An international committee to advise the World Health Organization (WHO) today called on countries the Arabian Peninsula to improve hospital hygiene and help in achieving much needed studies on how the Middle East respiratory syndrome (MERS) virus spreads. But the panel stopped declare the deadly new disease that emerged there 2 years ago, an international scope of emergency (USPI) Public Health.
There has been a dramatic increase in reported cases recently MERS, and calling the outbreak of a PHEIC would have given WHO the authority to issue travel advisories and other recommendations under Regulation International health. It would also increase the political pressure on the countries affected.
But after a conference call 5:00 yesterday, the Panel decided that the criteria for a PHEIC are not met, Keiji Fukuda, WHO's assistant director general for health security and the environment, announced at a press conference in Geneva, Switzerland, today. "They believe that the situation has grown in terms of its seriousness and urgency, but not at this point constitutes a PHEIC," Fukuda said.
Preben Aavitsland, a Norwegian epidemiologist who helped draft the International Health Regulations, the critical decision. "I personally think the information that is publicly available as the event must be declared USPI," said Aavitsland Science Insider in an email. "MERS is an international concern, it spreads to other countries, and there is a need for an international response." But David Heymann, a former executive director of communicable diseases at WHO and now head of the Centre on Global Health Security at Chatham House, it seems "right decision." "We have to trust the international organizations" Heymann said.
the emergency panel was established in July last year and has met four times before, most recently in December. After each meetings, he expressed concern, but concluded that it was too early to call emergency. The group will be invited to make a new assessment in a few weeks, Fukuda said.
in its latest set update, WHO puts the number of MERS infections to 536, including 145 deaths, but this official count is behind the figures announced by the governments of countries; .. the only Saudi Arabia has so far announced 157 deaths travelers also exported the virus to more than a dozen countries where MERS is not endemic. The United States announced a second imported case Monday, and the Netherlands reported its first day.
"suboptimal infection control practices" in hospitals and overcrowding in emergency rooms contributed to the rise, Fukuda said. The number of infections acquired outside the hospital also increased , he added ;. reasons for this are still unclear but he stressed that there is "no convincing evidence at this time to increase the transmissibility of the virus," which was one of the main reasons why the emergency committee has not declared a PHEIC. the Committee evaluated the genetic information available from five recent infections, three in Jeddah, one in Greece and the former US . "the genetic sequences of these latest viruses was much like sequences oldest virus," said Fukuda.
Aavitsland said the number of increasing cases could lead some countries to unilaterally introduce restrictions for travelers from the Middle East. "Declaring a PHEIC, WHO could put themselves in the driver's seat and give recommendations against such measures, which are very unlikely to be beneficial," wrote Aavitsland. "If someone [issues] travel restrictions against Saudi Arabia now, Oman and Lebanon can not declare if they have new cases tomorrow."
Statement of USPI could also exert more political pressure on Saudi Arabia and other countries in the region to fully confront the crisis. the world is still waiting for critical research, as a case-control study to ascertain how the virus makes its way from the likely reservoir camels animals to humans, Heymann said. "That's the real question. l the study has not been done to show whether this can be avoided through simple efforts "But just declaring a PHEIC to facilitate these studies would have been irresponsible, said Fukuda. "I hope the emergency increased sense pushing the barriers," he wrote in an email.
People should not interpret the panel ruling to mean everything is under control, said Michael Osterholm, director of the Center for research and policy at the University of Minnesota, Twin Cities. infectious diseases "is not." It is obvious that some people called supershedders have infected many other people on the Arabian Peninsula, said Osterholm. " If it emerges elsewhere, the world will have a very different view on this. "
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