Virus Spread by Camels Isn’t Global Emergency for WHO

The deadly respiratory virus that’s spread from Saudi Arabia to the U.S. doesn’t represent a global health emergency, a World Health Organization panel said today, even as infections more than doubled in the past month.

There’s no evidence of sustained human-to-human transmission of Middle East respiratory syndrome coronavirus, or MERS-CoV, the WHO’s emergency committee said in a statement today, the fifth time it’s decided the virus doesn’t meet the criteria to be declared a public health emergency of international concern.

Since April 2012, 571 laboratory-confirmed infections have been reported to the Geneva-based WHO in 17 countries, including 171 deaths, most of them in Saudi Arabia, the agency said today. Many of the cases are related to outbreaks in Saudi hospitals, where a WHO team recently found basic infection control measures weren’t being followed, said Keiji Fukuda, the agency’s assistant director general for health security.

“If you glove up when you see a patient who may be infected, then you don’t want to use those same gloves with another patient,” Fukuda said at a briefing in Geneva today. “If you want to use masks, then you don’t want to be using that mask the entire day, you want to change them between seeing patients. These are some of the basic steps that were being looked for, and it was noted there were a lot of lapses.”

U.S. Cases

The U.S. this week reported its second case, in a health-care worker who lives and works in Saudi Arabia and is visiting family in Florida. The Netherlands reported its first case today, in a traveler who was infected abroad.

MERS causes fever, cough and shortness of breath, leading in severe cases to respiratory failure, organ failure and death. People with weakened immune systems such as the elderly and those with diabetes, cancer or chronic lung disease are most at risk. There’s no vaccine and no specific treatment.

The virus belongs to the same family of pathogens as SARS, which killed about 800 people worldwide after first appearing in China more than a decade ago. MERS-CoV was detected in three-quarters of samples taken from camels across Saudi Arabia, according to a study published in February in the journal mBio.

Camel Connection

At least 365 cases have been reported to the WHO since March 27, more than doubling the number of infections since the start of the outbreak. Contact with camels during the spring, when females wean their young, may have contributed to the surge in new cases, which has been amplified by poor infection control measures in hospitals, the WHO said in a report last week. An analysis of 128 cases in the Saudi city of Jeddah found that more than 60 percent were infected while in hospital.

Still, there’s no evidence the virus has mutated into a more transmissible form, nor that it can sustainably jump from one person to another, the agency said today.

“We don’t see any evidence of community infections sweeping through,” Fukuda said.

Saudi Arabia expects millions of Muslims from around the world to perform the annual Hajj pilgrimage to Mecca and Medina in early October. The WHO doesn’t recommend any travel restrictions related to MERS, though Saudi Arabia has recommended that pilgrims over 65 years or under 12, and pregnant women, shouldn’t make the journey.

The case reported by the U.S. Centers for Disease Control and Prevention yesterday was a person who traveled to Florida to visit family and began to feel ill during a flight from Jeddah to London.

Passenger Tracking

The CDC has sent staff to Saudi Arabia to work with the WHO to seek more information about the virus, and is tracking more than 500 passengers on three flights that the patient took within the U.S. before arriving in Florida.

Public Health England said it’s working with Saudi Airlines to contact British passengers who were sitting near the patient on the flight to London, even as it said the risk of transmission “is considered extremely low.”

The WHO on May 5 declared the spread of polio a global health emergency as the virus rebounds after being almost eradicated less than two years ago. Before last week, the agency had only declared an emergency once, for the 2009 influenza pandemic.

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