2015. 6. 1. 20:40ㆍ기타
메르스라는 중동호흡기중후근으로 온 나라가 난리다. 초기 대응에 실패하여 메르스에 감염 확진 판정자가 늘어나고 있는 상황이다. 한순간의 실수로 굉장히 치명적인 결과를 초래할 수도 있을 것 같아 심히 염려스럽다.
중동호흡기증후군(MERS) 개요
중동호흡기증후군(MERS) 이란?
- 중동호흡기증후군(MERS, Middle East Respiratory Syndrome)은 코로나바이러스(Coronavirus) 감염으로 인한 중증급성호흡기 질환입니다.
- 최근 중동지역 아라비아반도를 중심으로 주로 감염환자가 발생하여 MERS란 이름으로 명명되었으며, 중동호흡기증후군 코로나바이러스는 과거 사람에게서는 발견되지 않은 새로운 유형의 바이러스입니다.
임상적 특성
- 잠복기 : 5일(2~14일) 이내 증상 발생
- 증상 및 징후 : 38℃ 이상의 발열, 호흡기 증상(기침, 호흡곤란 등)
- 만성질환 혹은 면역기능 저하자 예후 불량
- 치료 : 환자의 증상에 따라 적절한 내과적 치료 시행
- 예방 : 호흡기 증상을 보이는 환자 및 동물(특히, 낙타)과의 접촉을 피하고, 중동지역 여행 시 손 씻기 등의 일반적인 호흡기질환 예방수칙 준수
역학적 특성
- 연령분포 1-94세(평균연령 48.5세)
- 남:여≒1.7:1
- 모든 환자들에게서 직·간접적으로 중동(특히, 사우디아라비아, 아랍에미리트) 지역과 연관
- 최근 병원 내 감염을 비롯한 2차 감염자 비율 증가
- 현재까지 명확한 감염원과 감염경로는 확인되지 않았으나, 낙타를 통한 감염 가능성에 대한 연구결과들이 발표되고 있으며,
확진환자의 가족, 의료진 등에서 밀접 접촉*에 의한 감염 사례가 보고됨
* 밀접접촉(Close contact) 예시
- 확진 또는 의사환자를 돌본 사람(의료인, 가족포함)
- 환자 및 의사환자가 증상이 있는 동안 동일한 장소에 머문 사람(동거, 방문 등)
Most people confirmed to have MERS-CoV infection have had severe acute respiratory illness with symptoms of:
- fever
- cough
- shortness of breath
Some people also had gastrointestinal (위장의) symptoms including diarrhea (설사) and nausea(구역질, 메스꺼움)/vomiting(구토). For many people with MERS, more severe complications followed, such as pneumonia (폐렴) and kidney failure (신장 기능 상실). About 3-4 out of every 10 people reported with MERS have died (10명 중 3-4명은 사망에 이름). Most of the people who died had an underlying medical condition. Some infected people had mild symptoms (such as cold-like symptoms) or no symptoms at all; they recovered. (심각하지 않은 증상을 가진 사람들은 회복됨)
Based on what researchers know so far, people with pre-existing medical conditions (also called comorbidities) may be more likely to become infected with MERS-CoV, or have a severe case. Pre-existing conditions from reported cases for which we have information have included diabetes; cancer; and chronic lung, heart, and kidney disease. Individuals with weakened immune systems are also at higher risk for getting MERS or having a severe case.
Based on information we have to date, the incubation period for MERS (time between when a person is exposed to MERS-CoV and when they start to have symptoms) is usually about 5 or 6 days, but can range from 2-14 days.
Details of the cases are as follows:
- The case is a 35-year-old male who developed symptoms of cough, sputum and fever on 6 May and was admitted to hospital on 13 May. The patient has been on Tuberculosis (결핵) medication since his son was diagnosed with the bacterial disease in April. Between 15 and 17, he shared the same ward (병동) with the first case during his hospitalization from 15 to 17 May. On 20 May, after his discharge (퇴원), the patient visited two different hospitals due to fever and was put on antibiotics(항생제). As symptoms persisted despite antibiotic therapy, he was admitted to a hospital again on 27 May and confirmed positive for MERS-CoV on 29 May.
- The case is a 35 year-old male whose mother shared the same ward with the first case. From 15 to 21 May, the patient visited his mother every day at the hospital. He developed symptoms and visited an emergency room on 24 May. The patient was admitted to hospital between 25 and 27 May and confirmed positive for MERS-CoV on 30 May.
Contact tracing of household contacts and healthcare contacts is ongoing for the cases.
Globally, WHO has been notified of 1154 laboratory-confirmed cases of infection with MERS-CoV, including at least 431 related deaths. *