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The current wave of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) infections is related to poor infection control in hospitals, officials of the World Health Organization said June 17.
"There is no evidence of sustained person-to-person transmission occurring in communities," Dr. Kenji Fukuda, assistant director general of WHO in Geneva, said during a press conference to disclose findings from the organization’s International Health Regulations Emergency Committee on MERS-CoV. The committee met the day before.
Courtesy of Maureen Metcalfe/Azaibi Tamin
The spread of MERS-CoV can be contained through stricter infection control measures, says the WHO.
Rather, Dr. Fukuda said, the most recent cases appear to be related to "suboptimal" infection control measures in hospitals. He stressed that the measures required for controlling MERS-CoV transmission in hospital settings were "basic" and could be implemented anywhere, regardless of resources.
"Infection control can really reduce spread in hospitals. This is a critical finding," he said.
WHO officials have reported 701 laboratory confirmed cases of MERS-CoV to date and 249 deaths worldwide. Dr. Fukuda downplayed concerns that Saudi Arabia, where the majority of MERS-CoV cases and deaths have occurred, continues to report inaccurate or out-of-date figures. Significant under-reporting of MERS-CoV cases and deaths was revealed and corrected by Saudi officials early this month, raising the number of cases there by 20%.
"Saudi Arabia is making a very strong effort to catch up," Dr. Fukuda said. "I am confident that the government has really strengthened its efforts to keep on top of the numbers."
He also said that WHO’s infection-prevention recommendations for MERS-CoV have changed to reflect the most recent findings that the virus can be directly transmitted from camels to humans.
"We have a better understanding that camels are a very important source of exposure in the community," he noted. For people working directly with camels, including veterinarians and keepers, Dr. Fukuda said, "recommended practices include leaving clothes in the workplace." Other recommendations include drinking only pasteurized milk and cooking all food thoroughly to prevent another potential source of viral contamination.
Recommendations for pilgrims to Mecca, Saudi Arabia, and for medical delegations accompanying them, "have expanded a lot since last year" to reflect what is known about transmission and exposure. Still, Dr. Fukuda said, WHO officials remain concerned that basic infection control measures be communicated and improved prior to this year’s Hajj in October.
Because so little person-to-person transmission in community settings has been reported so far, he said, "the current situation does not constitute a public health emergency of international concern."
MERS-CoV, however, remains a "serious" public health threat because of its high fatality rate and the fact that much remains unknown about how the virus is transmitted from camels to people, and a lack of understanding about the ultimate source of the virus.
"The gorilla in the room," Dr. Fukuda said, is whether the virus "has the potential to change and become much more transmissible person to person."