Keiji Fukuda, WHO Assistant Director-General for Health Security and Environment, briefed delegates to the 52nd Directing Council on the status of outbreaks of Middle East respiratory syndrome coronavirus (MERS-CoV) and the influenza virus A(H7N9), which are being closely monitored for their potential impact on international health security.
Fukuda noted that there are both similarities and difference between the two viruses. Both are from animal reservoirs, both are “unusually pathogenic,” and both are capable of human-to-human transmission. Although neither has shown sustained transmission in the community, both remain major underlying public health risks.
A(H7N9) is an avian influenza virus that so far has caused outbreaks only in China, the largest outbreak so far during March and April of 2013, when 130 cases were reported during one four-week period. The source of human infection is contact with infected poultry, said Fukuda, mostly in live markets. As with all influenza viruses, A(H7N9) appears to be more active in cold weather, both in birds and in humans.
In contrast to A(H7N9)’s appearance only in China, MERS-CoV has been reported in nine countries, most in the Middle East, but also in Tunisia and in patients with histories of travel to the Middle East returning to France, Italy and the United Kingdom. Fukuda noted that less is known about coronaviruses in general than about influenza viruses, for example, it is not known if coronaviruses are seasonal.
Fukuda also presented technical aspects related to the spread of the viruses, treatment for patients, and the possibilities of developing vaccines. He encouraged countries to be on the alert and to strengthen public health preparedness in preparation for the possible spread of either of the two viruses.
Marcos Espinal, director of PAHO’s Communicable Diseases and Health Analysis department, said that PAHO was providing support for its member countries to strengthen regional preparedness for both MERS-CoV and A(H7N9). Technical cooperation in this area includes the establishment of IHR national focal points in member countries, the establishment and strengthening of surveillance for severe acute respiratory infections (SARI), support for the reorganization of health services during outbreaks, training on bio-risk management, and the integration of regional surveillance into global surveillance networks.