Preventing Infection

Immunization

At the time the outbreak of MERS-CoV was most intense, research into antiviral drugs and immunizations was underway, but the virus ran its course long before any vaccines were approved for human use. Some notable vaccines that have passed Phase 1 trials include: GLS-5300, ChAdOx1, and MVA-MERS-S. All of the viruses in preclinical stages target the S protein, causing attachment inhibition, and prevention of cellular entry. (Tai, 2022)

Detection and diagnosis

Probably the most important factor in preventing infection with MERS, early detection of the presence of the virus in populations of dromedary camels could have had a great impact on the number of infections during the MERS endemic. The biggest issue faced at the time was the distrust of the government and the reliance on the goods and services the dromedary camels provided to the people that shepherded them.

Education

Properly educating the locals that interacted with the camels on a daily basis could have greatly reduced the number of infections, because the containment procedures for this virus were not difficult:

-Stop kissing the camels

-Stop drinking camel fluids

-Separate the herds to reduce the spread

Even with these simple instructions, the virus propagated easily, because there was too much money in keeping the camels around people. Education of foreign travelers was the critical component, but preventing travelers from taking photos with these camels was nigh impossible due to the encouragement of the shepherds.

Access to healthcare

Patients seeking treatment at healthcare facilities generally had a good survival chance from MERS. The biggest problem when seeking healthcare from a MERS infection was the risk of inter-hospital transmission, also known as nosocomial infection, which stood the chance of causing infection of hospital staff and other patients due to the formation of fomites, although the risk was very minimal outside of a few clusters of infection, including the breakout cluster in the Republic of Korea in 2015. (Joo, 2019)

Engineering controls and quarantine

Moderate engineering controls to limit the spread of MERS were not unlike the controls we experienced during the early SARS-CoV-2 pandemic in 2020:

-Physical barriers in place to limit interaction with camels and patients with symptoms of infection

-Separating the herds to reduce the spread

-Masking camels to prevent spitting cud (banner image above)

These mitigation procedures, when put in place, did a fantastic job of limiting infection. The problem was these procedures were generally disregarded until the virus had spread throughout a region.