The increase in the number of MERS cases around the world isn't yet enough to make it a major public health emergency, a panel of World Health Organization experts says.
The panel members met for five hours by teleconference on Tuesday, Dr. Keiji Fukuda, assistant director general for health security with WHO, told a news conference Wednesday.
"What they reached was a consensus that the situation had increased in seriousness and urgency, but does not at this point constitute a public health emergency of international concern," he said.
Worldwide, the virus that causes Middle East respiratory syndrome has resulted in 571 laboratory-confimed cases that have been reported to the WHO, Fukuda said. There have been at least 145 deaths since September 2012, according to WHO. It was in late March that the 200-cases mark was crossed.
Fukuda said there were concerns about whether the ability of the virus to move from person to person could be growing. So far, however, there is "no evidence yet of an increase in the transmissibility of this virus."
An electron microscope image shows novel coronavirus particles, also known as the MERS virus, colourized in yellow. (National Institute of Allergy and Infectious Diseases-Rocky Mountain Laboratories/Associated Press)
The WHO emergency committee noted that hospital outbreaks have been a key factor in the spread of the virus. Asked why infection control is still a problem in hospitals after so many years of effort, Fukuda said that while the necessary practices are well known, "the most difficult thing … has been about how to get them implemented."
Even handwashing, he said, is done "pretty inconsistently, and it doesn't matter what country you're in."
Infectious disease specialists say that proper infection control early on for suspected MERS patients is key.
For example, a 44-year-old Saudi citizen may have passed the MERS virus on to health-care workers who treated him in Florida, including a doctor who had travelled to Canada.
It happened before health care adopted isolation precautions like wearing a mask, said Dr. Antonio Crespo of Dr. P. Phillips Hospital in Orlando.
The WHO committee took into account recent increase in cases in communities and in hospitals, transmission patterns, and the main observations of a WHO mission to Saudi Arabia between April 28 and May 5. Affected countries gave information, including the measures they have taken to halt the virus.
The spread of the virus from its base in the Arabian Peninsula has concerned Canadian experts.
"The big concern is that this could actually become a much bigger deal in multiple other countries, kind of a kin to what SARS did," Dr. Michael Gardam, director of infection prevention and control at the University Health Network in Toronto, told CBC News on Tuesday.
MERS seemed to have caught people in Saudi Arabia unaware before a systematic plan was put in place, he said.
Gardam was frustrated with the lack of clarity on Saudi Arabia's MERS patients and what is happening cases and concerned about the lack
Symptoms of MERS include cough, fever and sometimes fatal pneumonia. There can also be gastrointestinal symptoms. It is caused by the MERS coronavirus, a cousin of the SARS or severe acute respiratory syndrome coronavirus that killed around 800 people worldwide after first appearing in China in 2002. Coronaviruses are also a cause of the common cold.
In Canada and the U.S., the advice to the general public remains that the threat is low and standard precautions for a respiratory virus apply, such as frequent hand washing, avoiding someone who is coughing and sneezing, and staying home when sick.
"There's certainly lots of business travel between our country and the Middle East, so I would actually be surprised if we don't have an imported case or two," Dr. Mary Vearncombe, who was in charge of infection control at Toronto's Sunnybrook Hospital during the SARS outbreak, said Tuesday.
According to the U.S. Centers for Disease Control and Prevention, the origin of MERS is uncertain, but the virus likely came from an animal source. As well as humans, the virus has been found in camels in Qatar, Egypt and Saudi Arabia, and a bat in Saudi Arabia. The CDC stresses, however, that it's uncertain if camels are the source of MERS.
The case fatality rate for MERS is about 27 per cent, something doctors need to be careful about, Vearncombe said. Fortunately, the virus isn't efficient at spreading person to person in households.
For health-care workers, masks, eye protection, gown and gloves are recommended when treating patients with respiratory viruses.
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