June 11, 2013
WHO Says MERS Coronavirus Has Pandemic Qualities
Lawrence LeBlond for redOrbit.com - Your Universe Online
The World Health Organization (WHO) met with the officials from the Kingdom of Saudi Arabia (KSA) last week to discuss and assess the MERS-coronavirus outbreak that has been steadily growing in the Middle East and surrounding countries.
The virus, which was recently renamed from novel coronavirus to Middle East respiratory syndrome-coronavirus, is a distant relative of the SARS strain that killed 740 people in 2003. The first documented cases of MERS-coronavirus occurred in Jordan in early 2012 and to date, there have been 55 confirmed cases of the disease.
While the virus has been documented in the UK, France, Italy, Germany and Tunisia, the bulk of the cases have been reported in the Middle East. While the overall number of cases is limited, the concerning aspect of the disease is that it kills about 60 percent of patients. In KSA, 75 percent of the cases have been in men and most have occurred in people with underlying medical conditions.
A press release by the WHO states there are three main epidemiological patterns that are apparent with the outbreak.
They report that in the first pattern, sporadic cases have occurred in communities. Experts are unclear on the exact source of transmission in these patients.
In a second pattern, infections are occurring in families, where person-to-person transmission seems to be apparent. Transmissions do appear to only be limited to people who are in very close contact with sick family members, however.
In the third pattern, the WHO reports clusters of infections are occurring in healthcare facilities. These infections have been reported in France, Jordan, and Saudi Arabia. In these clusters, it seems that the infection is spread when the admitted person comes into contact with healthcare workers and other patients.
The WHO said currently there is no evidence of widespread human-to-human transmission across all cases. However, in the few cases where the virus has spread from person to person, it appears it is only spread via close contact, rather than airborne as with cold and flu bugs.
Diagnosis of MERS-CoV is currently accomplished via laboratory testing; no bedside test yet exists. Treatment is primarily supportive as antiviral drugs, such as ribavirin and interferon, have been limited in their effectiveness. Steroid use is highly discouraged.
The WHO/KSA meeting, which lasted from June 4-9, reviewed the response to MERS-CoV in Saudi Arabia and found the country has done an excellent job in investigating and controlling the outbreaks. Once the first cases were reported in 2012, a number of measures were taken to keep the virus from spreading rapidly.
The country introduced infection control measures to stop outbreaks in hospitals and healthcare facilities. It increased surveillance for viral infections and awareness campaigns to alert and educate the public. All cases were reported to the WHO and investigations were initiated to identify sources of infection, risk factors and routes of transmission. Also, KSA health officials invited international experts to help investigate.
However, it was not all good news at the joint meeting.
The WHO stated there are still huge gaps in knowledge about the virus. The health group noted that although great strides have been met in learning about MERS-CoV, it could still take some time to produce beneficial results.
It further stated that international concern about infections from MERS-CoV is high, because it is very possible that this virus could move around the world, causing a global pandemic. Moving outside the Middle East to surrounding countries already proves the virus is capable of bypassing borders via travelers.
The organization said that all countries around the world “need to ensure that their health care workers are aware of the virus and the disease it can cause and that when unexplained cases of pneumonia are identified, MERS CoV should be considered. If cases of MERS CoV are found, they should be reported to WHO under the terms of the International Health Regulations (2005).”
Meanwhile, Saudi Arabia´s Ministry of Health has notified the WHO of an additional lab-confirmed case/death of MERS-CoV last Friday.
The patient is an 83-year-old man with underlying medical conditions. He became ill on May 27 and died on May 31. He was from Al-Ahsa, where an outbreak began in a healthcare facility in April 2013.
Globally, the WHO has been informed of a total of 55 lab-confirmed cases of MERS-CoV with 31 deaths.