WHO panel: MERS still not an international emergency


MERS-CoV particles (in green) on camel epithelial cells., NIAID / Colorado State University

Editor's note: This story was revised on Oct 2, 2014, to correct the erroneous statement that a MERS case recently identified in Austria involved a woman from Medina, Saudi Arabia. The woman's home city in Saudi Arabia was not initially disclosed, but a case reported by Saudi Arabia Sep 30 involved a 70-year-old man from Medina.

Following a summer lull of MERS-CoV cases but a renewed trickle in recent weeks, and amid worldwide worries about Ebola, the World Health Organization's (WHO's) Emergency Committee on MERS has concluded that the outbreak still falls short of representing a public health emergency of international concern.

In an epidemiologic update today, the European Centre for Disease Prevention and Control (ECDC) put the global count of MERS-CoV (Middle East respiratory syndrome coronavirus) cases at 887, with 352 deaths, in 22 countries. Saudi Arabia accounts for 754 cases and 319 deaths, including 12 cases in September.

The WHO announced its committee's conclusion after a 5-day meeting conducted by electronic correspondence, from Sep 26 to 30. The panel has met seven times, the last time in mid-June.

The announcement comes on the eve of the annual Hajj, which will draw vast crowds of pilgrims to holy sites in Saudi Arabia, epicenter of the outbreak. The committee called for efforts to improve the pilgrims' awareness of MERS-CoV (Middle East respiratory syndrome coronavirus) and for surveillance during and after the Hajj.

One of the latest reported MERS cases involves a 70-year-old man from Medina, one of Saudi Arabia's holy sites. The case was announced by the Saudi health ministry Sep 30.

During its meeting, the panel heard updates from WHO officials on epidemiologic and scientific developments, and Iran and Saudi Arabia provided assessments of their situations and reported on progress toward implementing the committee's previous recommendations, the WHO said.

In reaching its recommendation, the committee noted that:

  • The epidemiologic situation has not changed since the last meeting, and significant efforts have been made to strengthen infection prevention and control.
  • The rate of new cases has fallen since the spring, and there is no sign of sustained human transmission.
  • "Although transmission in health care settings is still occurring in small clusters, transmission seems generally contained."
  • Efforts to reduce the international spread of MERS-CoV seem effective.
  • Current data suggest that MERS-CoV transmission could be seasonal, with an upsurge expected next spring.

The panel was unanimous in concluding that the MERS situation does not amount to an international health emergency.

The committee offered only half as many recommendations as it did after the June meeting, but it said its previous advice remains relevant. Besides calling for Hajj-related precautions, the panel recommended continued strengthening of infection control practices and a buildup of healthcare capacity, especially in "vulnerable African countries."

The panel also called for harmonizing lab testing algorithms and increasing surveillance in both camels and humans to fill critical gaps in knowledge of human and animal transmission.

See also:

Oct 1 WHO statement

Jun 17 WHO statement on committee's sixth meeting

Oct 1 ECDC update

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