Friday, December 16, 2022

Ignoring The Camel In The Room (For the moment . . . )



Credit FAO

#17,175


Every day there are disease reports on the internet - often promoted by reputable news agencies - that are simply impossible to verify.  Some are undoubtedly true, others may be misinterpreted, while some are nothing more than cynical clickbait for slow news days. 

Over the past 24 hours there have been `reports' of the suspicion of MERS-CoV among players at the FIFA world cup in Qatar (see here, here, and here).  Regrettably, the media has taken to calling it `Camel Flu', because science and accuracy are always trumped by a catchy headline. 

I would stress that I've seen no credible evidence that any MERS-CoV cases have been identified at the FIFA World Cup, but the story is out there, MERS-CoV is endemic in camels in the region, and human cases have been reported in Qatar this year. 

We discussed the possibility of seeing MERS cases emerge at the FIFA World Cup in late November (see ECDC Risk Assessment On 2022 FIFA World Cup In Qatar) and while the risks are believed low, they are not zero.

These risk assessments reassuringly cite the low number of MERS-CoV cases reported by Qatar (n=28) over the past decade, but we also know that the incidence of MERS-CoV is likely under-reported (see EID Journal: Estimation of Severe MERS Cases in the Middle East, 2012–2016).

In their latest Update: Middle East Respiratory Syndrome Coronavirus (MERS-CoV) – Saudi Arabia, the World Health Organization cautioned:

The number of MERS-CoV cases reported to WHO has substantially declined since the beginning of the ongoing COVID-19 pandemic. This is likely the result of epidemiological surveillance activities for COVID-19 being prioritized, resulting in reduced testing and detection of MERS-CoV cases. 

In addition, measures taken during the COVID-19 pandemic to reduce SARS-CoV-2 transmission (e.g. mask-wearing, hand hygiene, physical distancing, improving the ventilation of indoor spaces, respiratory etiquette, stay-at-home orders, reduced mobility) are also likely reduce opportunities for onward human-to-human transmission of MERS-CoV.

However, the circulation of MERS-CoV in dromedary camels is not likely to have been impacted by these measures. Therefore, while the number of reported secondary cases of MERS has been reduced, the risk of zoonotic transmission remains. 

Unless and until we get some solid information to the contrary, I'm taking these recent reports of MERS at the World Cup in Qatar with a very large grain of salt.   

But the possibility exists, as the following article in The Lancet - published earlier this week - explains.

Esam I Azhar,,David S Hui, Brian McCloskey, Sherif A El-Kafrawy,,Avinash Sharma,Markus Maeurer et al.
 
Open AccessPublished:December 13, 2022DOI:

While MERS-CoV hasn't embarked on a world tour the way that COVID has, we've seen studies (see A Pandemic Risk Assessment Of MERS-CoV In Saudi Arabia) suggesting the virus doesn't have all that far to evolve before it could pose a genuine global threat.

Prior to the emergence of COVID, MERS-CoV was considered the biggest coronavirus threat.  While SARS-COV-2 beat it to the punch, it remains a credible pandemic threat. 
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