NCoV, Saudi Arabia: Statement on the visit of the World Health Organization Mission (Health Min., June 10 2013, edited)

[Giuseppe]

[Source: Saudi Arabia Ministry of Health, full page in Arabic: (LINK). Automatic translation.]

Statement on the visit of the World Health Organization Mission

June 10 2013


The World Health Organization (WHO) issued a press release through its mission stationed in Saudi Arabia in order to assess the status of Corona virus new (MERS-Cov) in the United Kingdom which showed many of the important things about this virus and pathological cases recorded globally in the statement:

Met with the World Health Organization Mission in common with the Kingdom of Saudi Arabia in Riyadh between 4-6 \ 6 \ 2013, corresponding to 25-30 \ 7 \ 1434 AH, in order to assess the situation caused to the new Corona virus in the Kingdom, which was recently renamed the Middle East respiratory syndrome virus Coruna (MERS-Cov) Mears, a newly emerged virus is relevant far the virus that caused the SARS virus.

The first documented cases of the Middle East respiratory syndrome virus Corona (MERS-Cov) emerged in Jordan in early 2012. Currently, there are 55 confirmed cases of laboratory, 40 cases have emerged in Saudi Arabia, and the rest, it has been reported from other countries, including (Qatar, United Arab Emirates) in the Middle East, and Tunisia in North Africa, France, Germany, Italy, the United Kingdom, and Northern Ireland in Europe.

The total number of cases is still limited; but the virus has led to the death of 60% of the infected cases. So far, nearly 75% of the cases in Saudi Arabia may hit the male, and mostly hit people with a disease or more serious chronic diseases.
It seems that there are three forms of epidemiological President of the virus:

• The first form: sporadic cases appear in the communities. Up to this moment we do not know the source of the virus or how are infected.
• Figure II: A group of infections occur among family members (cluster Clusters), and appeared in most of these groups that the transition occurs from one person to another; but it seems that the infection is limited direct friction with the sick person in the family.
• Figure III: A group of infections occur in health care facilities. Have been reported such a pattern in France, Jordan, and Saudi Arabia. In these groups shows that the infection is transmitted from one person to another after the introduction of infected case for treatment at the health facility.

Nor must emphasize two important points, namely:

• First: There is no clear evidence of the widespread transmission of with Middle East respiratory syndrome virus Corona (MERS-Cov) from one person to another. When speaking of transmission of the virus from one person to another, often occur as a result of contact with infected with close to someone who may be a family member, or sick, or working in the field of health care.
• Second: in Saudi Arabia, it appears that there are fewer than expected in infections with Middle East respiratory syndrome virus Corona (MERS-Cov) among workers in the health field; based on the comparison with the situation in the SARS virus, it is in the incidence of SARS epidemic , was working in the health field of the groups most vulnerable to infection. The syndrome Middle East respiratory virus Corona (MERS-Cov) different from the SARS virus, with the reason for the lack of risk syndrome Middle East respiratory virus Corona (MERS-Cov) among workers in the health field is not clear; but it seems that the measures taken by most states to fight infection after an outbreak of the SARS virus led to a marked improvement in the fight against infection. In this context, it appears that the measures pursued by Saudi Arabia to fight infection were effective.

In the current situation, the diagnosis of respiratory syndrome Middle East Corona virus (MERS-Cov) depends heavily on clinical knowledge, as well as to confirm the situation by testing a polymerase chain reaction (PCR). It is also not available rapid clinical tests identify the disease.

And treat the injured depends primarily on supportive therapy, as there are no convincing data that the use of powerful drugs against viruses such as: ribavirin or interferon may not work. It also must avoid the use of high doses of cortisone.

It has informed the World Health Organization Mission - closely - to respond in dealing with the virus in Saudi Arabia. And concluded that Saudi Arabia has done an outstanding job in the investigation and control of the outbreak. When the discovery of the first case in 2012, the Ministry of Health has taken a number of measures, including the following:

• infection control measures to reduce the spread of infection in hospitals.
• increase the level of the epidemiological investigation Middle East respiratory syndrome virus Coruna (MERS-Cov).
• launch of awareness campaigns to educate and alert the community.

Report cases to the World Health Organization.

• begin to conduct epidemiological tests to determine the source of infection, risk factors, and ways of transmission.
• invite international experts to help.

And Astanda to it, it was sure to take the right steps to prevent and control the virus. And worthy of the Government of the Kingdom of Saudi Arabia to be congratulated for expedited procedures and necessary task they have taken.

Finally, it should be emphasized on some of the focal points:

• First: There is still a big gap on our knowledge of the disease. In spite of the continuing efforts intense about it; it is imperative to recognize the need for more time to reach the results of these scientific efforts.
• Second: there is a high level of international attention on these infections; because it is likely that the virus is transmitted around the world.

We now have a number of examples of transmission of the virus from one country to another by travelers.

