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 Experts in virology say the biochemical know-how is
there to create a vaccine against Middle East Respiratory Syndrome,
or MERS, but question why authorities would want to spend millions
immunizing an entire population against a disease that has affected
only a few hundred people.
Far better for public health, they say, would be to pin down the
source of the infection — likely to be among animals, possibly
camels or bats — and devise a strategy to halt the virus there.
"There are enormous problems with the idea of a MERS vaccine," said
Ian Jones, a virologist at Britain's Reading University who has been
following the outbreak from the start.
"I can see it works as an appeasement — that they want to say they
can make it — and biochemically of course they could, but
practically it doesn't make any sense."
"Who would you vaccinate? Would you vaccinate the whole population
when only a tiny number of people seem to be susceptible?"
MERS first emerged in April 2012 and has caused more than 250 human
infections, including 93 deaths, across the Middle East as well as
in Europe, Asia and North Africa.
The infection can cause coughing, fever and pneumonia, which can be
fatal. So far, its death rate is around 30 percent.
SHARP RISE IN SAUDI CASES
The number of human cases has risen sharply in recent weeks in Saudi
Arabia, piling pressure on the government to be seen to be taking
action to protect its people. Of the 91 new cases announced in the
kingdom in so far April, 73 have been in Jeddah. Many of those
infected were healthcare workers.
A Saudi Health Ministry spokesman was not immediately available for
comment on Friday, but the local surge is fuelling rumor and
mistrust, and has made people jittery.
Sales of face masks and hand sanitizing gels have soared, and some
people are expressing concern about going to hospitals or attending
funerals.
A spokesman for the World Health Organisation in Geneva said on
Friday it was "concerned" about the rising MERS numbers in Saudi
Arabia. "This just highlights the need to learn more about the
virus, about the transmission, and about the route of infection," he
said.
Amid heightened anxieties, Saudi authorities say they have invited
five leading international vaccine makers to collaborate with them
in developing a MERS vaccine.
Giving no names or details, they said the companies were from North
America and Europe and some would visit soon to discuss how to go
about developing an affordable MERS shot.
But with worldwide cases of the respiratory infection still only in
the hundreds, and deaths not yet into three figures, scientists are
skeptical about why Saudi officials would want to focus on a vaccine — except for political reasons.
"I question whether there would really be any interest from vaccine
companies to develop a human vaccine at this stage," said Bart
Haagmans, a virus expert at the Erasmus Medical Centre in Rotterdam
in the Netherlands.
"That's what we know already from many other viral infections where
there are only a very limited number of people affected. It's common
sense and general knowledge, I'd say."
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CAMELS IN THE FRAME
Researchers around the world have been working hard to investigate
the MERS virus since it first emerged in 2012.
Known as a coronavirus for the crown-like shape it has when viewed
under a microscope, it belongs to the same family as the virus that
caused a deadly outbreak of Severe Acute Respiratory Syndrome, or
SARS, in 2003.
Scientists first linked it to bats and research has found that
infections with the virus, or signs of it having been present, are
widespread in dromedary camels in the Middle East.
Noting that "all the evidence at the moment points to camels" as the
likely source of human infections, Haagmans agreed with Ian Lipkin,
director of the Center for Infection and Immunity at Columbia
University in the United States, in saying that developing a MERS
vaccine for possible veterinary use might be a more effective
long-term strategy to control human cases.
As a public health measure, trying to limit the spread from animals — possibly camels in this case — would be a sensible approach, he
said.
With veterinary vaccines, the bar for testing and trialing a
potential product is far lower than for humans — where full clinical
trials taking several years would be needed before a product is
passed as safe and effective and licensed for market.
And with the MERS virus apparently common in camels, the
risk-benefit analysis of mass immunization would stack up far more
favorably towards protecting large numbers of animals from something
they really are at risk of contracting.
Yet the question as to why Saudi authorities are apparently avoiding
talk of controlling the disease in camels is confusing some experts,
when it appears that tackling the disease at its animal source, or
even protecting animals, might be best.
Lipkin is concerned the animals' reputation in the kingdom — where
they carry high cultural and monetary value, are they are respected
in sport and admired for their beauty, as well as used to provide
meat and milk, may be clouding Saudi judgment.
If people begin to associate camels strongly with a dangerous and
deadly virus, he said, their reputation as objects of beauty and
value may be tarnished.
"Remember the hue and cry (among dog-loving Westerners) when people
started killing dogs in Egypt because of fears about rabies? Well,
in Saudi Arabia people feel similarly about their camels."
(Additional reporting by Tom Miles in Geneva; editing by Giles Elgood)
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