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ARCHIVE MERS-CoV situation update

22 March 2017, 17:00 hours; Rome

The next update will be issued on 26 April 2017

Disclaimer

Information provided herein is current as of the date of issue. Information added or changed since the last MERS-CoV situation update appears in red. Human cases are depicted in the geographic location of their report. For some cases, exposure may have occurred in one geographic location but reported in another. For cases with unknown onset date, reporting date was used instead. FAO compiles information drawn from multiple national (Ministries of Agriculture or Livestock, Ministries of Health; Centers for Disease Prevention and Control [CDC]) and international sources (World Health Organization [WHO], World Organisatwion for Animal Health [OIE]) as well as peer-reviewed scientific articles. FAO makes every effort to ensure, but does not guarantee, accuracy, completeness or authenticity of the information. The designation employed and the presentation of material on the map do not imply the expression of any opinion whatsoever on the part of FAO concerning the legal or constitutional status of any country, territory or sea area, or concerning the delimitation of frontiers.

 

 Overview

Situation: Middle East Respiratory Syndrome Coronavirus (MERS-CoV): zoonotic virus with pandemic potential.
Countries with known human cases1: Jordan, Saudi Arabia (KSA), Qatar, the United Arab Emirates (UAE), Oman, Kuwait, Yemen, United Kingdom*, France*, Germany*, Italy*, Tunisia*, Malaysia*, the Philippines*, the United States of America (USA)*, Egypt*, Lebanon*, the Netherlands*, Iran, Algeria*, Turkey*, Austria*, Greece*, Republic of Korea, China*, Thailand*, the Kingdom of Bahrain2.
Findings in humans: 1,936 cases confirmed; including 739 fatalities (since September 2012)3.
Countries with published animal findings (serology and/or virology): Canary Islands, Egypt, Ethiopia, Iran, Jordan, Kenya, Kuwait, Nigeria, Oman, Pakistan, Qatar, Saudi Arabia (KSA), Tunisia, United Arab Emirates.

 

 Situation in animals

  • MERS-CoV in Camelidae in Saudi Arabia was reported to the OIE on 21 March 2017. The report consists of detections occurring between 7 December 2016 and 12 January 2017, affecting a total of 7/28 animals in 4 farms in four separate Govenorates: Asir, Madinah, Makkah and Quassim [reference]. No information was provided on the reason for MERS-CoV testing.

Map 1. MERS-CoV livestock field surveys by country*

Map of MERS-CoV livestock field surveys by country
Click to enlarge - *Note: Positive findings in Spain refer to samples taken in the Canary Islands.

 

 Situation in humans

  • Between 22 February and 22 March 2017, Eighteen (n=18) new human cases have been reported all in Saudi Arabia, including ten (n=10) fatalities. Between 5 and 13 March 2017, a hospital cluster of possible human to human transmission was reported in Wadi Aldawasir, Riyadh province. Ten cases were observed among patients and health care workers.

Map 2. Global distribution of human cases of MERS-CoVMap of global distribution of human cases of MERS-CoV

Click to enlarge

 

Table 1. MERS-CoV cases in humans by country and dates of first and most recent observations

 

 

Country

Cumulative number of confirmed MERS-CoV human cases

First observation

Last Observation

Middle East Saudi Arabia 1,577 13/06/2012 18/03/2017
United Arab Emirates 80 19/03/2013 09/06/2016
Jordan 26 02/04/2012 26/09/2015
Qatar 16 15/08/2013 12/06/2016
Oman 8 26/10/2013 18/11/2016
Iran (Islamic Republic of) 6 11/05/2014 18/03/2015
Kuwait 4 30/10/2013 08/09/2015
Lebanon 1 22/04/2014 22/04/2014
Yemen 1 17/03/2014 17/03/2014
Bahrain (the Kingdom of) 1 04/04/2016 04/04/2016
Europe U.K. 4 03/09/2012 05/02/2013
Germany 2 05/10/2012 07/03/2015
Netherlands 2 01/05/2014 05/05/2014
France 2 23/04/2013 27/04/2013
Austria 2 22/09/2014 08/09/2016
Turkey 1 25/09/2014 25/09/2014
Italy 1 25/05/2013 25/05/2013
Greece 1 08/04/2014 08/04/2014
Asia Republic of Korea 185 11/05/2015 02/07/2015
Philippines 3 15/04/2014 30/06/2015
Thailand 3 10/06/2015 25/07/2016
China 1 21/05/2015 21/05/2015
Malaysia 1 08/04/2014 08/04/2014
Americas United States of America 2 14/04/2014 01/05/2014
Africa Tunisia 3 01/05/2013 17/06/2013
Algeria 2 23/05/2014 23/05/2014
Egypt 1 22/04/2014 22/04/2014

Figure 1. Human epidemiological timeline (with cases reporting animal exposure in blue), by month of disease onset (since September 2012)

