Middle East Respiratory Syndrome - need for increased vigilance and watchful surveillance for MERS-CoV in sub-Saharan Africa

Zumla, Alimuddin; Rustomjee, Roxana; Ntoumi, Francine; Mwaba, Peter; Bates, Matthew; Maeurer, Markus; Hui, David S.; Petersen, Eskild

doi:10.1016/j.ijid.2015.06.020

Cited by 14 publications

(11 citation statements)

References 30 publications

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“…74 With 10 million pilgrims visiting Saudi Arabia each year from 182 countries for the Hajj and Umrah pilgrimages, 75 watchful surveillance by public health systems, and a high degree of clinical awareness of the possibility of MERS-CoV infection is essential, especially for countries with inadequate public health systems. 76 Nosocomial transmission is often due to a delayed diagnosis of MERS-CoV infection in a patient shedding MERS-CoV in a crowded health-care setting, such as an inpatient ward, emergency department, or renal dialysis unit. [28][29][30][31]36,[47][48][49]52,56 Early recognition of MERS-CoV infections, improved compliance with internationally recommended infection control protocols, and rapid implementation of infection control measures are required to prevent outbreaks of MERS-CoV associated with health-care facilities.…”

Section: Discussionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Hui

Azhar

Kim

et al. 2018

The Lancet Infectious Diseases

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395

327

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Middle East respiratory syndrome coronavirus (MERS-CoV) is a lethal zoonosis that causes death in 35·7% of cases. As of Feb 28, 2018, 2182 cases of MERS-CoV infection (with 779 deaths) in 27 countries were reported to WHO worldwide, with most being reported in Saudi Arabia (1807 cases with 705 deaths). MERS-CoV features prominently in the WHO blueprint list of priority pathogens that threaten global health security. Although primary transmission of MERS-CoV to human beings is linked to exposure to dromedary camels (Camelus dromedarius), the exact mode by which MERS-CoV infection is acquired remains undefined. Up to 50% of MERS-CoV cases in Saudi Arabia have been classified as secondary, occurring from human-to-human transmission through contact with asymptomatic or symptomatic individuals infected with MERS-CoV. Hospital outbreaks of MERS-CoV are a hallmark of MERS-CoV infection. The clinical features associated with MERS-CoV infection are not MERS-specific and are similar to other respiratory tract infections. Thus, the diagnosis of MERS can easily be missed, unless the doctor or health-care worker has a high degree of clinical awareness and the patient undergoes specific testing for MERS-CoV. The largest outbreak of MERS-CoV outside the Arabian Peninsula occurred in South Korea in May, 2015, resulting in 186 cases with 38 deaths. This outbreak was caused by a traveller with undiagnosed MERS-CoV infection who became ill after returning to Seoul from a trip to the Middle East. The traveller visited several health facilities in South Korea, transmitting the virus to many other individuals long before a diagnosis was made. With 10 million pilgrims visiting Saudi Arabia each year from 182 countries, watchful surveillance by public health systems, and a high degree of clinical awareness of the possibility of MERS-CoV infection is essential. In this Review, we provide a comprehensive update and synthesis of the latest available data on the epidemiology, determinants, and risk factors of primary, household, and nosocomial transmission of MERS-CoV, and suggest measures to reduce risk of transmission.

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Section: Discussionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Hui

Azhar

Kim

et al. 2018

The Lancet Infectious Diseases

Self Cite

395

327

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“…Global public health authorities guidelines (CDC 2016; WHO 2015b) recommend to use, whenever it is possible airborne infection control (Zumla et al 2015d). However this observation may reflect the lack of clinical awareness of MERS and that diagnosis and treatment of respiratory tract infections largely remains empiric, without laboratory confirmation.…”

Section: Infection Control and Transmission Riskmentioning

confidence: 99%

The Middle East Respiratory Syndrome Coronavirus – A Continuing Risk to Global Health Security

