Accelerating the global MERS response

While you may not have been hearing much in the news about MERS lately, don’t let that lack of news coverage lull you into a false sense of security. But also don’t let it scare you into an unnecessary panic about MERS either. That’s sort of the issue with MERS at the moment. We’re not totally sure how alarmed we should be. MERS is deadly for people, can spread from the Middle East quite easily via travelers, but no one is totally sure how people get it in the first place.

MERS transmission map. Courtesy WHO.

MERS transmission map. Courtesy WHO.

Current MERS in the world

As you can imagine, Middle East Respiratory Syndrome (MERS) is most commonly found in the Middle East. I’ve covered MERS before in a previous post so feel free to read it here. In summary, most of the cases occur in Saudi Arabia with the occasional spread of cases to other Middle East countries such as Oman, United Arab Emirates, and Qatar, among other Middle Eastern countries. Cases have also occurred in South Korea, Austria and Thailand, among other non-Middle East countries.

The most recent WHO MERS case count map and epi curve. Courtesy WHO.

The most recent WHO MERS case count map and epi curve. Courtesy WHO.

It’s not super easy to get MERS. Most of the people who got MERS either got it from hospital transmission (by being a nearby patient to a MERS case or a healthcare worker treating a MERS case) or from direct exposure to infected camels. So the average person is probably not going to come down with MERS, at this time. I can’t speak to any potential future mutations that make person-to-person spread of MERS more common, but the goal is to address MERS before it gets to that point.

THE WHO’s response to MERS

Serious gaps exist in the knowledge of MERS, specifically how it circulates in camels (camels with one hump, not two hump camels), the natural reservoir host, and how it gets into the human population. The WHO, Food and Agriculture Association (FAO) and World Organisation for Animal Health (OIE) hosted a meeting in September where they discussed the challenges faced by MERS. While progress has been made by the three organizations over the past five years, there are still key unknowns regarding MERS transmission.

While the numbers of MERS cases remains relatively low, the WHO and members of the Emergency Committee decided that MERS is not yet a Public Health Emergency of International Concern (PHEIC). But the Committee also noted that MERS continues to be closely watched and they urge countries to follow the advice they’ve been given. This advice includes reporting positive asymptomatic cases, sharing timely information between affected countries, and maintaining virological surveillance.

MERS vaccine?

So we know MERS lives in camels, but we’re not sure where else it lives. That means that the two obvious targets for vaccine development are humans and camels. Two camel vaccines have been developed, but only one, developed by the Jenner Institute, is in field trials. The other vaccine, developed by the Erasmus Medical Center, is still seeking funding for trials. Let’s not forget about human vaccines. GeneOne Life Science, Inc. has recently received approval from the South Korean Ministry of Food and Drug Safety to begin Phase I/IIa clinical trials of their MERS-Cov vaccine.

So what’s the takeaway?

Continue to keep MERS on your radar. I know it can be overwhelming to try to remain aware of so many different communicable diseases around the world, but, even with everything going on in the world, diseases will continue to spread. If you’re not travelling to the Middle East and/or having a ton of contact with camels then you probably don’t have to worry about MERS too much at the moment. But as with all communicable diseases, MERS is a mutation away from becoming a major global issue.

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