Human epidemiological timeline (with cases reporting animal exposure in blue), by month of disease onset
Click to enlarge

Figure 2. Breakdown of human MERS-CoV cases by potential source of exposure (in percent)

Breakdown of human MERS-CoV cases by potential source of exposure (in percent)
Click to enlarge

 

Recent publications

  • Hemida MG, Chu DK, Perera RA, Ko RL, So RT, Ng BC, Chan SM, Chu S, Alnaeem AA, Alhammadi MA, Webby RJ, Poon LL, Balasuriya UB, Peiris M. Coronavirus infections in horses in Saudi Arabia and Oman. Transbound Emerg Dis. Mar (2017). doi: 10.1111/tbed.12630. [Epub ahead of print] PubMed PMID: 28296228. [reference]. A survey of horses in Saudi Arabia and Oman collected samples for both antibody and antigen detection. No evidence of infection with or exposure to MERS-CoV was found.
  • Ali M. et al. Cross-sectional surveillance of Middle East respiratory syndrome coronavirus (MERS-CoV) in dromedary camels and other mammals in Egypt, August 2015 to January 2016. Euro Surveill. 2017; 22 (11): pii=30487. DOI: http: //dx.doi.org/10.2807/1560-7917.ES.2017.22.11.30487. [reference] Published results of USAID supported surveillance in camels and other domestic animals in Egypt.
  • Vergara-Alert, J., et al.  Searching for animal models and potential target species for emerging pathogens: Experience gained from Middle East respiratory syndrome (MERS) coronavirus. One Health. Mar (2017) [reference]A review of experimental data on potential hosts of MERS-CoV.
  • de Wit E, Feldmann F, Horne E, Martellaro C, Haddock E, Bushmaker T, et al. Domestic Pig Unlikely Reservoir for MERS-CoV. Emerg Infect Dis. [Internet]. Jun (2017) 23(6). [reference] Report of experimental infection of pigs with MERS-CoV.

 FAO and MERS-CoV

  • In close collaboration with OIE and WHO, monitoring the situation / inter-agency teleconferences;
  • Analysing available data, including results from surveillance in camels and advanced characterization of the virus;
  • Providing technical assistance and guidance to countries to improve understanding of the disease situation and help filling existing gaps in epidemiological knowledge;
  • Supporting national laboratories to develop capacity in serology and PCR diagnostic for MERS-CoV, quality assurance and quality control and biosafety, and establish national sample banks;
  • Keeping a dialogue between the scientific community and the field to ensure needs and gaps are addressed;
  • Assist in developing communication strategies to ensure appropriate information reaches the public on MERS-CoV and avoid possible negative impacts of the crisis on the livestock industry.

Country-level actions

Kenya

  • Plans are underway to implement longitudinal (cohort) surveillance in Soysambu Ranch, Nakuru County;
  • Testing of samples from cross-sectional surveillance (Marsabit, Isiolo and Nakuru counties) has been completed and results will be officially reported following consultations with the Directorate of Veterinary Services scheduled to take place on 28th March 2017.

Ethiopia

  • Camel and livestock sample collection and laboratory testing for MERS-CoV is underway in Somali, Afar, and Borena regions.

Egypt

  • In support of the MERS-CoV Surveillance in dromedary camels and other domestic animals in Egypt, three Letters of Agreement (LoAs) have been completed in close consultation with the General Organization Veterinary Services (GOVS), Animal Health Research Institute (AHRI) and National Research Centre (NRC). The objectives of these LOAs are to:
    • Conduct and ensure proper sampling and implementation of agreed cross-sectional and longitudinal surveillance plans for MERS-CoV in camels.
    • Define the serological and virological status of MERS-CoV in other domestic animals (ruminants and equines) in contact with camels.

Press Releases

  • 13-14 December 2016: FAO inter-regional training workshop: “Analysis of camel value chains and human behaviours in view of MERS-CoV surveillance”.
  • 30 March 2016: Launching of the “Reference Centre and Network on camel diseases” for the Gulf and neighbouring countries. (in Arabic)
  • 28 January 2016: FAO pushes for a road map to control and contain zoonotic diseases.
  • 21 to 22 January: Technical Meeting: Understanding MERS-CoV at the animal-human interface at FAO-HQ in Rome, Italy.
  • 20 October 2015: U.S. backs FAO efforts to combat global animal disease threats with $87 million.
  • 27 April 2015: Stepping up efforts for a better understanding of MERS at the human-animal interface.
  • 7 November 2016: FAO-ECTAD Egypt trains Laboratory staff from Animal Health Research Institute (AHRI) and the National Research Center (NRC) on lab tests for (MERS-CoV).

 Important links

 

1 Countries in order of first reported occurrence
2 (*) denotes cases with travel to/through the Middle East/Arabian Peninsula
3 For detailed information on human cases, please refer to WHO at http://www.who.int/emergencies/mers-cov/en/