WHO Declines Emergency Designation for Middle East Mystery Virus

A special committee of the World Health Organization today declined to classify a virus that’s killed about 50 people in the Middle East as a “Public Health Emergency of International Concern.” This is an important bureaucratic distinction that if made would kick into gear a global disease outbreak response mechanism that the WHO put into place following the 2003 SARS outbreak.

This is not to say that the Middle East Respiratory Syndrome -Coronavirus (MERS-Cov) is not a public health emergency of international concern. It kills over 50% of the people who are infected and is still of a mysterious origin. Rather, it means that the WHO committee of experts does not believe that the requisite threshold has been met to implement the “International Health Regulations” which guide the international response to sudden global virus outbreaks.

“The current virus and situation is serious in the sense that it has been persistent; and is possible it can spread further,” Dr. Keiji Fukuda, Assistant Director-General, Health Security and Environment, WHO told a press conference today. “But based on the current situation [the committee believes] there’s not enough evidence to declare a ‘Public Health Emergency of International Concern.'”

Dr. Fukuda added that the WHO has no plans on issuing any travel warnings for the Middle East, which could be particularly disruptive given that we are in the midst of Ramadan. Still, the WHO will be issuing advice about health precautions that individual travelers can take.

As of July 9, 80 laboratory-confirmed cases of MERS-CoV have been reported to WHO. Forty-five of the confirmed cases have died. The fatality rate and the unknown origins of the virus has alarmed public health officials, so the WHO called an outside group of experts for advice. The so-called Emergency Committee met last week and based on their inquiries does not recommend that the full-fledged international global outbreak response system managed by the WHO should be totally kicked into gear at this point.

That is probably a sober assessment for now. Should the “International Health Regulations” be invoked prematurely, there is concern that it would dilute what it means to declare a “Public Health Emergency of International Concern.”

“One of the issues which the emergency committee members discussed was that declarations and events have to be proportional, or you lose credibility, says Dr. Fukuda. “In their overall balance and assessment you want to be proportional to the event.”

For now, the WHO will continue to monitor the situation, support the biological investigation of the origins of the virus, and advise countries on how to properly respond to infections, says Dr. Fukuda. The Emergency Committee will meet again in the fall.