AG index page FAO homepage
Print this page | Close

ARCHIVE MERS-CoV situation update

22 May 2019, 17:00 hours; Rome

The next update will be issued on 19 June 2019

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 Organisation 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 Bahrain.
Findings in humans: 2,434 cases confirmed; including 876 case fatalities (since September 2012)2.
Countries with published animal findings (serology and/or virology): Bangladesh, Burkina Faso, Chile, Egypt, Ethiopia, Iran, Iraq, Israel, Jordan, Kenya, Kuwait, Mali, Morocco, Nigeria, Oman, Pakistan, Qatar, Saudi Arabia (KSA), Somalia, Spain (Canary Islands), Sudan, Tunisia, United Arab Emirates.

 

1 Countries in order of first reported occurrence
2 For detailed information on human cases, please refer to WHO at http://www.who.int/emergencies/mers-cov/en/

 

 Situation in animals

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. Livestock surveillance in Chile, not pictured, resulted negative.

 

 Situation in humans

  • Between 17 April and 22 May 2019, thirteen (n=13) new human cases have been reported in Saudi Arabia, including six (n=6) fatalities.

 

Map 2For a global distribution of human MERS-CoV cases please see our map [here]

 

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 2 044 13/06/2012 19/05/2019
United Arab Emirates 88 19/03/2013 04/05/2018
Jordan 26 02/04/2012 26/09/2015
Qatar 19 15/08/2013 14/05/2017
Oman 24 26/10/2013 20/02/2019
Iran (Islamic Republic of) 6 11/05/2014 18/03/2015
Kuwait 4 30/10/2013 08/09/2015
Lebanon 2 22/04/2014 08/06/2017
Yemen 1 17/03/2014 17/03/2014
Bahrain (the Kingdom of) 1 04/04/2016 04/04/2016
Europe United Kingdom 5 03/09/2012 16/08/2018
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 186 11/05/2015 28/08/2018
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 2 08/04/2014 24/12/2017
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 January 2015)
Human epidemiological timeline (with cases reporting animal exposure in blue), by month of disease   onset (since January 2015)

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 - Note: Please note that while infection control improves in healthcare settings and history of animal contact is recorded more consistently in case investigations, the overall number of cases has decreased (see figure 1). The apparent increase in proportion of primary cases with animal exposure therefore should be interpreted in the overall context of a reduced human case count. Data not displayed prior to July 2015 as a result of inconsistent collection of human epidemiological data before this date.

 

 Recent publications

  • Salah T. Al Awaidy and Faryal Khamis. Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in Oman: Current Situation and Going Forward. Oman Medical Journal, May .2019. Vol. 34, No. 3: 181-183. [Reference]. This review summarize the results of the epidemiological investigation of the latest MERs-CoV human cases in Oman reported between January and February 2019. The authors concluded that the index cases were in contact with or resided on a farm where camels were kept, and highlighted that between January and March, the season of dromedary camel breeding, races take place in the governorates where the human cases have been reported. It is possible that during these months there is increased MERS-CoV circulation in the animal reservoir.
  • Widagdo W, Okba N, Richard M, Meulder D, Bestebroer T, Lexmond P, Farag E, Al-Hajri M, Stittelaar K, Waal L, van Amerongen G, van den Brand J, Haagmans  B and Herfst S.  Lack of Middle East Respiratory Syndrome Coronavirus Transmission in Rabbits. Viruses 2019, 11(4). [Reference]. In this study, rabbits were used to further characterize the transmission potential of MERS-CoV. In line with the presence of MERS-CoV receptor in the rabbit nasal epithelium, high levels of viral RNA were shed from the nose following virus inoculation. However, unlike MERS-CoV-infected dromedaries, these rabbits did not develop clinical manifestations including nasal discharge and did shed only limited amounts of infectious virus from the nose, resulting in a lack of viral transmission.

 FAO and partners

  • The meeting report from the FAO-OIE-WHO tripartite meeting held in Geneva, 25-27 September 2017 has been published in Antiviral Research [reference].
  • A poster entitled ‘MERS-CoV in Animals: a Scoping Review’ has been accepted for the 5th International One Health Congress in Saskatoon, Canada from 22-25 June 2018.
  • A poster entitled ‘Harmonization and flexibility in a multi-country project - FAO MERS-CoV surveillance in camels’ has been accepted for the Prince Mahidol Award Conference (PMAC) held in Bangkok, Thailand from 29 January to 3 February 2018.
  • A FAO-OIE-WHO tripartite meeting was held in Geneva, 25-27 September 2017 [reference]. Representatives from Ministries of Health and Ministries of Agriculture in affected and at risk countries, MERS-CoV subject-matter experts and researchers, funders, industrial partners and representatives from FAO, OIE and WHO attended. The specific objectives of this meeting were to (i) summarize and communicate research progress made, with a focus on new research and knowledge gained; (ii) improve coordination and communication between animal health and public health sectors in outbreak preparedness and response, active surveillance and technical issues of disease control and prevention, and (iii) to review and update previous recommendations based on latest scientific evidence. [#tackleMERS]
  • 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

Egypt

  • The repeat cross-sectional surveillance study for 2019 started on 22 April with joint missions by the General Organization for Veterinary Services (GOVS) and Animal Health Research Institute (AHRI) to Abo-Simble Quarantine Station, Aswan Governorate: The two missions collected 108 camel sera and 108 nasal swaps. All samples were received by AHRI for further testing.

Ethiopia

  • A consignment of 128 camel sera and 256 camel nasal swab samples was shipped to the University of Hong Kong on 27 March 2019 for serologic and molecular testing and phylogenetic analysis of positive samples. The samples were collected from a cohort of 15 camels from two sampling locations of the Amibara District of the Afar Regional State.
  • Field testing of the WHO/FAO developed ”General Population Study” questionnaires was performed in Sebeta, Addis Ababa and Bishoftu during the week 25-29 March 2019. So far, 38 individuals were tested. Feedback will be provided to the WHO/FAO MERS-CoV working group by the end of April 2019 once the exercise is completed.

Kenya

  • The cohort follow-up study started on 7 May 2019 in a pastoral herd of Garissa County, involving 20 camels. Sampling is conducted every 10 days; two rounds of sampling have been conducted so far.

Jordan

  • Review and updating of the MERS-CoV surveillance plan (2019) is underway with the Ministry of Agriculture to include surveillance in camel slaughterhouse (collecting turbinate and lymph node specimens) and to conduct a cohort study on selected camel farms.

Press Releases

 

 Important links