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The fifth meeting of the Emergency Committee convened by director-general Margaret Chan under the International Health Regulations concerning Middle East respiratory syndrome coronavirus (MERS-CoV) was held on May 13, 2014.
In addition to members of the Emergency Committee, three expert advisors participated in the informational session only. These advisors did not participate in the formulation of advice to the director-general.
Thirteen affected states reporting cases of MERS-CoV or evidence of infection since December 2013, were also on the first part of the teleconference: Egypt, Greece, Jordan, Kuwait, Lebanon, Malaysia, Oman, Philippines, Qatar, Saudi Arabia, United Arab Emirates, United States of America, and Yemen.
The WHO secretariat provided an update on and assessment of epidemiological and scientific developments, including a description of the recent increase in cases in communities and in hospitals, transmission patterns, and the main observations of a WHO mission to Saudi Arabia, conducted April 28, 2014 through May 5, 2014.
Affected countries gave information about recent events in their countries, including measures taken and their concerns about the current situation.
The members of the committee discussed the information provided. Based on current information, the Committee indicated that the seriousness of the situation had increased in terms of public health impact, but that there is no evidence of sustained human-to-human transmission. As a result of their deliberations, the committee concluded that the conditions for a Public Health Emergency of International Concern (PHEIC) have not yet been met.
However, the committee emphasized that its concern about the situation had significantly increased. Their concerns centred on the recent sharp rise in cases; systemic weaknesses in infection prevention and control, as well as gaps in critical information; and possible exportation of cases to especially vulnerable countries. The committee strongly urged WHO and its member states to take immediate steps to:
- improve national policies for infection prevention and control, and implement them in healthcare facilities in all countries; this is most urgent for affected countries;
- initiate and accelerate critical investigations, including case-control, serological, environmental, and animal studies, to better understand the epidemiology, especially risk factors and assess the effectiveness of control measures;
- support countries that are particularly vulnerable, especially in sub-Saharan Africa, taking into account the regional challenges;
- strengthen case and contact identification and management;
- greatly enhance awareness and effective risk communication concerning MERS-CoV to the general public, health professionals, at-risk groups, and policy makers;
- strengthen intersectoral collaboration and information sharing across ministries and with relevant international organizations, especially with the World Organization for Animal Health (OIE) and the Food and Agriculture Organization of the United Nations (FAO);
- develop and disseminate advice regarding mass gatherings to prevent further spread of MERS-CoV;
- share information in a timely manner with WHO, in accordance with the International Health Regulations (2005).
Based on the committee’s advice, and information currently available, the director-general accepted the committee’s assessment.
The WHO secretariat will continue to provide regular updates to the committee members and advisors. In view of the committee’s concerns, the Emergency Committee will be reconvened in June 2014 or earlier if circumstances warrant.