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The World Health Organization (WHO) is concerned about the rising number of cases of Middle East respiratory syndrome coronavirus (MERS-CoV) in recent weeks, especially in Saudi Arabia and the United Arab Emirates, and in particular that two significant outbreaks occurred in healthcare facilities.
“Approximately 75 percent of the recently reported cases are secondary cases, meaning that they are considered to have acquired the infection from another case through human-to-human transmission,” says WHO regional director for the Eastern Mediterranean, Dr. Ala Alwan. “The majority of these secondary cases have been infected within the healthcare setting and are mainly healthcare workers, although several patients are also considered to have been infected with MERS-CoV while in hospital for other reasons.”
Although the majority of the cases had either no or only minor symptoms, and most do not continue to spread the virus, WHO acknowledges that some critical information gaps remain to better understand the transmission of the virus as well as the route of infection. WHO is unaware at this point in time of the specific types of exposure in the health care facilities that have resulted in transmission of these infections, but this remains a concern.
Therefore, WHO has offered its assistance to mobilize international expertise to work jointly with national health authorities in Saudi Arabia and the United Arab Emirates to investigate the current outbreaks in order to determine the transmission chain of this recent cluster and whether there is any evolving risk that may be associated with the current transmissibility pattern of the virus.
Since the emergence of MERS in April 2012, a total of 253 laboratory-confirmed cases of human infections with MERS have been reported to WHO, including 93 deaths. These cases have been reported in the Middle East (including Jordan, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates); in Europe (France, Germany, Greece, Italy and the United Kingdom of Great Britain and Northern Ireland); in North Africa (Tunisia); and in Asia (Malaysia and the Philippines). The source and mode of infection for the virus remain undetermined.
Several recent cases of people becoming infected in either Saudi Arabia or United Arab Emirates and travelling to a third country have also been reported. Greece, Jordan, Malaysia, and Philippines each reported one such case. So far no further spread of the virus in those countries has been detected. Imported cases already occurred in the past that resulted in limited further human-to-human transmission in France and United Kingdom.
WHO urges all of its member states to remain vigilant and enhance surveillance to detect any early sign that the virus has changed and has attained the possibilities of causing sustained person-to-person transmission. WHO expects that it is only through an enhanced coordinated effort the mystery and the risk to global health associated with the emergence of this virus can be unraveled.