Azhar

Lanini

Ippolito

et al. 2016

Emerging and Re-Emerging Viral Infections

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Two new zoonotic coronaviruses causing disease in humans (Zumla et al. 2015a; Hui and Zumla 2015; Peiris et al. 2003; Yu et al. 2014) have been the focus of international attention for the past 14 years due to their epidemic potential; (1) The Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) (Peiris et al. 2003) first discovered in China in 2001 caused a major global epidemic of the Severe Acute Respiratory Syndrome (SARS). (2) The Middle East respiratory syndrome coronavirus (MERS-CoV) is a new corona virus isolated for the first time in a patients who died of severe lower respiratory tract infection in Jeddah (Saudi Arabia) in June 2012 (Zaki et al. 2012). The disease has been named Middle East Respiratory Syndrome (MERS) and it has remained on the radar of global public health authorities because of recurrent nosocomial and community outbreaks, and its association with severe disease and high mortality rates (Assiri et al. 2013a; Al-Abdallat et al. 2014; Memish et al. 2013a; Oboho et al. 2015; The WHO MERS-CoV Research Group 2013; Cotten et al. 2013a; Assiri et al. 2013b; Memish et al. 2013b; Azhar et al. 2014; Kim et al. 2015; Wang et al. 2015; Hui et al. 2015a). Cases of MERS have been reported from all continents and have been linked with travel to the Middle East (Hui et al. 2015a; WHO 2015c). The World Health Organization (WHO) have held nine meetings of the Emergency Committee (EC) convened by the Director-General under the International Health Regulations (IHR 2005) regarding MERS-CoV (WHO 2015c). There is wishful anticipation in the political and scientific communities that MERS-CoV like SARS-CoV will disappear with time. However it's been nearly 4 years since the first discovery of MERS-CoV, and MERS cases continue to be reported throughout the year from the Middle East (WHO 2015c). There is a large MERS-CoV camel reservoir, and there is no specific treatment or vaccine (Zumla et al. 2015a). With 10 million people visiting Saudi Arabia every year for Umrah and/or Hajj, the potential risk of global spread is ever present (Memish et al. 2014a; McCloskey et al. 2014; Al-Tawfiq et al. 2014a).

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“…1 The emergence of intensive camel livestock system and large trade between countries, particularly from Somalia to Gulf regions, leading to roughly 77,000 live camels being exported each year, can significantly contribute to multiple disease transmissions. 43…”

Section: Sources and Transmissionmentioning

confidence: 99%

Middle East respiratory syndrome coronavirus (MERS-CoV): A review

Ramadan¹,

Shaib²

2019

Germs

275

202

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As a novel coronavirus first reported by Saudi Arabia in 2012, the Middle East respiratory syndrome coronavirus (MERS-CoV) is responsible for an acute human respiratory syndrome. The virus, of 2C beta-CoV lineage, expresses the dipeptidyl peptidase 4 (DPP4) receptor and is densely endemic in dromedary camels of East Africa and the Arabian Peninsula. MERS-CoV is zoonotic but human-to-human transmission is also possible. Surveillance and phylogenetic researches indicate MERS-CoV to be closely associated with bats' coronaviruses, suggesting bats as reservoirs, although unconfirmed. With no vaccine currently available for MERS-CoV nor approved prophylactics, its global spread to over 25 countries with high fatalities highlights its role as ongoing public health threat. An articulated action plan ought to be taken, preferably from a One Health perspective, for appropriately advanced countermeasures against MERS-CoV.

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Middle East Respiratory Syndrome - need for increased vigilance and watchful surveillance for MERS-CoV in sub-Saharan Africa

Cited by 14 publications

References 30 publications

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

Middle East respiratory syndrome coronavirus: risk factors and determinants of primary, household, and nosocomial transmission

The Middle East Respiratory Syndrome Coronavirus – A Continuing Risk to Global Health Security

Middle East respiratory syndrome coronavirus (MERS-CoV): A review

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