Commentary

MERS: New scourge poses old ID challenge


 

There are hardly any infectious diseases that a little soap and water can’t help.

That old chestnut resurfaced when Dr. Keiji Fukuda of the World Health Organization announced on May 14 that while a special WHO panel had determined that the worldwide spread of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) did not yet constitute an international public health emergency, its spread right now seems to be driven largely by poor infection-control measures.

courtesy Centers for Disease Control and Prevention

A WHO panel determined the spread of MERS-CoV has been largely driven by poor infection control measures.

"Hospital outbreaks have been a key feature of this virus," which has produced nearly 600 confirmed cases worldwide, mostly in Saudi Arabia and the United Arab Emirates, but also with at least two confirmed cases in the United States, Dr. Fukuda said.

The recent uptick in cases – half of all cases to date were diagnosed in April – as well as their spread to new countries led the WHO special panel on MERS-CoV to meet May 13-14.

The panel concluded that no emergency exists yet. And they urged hospitals to put a much greater emphasis on the principles of Infection Fighting 101: handwashing, using masks and gloves, and changing gloves between patients.

In late April and early May, WHO staffers inspected several Saudi Arabian hospitals where MERS-CoV clusters had appeared and found "infection control practices were not up to standards," and that issues such as overcrowded emergency departments "amplified" the spread of MERS-CoV, Dr. Fukuda, WHO assistant director general, said during a press conference in Geneva.

MERS-CoV cases in the community also increased in recent weeks, which may reflect a seasonal rise in infections, improved surveillance and case recognition, or increasing person-to-person transmission. But Dr. Fukuda stressed that for now there is "no convincing evidence" of any change in the transmissibility of MERS-CoV or of its genetic makeup, and no evidence that MERS-CoV is cutting infectious swaths through communities.

The WHO committee put all the MERS-CoV evidence "on the table to see how it adds up," to produce "a very sober and critical assessment," a process Dr. Fukuda said could not have happened even 10 years ago.

mzoler@frontlinemedcom.com

On Twitter @mitchelzoler

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