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WHO warns international spread of MERS 'very likely'; Canada on lookout

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WHO warns international spread of MERS 'very likely'; Canada on lookout

Last updated: May 24 2014
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  • WHO warns international spread of MERS 'very likely'; Canada on lookout

    Any step taken by Government of India for preventing MERS in India. ?

    TORONTO -- Countries should be on the lookout for cases of MERS in people returning from Middle Eastern countries affected by the virus, the World Health Organization said Thursday in an updated risk assessment of the new coronavirus.

    The number of known infections has skyrocketed in recent days, with Saudi Arabia alone reporting 48 cases on Wednesday and Thursday. In the 20 months since the world became aware a new coronavirus was infecting people, there has not been a single month where the total cases from all affected countries was as high as that two-day tally.

    In the past two weeks alone cases were exported to Greece, Malaysia, Jordan and the Philippines, the global health agency said, warning that the virus may pop up in various parts of the globe carried by people who have been to countries like Saudi Arabia and the United Arab Emirates.


    "It is very likely that cases will continue to be exported to other countries, through tourists, travellers, guest workers or pilgrims, who might have acquired the infection following an exposure to the animal or environmental source, or to other cases, in a hospital for instance," the risk assessment said.

    The WHO noted that diagnosing cases rapidly may be a challenge because some have mild or atypical symptoms. The man detected in Greece, for instance, did not initially appear to have a respiratory infection. He had a protracted fever and diarrhea, but doctors were suspicious because he had travelled to Greece from Saudi Arabia. The man developed pneumonia while in hospital.

    The risk assessment suggested that given the potential to initially miss MERS cases, health-care workers should apply infection control precautions consistently with all patients, all the time, regardless of their diagnosis.

    The document said the WHO continues to recommend against border screening as a method of trying to detect incoming cases. As well, it recommends that governments not apply travel or trade restrictions against countries that are sources of MERS infections.
    A senior official of the Public Health Agency of Canada said federal authorities are in regular communications with provincial and territorial counterparts about the situation and the possibility of imported cases of MERS or avian influenza in travellers.
    Dr. Theresa Tam said since last September more than 3,000 people have been screened in Canada, but to date no cases of MERS have been found.

    "The bottom line is that we've been ramped up for quite some time, not just on this bug but to deal with any emerging viruses," said Tam, who is the head of the Public Health Agency's health security infrastructure branch.

    "Like Greece or France or Italy, it's possible to get a traveller for sure. And so the system is designed to try to pick that up."

    France, Italy, Germany and Britain have also diagnosed MERS cases in people who travelled to the Middle East or flew from there to Europe for treatment. Those importations happened in 2012 and 2013.


    The number of MERS cases has soared this month, fuelled in part by outbreaks in health-care settings in Jidda, Saudi Arabia, and Abu Dhabi, United Arab Emirates.

    The WHO has confirmed 254 cases, but at this point its tally lags far behind the numbers reported by affected countries. The combined case count announced by countries has reached about 385 cases since the first known infections. The death toll to date is over 100.

    More than 45 per cent of all MERS cases that have ever been diagnosed have been recorded this month. That enormous spike in cases is raising concerns about the virus, with experts wondering if it has changed to become more easily transmitted from person to person.

    The WHO says three-quarters of the recent cases appear to be ones where the transmission was person to person, not from an animal or environmental source to a person.

    In two cases, person-to-person-to-person spread has been suspected, the risk assessment said.

    There have been no recent reports of scientists analyzing MERS viruses to see if they have changed. But on Thursday, German coronavirus expert Dr. Christian Drosten confirmed that he recently received a shipment of samples from Saudi Arabia and his laboratory has begun to sequence the material.

    "Currently the sequences don't tell a lot. They look all the same," said Drosten, who is the head of virology at the University of Bonn.

    He cautioned that the work has just begun, and only a small portion of the viruses have been sequenced, but said that what he has seen so far looks 100 per cent identical to viruses from earlier in the outbreak.

    The WHO risk assessment said it appears that there is slightly more human-to-human spread than there has been in the past. But whether that is because the virus had become more transmissible or is due to a combination of outbreaks in hospitals and more aggressive searching for cases can't be determined at this point.
    The global health agency suggested that people who are likely at high risk of becoming seriously sick if they contract the virus should take precautions when visiting farms, barn areas or markets where camels are present.

