http://www.digitaljournal.com/article/354634

MERS coronavirus no emergency, rules WHO panel

Posted Jul 17, 2013 by Kathleen Blanchard
A panel of experts convened by the World Health Organization (WHO) has unanimously decided the MERS coronavirus is not, at least yet, an emergency threat to public health.
WHO experts panel rules MERS coronavirus not a public health emergency.
WHO experts panel rules MERS coronavirus not a public health emergency.
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The decision follows a teleconference that took place yesterday among Saudi Arabia’s deputy health minister Ziad Memish and officials from six other countries.
MERS coronavirus that has predominantly been confined to the Middle East and has infected 82 people and killed 45 since September was described as a “… threat to the entire world” by Margaret Chan, the WHO’s director-general in May, 2013. Chan is in agreement with the panel's decision.
Since then, the WHO has discussed at length whether travel should be limited, announcing their decision one week after the 15-member panel of epidemiologists met on July 10.
Fukuda said taking “dramatic action” by declaring MERS coronavirus and “emergency” could do more harm than good. He expressed concern that doing so might also ruin the WHO’s credibility.
Within hours after the announcement, there were reports of 2 new MERS CoV cases involving a 26-year-old Saudi male and a 42-year-old female "resident," both living in the southwestern province of Asir, the Center for Infectious Disease and Research Policy (CIDRP) reports, that have not yet been acknowledged by the WHO.
Each infection source is accounted for. The female is a health worker and the Saudi male had contact with a previously infected individual.
But that’s not to say the respiratory virus isn’t concerning, WHO assistant director-general for health security and environment, Keiji Fukuda, said in a press release.
When asked if not declaring the MERS CoV an ‘emergency’ would mean the virus isn’t serious, Fukuda responded: “The emergency committee did a really good job in landing where I think many of us assess the situation to be. In essence they're not saying this is unimportant. They're saying you need to keep us updated…I think they're sending out a pretty balanced message."
The WHO plans to release travel guidelines in several days.
Fukuda said the panel extensively discussed the issue of travel given the upcoming Umrah and Hajj pilgrimages that is expected to draw large numbers of people to Saudi Arabia.
For now there are no plans to restrict travel or issue advisories for people to avoid going anywhere.
Fukuda continues to admit there are still many unanswered question about the MERS coronavirus; some of which include why there are not many contact cases. He says it may be that testing is not picking the virus up. “We don't have the kind of serologic studies we'd like to see”, he said, though several tests are available that may not be detecting the same things.
Another mystery is the animal source of coronavirus that teams in the Netherlands, the United States are researching.
Recommended investigation for animal source of infection include investigating animals in and around areas where there is a human infection, handling and working with livestock, visiting farms, practicing falconry and handling of excrement or contaminated body fluids from potentially infected animals.
The expert panel also provided recommendations to WHO that included infection control and clinical management, increased surveillance for MERS CoV including contact history and serologic studies, guidance for travel that is pending, maintaining public communication about risks, ongoing animal, clinical and epidemiological research and meticulous and timely reporting of any suspected cases of the virus.
The virus, unlike others, carries a 50 percent rate of mortality in confirmed cases, which has been a major concern.
Respiratory symptoms including cough, fever and respiratory failure are the primary symptoms. According to the U.S. Centers for Disease Control (CDC), secondary conditions associated with the virus include "acute renal failure, multi-organ failure, acute respiratory distress syndrome (ARDS), and consumptive coagulopathy - a clotting disorder that leads to hemorrhage, organ failure and death.
The expert committee plans to reconvene in September, the WHO said in their website press release.