More progress is needed to control the Middle East respiratory syndrome coronavirus (Mers-CoV) in Saudi Arabia, according to a team of experts from the World Health Organization (WHO), the UN’s Food and Agriculture Organization (FAO), the World Organization for Animal Health (OIE) and Institut Pasteur, France.

The experts recently concluded a mission to the kingdom to assess the current situation of the Mers-CoV following a surge of cases in the past few weeks and to make recommendations for improving the surveillance, prevention and control of the virus.

More than 50 cases were reported in several locations in Saudi Arabia this month, including infections acquired in health facilities (called nosocomial infections) in Riyadh, Qassim Region and Damman City, eastern region.

The members of the joint mission held discussions with high-level representatives from the Ministry of Health, visited the Command and Control Centre that has been leading all activities related to the control of the virus, and toured the emergency and isolation facilities of the Prince Mohammed Bin Abdulaziz Hospital.

The government officials and the WHO-led mission shared their concern about the rising number of Mers-CoV cases in recent weeks and in particular in health care facilities.

Ahmed Bin Aqeel Al Khateeb, Saudi Arabia’s Minister of Health, said: “The kingdom did a lot to control the Mers-CoV. We want to hear WHO experts’ feedback on the kingdom’s progress but also where we can improve.

“The government is fully committed to implementing the right control and prevention measures and also to funding any activities needed to control this disease.”

The minister also stressed the need to enable any hospital, whether government–run or private to handle a Mers-CoV case.

Although data collection and surveillance have improved globally in recent months, critical gaps in knowledge remain, and several challenges in the country will require further work, the experts pointed out.

Dr Keiji Fukuda, WHO assistant director general who led the mission, said: “When health workers are infected at work, this puts other health-care workers at risk, but also can be a risk to all other patients who seek care for other health conditions.

“Understanding where the breach in these measures is occurring and taking the steps needed to fully implement infection prevention and control measures can put an end to these nosocomial infections.”

Besides implementing good infection control and prevention measures, efforts to educate professionals and the public are urgently needed, they said.

There are also significant gaps in community engagement to fully understand routes of infection and the preventive steps that should be taken. Defining groups that are most at risk, such as the elderly and those with underlying medical conditions, and how to target these groups with the right health messages remains a challenge.

Dr Berhe Tekola, director of Animal Production and Health division, FAO, said: “There are so many aspects of the virus that are still unknown. FAO is determined to use its expertise to better understand the human and animal interface of this virus.”

The mission, along with the Saudi Arabian health authorities, identified main areas that should be urgently addressed, including understanding the animal/human interface, that is, modes of infection and transmission; filling critical knowledge gaps in the science and epidemiology of Mers-CoV by conducting further research studies and by sharing the findings widely and rapidly; improving disease prevention, especially in health facilities that continue to experience avoidable infections; and intensifying social mobilisation, community engagement activities and communications.

Additional information from research studies are also required to better understand the risk factors for infection and transmission, the experts said.

Results from case-control studies from affected countries are urgently needed, in particular, from the most affected one, Saudi Arabia. Understanding the evolution of the virus is needed, through studies to address the knowledge gaps at the human/animal interface environment, they added. - TradeArabia News Service