Friday, 17 January 2014

MERS-CoV cases climb...still a one hump camel

Click on image to enlarge.
..not that I'm implying anything about camels!

We're about 97-weeks or 1.87 years into the MERS-CoV outbreak. That' sis calculated by taking the week beginning Monday 19-Mar-2012 as Week 1 (if Excel hasn't failed me at least). It was in Week 1 that a 40-year old healthcare worker in Jordan showed signs of disease onset (See the literature on this here). 21-Mar-2012 to be precise.

Unlike avian influenza A(H7N9) virus, there has been no similar precipitous drop in MERS-CoV case accumulation. Why would there have been? The source of acquisition remains unknown. And the disease is still very much one reported by the Kingdom of Saudi Arabia (KSA). Although of late there have been no new confirmations. The last public case announcement was on Xmas day, 25-Dec. Has something been done to limit or control exposure to the virus or are cases just not occurring? Or are we just hearing about them any longer?

Whether the KSA is the main site of viral activity we don't know for certain, but it is certainly the main origin of case reporting. I seem to remember that Qatar had actively  sought other instances of MERS-CoV. I'm hoping to see some more research papers about that and other efforts to seek out MERS-CoV among humans...at some point. Negative results are results nonetheless!

Overall MERS-CoV numbers are still very small in the global scheme of things and while transmission to close contacts and healthcare workers does occur, it is not frequent. One round of transfer (from ill person to contact) seems to be the end of the transmission chain. I wonder if anyone has tested the contacts of the contacts?

Still no sign of any prospective in-country molecular (PCR-based) screening of well and mild general respiratory illnesses. This mean there is no real evidence to dismiss that the virus could be circulating in great numbers with only minor signs and symptoms. For all we know, MERS-CoV is contributing to the seasonal "common cold" and "influenza-like illness" burden in the region. This is not a difficult unknown to address by any means. PCR-based screening of upper respiratory tract samples; decent numbers will give you a trustworthy answer. Pretty basic stuff. Oh well.