IHR Emergency Committee alerts to continued and significant public health risks posed by MERS
The WHO Emergency Committee has emphasised a "heightened sense of concern" with the overall MERS situation, but does not deem the current sitatuion to be a Public Health Emergency of International Concern.
On 2 September 2015, for the tenth time since Middle East respiratory syndrome (MERS) was first reported in 2012, WHO convened its Emergency Committee on MERS to consider if the situation constitutes a Public Health Emergency of International Concern, taking into account the recent cases and transmission patterns in the Middle East. It was the third time this committee convened in 2015, having previously met to consider the outbreak in South Korea in June and the surge in cases in February.
While agreeing once again that the situation still does not constitute a Public Health Emergency of International Concern (PHEIC), the committee emphasised a “heightened sense of concern about the overall MERS situation” and concluded that, since the emergence of MERS three years ago, steps to combat the disease have been insufficient and that the global community stands at significant risk of further MERS outbreaks. As illustrated by the recent outbreak in South Korea, a MERS outbreak in a new setting can lead to widespread transmission.
The committee pointed to:
- insufficient awareness about the urgent dangers posed by MERS;
- insufficient engagement by all relevant sectors including animal and human health;
- insufficient implementation of infection control measures, especially in healthcare settings such as emergency departments;
- inadequate progress in understanding how MERS is transmitted in various settings.
The Emergency Committee issued additional advice to governments and other authorities, highlighting the need to address deeper systemic issues impeding the control of MERS in both animals and humans, as well as calling for rapid and timely sharing of information of public health importance, and accelerated development of human and animal vaccines and therapeutics, among other measures.
Through its risk assessment updates on MERS, ECDC has repeatedly emphasised the importance of infection control measures and heightened vigilance among healthcare workers and travellers from areas with continued MERS transmission. The current nosocomial outbreaks in Riyadh and Amman are the latest reminder of the need for healthcare systems to be prepared.
The source of infection for cases without known exposure to camels, confirmed MERS cases or healthcare settings remains unknown. More in-depth epidemiological and virological analyses in affected countries are needed to identify risk factors and relationships between infection chains. Publicly available sequences of a sufficient amount of viruses is useful in order to better understand viral evolution. Detailed epidemiologic descriptions and analysis on the current hospital-related outbreaks, as well as communication on timing and implementation of control measures, are necessary for ongoing risk assessments.
In the current circumstances, sporadic imported cases of MERS can be expected in the EU/EEA and are associated with a risk of nosocomial transmission. This highlights the need for awareness among healthcare workers, early detection through functioning testing algorithms, preparedness planning and stringent infection control precautions. However, the risk of widespread transmission of MERS-CoV in the community after sporadic importation into the EU/EEA remains low.