MERS AND THE PILGRIMAGE : WHAT RISKS DOES THE YEARLY UMRAH IN SAUDI ARABIA POSE TO THE SPREAD OF THE DEADLY CORONAVIRUS?

 


The World Health Organization has a problem: the cavalier attitude of Saudi Authorities toward the deadly epidemic of the new coronavirus, called MERS, in consideration of the yearly pilgrimages in the areas with the highest incidence of registered cases. 

During the next few weeks and all the way to Ramadan, millions of Muslims will converge towards Saudi ARabia's most dangerous region for the Umrah.  

The areas they are to travel to are the epicenters of the new coronavirus, MERS.  The problem is aggravated by the reticence with which Saudi authorities have been stonewalling world health authorities on disclosures about the disease.  In fact, there has already been a scandal about the stealing of samples to a laboratory in the Netherlands, as pharmaceuticals corporations try to gain exclusive information about the disease to formulate vaccines and cures that can be exclusively patented in their favor. 

There is still no clue as to the zoonotic agent of the virus.  And without more information, the WHO cannot formulate effective policies for the prevention of the spread of the disease among the innumerable pilgrims.  

In October, furthermore, the even more populous Hajj will take place.  During the Hajj, millions of muslims from every part of the world converge on Mecca, as the pilgrimage is one of the most important actions of Islamic faith.  In fact it was right after the last Hajj that the first case was detected when a man of Egyptian nationality became sick.  

An infectious disease specialist, Dr. Kamran Khan, is worried: "We still don't have a good idea where this virus is coming from, so taking measures to mitigate risks are constrained." Translation: we don't know what causes it so any measure to contain it could be fruitless.  

MERS is a 'cousin' of SARS, a deadly disease that spread quickly but was contained before it seemingly disappeared in 2004.  The new MERS seems to possess less virality until now, but that could change in a blink of an eye, especially if the virus has a chance to infect a large number of people from different parts of the world.  

What is worrisome however, is the lack of hospital protocol so far.  Most of the new cases have occurred through exposure in clinical settings.  That signifies a higher virality and a lack of proper management of the disease.  

While worldwide experts hope that Saudi Arabia gets serious about combating the disease, they are also afraid that if they stall any longer they might too be late.  The disease could easily evolve into a highly viral disease, or at least create superspreaders, people who can pass the disease to many others, as SARS did years ago.  In one case of SARS in Toronto Canada, one person caused 44 infections.  And the 'superspreaders' are what caused the disease to kill almost a 1000 people in the short time before it was contained. 

One thing is for certain: the disease is now in its new phase, which could be explosive or not.  It is clear that infections are now being accounted for at a more rapid pace.  Saudi Arabia, however, has not ceded to increased pressure from the WHO authorities to offer full disclosure on the disease. 

In fact, there has been so little information, that the WHO does not even know how long the incubation period is, what makes people more at risk,i.e. gender, age etc, whether there are mild cases or healthy carriers, and other vital information on the disease. 

This lack of data also means that scientists cannot track how fast and much the virus has changed over time.  Only four viral isolates have been effected so far for genetic sequencing.  And the most recent sample is old: it goes back to a February case.  However, none of the sequences have been shared by the Saudi Government. 

An international team of WHO experts are converging this week in Jeddah to try and bring the Saudi government to reason and share all the information and samples they have.  

Source : Scientific American  6.10.13



 

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