Thursday, May 21, 2020

MERS-CoV: Forgotten, But Not Gone

Credit Hong Kong CHP


Although our attention is understandably on COVID-19, between the summer of 2012 and the start of 2020, MERS-CoV - which has killed more than 875 people, primarily in the Middle east - was the coronavirus of greatest concern.

It wasn't the only one, of course. Some of the other coronaviruses with zoonotic potential we've looked at over the years include:
EID Journal: A New Bat-HKU2–like Coronavirus in Swine, China, 2017
Emerg. Microbes & Infect.: Novel Coronaviruses In Least Horseshoe Bats In Southwestern China
PNAS: SARS-like WIV1-CoV Poised For Human Emergence
Study: Hotspots For Bat To Human Disease Transmission
While the exact virus that we now call SARS-CoV-2 was unknown 5 months ago, the fact that a novel coronavirus was able to spark a pandemic wasn't much of a surprise.
Not only did the world dodge a bullet in 2003 with SARS, a similar virus was chosen for 2019's Johns Hopkins' #EVENT201 table top exercise, and 9 years ago was the viral villain in Steven Soderbergh’s pandemic thriller `Contagion
These other novel coronaviruses are still out there - along with many that remain undiscovered - carried mostly by bats, but occasionally jumping to other species, like camels and pigs. 
As preoccupied as we are right now with COVID-19, it would be inadvisable to turn a blind eye to these (and other) pandemic threats. 
On the influenza side of things, last week the CDC added 3 Novel Flu Viruses To Their IRAT Listbut over the past few months we've heard very little about MERS-COV from the Middle East. If fact, Saudi Arabia's MOH hasn't updated their MERS daily case counts since Epi Week 14 (early April)

In the first 14 weeks of 2020, Saudi Arabia reported 50 MERS cases.  In the last 7 weeks, they've reported none.  
Admittedly, KSA has never been enthusiastic about public reporting of cases, and we've seen the Saudis take `breaks' in reporting in the past (see 2018's The Saudi MOH Breaks Their Silence On MERS-CoV).  
But even during these `gaps', the World Health Organization (EMRO) has continued to publish monthly MERS-CoV updates.  Somewhat unusually, the last Outbreak Situation Update published by EMRO was in February for January, 2020. 

The WHO did publish a Middle East respiratory syndrome coronavirus (MERS-CoV) – Saudi Arabia DON on May 5th, but it was for cases reported during the month of March.  

While it is possible there have been no reported cases of MERS in Saudi Arabia (or elsewhere in the Middle East) over the past 7 weeks, late spring and early summer are typically the `high season' for cases (see The Global Seasonal Occurrence of MERS-CoV)

I don't profess to know the reasons behind this abrupt halt in reporting by KSA and the WHO, and I have no reason to believe something untoward is currently happening with MERS-CoV in the Middle East.  
I only know that just because we are dealing with one global health crisis, that doesn't preclude our being blindsided by another.
Whether it is for avian influenza, MERS-CoV, or any other emerging disease threat, we need to improve surveillance, and increase our readiness to deal with not only this pandemic, but next one.

Anything less, and we risk being caught flat-footed again.