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MERS outbreak is a ‘wake-up call’ for highly mobile world

All countries need to be prepared for the unanticipated spread of serious infectious diseases says WHO.

After a meeting on the 17th June, the United Nations World Health Organization (WHO) declared that the Middle East Respiratory Syndrome, or MERS, outbreak that spread from the Middle East to the Republic of Korea does not constitute a ‘public health emergency of international concern’ but is nonetheless a ‘wake-up call’ for all countries to be prepared for the unanticipated spread of serious infectious diseases.

The Emergency Committee, convened by the WHO Director-General under the International Health Regulations regarding Middle East respiratory syndrome coronavirus (MERS-CoV) in regards to the outbreak in the Republic of Korea, also recommended against the application of any travel or trade restrictions and considers screening at points of entry to be unnecessary at this time.

WHO did recommend “raising awareness about MERS and its symptoms among those travelling to and from affected areas” as “good public health practice.”

The Committee noted that there are still many gaps in knowledge regarding the transmission of this virus between people, including the potential role of environmental contamination, poor ventilation and other factors, and indicated that continued research in these areas was critical.

Meanwhile, in a JAMA Viewpoint article, Georgetown public health law professor Lawrence O. Gostin and infectious disease physician Daniel Lucey state that MERS-CoV requires constant vigilance and could spread to other countries including the United States. However, MERS can be brought under control with effective public health strategies.

In the Viewpoint, published online on June 17th, the authors outline strategies for managing the outbreak, focusing on transparency, trust and infection control in health care settings. The duo also outline weaknesses in the World Health Organization's framework designed to govern patents on certain viruses, which is likely to impact critical future research.

Key points Gostin and Lucey make about MERS-CoV infection control include:

  • Training health workers and conducting diagnostic testing of certain travelers;
  • Limiting quarantine quarantines use to well-documented exposures using the least restrictive means possible;
  • Restricting travel should be avoided as it would be ineffective as evidence is lacking of MERS-CoV community transmission; and
  • Closing schools also should be avoided given the lack of community transmission of MERS-CoV.

In addition, Gostin and Lucey say the WHO's Pandemic Influenza Preparedness Framework fails to cover non-influenza pathogens like MERS-CoV noting, "...there remain substantial holes in international rules needed to facilitate critical research."



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