23 May 2014, Muscat, Oman/Rome – Health experts and veterinarians are among those calling for stepped up monitoring, investigations, and immediate reporting of cases of the potentially fatal Middle East Respiratory Syndrome (MERS), an infection that has caused numerous human illnesses and deaths, but whose origins may be linked to animals.
A declaration at a regional technical consultation meeting, convened by FAO in the Sultanate of Oman, warned countries in the region and beyond of the need for public health and veterinary authorities to carry out coordinated investigations, and share information and results.
Participants noted the “recent upsurge in human cases in the Arabian Peninsula and the suspected zoonotic transmission involving, in particular, dromedary camels.” They agreed on a list of specific recommendations to increase knowledge about the transmission of the virus to humans and to minimize its impact on animal and human health, as well as agriculture and livestock-related livelihoods.
“It is vitally important for the international community to increase our understanding of ‘where’ and ‘how’ the virus is transmitted, ‘who’ the source is – whether animal or human – and ‘when’ and ‘why’ certain people are spreading the virus,” said Juan Lubroth, Chief Veterinary Officer at FAO.
“There is an urgent need to focus investigations on the epidemiology of MERS-CoV in animal species, to prevent human primary infections and to avoid putting other people in danger,” added Lubroth.
“By better understanding the epidemiology, we can provide the necessary guidelines to avoid spillover from animals to humans and protect the camel or other animal industries from potential negative consequences,” he said.
As of May 21, MERS had led to over 630 laboratory-confirmed illnesses among humans and more than 190 deaths since 2012, according to the World Health Organization (WHO). It has affected people primarily in the Kingdom of Saudi Arabia, but cases have also been reported in the United Arab Emirates, Qatar, Jordan, Oman and Yemen.
Other cases reported in Asia, North Africa, Europe and North America have been linked to travel or work in the Middle East region, reflecting the role that the speed of global travel can potentially play in the spread of disease agents.
The majority of cases have occurred through human-to-human transmission, however it remains to be determined if people may have been infected by contact with environmental or animal sources.
“Participants in the MERS consultation agreed that there is also a vital need to raise awareness among the public at large about the importance of seeking medical attention, the nature of the disease, and ways to avoid it,” Lubroth stressed.
The recommendations are focused on the potential link with camels or other animal sources. Priorities should be given to:
1. raising public awareness of MERS-CoV
2. urgent investment in research and surveillance of animals;
3. the systematic search for potential sources of human infection from animal sources or the environment;
4. joint efforts and coordination among public health authorities.
Concerted action is also called for in the areas of:
- good practices in heightening biosecurity measures at farms or at border crossings;
- underscoring the importance of personal hygiene practiced by people who work around livestock, slaughterhouses and racing animals — such as frequent hand-washing after touching animals, protective clothing and washing of soiled clothing, shoes and other items;
- greater region-wide information sharing and closer coordination to manage risks posed by the movement and trade of livestock;
- possible introduction of animal passports/certificates for racing camels;
- engagement of the private sector (such as racing associations, breeding enterprises and meat packing operations).
The guidance emerging from the consultation reflected discussions during the 20-21 May consultation, which was opened by the Minister of Agriculture and Fisheries of Oman, Dr Fuad Jaffer al Sajwani. Participants included the World Organisation for Animal Health (OIE), the World Health Organization (WHO), the Gulf Cooperation Council and renowned experts who are currently collaborating with researchers and authorities of the region.
The meeting also drew public health and veterinary authorities and other specialists from eleven countries: Ethiopia, Egypt, Bahrain, Jordan, Kuwait, Qatar, Oman, Palestine, Saudi Arabia, Sudan, United Arab Emirates, and Yemen.
Camels and MERS
Several studies have reported high proportions of camels with antibodies against MERS-CoV or that of a closely-related virus, both in countries where human cases were detected and also in countries with no reported cases.
Some of these studies have shown that MERS-CoV has been circulating in camels in Saudi Arabia since at least 1992. Genetic evidence of MERS-CoV infection was found in tests of camel samples from a farm in Qatar and in other studies in Egypt and Saudi Arabia.
Coronaviruses are widespread in animal species and they can infect livestock and a wide range of wild species, including bats, rodents and wild birds.