Sunday, July 7, 2013

Did I Contract the Corona Virus in Europe?

An electron microscope image of a coronavirus
"Unless the many barriers to a transparent international research and information system disappear...the world could be dragged into another Black Death, and MERS could easily spread far beyond the bounds of the region for which it is named."
- Laurie Garrett, The Denver Post, today, 'Plague in the Middle East Could Spread Globally', p. 1D

Entering now the 6th week since developing probably the most severe respiratory infection I’ve ever had (other than the Hong Kong H1N1 flu in 1968), my lungs are finally starting to return to normal. I can breathe, walk and talk without descending into a prolonged coughing fit. (Heck, yesterday, for the first time in 6 weeks I was able to go to the cinema with wifey, to see ‘World War Z’). I also no longer am finding it necessary to take a mix of cough medicines just to get a decent night’s sleep.


All this echoes back to the 2nd day after returning from Munich, Germany, and speaking to my middle brother Jerome about my brother John’s recent death and plans for cremation. He noted my constant hacking before being able to even speak a few syllables and said: “You really ought to get that checked out! You might have that corona virus, and it’s been infecting people in Germany!” (He might have been referencing this report: http://www.cidrap.umn.edu/news-perspective/2013/03/germany-saudi-arabia-report-new-novel-coronavirus-cases )


I said I would, but feeling that I could cope with it, like the flu- I didn’t bother – preferring to “ride it out” despite having a fever that reached 101.7 several days in a row accompanied by severe nausea (I ‘broke’ the fever each time by popping a 361 mg tab of aspirin).


According to the CDC website:

"Coronaviruses are common throughout the world. They can infect people and animals. Five different coronaviruses can infect people and make them sick. They usually cause mild to moderate upper-respiratory illness. But, some coronaviruses, like the one that caused SARS in 2003, can cause severe illness..."


There is also a more recent mutation, and according to CDC, is:


“a novel coronavirus called Middle East Respiratory Syndrome Coronavirus (MERS-CoV) was identified in 2012 as the cause of respiratory illness in people. Investigations are being done to figure out the source of MERS-CoV and how it spreads. So far, there are no reports of anyone in the U.S. getting infected with MERS-CoV.  The Coronavirus Study Group (CSG) of the International Committee on Taxonomy of Viruses (ICTV) decided in May 2013 to call the novel coronavirus Middle East Respiratory Syndrome Coronavirus 


Evidently, this is a much more severe strain. According to today’s Denver Post (‘Perspective’, p. 1D, 'Plague in the Middle East Could Spread Globally')  MERS-CoV may well be the precursor to a new global "plague". 79 have so far been documented as contracting it and 40 have died- often after kidneys have shut down. If such stats hold it would make it a more prolific killer than Avian flu. But then, as the article also notes, there may be milder symptoms which have not yet been fully documented say in longitudinal studies. Meanwhile, there has been a CDC update of the MERS-CoV, e.g.  http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6223a6.htm?s_cid=mm6223a6_w

Excerpt:

"The continued reporting of new cases indicates that there is an ongoing risk for transmission to humans in the area of the Arabian Peninsula. New reports of cases outside the region raise concerns about importation to other geographic areas. Nosocomial outbreaks with transmission to health-care personnel highlight the importance of infection control procedures. Recent data suggest that mild respiratory illness might be part of the clinical spectrum of MERS-CoV infection, and presentations might not initially include respiratory symptoms. In addition, patients with comorbidities or immunosuppression might be at increased risk for infection, severe disease, or both. Importantly, the incubation period might be longer than previously estimated. Finally, lower respiratory tract specimens (e.g., sputum, bronchoalveolar lavage, bronchial wash, or tracheal aspirate) should be collected in addition to nasopharyngeal sampling for evaluation of patients under investigation. An Emergency Use Authorization (EUA) was recently issued by the Food and Drug Administration (FDA) to allow for expanded availability of diagnostic testing in the United States”


This is important and could well mean that, while in Munich (or other places) I may well have contracted a “milder respiratory illness” – though from my perspective, “milder” isn’t a term I'd choose to use – not when coughing spasms have been triggered where I could barely catch my breath and sometimes spat up blood. My wife at times compared it to Whooping cough. Yes, she also contracted what I have had (nosocomial transmission?) and said it was the worst respiratory infection she’s ever had, and even worse than her H1N1 flu that scuttled our Xmas plans last year. Though I took pains to cover my mouth, nose whenever I coughed or sneezed, it is possible she contracted it from using the mutual laptop without first applying disinfecting wipes  (the CoV can last up to 24 hrs. outside the host)


Still, it’s necessary to be cautious in trying to ascribe blame. As the UK Guardian site noted: “In confirmed cases, patients had a fever, cough, shortness of breath and breathing difficulties. It is not known whether these symptoms are typical or whether the virus may be circulating more widely but causing milder illness.”

Therein lies the rub, or quandary. Until we know if the symptoms ARE typical, how can one differentiate them from say something like severe, acute bronchitis? And incidentally that was the self-diagnosis I finally settled on, but again it could be wrong. I mean how accurate a diagnosis can one make using only Google?


"Why don’t you go to the doc then?"

Well, maybe because I believe I’ve already had enough medical interventions the past two years (including for prostate cancer treatment) and don’t want to help run up national health care costs any more than they are! Especially on the eve of the implementation of the Affordable Care Act. The Neoliberals are already big on accusing those of us on Medicare of "over using" it!


Anyway, bottom line, I am still here and getting better: the lassitude is now the main hurdle. As to whether I actually had CoV (at least the MERS-CoV form), I don’t know. My take so far is that it likely wasn’t, and perhaps only a mild CoV or an acute case of bronchitis after all. Aggravated badly by a bout with smoke from the Black Forest fire. Stay tuned.

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