The detection of HCoV-EMC, as described by Zaki et al., probably forecasts an increasingly common theme in which new pathogens are identified before they may develop the potential for efficient human-to-human transmission.
From past experience, an astute clinician, public health official, or laboratory worker will recognize an unusual event and contact the appropriate health officials, who will investigate the event. Good communication between the clinic, laboratory, and public health community is important for rapid and effective assessment of the health risks.
Experience has shown that local investigation, if performed carefully and thoroughly, will correctly guide future response strategies. The dissemination of data on the clinical features of the illness allows for rapid case identification and contact tracing. Assessing the risk of human-to-human transmission indicates the broader health risk from the pathogen.
Cooperation with the veterinary health community is essential in identifying the animal reservoirs and in establishing methods to prevent future introductions of the virus. Laboratory studies provide the tools to detect the pathogen and develop diagnostic assays to confirm acute infections and detect previous ones.
The global community, represented by the World Health Organization (WHO), should be informed about cases in a timely fashion. The WHO can then lead the risk assessment and coordinate response efforts.
The global community was apparently not aware of the first case of HCoV-EMC infection until it was reported on ProMED, a website for monitoring emerging diseases, on September 20, 2012, approximately 3 months after the patient died. Luckily, there have been no new reports of cases since September 22, 2012, but local surveillance should continue.
With no evidence of human-to-human transmission, the WHO currently recommends no heightened global surveillance for this virus but continued “routine surveillance for early detection and rapid response to all potential public health threats.” However, such cases provide an opportunity to reconsider response strategies.