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“If you have cold or flu-like symptoms, please put on a mask”. Chances are you will see a sign along these lines as you enter the reception of a General Practice or Accident and Medical clinic with a box of masks close by. It is very good advice (rather like always washing your hands after going to the toilet) and is a simple part of controlling the spread of infections.
Many common viruses are spread through aerosols of respiratory droplets. “Coughs and sneezes spread diseases” was the title of a 1946 British government public information film and the great comedian Tony Hancock sang those words to the tune of the German national anthem in the famous Blood Donor Sketch, so the message is not new! Medical waiting rooms are a perfect place to pass on viruses – they are often full of sick people.
Apart from the common viruses, some of the more newsworthy exotic viral infections are also transmitted by respiratory secretions. Middle East Respiratory Virus (MERS) has been in the news over the past few weeks following the outbreak of the disease in South Korea. MERS is part of a large family of viruses called coronavirus – the family includes one of the viruses that causes the common cold. The Korean outbreak started with a person returning from visiting the Gulf States. The vast majority of MERS cases reported worldwide have occurred in Saudi Arabia.
While it is thought that MERS is transmitted by respiratory secretions, such as coughing, the precise ways in which the virus spreads is not well understood. It does not appear to be easily transmitted human to human in the community – the outbreak in Korea at this stage appears to be limited to family members – particularly those caring for infected people in hospital, healthcare workers, and patients who shared the same healthcare facilities as the initially infected person or people he infected. The World Health Organisation has emphasised the need to use “droplet precautions” and “aerosol prevention techniques” in medical facilities. The first level of these means putting on a mask. It would seem that the medical staff who first saw the initial patient (he visited a number of healthcare facilities – “doctor shopping” is not uncommon in Korea) did not suspect MERS despite his recent travel history.
If you become unwell soon after returning from a trip, seek medical advice and put a mask on in the waiting room – it might just be a cold but you will stop spreading it to other patients and to your doctor and other practice staff.