    Camels have been heavily implicated in the MERS story, though it is still not clear how people are catching the virus from the animals.

    The WHO said people at high risk should think about avoiding camels, and refraining from drinking raw camel milk or food that may have been contaminated with animal secretions until it has been properly washed, peeled or cooked.

    People considered to be at high risk of becoming seriously ill with MERS include those with diabetes, chronic lung disease, kidney failure or who are immunocompromised.


    Read more: Exported MERS cases 'very likely,' WHO warns; Canada on the lookout, PHAC says | CTV News
    Attached Files
    Last edited April 27 2014, 09:02 AM.
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  • #2

    #2

    Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

    5 Things You Should Know About MERS, The Deadly Virus That's Now Breaking Out In Saudi Arabia

    A new spike in cases of a deadly respiratory virus, in Saudi Arabia and the United Arab Emirates, is prompting new fears of an outbreak when the area's population spikes during the annual Hajj pilgrimage.
    The syndrome, called Middle East Respiratory Syndrome (MERS), is caused by a relatively new-to-humans virus that's a close cousin of SARS, a virus that infected thousands of people worldwide in 2002-2004.

    Millions of Muslims from around the world make pilgrimages to Mecca, and reports yesterday of the first confirmed case in the holy city raised concerns that MERS could spin out from the Middle East and spread more widely as people move into and out of the city.

    Saudi Arabia has already sacked its health minister, a move that was widely interpreted as a response to his mismanagement of the growing outbreak.

    Here's what you need to know about MERS, which currently has no vaccine and no cure.

    1. The recent spike in cases is alarming.
    The first confirmed cases of MERS in humans - scientists believe it jumped from camels - were reported in 2012. In 2013, and it seems again this year, cases of the disease peaked in March/April. But this year's outbreak seems more severe.

    "It took two years since those first cases for the global tally to hit the 200 mark. That happened in late March [2014]," Helen Branswell explains. "Now the combined total announced by the WHO and affected countries is over 360 cases." There have been 80 new cases in Saudi Arabia in the last week alone, Branswell reports.

    2. We don't know exactly how many people are infected.
    Branswell came to the 360 number by adding up all officially reported cases, but the number of cases confirmed by the World Health Organization is still just 254, with 50 in the last week. There is some lag in the WHO's numbers given their process to confirm diagnoses that have been reported by individual countries. Saudi Arabia, for example, reports 297 cases in their country alone.

    Furthermore, these are just the severe cases - some people may be asymptomatic, and some symptoms may be so mild that they are not reported. Still, even the most conservative estimates show a significant jump in the number of cases in the past month and the past week.

    3. MERS is considered a more deadly but less contagious cousin of SARS.
    Like SARS, MERS is caused by a coronavirus - a class of viruses that cause respiratory illnesses of varying severity and, under a microscope, look like they have spiky crowns. SARS killed less than 10% of the estimated 8,000 people infected; MERS has killed about 30% of those with confirmed infections, although those whose health is already compromised seem more likely to be infected.

    MERS starts out a bit like a cold, but can escalate into pneumonia, organ failure, and death. The onset of MERS is faster than SARS and generally requires closer contact to be transmitted. In the past, MERS has appeared to be easier than SARS to contain and fight off (for healthy people).

    "While MERS is a bad actor, it is no SARS and most likely will not cause a pandemic," writes microbiologist Jason Tetro at Popular Science.

    4. MERS might be more contagious now than in previous years.

    Scientists suspect (but don't yet know for sure) that MERS cases in humans tend to come from contact with camels. But the WHO reports that as many as 75% of the recent cases have been transmitted from human-to-human, generally in hospital settings.

    "There's a major change occurring that cannot just be attributed to better case detection," Dr. Michael Osterholm, Center for Infectious Disease Research and Policy at the University of Minnesota, told NPR. "Something's happening."

    This could be because the virus has changed into something more contagious, or because methods of infection control have been inadequate.

    Fortunately, it seems that while infected person A can spread MERS to person B, person B is highly unlikely to then be contagious enough to spread it further, say to person C. There have only been two such cases of this so-called "tertiary" transmission so far.

