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 MERS coronavirus (MERS-CoV), a member of a virus family ranging from
the common cold to Severe Acute Respiratory Syndrome, appears to
have emerged in humans in Saudi Arabia in 2012, but has now been
traced back in camels to at least 1983.
Almost all the outbreaks so far originated in the Arabian Gulf, but
MERS-CoV could infect humans wherever there are one-humped dromedary
camels - two-humped bactrians are not affected.
That means people across a swathe of Africa, the Middle East,
Pakistan and South Asia are potentially at risk. So the hunt is on
for vaccinations - both for humans, and camels.
"The virus is in camels everywhere. The virus is in Qatar, it’s in
United Arab Emirates, it’s wherever we look," said Maria Van
Kerkhove, a disease outbreak expert at the World Health Organization
(WHO), where 130 experts gathered last week to collaborate for the
first time on tackling the disease.
"I know so much more about camels than I ever thought I would," she
said.
People have probably caught MERS in Africa but the absence of
outbreaks recorded there may be due to poor disease surveillance,
less contact with camels, or lower rates of underlying conditions
like obesity and heart problems that make MERS more severe.
Saudi Arabia has been heavily criticized for not being transparent
about MERS, but Van Kerkhove said that had totally changed. It is
now testing 70,000 human samples a year and generating a vast amount
of research.
DRIVE-THRU
MERS is hard to spot, and far more deadly than other acute
respiratory infections, killing one in three sufferers.
It has a habit of infiltrating Saudi hospitals via patients visiting
for regular dialysis or cardiac appointments, causing outbreaks that
have killed patients and health workers alike.
Hospitals are raising their game.
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"One hospital even has a drive-thru. Literally a drive-thru in their
emergency department," said Van Kerkhove, explaining how patients
are vetted before being allowed in.
"You drive up in the car to the person in the booth and they ask you
three questions. It takes less than 13 seconds."
A dozen human vaccines are in development, with vaccine coalition
CEPI expected to announce soon which it will fund.
But the key to stopping human deaths is controlling MERS in camels.
Two camel vaccines have been developed, but only one, developed by
the Jenner Institute, is in field trials.
The other, developed at the Erasmus Medical Centre, is still seeking
funding. The WHO MERS program is also under-funded, Van Kerkhove
said.
At last week's meeting, hosted by the WHO, animal health body OIE
and the U.N. Food and Agriculture Organization, Saudi and Qatari
experts were "happy to talk to each other" despite their
governments' diplomatic friction, she said.
Collaboration is vital, because camels must be diagnosed,
quarantined and vaccinated as they enter the Gulf from the Horn of
Africa. The virus must be tracked like bird flu is in birds, Van
Kerkhove said.
But there is a long road ahead.
"I’ve never seen a really good map showing where camels move," she
said.
(Reporting by Tom Miles; Editing by Mark Potter)
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