Four New Coronavirus Cases May Indicate The Potential For An Epidemic

Over the past weekend, the World Health Organization (WHO) has been informed of four additional laboratory-confirmed cases of infection with Middle Eastern respiratory syndrome coronavirus (MERS-CoV). The new cases may actually come as no surprise to an international group of experts who reported last week that the disease may become a “slowly growing epidemic.”

Publishing a paper in The Lancet Infectious Diseases, the researchers have estimated that at least 62 percent of MERS cases have gone undetected, likely due to many cases being mild and not requiring hospitalization. Furthermore, surveillance efforts are geared toward the most severe cases. The research team also said it is unclear whether the disease can sustain human-to-human transmission without a recurrence of animal infections.

According to CIDRAP’s Robert Roos, the team followed four cases that occurred in visitors to Jordan, Qatar, Saudi Arabia, and the United Arab Emirates to work out an estimate for the number of undetected cases of MERS. Using these cases, they then calculated the average length of their visits and then noted that that each of the visitors had passed the virus to one or two other people after returning home from their visit.

The research team also used MERS-CoV genetic data to estimate the total number of infections in both animals and humans.

“Both the analysis of the genetic sequences and of the epidemic curves suggested that an epidemic is underway either in an animal reservoir or in man. These analyses do not allow us to distinguish between these scenarios and to determine whether MERS-CoV is currently self-sustaining in man,” the researchers said.

If there is an epidemic currently going on in humans, the team note that, given the current low estimated reproduction rate, it is likely that public health measures are sufficient to contain the spread of the disease and reduce morbidity and mortality.

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