The Lancet, Volume 381, Issue 9882, Page 1960, 8 June 2013
In her closing remarks at the World Health
Assembly in Geneva last week, WHO's Director-General Margaret Chan
announced that the new Middle East Respiratory Syndrome coronavirus
(MERS-CoV) was her present “greatest concern”.
What
do we know about MERS-CoV? The novel virus was first reported in
September, 2012, in a patient in Saudi Arabia. As of June 2, WHO has
been informed of 53 laboratory-confirmed cases of infection, including
30 deaths. Most cases have arisen in the Middle East (Saudi Arabia,
Qatar, Jordan, and the United Arab Emirates), with a smaller number of
cases present elsewhere (Tunisia, Germany, UK, France, and Italy)—either
related to travellers returning from the region or transferred to the
country for care. Common symptoms in patients are acute, serious
respiratory illness with fever, cough, shortness of breath, and
breathing difficulties. Many of those infected develop severe pneumonia.
There
have been small clusters of infection in several countries suggesting
that person-to-person transmission is possible when close contact
occurs. But there is no evidence of sustained transmission. Last week, a
LancetArticle
showed that the virus's incubation could be longer than previously
reported—9—12 days instead of 1—9 days—which has implications for length
of quarantine needed to prevent secondary cases.
Many
unanswered questions remain about MERS-CoV, including the source of,
and main risk factors for, infection. A collaborative global research
effort will help close the gaps in knowledge. In this regard, news that
the scientists at Erasmus Medical Centre, Netherlands, who first
identified the virus, have applied for a patent on virus data has caused
consternation. The researchers have publicly responded to say that they
have sent the virus free of charge to many public research and health
institutions and they will continue to do so. They have told media that
they applied for a patent to ensure companies invest in making
diagnostics, vaccines, and antiviral medication. Let us hope their
expectations prove correct.
Free
information sharing, trust, and research cooperation will be crucial to
aid prevention, diagnosis, and treatment of this evolving global health
threat.
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