Since April 2012, 992 cases of Middle East respiratory syndrome coronavirus (MERS-CoV) have been reported by local health authorities worldwide, including 401 deaths.
Incidence shows a decrease after the surge in October 2014 and the majority of cases are still reported from the Arabian Peninsula, mainly from Saudi Arabia, said the European Centers for Disease Control and Prevention (ECDC) in an update last week.
The source of the virus remains unknown, but the pattern of transmission points towards dromedary camels in the Middle East being a reservoir from which humans can become infected through zoonotic transmission.
Emergency Committee meeting
At the eighth meeting of the International Health Regulations (IHR) Emergency Committee (EC) Austria, Oman, Qatar, Saudi Arabia, and Turkey provided an update on the disease in their countries.
The committee noted although significant efforts have been made to strengthen infection prevention and control measures, transmission in healthcare settings is still occurring.
It said that although the pattern of transmission appears relatively unchanged, the overall situation and the possibility of international spread remain of concern.
“In addition, increased surveillance in many countries is needed to better monitor trends related to the spread of this virus. Additional information from studies is also required to better understand the risk factors for infection and transmission.
“In particular, the results of case-control studies from affected countries are urgently needed.”
The committee made a number of recommendations to affected countries including monitoring evolution of MERS-CoV infection, reinforcing epidemiological surveillance in camels, surveillance in humans and addressing critical gaps in knowledge of human and animal transmission.
Possible foodborne source
A possible route might be foodborne transmission through consumption of raw camel milk or undercooked meat, according to an assessment in Eurosurveillance.
Dromedary camels are a host species for the virus, and many of the primary cases in clusters have reported direct or indirect camel exposure, said ECDC.
However, close contact with infectious camels does not always seem to result in human infections.
Recent studies in Qatar show that MERS-CoV can be detected in raw milk from infected camels, said WHO.
“Whether camels excrete MERS-CoV in milk or the virus gets into the milk through cross-contamination during milking is unclear.
“However, if MERS-CoV is present, it will be destroyed by pasteurization or cooking.”
WHO said it will continue to provide updates to members and advisors and the committee will be reconvened if circumstances require.