WHO EMRO Updates A Year's Worth Of MERS-COV Reports From Saudi Arabia

 

#15,825

Although I don't check it every day, the reporting of MERS-CoV cases from Saudi Arabia essentially stopped shortly after COVID-19 emerged in the spring of 2020, with their last update coming in May. As of two weeks ago, the last monthly summary report posted on the WHO EMRO (Eastern Mediterranean Regional Office)  outbreaks webpage was for January 2020. 

The silence of the Saudis was finally broken briefly in November (see Saudi MOH Reports 1st MERS Case In More Than 5 Months and again in Early December (see Saudi MOH Reports 2 MERS-CoV Cases For Epi Week 50).

In each instance, a check of the WHO EMRO site showed no new updates since January of 2020.  Two weeks ago, we suddenly saw activity again on the Saudi MOH MERS-CoV daily surveillance site (see Saudi MOH Announces 4 MERS-CoV Cases For 2021). 

At that time, the WHO EMRO site remained unchanged, showing a total of 2519 laboratory-confirmed cases of Middle East respiratory syndrome (MERS) as of January 2020, including 866 associated deaths (case-fatality rate: 34.3%) were reported globally.

Sometime in the past week or so, monthly reports for February through December were added to the WHO EMRO MERS-CoV Outbreaks page

• December 2020
• November 2020
• October 2020
• September 2020
• August 2020
• July 2020
• June 2020
• May 2020
• April 2020
• March 2020
• February 2020

The most recent monthly update (see below) is for December, 2020. 

At the end of December 2020, a total of 2566 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 882 associated deaths (case-fatality rate: 34.37%) were reported globally. The majority of these cases were reported from Saudi Arabia (2167 cases), including 804 related deaths with a case-fatality rate of 37.1%.

While no update has been posted for 2021 at this time, the following note does appear at the top of the Outbreaks page, which somewhat confusingly mentions 2 new cases but reports the same totals as from December 2020.

By the end of January 2021, a total of 2566 laboratory-confirmed cases of Middle East respiratory syndrome (MERS), including 882 associated deaths (case-fatality ratio 34.4%) were reported globally. Two new cases were reported during this month.

While it is reassuring to see reporting from the Saudi MOH once again, and a backfilling of data at WHO EMRO (which can only post what they are notified of), the numbers reported through the end of 2020 have scarcely changed (+4 cases, +1 death) since May of last year. 

Over the same time span in 2019, 60 cases, and 19 deaths were reported. One can't help but wonder how many cases are going undetected due to COVID-19.  

Even in the best of times (before COVID), estimates were that only a fraction of symptomatic MERS cases were being identified (see EID Journal: Estimation of Severe MERS Cases in the Middle East, 2012–2016).

It isn't just Saudi Arabia where surveillance and reporting may be missing cases. Other countries in the region, and in Northern Africa where seroprevalence studies show MERS-like antibodies in camels (see Epi.& Inf.: Global Status Of MERS-CoV In Camels - A Systemic Review), have reported no human cases since the pandemic took off. 

Prior to SARS-CoV-2 successfully jumping to humans, MERS-CoV was considered the coronavirus with the greatest pandemic potential. While SARS-CoV-2 beat it to the punch, the pandemic potential of MERS-CoV has not gone away.

Hopefully these recent data releases by the Saudis, and updates by the WHO, are the start of renewed surveillance and reporting on this all too real threat.