Via The Lancet, an editorial: MERS-CoV: address the knowledge gaps to move forward.
The first and second cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection in the USA were reported by the Indiana State Department of Health and the Florida Department of Health on May 1 and May 11, respectively, to the Centers for Disease Control and Prevention. These two cases, like all previous cases reported worldwide, have a Middle Eastern connection.
Person-to-person transmission of MERS-CoV has not been sustained, but the number of cases reported to WHO has been increasing. However, according to the WHO Statement on the Fifth Meeting of the International Health Regulations Emergency Committee released on May 14, the conditions have not yet been met for a MERS-CoV public health emergency of international concern. More than 600 laboratory-confirmed cases have been reported to WHO so far. Alarmingly, Simon Cauchemez and colleagues reported that at least 62% of asymptomatic cases had not been detected up to Aug 8, 2013.
Although severe acute respiratory syndrome (SARS) coronavirus and MERS-CoV have different infection sources, some of the lessons learnt from SARS since 2003 are relevant for the prevention of MERS-CoV transmission. All confirmed and probable cases of MERS-CoV infection should be notified to WHO. Health-care personnel should be taught or given refreshers on infection control practices to safeguard against nosocomial transmission. In a Comment, Alimuddin Zumla and David Hui stress the importance of basic measures for infection control for curbing the increase in nosocomial infections.
Since the first case of MERS-CoV was reported in Saudi Arabia in September, 2012, much remains to be learnt about the virus. In 2013, Abdullah Assiri and colleagues pointed out major gaps in knowledge about the epidemiology, community prevalence, and clinical range of MERS-CoV.
Questions that still need to be addressed include what are the optimum measures for infection control, what is the potential for person-to-person transmission, and what is the complete range of expression of disease? International collaboration is imperative to address the gaps in knowledge and apply the lessons learnt from past outbreaks to existing and emerging infectious diseases.