MERS-CoV: KSA/WHO Joint Mission Statement

 

 

 

# 7980

 

 

From the World Health Organization’s  Regional Office for the Eastern Mediterranean (EMRO), we get a press release/statement on the their joint MERS investigation with the Kingdom of Saudi Arabia (KSA) this morning.

 

 

Middle East respiratory syndrome coronavirus: Joint Kingdom of Saudi Arabia/WHO mission

Between 4 and 9 June 2013, a joint mission of the Kingdom of Saudi Arabia (KSA) and the World Health Organization (WHO) met in Riyadh to assess the situation due to a new coronavirus in the Kingdom. This virus has recently been named the Middle East respiratory syndrome coronavirus (MERS-CoV). It is a new, emerging virus that is distantly related to the virus that caused SARS.

 

The first documented cases of MERS occurred in Jordan in early 2012. Globally, to date there has been a total of 55 cases confirmed by laboratory testing. Of these, 40 have occurred in KSA, and the rest have been reported from other countries in the Middle East (Qatar and the United Arab Emirates), from Tunisia in North Africa, and from France, Germany, Italy and the United Kingdom of Great Britain and Northern Ireland in Europe.

 

The overall number of cases is limited, but the virus causes death in about 60% of patients. So far, about 75% of the cases in KSA have been in men and most have occurred in people with one or more major chronic conditions.

 

There appears to be three main epidemiological patterns.

• In the first pattern, sporadic cases occur in communities. At present, we do not know the source or how these people became infected.
• In the second pattern, clusters of infections occur in families. In most of these clusters, there appears to be person-to-person transmission, but it seems that this transmission is limited to people who are in close contact with a sick family member.
• The third pattern comprises clusters of infections in health care facilities. Such events have been reported in France, Jordan and KSA. In these clusters, the sequence seems to be that an infected person is admitted to hospital where that person then transmits the virus to other people in the health care facility.

Two important points need to be stressed.

• First, there is no evidence of widespread person-to-person transmission of MERS-CoV. Where it has been suspected that the virus has been transmitted from person to person, it appears that there had been close contact between somebody who was sick and another person: a family member, a fellow patient or a health care worker.
• Secondly, many fewer infections with MERS-CoV have been reported in health care workers in KSA than might have been expected on the basis of the previous experience of SARS. During the SARS epidemic, health care workers were at high risk of infection. The MERS-CoV is different from the SARS virus. Although the reason why fewer health care workers have been infected with MERS-CoV is not clear, it could be that improvements in infection control that were made after the outbreak of SARS have made a significant difference. In this context, infection control measures in KSA appear to be effective.

(Continue . . .)

Follow the link to read the report in its entirety.

 

One might wonder over the amount of praise heaped upon KSA in this report, given the recent high profile reports on the Saudi’s lackluster response to the MERS crisis by Helen Branswell:

 

Saudi Silence on Deadly MERS Virus Outbreak Frustrates World Health Experts 

Saudi paperwork demands delay work to research to find MERS source: CDC)

 

Simply put, bluntness rarely evokes the desired response in diplomatic circles, whereas praise has been known to work wonders.

 

As David Frost is quoted as saying, Diplomacy is the art of letting somebody else have your way.

H7N9: China-WHO Joint Mission Report

 

 

# 7290

 

A 51-page PDF file outlining the results of the World Health Organization’s April visit to China to assist in their investigation into the H7N9 virus (see H7N9: Dr. Keiji Fukuda Summarizes Mission Findings) has been posted on the WHO website.

 

While I’ve not had time to absorb the entire document, I’ve provided a link, and a few excerpts below to give my readers a head start.

 

From the assessment (see below), it is obvious that the WHO takes this new avian influenza threat very seriously.

 

China-WHO Joint Mission on Human Infection with Avian Influenza A(H7N9) Virus, 18-24 April 2013, Mission Report pdf, 1.09Mb

 

From the Assessment:

 

Currently, evidence so far is not strong enough to conclude there is person‐to‐person transmission. The limited available information suggests that many infections caused by this virus may be related to exposure to infected poultry in live poultry markets or to environments contaminated by this virus. However, future studies can strengthen the evidence.

 

The risk to people posed by the emergence of the H7N9 virus must be considered unusually serious, for several reasons. First, this virus has caused serious disease, including death, in some people. Second, this virus does not appear to cause disease in poultry (although it could change in the future to become highly pathogenic) and therefore could spread silently. Third, this virus has caused more human infections and disease in a shorter period of time than any other known avian influenza virus. Fourth, some H7N9 viruses show genetic changes that suggest they are partially adapted to infect humans more easily than other avian influenza viruses.

 

Taken together, these findings suggest that the possibility of this virus becoming transmissible among people is higher than for any other known avian influenza virus and therefore it must not be ignored.

Recommendations

• Undertake intense and focused investigations to determine the source(s) of human H7N9 infections. Identification of the source will enable urgent action to prevent continuing virus spread, with its potentially severe consequences for human and animal health.

Maintain a high level of alert, preparedness and response even though human cases might drop in the summer (as they do for many other avian influenza viruses) because of the seriousness of the risk posed by this virus and because much basic information remains unknown.

Continue to conduct and strengthen both epidemiological and laboratory‐based surveillance in human and animals in all provinces of China to identify changes that might indicate the virus is spreading geographically and gaining the ability to infect people more easily or transmit efficiently from person to person.

Ensure frequent mutual sharing of information, close and timely communication and, when appropriate, coordinated or joint investigations and research among ministries of health, agriculture and forestry because this threat requires the combined efforts of all these sectors.

Continue high‐level scientific collaboration,  communication and sharing of sequence data and viruses with WHO and international partners because the threat of H7N9 is also an international shared risk and concern.

Encourage and foster the scientific and epidemiological studies and research needed to close major gaps in critical knowledge and understanding.

Continue preparedness planning and other IHR core capacity strengthening work because such investments make a major difference in readiness to address health security risks and emergencies, including H7N9.