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With Ramadan now just a month away (and the Hajj next October) - as many as 2 million religious pilgrims expected to visit the Kingdom of Saudi Arabia (KSA) over the next 60 days. There is, as you might expect, a good deal of global concern over travelers acquiring, and spreading, the MERS coronavirus.
We’ve already seen the virus exported by travelers returning to France, Tunisia, and Italy. And in each of those cases, the `index’ case transmitted the infection to one or more contacts upon their return.
Over the past week, what little real news we’ve gotten out of Saudi Arabia on this virus has dried up, and in its place we are beginning to see `reassuring’ articles in the Arabic press describing all the steps that KSA has taken to ensure the safety of visitors.
As I wrote last month in MERS, Mass Gatherings & Public Health, religious tourism is big business in Saudi Arabia. More than 7 million pilgrims visit the Kingdom each year, adding more than $16 billion dollars to the local economy.
So today, a look at two examples of reporting on the MERS threat in the Arabic press, and how what they say compares to advice being offered by the World Health Organization.
First stop, an article that appears today in Al Arabiya (a Saudi owned, news outlet in the UAE). Follow the links to read the entire article, as I’ll only post a few excerpts.
MERS: GCC infectious disease security
Monday, 10 June 2013
In the past few weeks, Middle East Respiratory Syndrome (MERS) is becoming an increasing threat to GCC National Health Security. MERS, apparently originating in the Kingdom of Saudi Arabia (KSA), is spreading rapidly to several continents around the globe.
A few of the assurances offered, include:
- Saudi Deputy Health Minister Ziad Memish has openly spoken about this potential crisis of MERS.
- Saudi Arabia, because of the King’s role as Custodian of the Holy Cities, is quite advanced in taking care of, and mitigating, any infection disease.
- All GCC states are now on the lookout for new outbreaks of MERS and have established the appropriate mechanisms in each country.
- It is important to point out that KSA provides free healthcare to all pilgrims during the Hajj and also implements stringent infection control measures.
- Along the pilgrimage route, the primary medical centers of the MoH, the Saudi National Guard, the Internal Security Forces and the Ministry of Defense and Aviation, provide 24-hour free medical care.
From the Saudi Gazette this morning, a report that describes the novel coronavirus. While admitting that little is known, it never mentions the high fatality rate, and tries very hard to equate the MERS infection to the flu.
What is the new coronavirus?
The new coronavirus (MERS-CoV)
Last updated: Monday, June 10, 2013 10:30 AM
Once again, we get assurances that:
- The Ministry of Health Affairs has readied all its resources to deal with this disease, control it from spreading, and provide the necessary health awareness, according to available information.
- . . . the ministry has taken all necessary precautions to monitor the disease, discover new cases, and provide complete medical care.
And to make sure no one worry more about visiting KSA than say, Europe, we get.
- This disease has infected many countries, including the Kingdom, Jordan, Qatar, the UAE, and a number of European countries.
The advice to those who may be infected (and those in contact with them) is `to follow the same rules as for influenza, or other contagious respiratory diseases’.
They suggest handwashing, use and bin tissues, stay home except for necessary chores, and to seek medical care if elderly, suffering from chronic illnesses, or if symptoms become `more acute’.
To recap, according to the Arabic press:
- Travel to KSA for Ramadan and the Hajj is safe.
- The Health Ministry has been open and honest about the threat, and is aggressively taking all required steps to protect travelers.
- The virus is `spreading rapidly to several continents around the globe’ (implying you are just as safe in KSA as anyplace else)
- MERS infections can be treated like ordinary flu
- Those infected should wash their hands, cover their coughs, and stay home unless they have `necessary chores’
- And you needn’t bother seeking medical care unless you are aged, infirmed, or your symptoms suddenly worsen
A remarkably cavalier response to what Margaret Chan – Director General of the World Health Organization – has recently characterized as `a threat to the entire world’.
In contrast, three weeks ago the WHO called for a `high level of vigilance and low threshold for testing’, and released a new, aggressive interim surveillance guidance update designed to help detect early, sustained human-to-human transmission and to determine the geographic risk area for infection with the virus.
Last week, in Middle East respiratory syndrome - coronavirus (MERS-CoV) – Update, WHO advised:
The most common symptoms observed are fever, cough, and breathing difficulties, while atypical symptoms such as diarrhoea have also been recorded in patients with immunosuppression.
Advice to health care practitioners:
- Consider the possibility of MERS-CoV infection in travellers with fever, cough, shortness of breath, or breathing difficulties, or other symptoms suggesting an infection, and with a recent history of travel in the Middle East.
- If a diagnosis of MERS–CoV infection is considered possible, apply infection prevention and control measures recommended by WHO, or outlined in national guidance, and refer the patient to a special infectious disease unit for further investigation.
Advice to ministries of health:
- Review current surveillance guidance and case definitions for case reporting available on the WHO coronavirus website.
- Alert health care practitioners to the possibility of MERS-CoV infection in symptomatic travellers with a recent history of travel in the Middle East.
- Provide health care practitioners with clear instructions for referral of patients suspected of having infection with the MERS-CoV for appropriate management and testing.
Advice to travellers:
Although the source of the virus and the mechanism of transmission is unknown, it would be prudent to try to reduce the general risk of infection while travelling by:
- Avoiding close contact with people suffering from acute respiratory infections.
- Frequent hand-washing, especially after direct contact with ill people or their environment.
- Adhering to food safety and hygiene rules such as avoiding undercooked meats, raw fruits and vegetables unless they have been peeled, or unsafe water.
- Avoiding close contact with live farm or wild animals.
Travellers to the Middle East who develop symptoms either during travel or after their return are encouraged to seek medical attention and to share their history of travel. People with symptoms of acute respiratory infection should practice cough etiquette (maintain distance, cover coughs and sneezes with disposable tissues or clothing, and wash hands) and to delay travel until they are no longer symptomatic.
If the goal is to identify, isolate, and eventually contain the MERS virus - then the Saudi response of minimizing the threat and only telling severe cases to seek medical care and isolation is risky business - not just in the Middle East, but for the entire world.
