Foreign doctors, nurses in Saudi Arabia could take MERS global

NEW YORK - The biggest risk that Middle East Respiratory Syndrome will become a global epidemic, ironically, may lie with globe-trotting healthcare workers.

From Houston to Manila, doctors and nurses are recruited for lucrative postings in Saudi Arabia, where MERS was first identified in 2012. Because the kingdom has stepped up hiring of foreign healthcare professionals in the last few years, disease experts said, there is a good chance the MERS virus will hitch a ride on workers as they return home.

"This is how MERS might spread around the world," said infectious disease expert Dr. Amesh Adalja of the University of Pittsburgh Medical Center.

It can take five to 14 days for someone infected with MERS to show symptoms, more than enough time for a contagious person to fly to the other side of the world without being detectable.

Healthcare workers "are at extremely high risk of contracting MERS compared to the general public," Adalja said.

The threat has attracted new attention with the confirmation of the first two MERS cases in the United States. Both are healthcare workers who fell ill shortly after leaving their work in Saudi hospitals and boarding planes bound west.

About one third of the MERS cases treated in hospitals in the Saudi Red Sea city of Jeddah were healthcare workers, according to the World Health Organization.

Despite the risk, few of the healthcare workers now in, or planning to go to, Saudi Arabia are having second thoughts about working there, according to nurses, doctors and recruiters interviewed by Reuters.

Michelle Tatro, 28, leaves next week for the kingdom, where she will work as an open-heart-surgery nurse. Tatro, who typically does 13-week stints at hospitals around the United States, said her family had sent her articles about MERS, but she wasn't worried.

"I was so glad to get this job," she told Reuters. "Travel is my number one passion."

So far, international health authorities have not publicly expressed concern about the flow of expatriate medical workers to and from Saudi Arabia.

"There is not much public health authorities or border agents can do," said infectious disease expert Dr. Michael Osterholm of the University of Minnesota. "Sure, they can ask people, 'did you work in a healthcare facility in Saudi Arabia,' but if the answer is yes, then what?"

Healthcare workers are best placed to understand the MERS risk, Osterholm said, and "there should be a heightened awareness among them of possible MERS symptoms."

Neither the Centers for Disease Control and Prevention nor the Department of Homeland Security responded to questions about whether they were considering monitoring healthcare workers returning to the United States.  Reuters

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