Tuesday, October 06, 2015

Saudi Arabia: 5 Days Without A Reported MERS Case


Credit Saudi MOH




After an unusually active August and September, Saudi Arabia has put together the longest streak (5 days) without reporting a new MERS case since mid-July. 



Credit Saudi MOH

In 2014 Saudi Arabia saw a huge springtime spike in cases, suggesting a potential `seasonality’ to outbreaks.  This year, we’ve seen two peaks (late winter & late summer), with an unexpected lull during the spring.   Other than a shared quiet early summer, almost the opposite of the pattern we saw last year.


Why the difference?


Unfortunately, we haven’t seen enough published epidemiological research coming out of Saudi Arabia to know.  Just as we don’t know how common asymptomatic or mild infections are, or whether (or how much) they contribute to community transmission of the virus. 


Credit Saudi MOH

Nor do we know why children are rarely reported infected, why males are twice as likely to fall ill as females, or how the majority of `primary’ cases (38% of the total) were exposed to the virus.


Last May, in WHO EMRO: Scientific Meeting Reviews MERS Progress & Knowledge Gaps, we looked at the `holes’ in our understanding of this virus, and just over a month ago, in WHO Statement On The 10th Meeting Of the IHR Emergency Committee On MERS, we saw an unusually candid criticism of the Saudi Response to MERS, with the Committee stating:


The Committee further noted that its advice has not been completely followed. Asymptomatic cases that have tested positive for the virus are not always being reported as required.

Timely sharing of detailed information of public health importance, including from research studies conducted in the affected countries, and virological surveillance, remains limited and has fallen short of expectations

Inadequate progress has been made, for example, in understanding how the virus is transmitted from animals to people, and between people, in a variety of settings. The Committee was disappointed at the lack of information from the animal sector


Five days without a reported MERS case is obviously a welcome trend - but until we have better understanding of how this virus spreads into, and through, the community - lulls like this are likely to be short lived.

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