The World Health Organization (WHO) has issued a bi-annual update on the Middle East respiratory syndrome coronavirus (MERS-CoV) infections reported from the Kingdom of Saudi Arabia. According to the WHO, six additional cases of MERS-CoV infections, including four associated deaths, were reported to WHO from the Kingdom of Saudi Arabia between 1 August 2021 to 28 February 2022.
What is MERS-CoV and how does it spread?
MERS-CoV is a zoonotic virus, which means that it is transmitted between animals and people. Studies have shown that humans are infected through direct or indirect contact with infected dromedary camels, although the exact route of transmission remains unclear. MERS-CoV can also spread from person to person through close contact, especially in health care settings.
MERS-CoV can cause severe respiratory illness, with symptoms such as fever, cough, shortness of breath, and pneumonia. Gastrointestinal symptoms, such as diarrhoea, have also been reported. Some people may have no symptoms or mild respiratory symptoms. The mortality rate of MERS-CoV infection is approximately 35%, but this may be an overestimate as mild cases may be missed by surveillance systems.
MERS-CoV was first identified in Saudi Arabia in 2012 and has since infected more than 2,000 individuals worldwide. Most of the cases have been reported from the Middle East, but some have also been exported to other countries by travellers who had exposure to camels or infected people.
How has the COVID-19 pandemic affected the detection and response to MERS-CoV?
The COVID-19 pandemic has posed significant challenges for the detection and response to MERS-CoV infections, as most of the resources have been redirected towards SARS-CoV-2, the virus that causes COVID-19. The testing capacity for MERS-CoV has been severely affected in many countries, resulting in a reduced number of reported cases. The WHO advises that countries should test all suspect MERS-CoV cases, and a subset sample of severe acute respiratory infections for MERS-CoV.
The infection prevention and control measures (IPC) are critical to prevent the possible spread of MERS-CoV in health care facilities. However, the COVID-19 pandemic has also increased the demand for personal protective equipment (PPE) and other IPC supplies, which may limit their availability for MERS-CoV prevention. The WHO recommends that health care workers should always apply standard precautions consistently with all patients, regardless of their diagnosis.
The COVID-19 pandemic has also affected the research and development of vaccines and therapeutics for MERS-CoV. The WHO has convened several expert consultations to review the progress and challenges of developing medical countermeasures for MERS-CoV. The WHO has also supported several clinical trials to evaluate potential treatments for MERS-CoV infection.
What are the recommendations and actions taken by the WHO and Saudi Arabia?
The WHO continues to monitor the epidemiological situation and conducts risk assessment based on the latest available information. The WHO expects that additional cases of MERS-CoV infection will be reported from the Middle East, and that cases will continue to be exported to other countries by individuals who might acquire the infection after exposure to camels or infected people.
The WHO encourages all Member States to continue their surveillance for acute respiratory infections, including MERS-CoV, and to carefully review any unusual patterns. The WHO also provides technical guidance and support to countries for the prevention, detection, and management of MERS-CoV infections.
The Ministry of Health of Saudi Arabia is working to increase the testing capacities for better detection of MERS-CoV infections. The Ministry of Health has also implemented several measures to prevent and control the spread of MERS-CoV, such as:
- Enhancing surveillance and laboratory testing for MERS-CoV
- Strengthening IPC practices in health care facilities
- Conducting active case finding and contact tracing
- Providing health education and awareness campaigns for the public and health care workers
- Collaborating with animal health authorities and other sectors to reduce the risk of zoonotic transmission
- Participating in regional and international cooperation and research on MERS-CoV
