WHO confirms MERS in a United Arab Emirates man, expects more cases

The World Health Organisation has confirmed a case of Middle East Respiratory Syndrome Coronavirus (MERS-CoV) in a 28-year-old man in the United Arab Emirates (UAE), and expects more such cases.

The UAE notified the global health body of the first virus case in the country this year on July 10.

The last MERS-CoV infection reported from the UAE was in November 2021.

The infected man visited a private medical centre multiple times between June 3 and 7, complaining of vomiting, right flank pain, and dysuria (pain when passing urine).

On June 8, he came to a government hospital with vomiting, and gastrointestinal symptoms including diarrhoea, and was given an initial diagnosis of acute pancreatitis, acute kidney injury, and sepsis.

On June 13, he was in critical condition and referred to an intensive care unit (ICU) at a specialised government tertiary hospital where he was put on mechanical ventilation.

His condition deteriorated and a nasopharyngeal swab collected on June 21 tested positive for MERS-CoV by PCR on June 23.

However, what’s surprising is that the infected man from Al Ain city in Abu Dhabi has had no history of direct or indirect contact with dromedaries, goats, or sheep, a non-healthcare worker and did not recently travel outside the UAE.

MERS is a viral respiratory infection that is caused by a coronavirus called Middle East respiratory syndrome coronavirus (MERS-CoV). Humans are infected with MERS-CoV from direct or indirect contact with dromedary camels who are the natural host and zoonotic source of the MERS-CoV infection.

So far, the observed non-sustained human-to-human transmission has occurred among close contacts and in healthcare settings. Outside of the healthcare setting, there has been limited human-to-human transmission.

Thus, it is “important to sequence the virus and conduct genomic analysis to screen for any unusual patterns”, said the WHO, noting that the process for genomic analysis has begun to identify any possible "genetic evolution of the virus".

The WHO said all 108 identified contacts were monitored for 14 days from the last date of exposure to the MERS-CoV patient. While to date, "no secondary cases have been detected", the WHO, in a statement, said it "expects that additional cases of MERS-CoV infection will be reported from the Middle East and/or other countries where MERS-CoV is circulating in dromedaries".

"Cases will continue to be exported to other countries by individuals who were exposed to the virus through contact with dromedaries or their products (for example, consumption of camel’s raw milk), or in a healthcare setting," it added.

The first case of MERS-CoV was detected in the UAE in 2013. So far the country has 94 confirmed cases (including the new case) and 12 deaths have been reported. Globally, the total number of confirmed MERS-CoV cases is 2,605, including 936 associated deaths, the WHO said.

No vaccine or specific treatment is currently available, although several MERS-CoV-specific vaccines and treatments are in development