    Still, because the virus seems to be spreading between humans more than it did in the past, the WHO is on alert: "Urgent investigations are required to better understand the transmission pattern of this virus."

    5. MERS will continue to spread beyond the Middle East.
    The recent spike in cases is primarily in Saudi Arabia (especially in Jeddah) and the UAE, but - as with other recent outbreaks - it is expected to spread beyond those countries. "The spike in cases, especially among health care workers, could be a signal that the virus has reached a tipping point and could be ready to spread out of the region," NPR reports.

    Since 2012, MERS has been confirmed in Jordan, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates, France, Germany, Greece, Italy, the United Kingdom, Tunisia, Malaysia and the Philippines.

    Cases that have been "exported" from the current outbreak centered in Saudi Arabia have not spread beyond the infected travelers, but MERS will probably crop up in more far-flung places soon.

    "It is very likely that cases will continue to be exported to other countries," WHO predicts. "Whether these cases will [spread further] will depend of the capacity of the receiving country to rapidly detect, diagnose and implement appropriate infection prevention and control measures."



    5 Things You Should Know About MERS, The Deadly Virus That's Now Breaking Out In Saudi Arabia | Business Insider India
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    • #3

      #3

      Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

      Originally posted by planner
      Thanks, These days I am in Saudi Arabia,,,,,
      Be safe, keep yourself away from public places.....

      Might be useful:


      Daily situation report cases of Coronavirus that causes Middle East Respiratory Syndrome (MERS-CoV), as of Friday, 25 April


      total number of confirmed cases within 24 hours: 14 cases
      total number of deaths within 24 hours: 5 (4 deaths in newly diagnosed cases, and one in an earlier reported case)
      Distribution of cases on the cities of the Kingdom:
      Riyadh - 4 cases
      Jeddah - 7 cases
      Mecca - 3 cases
      Summary of the health status of cases:
      4 cases without symptoms
      4 cases in stable condition
      two in intensive care
      4 deaths
      distribution of cases to hospitals in the Kingdom: (Hospital – Cases)
      Prince Sultan Medical City in Riyadh Military - One fatal case
      Hospital military warfare factories in Al-Kharj - One case in stable condition
      Hospital d. Sulaiman Al Habib Riyadh - One case, a nurse without symptoms
      King Khalid University Hospital - One case in critical condition
      King Fahd Hospital in Jeddah
      One case, a nurse with no symptoms
      One case of a resident without symptoms
      One case of a resident in stable condition
      Two fatal cases
      King Faisal Specialist Hospital in Jeddah- One case, in critical condition
      Military Hospital in Jeddah - One case in stable condition
      Al Noor Hospital in the capital of the Holy - One fatal cas
      ...
      ...

      Read More on Coronavirus cases April 25, 2014 (confirmed cases: 21, confirmed deaths: 5) (suspected cases: 0, suspected deaths: 0) MERS - FluTrackers


      WHO | Coronavirus infections
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      • #4

        #4

        Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

        Thanks,

        Really worthy...

        Comment

        • #5

          #5

          Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

          How Much Do You Know About the Mysterious MERS Virus?

          Click image for larger version

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          Over the last few years, the world has been gripped with the news of viruses, whether known or emerging, causing epidemics in certain parts of the world. Inevitably, when this occurs, a familiar question is asked: "Will this cause a pandemic?"

          It's an entirely understandable query. After all, when avian flu first appeared in 1997 health officials were completely unprepared. A few years later, SARS practically shut down the city of Toronto and put the entire province of Ontario on lockdown. Then, in 2009, when a pandemic actually occurred thanks to the H1N1 flu virus, Canada was hit relatively hard with some 10 per cent of the population infected and 428 deaths. Then there are the recent close calls of imported H5N1 earlier this year and the suspected case of Ebola just last month (which was thankfully negative).

          Now there's a new virus making headlines. It's called the Middle East Respiratory Syndrome Coronavirus although most people truncate that to the simplified MERS. Not to be mistaken with the Mortgage Electronic Registration Systems, which some believe is a silent economic pathogen, this once quiet virus is making noise as it spreads throughout the Kingdom of Saudi Arabia and hitches rides to several other countries.

