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‘MERS virus very serious, but not emergency’

By Reuters - May 14,2014 - Last updated at May 14,2014

LONDON — Concern about the deadly new Middle East Respiratory Syndrome (MERS) virus has "significantly increased" but the disease is not yet a global health emergency, the World Health Organisation said on Wednesday.

The virus, which causes coughing, fever and sometimes fatal pneumonia, has been reported in more than 500 patients, mainly in Saudi Arabia, and has spread to neighbouring countries, as well as in a few cases to Europe, Asia and the United States. It kills about 30 per cent of those who are infected.

The WHO's emergency committee, which met for five hours in Geneva on Tuesday, said on Wednesday that the seriousness of the MERS situation had increased in terms of public health impact, but there is no evidence of sustained human-to-human transmission of the virus.

Because of that, "the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met," the WHO said in a statement.

The virus is from the same family as SARS, or Severe Acute Respiratory Syndrome, which killed around 800 people worldwide after it first appeared in China in 2002.

The WHO’s assistant director general for health security, Keiji Fukuda, said the main reason for not declaring MERS an emergency was that despite a surge in cases, the evidence did not suggest it was spreading easily from person to person.

“It’s the [viruses] that can really sustain transmission in communities which pose the greatest danger of spreading around the world and causing large numbers of illnesses and deaths,” Fukuda told reporters on a telephone briefing.

“[And] there is no convincing evidence right now for an increase in the transmissibility of this virus.”


Rising concern


Ben Neuman, a virus expert at Britain’s University of Reading, said the WHO committee’s decision was “a measured and sensible reaction to an evolving epidemic”.

“It is important to remember that MERS still does not spread very efficiently between people,” he said. “It is a very serious disease if you are unlucky enough to catch it, but the odds of catching the virus — even in Saudi Arabia — are still very small.”

Global health regulations define a PHEIC as an extraordinary event that poses a risk to other WHO member states through the international spread of disease, and which may require a coordinated international response.

Fukuda said the emergency committee would meet again in a few weeks’ time to review the MERS situation.

International fear about the new virus has grown in recent weeks with a surge in cases detected in Saudi Arabia, where 495 people have been infected — 152 of whom have died — since the virus first emerged in 2012.

Scores of other MERS cases have also been detected in other countries throughout the Middle East region, and there have been at least eight cases imported into seven further countries, including Malaysia, Lebanon and the United States.

Dutch health authorities said on Wednesday that a man returning to the Netherlands from Saudi Arabia had been admitted to hospital there with MERS.

Saudi Arabia, which has been at the epicentre of the MERS outbreak since the virus was first identified in September 2012, has been criticised by the WHO for failing to implement basic hygiene and infection control measures in hospitals — allowing the virus to spread in clusters of health workers.

Recent outbreaks of MERS in Jeddah’s two main hospitals — King Fahd and King Faisal — were partly due to “breaches” in recommended infection prevention and control measures, the United Nations health agency said.


Gloves, masks, handwashing


Fukuda stressed the need for countries where MERS cases are common to take immediate action to improve infection prevention and control measures to try to halt its spread.

“Infection control is issue number one,” Fukuda said, explaining that simple measures such as ensuring health workers wear gloves and masks and wash their hands between patients were vital. “This is most urgent for affected countries.”

He added that key scientific investigations should also be started as soon as possible to better understand the risk factors behind the disease. These include case-control, serological, environmental and animal studies.

News in the past fortnight that MERS had reached the United States, imported via two healthcare workers who had travelled from Saudi Arabia, added to global concern.

On Tuesday, US health officials said two health workers based at a Florida hospital who had been exposed to a patient with MERS had begun showing flu-like symptoms.

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