Friday, 23 August 2013

Maths says MERS-CoV still doesn't have pandemic potential

Breban and colleagues note in the Lancet that even with their most optimistic number crunching, there is only a low risk that that the coronavirus causing MERS could jump from an infected case to a naive person. Certainly not enough to pose a serious possibility of pandemic spread at this stage, based on what we know of the virus now and the case numbers and details we have to work with. The basic reproduction number (R0), or number of secondary cases (see the orange circles below), is still calculated to be less than 1. When >1, we consider epidemic potential reached.

Apparently that is despite clusters that may sometimes suggest otherwise.

Keeping in mind that a pandemic is largely about numbers - how many secondary infections occur  in close or other contacts - and how far and fast that transmission chain continues (the yellow circles and beyond).  
For me, this really reinforces just how important it is to have a full picture of a virus's transmission pathway. Not just the severe cases that show up in hospital, not just their contacts but also mild and asymptomatic cases in the community and the rest of the hospital. Prospective screening without regard to signs and symptoms in fact. 

Each and every person positive for the virus may represent a link in the transmission chain

You address whether mild cases can spread virus in another study. Oh, and we should probably keep monitoring all the viral strains we detect for genetic changes that occur in parallel with family clusters or upticks in transmission - which might signal increased potential to spread.

Don't test, don't find. Know nothing.