Monday, July 27, 2015

Middle Eastern Respiratory Syndrome (MERS-CoV)

In the last hour or so up popped an alert on my phone from the Guardian, reporting that Manchester Royal Infirmary has closed its A and E department while it investigates two possible cases of this syndrome.

A search of Google for news shows that many other news sources are reporting the same story.

According to the Guardian, reporting Public Health England, there have been no new cases of MERS-CoV in the UK since February 2013.  This is PHE's guidance, first produced in 2012, but still being updated.     

NCBI have a MERS-CoV Resource Page, giving links to their MERS coronavirus database and other NCBI resources, including publications.  There are also links to WHO, CDC and other external resources, and also to HealthMap, which presents a map of cases, and includes the two in Manchester reported today.   You can click a country and see where in that country cases have been reported.

Here are some resources about MERS-CoV.   As well as the list, also try NICE Evidence Search - more comes up if you look for MERS-CoV than if you look for the full name.  

Other UK guidance

Having said that, guidance from Health Protection Scotland comes up if you use the full name, guidance produced in 2013, to raise awareness of the possibility of MERS-CoV in people returning from the Hajj.

Public Health Wales - a summary of symptoms, with links to other information, some advice for travellers, and (if you are in Wales and have a login) information for clinicians.

Guidance from elsewhere in the world

ProMed-Mail - at the moment (1830 BST, 27/7/15) there is nothing there about these possible UK cases, but ProMed-Mail is a good place to get up to date information about cases across the world.

Centers for Disease Control and Prevention - information about MERS and for clinicians and travellers, from this US Federal agency.

World Health Organization - a wealth of information, including an infographic of signs and symptoms, news, multimedia, current outbreak information, and links to information from WHO regions.  There is currently an outbreak in China and the Republic of Korea, and there are up to date figures on the WHO site.

European Centre for Disease Control and Prevention.

Thursday, July 23, 2015

Post Ebola syndrome, and choice of search terms

On the BBC news recently was an interview with a survivor of Ebola, which made reference to "post Ebola syndrome".  A search of the web finds a lot of news items mentioning this term, a short Wikipedia page and an article from Medecins Sans Frontieres.  According to that MSF article, joint pain, eye problems and depression, among other things, can follow Ebola.

Another item found by a web search for "post Ebola syndrome" is this blog post on the H5N1 blog. It refers to an editorial in Lancet Infectious Diseases (the link in the blog post goes to the Lancet but here is the PubMed record):

Bausch DG.
Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70165-9. doi: 10.1016/S1473-3099(15)70165-9.
PMID: 25910638
A search of PubMed for post ebola syndrome finds only 6 items, which are perhaps not the most relevant.  A search for ebola sequelae, taking the hint from this editorial, finds 89.   Among them is this, which is mentioned in that blog post:

Clark DV, Kibuuka H, Millard M, Wakabi S, Lukwago L, Taylor A, Eller MA, Eller LA, Michael NL, Honko AN, Olinger GG Jr, Schoepp RJ, Hepburn MJ, Hensley LE, Robb ML.
Lancet Infect Dis. 2015 Apr 21. pii: S1473-3099(15)70152-0. doi: 10.1016/S1473-3099(15)70152-0.
PMID: 25910637
PubMed's Automatic Term Mapping maps post ebola syndrome to both relevant MeSH terms, virus and disease.  Searching for ebola sequelae does the same, but also to the subheading Complications.   This can be applied to the disease heading (Hemorrhagic Fever, Ebola), and effectively is a floating subheading with the virus heading (Ebolavirus).  Adding complications to the search (ebola (complications OR sequelae)) finds 89 as well.

However, using MeSH alone would find neither item from Lancet Infectious Diseases, as neither has been indexed yet. 
So, the literature searching lessons here - try alternative terms, try to identify the ones that are used in the medical literature and not just ones used in the general media, and try to find terms that make best use of PubMed's Automatic Term Mapping.