ED Manag. 2014 Jul;26(7):73-7.
The first cases of Middle East Respiratory Syndrome coronavirus (MERS-CoV) have turned up in the United States. First, in late April, a patient tested positive for the virus at a hospital in Munster, IN, and then shortly thereafter, a second patient tested positive at a hospital in Orlando, FL. While both patients have since recovered from the virus and been released, the cases have raised awareness of the infectious threat of MERS-CoV, and they have put EDs and other frontline providers on heightened alert for patients with severe respiratory symptoms and other risk factors. While MERS-CoV is not yet as contagious as seasonal influenza or the severe acute respiratory syndrome (SARS) that started in China and then swept around the globe in 2003, it is more deadly. The World Health Organization reports that roughly one-quarter of 514 people who have tested positive for the virus have died. Experts note that health care workers make up a large percentage of the documented cases of MERS-CoV, and they point out that most human-to-human transmissions of the virus occur in the hospital setting. Public health officials urge emergency personnel to pay strict attention to infection control practices, and to query patients who present with fever and respiratory distress about recent travel to the Arabian Peninsula and/or close contact with a person who has a confirmed or probable case of MERS-CoV.
中东呼吸综合征冠状病毒（MERS-CoV）的首批病例已在美国出现。首先，4月下旬，印第安纳州明斯特市一家医院的一名患者病毒检测呈阳性，此后不久，佛罗里达州奥兰多市一家医院的另一名患者检测也呈阳性。虽然两名患者此后均已从病毒感染中康复并出院，但这些病例提高了人们对MERS-CoV感染威胁的认识，也让急诊部门和其他一线医护人员对出现严重呼吸道症状及其他风险因素的患者提高了警惕。虽然MERS-CoV的传染性还不及季节性流感或2003年始于中国并随后席卷全球的严重急性呼吸综合征（SARS），但其致死性更强。世界卫生组织报告称，在514例病毒检测呈阳性的患者中，约四分之一已经死亡。专家指出，在有记录的MERS-CoV病例中，医护人员占了很大比例，他们还指出，该病毒的大多数人际传播都发生在医院环境中。公共卫生官员敦促急救人员严格注意感染控制措施，并询问出现发热和呼吸窘迫症状的患者近期是否去过阿拉伯半岛和/或是否与确诊或疑似MERS-CoV病例的人有过密切接触。