Due to this situation, must on all countries in the world to make sure that the workers in the field of health awareness about this virus and the disease, which is caused by, and if the emergence of cases of pneumonia unspecified; it must be checked and put syndrome Middle East respiratory virus Corona (MERS -Cov) into account. In the event of discovery of cases of with Middle East respiratory syndrome virus Corona (MERS-Cov), there must inform the World Health Organization (WHO) reported in accordance with the International Health Regulations (2005).

So far, it appears that most cases of infection with the Middle East respiratory syndrome virus Corona (MERS-Cov) acquired in the community have emerged in the Middle East. And all countries in the region to intensify epidemiological investigation procedures sooner to this infection.
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[Giuseppe]

Re: NCoV, Saudi Arabia: Statement on the visit of the World Health Organization Mission (Health Min., June 10 2013, edited)

[Source: World Health Organization, Regional Office for the Eastern Mediterranean, full page: (LINK). Edited.]


Middle East respiratory syndrome coronavirus: Joint Kingdom of Saudi Arabia/WHO mission


Between 4 and 9 June 2013, a joint mission of the Kingdom of Saudi Arabia (KSA) and the World Health Organization (WHO) met in Riyadh to assess the situation due to a new coronavirus in the Kingdom. This virus has recently been named the Middle East respiratory syndrome coronavirus (MERS-CoV). It is a new, emerging virus that is distantly related to the virus that caused SARS.

The first documented cases of MERS occurred in Jordan in early 2012. Globally, to date there has been a total of 55 cases confirmed by laboratory testing. Of these, 40 have occurred in KSA, and the rest have been reported from other countries in the Middle East (Qatar and the United Arab Emirates), from Tunisia in North Africa, and from France, Germany, Italy and the United Kingdom of Great Britain and Northern Ireland in Europe.

The overall number of cases is limited, but the virus causes death in about 60% of patients. So far, about 75% of the cases in KSA have been in men and most have occurred in people with one or more major chronic conditions.


There appears to be three main epidemiological patterns.

• In the first pattern, sporadic cases occur in communities. At present, we do not know the source or how these people became infected.
• In the second pattern, clusters of infections occur in families. In most of these clusters, there appears to be person-to-person transmission, but it seems that this transmission is limited to people who are in close contact with a sick family member.
• The third pattern comprises clusters of infections in health care facilities. Such events have been reported in France, Jordan and KSA. In these clusters, the sequence seems to be that an infected person is admitted to hospital where that person then transmits the virus to other people in the health care facility.

Two important points need to be stressed.

• First, there is no evidence of widespread person-to-person transmission of MERS-CoV. Where it has been suspected that the virus has been transmitted from person to person, it appears that there had been close contact between somebody who was sick and another person: a family member, a fellow patient or a health care worker.
• Secondly, many fewer infections with MERS-CoV have been reported in health care workers in KSA than might have been expected on the basis of the previous experience of SARS. During the SARS epidemic, health care workers were at high risk of infection. The MERS-CoV is different from the SARS virus. Although the reason why fewer health care workers have been infected with MERS-CoV is not clear, it could be that improvements in infection control that were made after the outbreak of SARS have made a significant difference. In this context, infection control measures in KSA appear to be effective.

Currently, the diagnosis of MERS CoV relies heavily on clinical awareness combined with confirmatory testing for the presence of MERS-CoV by the polymerase chain reaction. No bedside test exists.


Treatment is primarily supportive and there are no convincing data that the use of potent antiviral agents, such as ribavirin and interferon, brings any benefit. The use of steroids in high doses should be avoided.


The joint mission reviewed the response in KSA, and concluded that the country has done an excellent job in investigating and controlling the outbreaks. Once the first cases were identified in 2012, several steps were taken, including the following:

• Measures, including infection control measures, were introduced to stop hospital outbreaks
• surveillance for MERS CoV cases was significantly increased
• awareness campaigns to alert and educate the public were started
• cases of MERS CoV were reported to WHO
• epidemiological investigations were initiated to identify the sources of infection, risk factors and routes of transmission
• international experts were invited to help.

At this point, the right prevention and control measures have been applied, and the KSA Government is to be congratulated for urgently taking crucial actions.

Some final points must be stressed.

• First, large gaps in our knowledge about this virus remain. Although extensive work has been done and is ongoing, it should be remembered that it often takes time for scientific investigations to produce results.
• Secondly, international concern about these infections is high, because it is possible for this virus to move around the world. There have been now several examples where the virus has moved from one country to another through travellers.

Consequently, all countries in the world need to ensure that their health care workers are aware of the virus and the disease it can cause and that when unexplained cases of pneumonia are identified, MERS CoV should be considered. If cases of MERS CoV are found, they should be reported to WHO under the terms of the International Health Regulations (2005).


So far, all cases of community acquired MERS CoV infection have been seen in the countries of the Middle East. All countries in this region should urgently intensify their surveillance efforts for infection by MERS-CoV.


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