          The numbers are changing daily but to date it has infected over 200 people and killed just over a quarter of them. In public health terms, on a scale of 1-10 in terms of concern, this would be an 11. As expected, the data once released has sent worries of a pandemic travelling through the airwaves and the internet. In the meantime, public health officials have worked diligently to determine the nature of the epidemic and more importantly, how to keep it from going global.

          Using the tenets of epidemiology, which are akin to deduction devices of Sherlock Holmes, these disease detectives have done their darnedest to learn as much as they can so we can all be safe. Although the conclusions are far from over, what we have learned so far may offer some peace of mind and the realization this most likely will not be a pandemic.

          As with any murder investigation, in this case microbial, the first order of business was to identify the culprit. In the case of MERS, this happened back in 2012, when a group in the Netherlands isolated and examined the nature of the virus. It was a coronavirus, which puts it in the same family as the common cold and SARS. But further study of the virus revealed it was unlike either - it was more deadly than the common cold and it had a different biology than SARS. This meant a new type with presumably different traits.

          The next step was to determine its modus operandii - how it infects and kills. With both studies of the clinical cases and work in the laboratory, researchers determined how the symptoms of lung infection, pneumonia, diarrhea and eventual collapse are caused. The virus attacks cells possessing a protein known as depeptidyl peptidade 4 (DPP4), which is found in the deep part of the lung, the intestines and many other parts of the body. It then travels throughout the body leading to organ failure and eventual need for intensive care. Eventually, the virus wins and the patient dies. The data also suggested the presence of pre-existing conditions, such as diabetes, cardiovascular disease, kidney disease and respiratory problems could lead to worse outcomes.

          With the biology figured out, the next question was whether MERS could be transmitted from human to human, a necessity for any pandemic. The answer was bittersweet. Although some cases spread between humans, they all happened in close contact, usually in the home or the hospital, not in the open space of a market or religious structure. This meant the virus was capable of spread but was limited. Though this meant people would have to rely on hygiene and infection control to keep the virus from spreading, in the context of a pandemic, this was entirely good news.

          The last part of the analysis was identifying the source of the outbreak. Originally bats were believed to be the primary source of the virus and interaction with them would lead to infection. However, this type of contact could not account for the number of cases. Then earlier this year, the virus was found in a much more domesticated animal: the camel. In Saudi Arabia, these animals are a part of everyday life for many; the virus could easily transfer to humans. However, this raised a question concerning the numbers of infected individuals. If so many people were interacting with camels, then why were the numbers so low?

          In Saudi Arabia, this was exactly the question posed by Deputy Health Minister Ziad Memish. He wondered if perhaps they were only testing the sickest people for the virus leaving those who may have mild or no symptoms out of the statistics. Last month, he decided to test anyone who might have been exposed. Sure enough, the case numbers exploded. But, unlike the incredibly high numbers of fatalities originally recorded, the number of deaths in relation to infection dropped significantly. In addition, those who did not suffer from underlying conditions for the most part fared well and needed little to no medical intervention. Unbeknownst to everyone, MERS was spreading; it just wasn't killing.

          That leaves us to today where the mystery continues although we are closing in on an answer. Eventually, the source of the virus will be found and the picture will be complete. However, what has already been learned is of incredible value. First, the virus can be easily controlled, just like the common cold and SARS. Second, healthy individuals seem to be at little risk of problems while those with underlying conditions have to be more careful; this is reminiscent of the concerns during the H1N1 pandemic. Finally, while the virus continues to be exported, there have been no transmitted cases either on airplanes or after landing; similar to the H5N1 case in Alberta.

          There is little doubt the virus continues to spread but its effect appears to be limited. While the chance is always present for global spread, there are few indications this will be a killer in Canada. More likely than not, the worst case scenario would be the introduction of this virus into a highly susceptible community causing a single outbreak. While this might cause unease, just remember the same thing is happening right now in several locations across the country with another potentially lethal virus: measles.

