Friday, 24 January 2014

MERS-CoV: another emerging virus that just...stopped emerging?

Click on image to enlarge.
Data are plotted using sites of acquisition of MERS-CoV
infection. Dates are of illness onset when reported, 
otherwise the date the case was announced
Two charts by way of an update on cases of infection by the Middle East respiratory syndrome coronavirus (MERS-CoV)...which shows that there is not much to update from my last charts on Jan-17 here and here.
Click on image to enlarge.
Same accumulation graph (green) together with the
accumulated fatal cases and the proportion of fatal cases (PFC)

The main feature of these two charts is that cases have plateaued. There has been little recent reporting of new MERS-CoV infections...from anywhere.. for some weeks.

Has something been done within the Kingdom of Saudi Arabia (KSA) to interrupt the transmission chain between whatever the MERS-CoV source(s) was(were) and humans? 

We have not heard of any measures and of course no-one is generously offering to clarify this obvious and abrupt change in epidemiology. As has always been the case with the MERS story, this new turn of events leaves one unsure of what to think about this apparent sudden decline of case announcements. 

I'm wondering if reporting has simply ceased. Two reasons for this personal view:

  1. The most recent MERS-CoV case was a 55-year old male healthcare worker (HCW; Bangladeshi surgeon working at Prince Salman Hospital) who died 15-Jan in Riyadh. Now sure, he may have acquired MERS from an animal source (camel, bat, mouse, or cow, we don't know) but the odds, to my mind and with the MERS-CoV picture to date, it seem much more likely that he was caring for someone afflicted with MERS-CoV, which would mean 1 or more other cases exist but have not been reported.
  2.  The level of communication from the KSA about many aspects of MERS-CoV has not been of the quality that could foster any trust. It often appears that free communication of has been stifled or strangled rather than nurtured or nourished. The specifics to support that opinion can be found in browsing through my posts on MERS-CoV this past year or so.


So its impossible to say more about what's happening with MERS-CoV infections beyond the fact that they have not spread, noticeably, beyond the bounds of the Arabian peninsula.