The Enigmatic Epidemic

     

December 4, 2014

Dear Colleagues,

Since it first emerged, the MERS-CoV (Middle East Respiratory Syndrome Coronavirus) has infected at least 940 people and killed over 350. The disease has been seen mostly in Saudi Arabia, the focal point since early in the outbreak, but there have been autochthonous cases elsewhere in the Middle East and at least 20 cases in which infected individuals have traveled from that region only to sicken elsewhere.

Two years after the first news reports, we still understand little about MERS. The Saudi Ministry of Health issues daily bulletins on reported cases of MERS-CoV. Pursuing patterns, each report details not only the gender and age of the patient, but also a long list of suspected high risk exposures: whether he or she is a health care worker or has had contact with confirmed cases in hospitals or clinics or in the community, whether they have other pre-existing disease or had exposure to animals. But, if there is a pattern, it hasn't revealed itself in the data. While camels are regarded as the most likely reservoir for human infections, we still don't know how the virus makes the leap from camel to human. Or why camel handlers, butchers, and others who have intense contact with the animals and their bodily fluids appear no more likely to get MERS than people with no contact at all. Many who have fallen ill were city dwellers who had had no contact with camels; many have had no contact with confirmed cases. Research suggests an origin of MERS-CoV in bats, but the role of bats in transmission to camels and humans remains unclear.

One thing is certain, while MERS-CoV had a brief moment in the popular media spotlight, the steady increase in reported cases has not kept most people's attention. Where others have dropped the story, ProMED has been following the MERS story methodically, consistently, in detail, since the disease first emerged. We've posted 173 reports on this emerging disease in the past year and we'll keep pursuing it.

For the past twenty years, ProMED-mail has provided the thorough, comprehensive news and evidence-based information that helps doctors, hospital staff, and public health departments worldwide understand what is happeningnow around the globe. Whether reporting on MERS-CoV in the Middle East, SARS in China, HPAI in Southeast Asia, or enterovirus D68 in North America, ProMED brings you accurate, relevant, and timely emerging infectious disease reporting multiple times each day. With over 2955 reports so far this year, ProMED informs you about infectious disease, puts the information in context, and helps you understand its impact and import. But to maintain this level of coverage,ProMED-mail needs your support today.

The ECDC website has developed excellent graphics to help us understand the MERS-CoV outbreak. Among them is a map illustrating where MERS-CoV cases are local and where they've been imported. MERS has afflicted the holy city of Mecca, where pilgrims from the entire world converge for the annual hajj. But, while pilgrims are known to have brought the disease back to Iran, Jordan and Algeria, so far these importations have not caused further large outbreaks.

Because ProMED recognizes that microbes cross national frontiers ever more rapidly thanks to trans-border highways and air transport, and that animal, plant, and environmental health are inextricably interdependent, we are committed to doing more than track emerging diseases. The most important thing ProMED does is make connections among people and daily build an international community. Along with our parent organization, the International Society for Infectious Diseases, ProMED actively engages with partners around the world to promote the exchange of data, the sharing of information, and the creation of knowledge. Your support is essential to our achieving these goals. Your contribution will help ProMED continue to make connections, build awareness, and spread knowledge.

 

Sincerely,

Marjorie P. Pollack, Deputy Editor ProMED-mail