There’s a mystery virus in the Middle East that is killing over half the people who get sick.  Of 80 people confirmed to have contracted “Middle East respiratory syndrome coronavirus” (MERS-CoV) since September, 44 are dead.

That is an astounding mortality rate. And it has the World Health Organization very concerned. At the Geneva headquarters of the WHO, experts are kicking into gear a response system developed after the deadly 2003 SARS outbreak.

The good news is that so far,  MERS-CoV is not sweeping through communities like a common influenza virus. Whole villages are not getting sick, just a limited number of people who have come in direct contact with someone who is infected. “Right now the overall pattern looks like we’re seeing a patchwork of sporadic infections with some local transmission,” says Dr. Keiji Fukuda, the WHO’s assistant director general for health security and the environment.

Still, there is very much the scientific community does not yet know about MERS-CoV and how it spreads. There have been some isolated cases of MERS-CoV in Europe, but each case involved some connection to an infected person in the Middle East and were quickly contained.

As people from around the world  visit Saudi Arabia during the holy month, MERS-CoV could more vigorously spread worldwide.

Last week, the WHO officials responsible for monitoring flu viruses worldwide called together an emergency committee of experts to guide the WHO’s response to a potential global public health emergency. The so-called “Emergency Committee” is really an emergency preparedness committee. It is part of a global health emergency monitoring and response system called “The International Health Regulations” (IHR) that the WHO put in place after the 2003 SARS outbreak.

The initial response to SARS was slow, and very much ad hoc. The fact that there were no common set of procedures to deal with emergent health crises across country boundaries cost lives and a great deal of money. In 2005 the members of the WHO, which includes every UN member state, devised a common protocol for dealing with something like a future SARS-like outbreak. The regulations cover everything from expediting visa requests for global health responders to procedures for the hygienic burying of corpses. They are little known outside the public health community, but they are a crucial innovation in policy and practice that may very well limit the global spread of this truly frightening super-bug.

Overseeing and implementing the IHR is among the most important tasks of the World Health Organization. Viruses don’t respect international borders, so the response to outbreaks like MERS-CoV has to be coordinated across boundaries. If MERS-CoV is contained and eliminated before reaching American shores, it will be because of this global response system.


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