Thursday, 29 August 2013

MERS-CoV case numbers: WHO knows???

With the WHO's latest update we see that body's official MERS-CoV case count rise to 102 cases and 49 deaths. Its clear that even WHO is suffering from a lack of information - most cases listed here have no sex, date of onset of illness, hospitalisation or date of death. And its clearly not their role to dig into the minutiae of why the Saudi Arabian Ministry of Health reports deaths among previously reported cases....that clearly have not been previously reported

My count  with details available sits at 105 cases and 48 deaths. FluTrackers, who spend a lot of time sorting through  up-to-the-minute numbers, tweeted this morning that the case count was 106 and deaths were at 49. There is also a good comparison of the variability in a post by Pathfinder, a Senior Moderator, which really highlights how everyone has their own number. Some have new datasets that include probable cases - that's a very slippery slope, open to far too much interpretation and the potential for confusion. I favour the FluTrackers method of leaving a case list as a list of cases....anything else can be described and discussed separately.

And let's not even get into where we say a case is geographically based - do we do that based on whether it was detected there or acquired there (my prefence)?

There clearly is a need to consolidate case reporting and streamline the definition of case locations. Perhaps WHO could take a lead on proposing something here? 

Realistically it wouldn't change things too much. Since the internet provides the data for home-brew epidemiology (like my own MERS and H7N9 data!), its not surprising that we end up with this spectrum of figures.

While it might take longer to report on the cases, I think the WHO numbers are probably what we fall back on for reliability. These are people in direct contact with the sites of infections and reporting. For speed (and great accuracy as well!), FluTrackers cannot be beat.

In terms of MERS at least, at the end of the day we know it is not spreading with pandemic-level efficiency, we have a good idea of how to stymie its spread in healthcare settings, research is ongoing to find the host and then work out how humans get infected. We have only just crossed the line of 100 cases, worldwide. Not knowing about the dates and ages of a small number of MERS-CoV cases doesn't really impact on public health decisions, so long as the data are added to the total before a reasonable period of time has passed. Days not weeks lets say.

It's worth keeping everything in context when there are much larger and more devastating outbreaks of infection and disease happening elsewhere in the world. Polio and cholera are examples well covered by crofsblogs for example.