          How Much Do You Know About the Mysterious MERS Virus? | Jason Tetro
          __________________________________________________ __________
          It is better to be blind than to see things from only one point of view

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          • #6

            #6

            Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

            Deadly MERS-CoV Virus Threatens Globally In Latest Pandemic Scare – Natural Treatments To Protect Yourself

            Like a ticking time bomb, the World Health Organization (WHO) warns of a deadly new virus known as Middle East Respiratory Symptom Coronavirus, or MERS-CoV, that has reared its ugly head killing approximately 50 percent of its known victims thus far. There’s no evidence showing from where the virus derives and no information whether it originates in any particular animal, according to WHO


            Initial contact with MERS-CoV virus

            The New England Journal of Medicine reported in November 2012 on MERS-CoV, noting that initial symptoms mimic a mild respiratory flu. Because researchers don’t know where the MERS-CoV virus comes from, there is no clear way of identifying how it’s transmitted; however, they do know it can be passed from human to human based on a report in March 2013 by Eurosurveillance where symptoms appeared in a family group within 10 days.

            MERS-CoV Symptoms

            Following initial flu-like symptoms, the virus causes an upper respiratory tract infection develops with coughing, heavy mucus, and difficulty breathing, requiring hospitalization. As the virus aggressively invades the body’s cells, the immune response is destroyed causing systemic breakdown, according to a study published in mBIO.

            Pneumonia develops after several days along with other symptoms of Acute Respiratory Distress Syndrome and the patient may be treated with “convalescent plasma,” recommended by WHO. This is the clear fluid part of the blood containing antibodies taken from MERS-CoV survivors.

            Death eventually results from multiple organ collapse in MERS-CoV victims in approximately 10 days for those not responding to conventional treatments.

            Natural prevention and treatment for MERS-CoV

            Natural treatments can strengthen the immune system, offering a better chance to resist MERS-CoV.

            • Colloidal silver strengthens the immune system due to it’s antiviral properties, destroying almost all pathogens. Take as an oral tonic and use in nebulizer for upper respiratory ailments including pneumonia. Use prophylactically to prevent illness.

            Herbs for MERS-CoV


            • Oil of Oregano possesses germ-killing and anti-viral properties as effective as most antibiotics and anti-microbials.

            • Garlic - Research confirms that garlic possesses numerous antioxidants that kill viruses and free radicals protecting the immune system. Taking garlic prophylactically may help to protect against various pathogens and prevent the onset of disease.

            • Echinacea strengthens the immune system against a variety of infections. This powerful herb possesses the ability to destroy the most virulent bacteria and viruses.

            • Pau D’arco relieves a wide range of infections including those initiated by viruses. Pau d’arco is used by the Indians of South America to strengthen the immune system and fight life-threatening diseases.

            • Mullein relieves chest congestion from coughs, colds, pneumonia and the flu. It acts as an expectorant, loosening trapped mucous.

            Homeopathy for MERS-CoV

            • Phosphorous - Painful cough accompanied by extreme thirst for icy cold water, which is vomited shortly after getting warm in the stomach…READ MORE HERE: Deadly MERS-CoV virus threatens globally in the latest pandemic scare – What you need to protect yourself :: The JB Bardot Archives
            __________________________________________________ __________
            It is better to be blind than to see things from only one point of view

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            • #7

              #7

              Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

              Scientists find MERS virus antibodies that may lead to treatmentsHealthcare - Zawya


              Apr 28 2014

              MERS claims 94th victim; 3 specialist centers set up
              No elderly Emirati will be neglected in Dubai
              Deposit SAR10,000 or leave, some MERS patients told
              Scientists find MERS virus antibodies that may lead to treatments

              * Deadly MERS virus first emerged in Middle East in 2012

              * Sharp rise in cases in Saudi Arabia causing global alarm

              * Scientists say antibody discovery points to possible drugs


              By Kate Kelland
              LONDON, April 28 (Reuters) - Scientists have found natural human antibodies to the newly-emerging Middle East Respiratory Syndrome (MERS) virus and say their discovery marks a step towards developing treatments for the often fatal disease.

              MERS, a SARS-like viral disease first detected in 2012 that has caused outbreaks in the Middle East and sporadic cases around the world, has raised international alarm in recent weeks with a surge in infections and deaths in Saudi Arabia.

              Saudi officials confirmed 26 more MERS cases and 10 deaths at the weekend, bringing the toll in the kingdom alone to 339 confirmed cases, of which 102 have been fatal.

