AFP

Five unique influenza strains have emerged in the last 17 years. Of these, the more commonly known ones are the H5N1 and the H7N9 viruses. 

H5N1 first occurred among humans in 1997 and has been a perennial headache for health officials, with sporadic outbreaks over the years.

The H7N9 virus emerged last year and has infected 159 people in China, including 71 deaths, reported Agence France-Presse.

The most recent novel influenza virus in humans was detected in December last year after Chinese authorities announced the death of a 73-year-old woman from H10N8. Since then, a second case, also in China, has been recorded. 

3) H1N1

Getting an H1N1 vaccination in Singapore in 2009. ST FILE PHOTO: TERENCE TAN

The H1N1 pandemic originated in early 2009 in Mexico, where more than 100 died, and quickly spread to the United States. It was quickly dubbed the swine flu due to its origins from Influenza A, which infects pigs. 

By May, the virus had reached Beijing, Hong Kong, Malaysia, Tokyo and Thailand. Singapore had its first confirmed case by the end of that month and its first H1N1-related death in July 2009.

Scarred by its experience with Sars, Singapore kicked into high gear to deal with the impending arrival of the virus to its shores. Different groups of people suspected of coming in contact with the virus on their travels were quarantined. Border checks were stepped up, including temperature checks at ferry terminals and airports. 

In February 2010, Singapore lowered its alert status for the virus to green. By then, more than 420,000 were vaccinated, while another 415,000 were presumed to be infected, giving them immunity. 

4) Severe Acute Respiratory Syndrome (Sars)

People waiting to be screened for Sars at Tan Tock Seng Hospital in 2003. ST FILE PHOTO: HOW HWEE YOUNG

Sars originated in southern China sometime between late 2002 and early 2003. It then spread throughout greater China, hitting Hong Kong particularly hard. 

The outbreak also affected Singapore significantly in 2003. From the first patient admitted on March 1, 2003, until the virus was eradicated here in July 2003, the spectre of Sars hung over Singapore for five long months.

Home quarantines were ordered and schools were closed for about two weeks as a precaution. Temperature checks were introduced for students, hospital staff and at Changi Airport. A ministerial committee was formed to address the escalating situation as the death toll hit six. Tan Tock Seng Hospital became the designated Sars treatment centre and a Sars hotline was set up. 

The outbreak eventually infected 238 people here and killed 33 of its victims, including health-care workers.  

In 2013, Singapore marked the 10th anniversary of Sars with an exhibition at Tan Tock Seng Hospital, chronicling the country's fight against the pandemic and honouring the frontline health-care workers who were instrumental in overcoming the crisis.