As the recent surge in Middle East respiratory syndrome coronavirus - or MERS-CoV - begins to wane in Saudi Arabia, a World Health Organization committee announces that the situation remains a serious concern but does not amount to an international public health emergency.
Following a telephone conference meeting earlier this week, the World Health Organization's (WHO's) MERS-CoV emergency committee says that the "situation remains serious in terms of public health impact," but there is "no evidence of sustained human-to-human transmission in communities."
The likely reason is because the surge, which began in April, was mainly related to spread in hospitals, before improved infection prevention and control measures were brought in, Dr. Keiji Fukuda, WHO Assistant Director-General for Health Security, says in a press briefing.
As significant efforts have been made to strengthen infection prevention and control, the WHO panel unanimously concluded that the conditions for a Public Health Emergency of International Concern have not yet been met.
However, the panel of WHO officials, expert advisors and representatives of countries with recent cases say the situation is still serious and continues to be of concern, particularly in view of the anticipated increase in travel to and within Saudi Arabia related to Umra, Ramadan and Hajj.
The WHO panel highlighted the need to continue analyzing hospital outbreaks of MERS to find out where infection prevention and control may not be working as well as they should. This can happen in crowded areas, such as in emergency departments and clinics where patients gather before receiving a diagnosis.
The panel also notes that recent investigations increasingly support the idea that camels are an important source of MERS infection outside hospitals.
WHO panel urges basic infection prevention and control
Dr. Fukuda says the WHO is emphasizing basic infection prevention and control measures such thorough hand washing, which can be implemented anywhere, are effective in containing MERS. He does not believe anything "esoteric or unusual," is needed, which in any case would be difficult for many hospitals to implement. An example of an esoteric measure would be negative pressure rooms.
Although WHO acknowledges that the MERS situation remains serious, the organization considers there to be "no evidence of sustained human-to-human transmission in communities."
The WHO committee also repeated its previous advice to countries tackling MERS infections:
- Strengthen infection prevention and control and related awareness and education
- Complete critical investigations as soon as possible and assess where breakdowns in prevention and control measures are occurring
- Bolster capacity in vulnerable countries, especially in Africa
- Improve awareness about MERS among pilgrims traveling to Saudi Arabia for Umra and Hajj, especially if they have chronic illness
- Ensure accompanying doctors and medical teams know how to detect MERS and understand the importance of personal hygiene and basic infection control measures
- Strengthen working partnerships between animal and human health sectors
- Follow WHO recommendations, including for groups at higher risk of infection
- Communicate and share relevant information with WHO in a timely fashion.
The panel says there is no solid evidence to support the use of thermal imaging - for instance to screen visitors returning from the Middle East - as a way to stop or slow the entry of MERS-CoV infections.
They say resources for supporting such measures would be better deployed in strengthening surveillance, infection prevention and control, and other public health measures.
Dr. Fukuda says there is some uncertainty about the MERS case recently reported by officials in Bangladesh. He says the test situation is unclear and that a sample has been sent to another reference lab for testing.
Altogether, Dr. Fukuda says the WHO has received official reports of 701 lab-confirmed worldwide cases of MERS, including 249 deaths. These figures differ slightly from those of other authorities because of time delays he says.
Medical News Today recently learned how an enzyme discovery holds promise for a MERS vaccine. Researchers from Purdue University in West Lafayette, IN, found a way to disable a part of the severe acute respiratory syndrome (SARS) virus that allows it to hide from the immune system. They believe the discovery may lead to a new vaccine against SARS and its relative, MERS.
Written by Catharine Paddock PhD