              There is currently no cure or vaccine for MERS - a severe respiratory disease which causes cough, fever, shortness of breath, and can lead to pneumonia and kidney failure.

              But in studies published in two leading scientific journals on Monday, scientists from the United States, China and Hong Kong said they had found several so-called neutralising antibodies that were able to prevent a key part of the virus from attaching to receptors that allow it to infect human cells.

              Antibodies are proteins made by the immune system that recognise foreign viruses and bacteria. A neutralising antibody is one that not only recognises a specific virus but also prevents it from infecting host cells, eventually meaning the infection is cleared from the person or animal.

              In one study in the Science Translational Medicine journal, a Chinese-led team found that two antibodies, called MERS-4 and MERS-27, were able to block cells in a lab dish from becoming infected with the MERS virus.

              "While early, the results hint that these antibodies, especially ... used in combination, could be promising candidates for interventions against MERS," the scientists wrote.

              In a second study in the Proceedings of the National Academy of Sciences (PNAS) journal, a team from the United States said their discovery of a panel of seven neutralising antibodies offered the long-term possibility that either a vaccine or treatments could be developed to fight MERS.

              The vast majority of MERS cases have been in Saudi Arabia and other countries in the Middle East, but the discovery of sporadic cases in Britain, Greece, France, Italy, Malaysia and other countries have raised concerns about the potential global spread of the disease by infected airline passengers.

              Although the disease has not yet been seen in North America, "the chance of someone infected with MERS landing on U.S. shores is possible," said Wayne Marasco, an infectious disease expert at the Dana-Farber Cancer Institute who led the PNAS study.

              Scientists are not yet clear precisely how the MERS virus is transmitted to people, but it has been found in bats and camels, and many experts say camels are the most likely animal reservoir from which humans are becoming infected.

              The virus is similar to the one that caused Severe Acute Respiratory Syndrome (SARS) which emerged in China in 2002/2003 and killed some 800 people - around a tenth of those it infected.

              The World Health Organisation has said it is "concerned" about the rising number of MERS infections in Saudi Arabia. The United Nations health agency said it plans to send a team of international experts to the kingdom this week to help investigate the outbreak.

              (Editing by Sonya Hepinstall)

              ((kate.kelland@thomsonreuters.com)(+44)(0)(207 542 0823)(Reuters Messaging: ))

              Keywords: HEALTH MERS/ANTIBODIES

              Comment

              • #8

                #8

                Re : WHO warns international spread of MERS 'very likely'; Canada on lookout

                Pls Read on own Risk

                Two Filipinos die of MERS virus in Middle East
                AFPBy AFP | AFP – Thu, May 22, 2014

                A microscopic view of the MERS coronavirus, which has so far killed 173 people in Saudi Arabia

                AFP - A microscopic view of the MERS coronavirus, which has so far killed 173 people in Saudi Arabia
                The Philippines said Thursday that two of its citizens working in Saudi Arabia have died from the MERS coronavirus.
                Foreign Department spokesman Charles Jose said their relatives have been informed and efforts were being made to bring the bodies home.
                "Our consul general in Jeddah confirmed that there were two Filipinos who died of MERS," he told AFP.
                "The consulate is helping to repatriate their remains," he said, adding that the deaths were recorded on May 12 and 18.
                The identities of the two, as well as other details, were not revealed to protect their relatives' privacy.
                Thousands of Filipinos work in the Middle East, while it is estimated as many as 10 million work overseas to escape widespread poverty at home.
                MERS or the Middle East Respiratory Syndrome is considered a deadlier but less transmittable cousin of the SARS virus that appeared in Asia in 2003.
                It infected more than 8,000 people, and had a fatality rate of nine percent.
                Health authorities in Saudi Arabia this week reported new deaths from the MERS coronavirus, taking the death toll to 173. It has been the worst affected by the outbreak with a total of 537 people infected.
                Other nations including Egypt, Jordan, Lebanon, the Netherlands, the United Arab Emirates and the United States have also recorded cases, mostly in people who had recently returned from travel in the desert kingdom.
                The Filipinos' deaths came as the Philippines has been stepping up its defence against the virus by screening all those coming from the Middle East at ports of entry.
                Last month, it quarantined a male Filipino nurse who had tested positive for the virus.

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