World Health Organization: MERS isn’t an emergency

Muslim pilgrims wears surgical masks to help prevent infection from MERS in the holy city of Mecca, Saudi Arabia, on May 13.

The World Health Organization said it is very concerned about a potentially lethal virus called MERS, but it stopped short of calling the recent outbreak a public health emergency.

The Middle East Respiratory Syndrome virus, which originated in Saudi Arabia, has been spreading rapidly since March and has been transmitted recently by travelers to seven different countries, including the United States.

One of those travelers, treated in Indiana, has recovered fully and apparently did not pass on the virus; a second, in Orlando, is still hospitalized.

On the positive side, a spokeswoman for the Orlando hospital says two employees tested negative for the rare MERS virus days after coming into contact with a Saudi resident with the second confirmed case in the U.S. Katie Dagenais said Wednesday that the two tested employees from Dr. P. Phillips Hospital include one who was hospitalized Monday. The other was discharged the same day.

Hospital officials are still awaiting test results from 18 health care workers from Dr. P. Phillips Hospital and Orlando Regional Medical Center who are being monitored for potentially having the virus.

So far, the virus has infected 571 people globally, killing 171 of them. On Wednesday, the Netherlands’ National Institute for Public Health and the Environment announced its first case of MERS, a man who became infected during a visit to Saudi Arabia. He is now in isolation at a hospital in the Hague.

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The majority of cases have been in Saudi Arabia, although the disease has spread within the region and to Asia, North Africa, Europe and the United States.

MERS often starts with flulike symptoms but can lead to pneumonia, breathing problems and in severe cases, kidney failure and death.

A committee of the World Health Organization met Tuesday for five hours to discuss the outbreak and its recent spread. Though extremely concerning, the committee decided the outbreak was not a public health emergency because transmission has largely taken place in hospitals, not in the general community.

The virus is formally called MERS-CoV because it is a member of the coronavirus family that includes the common cold and Severe Acute Respiratory Syndrome, which killed about 800 people worldwide in 2003.

“Calling a global emergency in a world which has a lot of issues is a major act,” Keiji Fukuda, an assistant director-general of WHO, told reporters Wednesday. “You have to have really solid evidence to say this is a global emergency.”.

Fukuda said there wasn’t yet proof of the virus’ sustained transmission among people.

Last week, however, WHO did declare the world’s widening polio outbreaks to be an international health emergency.

Some scientists said while MERS technically meets the criteria for a global health emergency, declaring it as such could confuse the public.

“People might think (WHO) is crying wolf because MERS is still primarily a problem in the Middle East,” said Michael Osterholm, an infectious diseases expert at the University of Minnesota who has worked in the Middle East. “But if one of those infected people gets on a plane and lands in London, Toronto, New York or Hong Kong and transmits to another 30 people, everyone will have a different view.”.

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The committee issued four recommendations and cited key concerns, according to Fukuda, who held a news conference early Wednesday to discuss the findings:.

• Countries must step up their infection control to limit spread of the disease, particularly in hospitals. WHO representatives recently in Saudi Arabia noticed infection control lapses in several hospitals, such as failure to wash hands between patients or wear gloves and masks properly. These lapses are typical of hospitals everywhere, Fukuda said, but are essential to rein in the virus.

• Some studies must be completed quickly to fill in gaps in information. There are still a lot of unknowns about the virus that emerged only a little over two years ago, he said. It’s still not clear, for instance, exactly how the virus is transmitted, either from animals to people or among people. Camels in Saudi Arabia have been found to have the virus, but it is not known whether they are the only source of it, and what kind of contact is required, such as eating their meat, drinking their milk or handling them directly. It is also unclear whether the virus is passed between people primarily through cough droplets and whether those need to be airborne, or can be on surfaces, for instance. The extremely dangerous SARS virus was brought under control a decade ago by killing off caged animals that had been a primary source of transmission, but killing all the infected camels would be impossible, officials have said.

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• Countries need to provide consistent guidance on how to manage those who come into contact with MERS victims, so they are treated the same way across international borders.

• Awareness about MERS must be raised among people who are going to be involved in mass gatherings, like the Hajj pilgrimage, which will occur in early October and attract more than 2 million people to the small city of Mecca in Saudi Arabia. Diseases are more likely to be transmitted among people when so many are in such close contact.

The MERS committee plans to meet again in the next few weeks to reassess the situation.

As viruses are transmitted from animals to people and within populations, their genes can mutate, changing their level of contagion and risk. The MERS-CoV virus has not mutated much since it first emerged two years ago, according to genetic analysis of recent cases, Fukuda said – though, of course, it still might.

The biggest concern among health officials is that a virus like the 1918 flu might develop, which is both lethal and highly contagious. That flu affected as much as 20% of the world’s population and killed 675,000 Americans.

Contributing: Associated Press.

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