UAE’s Proximity to Saudi Arabia
# 8714
While nowhere near the magnitude of the MERS outbreak in Saudi Arabia, since late March the UAE has reported several (apparently) hospital-centric outbreaks of MERS infection, numbering nearly 50 cases during the past couple of months (see WHO MERS Update – UAE).
Today the World Health Organization has published a report on a visit by their experts to the UAE to conduct a risk assessment of the situation.
While more of a feature article, than a scientific report, we do learn that their experts found no evidence of sustained human to human infection, and instead attributed these outbreaks to a: `breach in infection prevention and control measures in health care settings, active surveillance and increase in community acquired cases’.
Once again we see calls for greater regional sharing of information on this disease, and a stressing of the `importance of participating in multi-country case control studies from both the human health and animal health perspective’. The quantity and quality of information and cooperation has varied considerably between Gulf states, and that has slowed progress on both understanding, and containing, this emerging virus.
WHO concludes a MERS-CoV risk assessment mission in the United Arab Emirates
June 2014
A team from the WHO and technical partners from the Global Outbreak Alert and Response Network (GOARN) has concluded a 5 day mission in United Arab Emirates (UAE).
WHO/R. Sidani
The team assessed the risk posed by the Middle East respiratory syndrome coronavirus, or MERS-CoV in the country. The team consisted of 6 experts in coordination, epidemiology, infection prevention and control, food safety and the human-animal interface, and risk communication.
Health authorities in the UAE had invited WHO to review the current situation after an upsurge in MERS-CoV infections in April. Upon arrival, the WHO team met with H.E Mr Abdul Rahman bin Mohammed Al Owais, the Minister of Health, in Dubai to discuss the mission.
Investigation and evaluation
During the mission, the team had extensive meetings with experts from Health Authority Abu Dhabi, Dubai Health Authority and the Abu Dhabi Food Control Authority. The team visited the hospital to which two-thirds of the country’s cases can be traced, in order to review the epidemiological investigation and assess the infection prevention and control measures that have been applied. The WHO team evaluated the work done on investigating possible exposure routes, transmission patterns, and the clinical situation.
"We are impressed by the amount of data and information generated during the investigation of MERS cases by UAE to help better understand MERS- CoV. This knowledge is of utmost importance to the rest of the world to better discover the source of the virus and the routes of transmissions from animals to humans, "said Peter Ben Embarek, WHO team leader.
“The UAE health authorities have been following up diligently on the MERS-CoV cases, including repeated laboratory testing to check when cases have been cleared of the virus. This data will make an important contribution to the risk assessment and to guide the health response internationally," Ben Embarek concluded.
Need to share experience and knowledge
The preliminary result of the mission indicates that the cases in UAE do not show evidence of sustained human to human infection. The recent upsurge of cases in Abu Dhabi appears to have been caused by a combination of factors, including a breach in infection prevention and control measures in health care settings, active surveillance and increase in community acquired cases.
WHO recommends that the UAE health authorities to continue to investigate MERS, including the source of infection, and share new information as it becomes available. There is an ongoing need to share experiences and knowledge from all countries that have cases of MERS-CoV to better understand this emerging disease, including the role of animals in the spread of the MERS-CoV.
WHO stressed the importance of participating in multi-country case control studies from both the human health and animal health perspective. There are opportunities to do joint analysis of samples from infected camels and the infected humans around them. These studies will help understand the role of camels in the disease - particularly how human infection happens. This information will help inform people who are in close contact with camels to gain a realistic picture of the risk, and the level of precaution needed.
Globally, as of 4 June, 681 laboratory-confirmed cases of infection with MERS-CoV have officially been reported to WHO, including 204 deaths.
