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Commentary
MERS
Confirmed In Abu Dhabi United Arab Emirates
Recombinomics
Commentary 15:15
July 12, 2013
The patient is male with multiple myeloma and currently admitted in the ICU, the Health Authority in Abu Dhabi (HAAD) confirmed.
The above comments describe the first case (82M) diagnosed in the United Arab Emirates (UAE). Prior confirmed cases from the UAE include a resident (73M) who flew to Germany for diagnosis and treatment, as well as a tourist (65M) from France (both prior cases died). The case from France represented the first case imported into France, which followed the first case (60M) imported into England (other than a case flown by air ambulance), and was followed by the first reported case (66M) imported into Tunisia and the first case (45M) imported into Italy (see map).
These recent imports, coupled with the confirmation of associated mild cases and subsequent lab confirmation of asymptomatic cases in Jordan and Saudi Arabia has led to an emergency meeting called by the WHO to determine if additional measures, such as a travel ban, are in order.
This meeting was associated with the first direct acknowledgement of the WHO of the distinct possibility that these cases represent sustained transmission. In the past WHO called these cases sporadic or “seemingly sporadic.” However, the sequence data from human cases and the absence of any closely related sequence from any animal source, coupled with the frequent confirmation of clusters identified with an insensitive assay has left little doubt that MERS-CoV has been transmitting in humans in the Middle East for more than a year, including transmissions to health care workers which are similar to SARS outbreaks in 2003.
Although most cases have been from Saudi Arabia, imported cases from the UAE, Qatar, and Jordan indicate MERS-CoV is widespread in the Middle East, and the failure to diagnose cases in the above countries represents a profound surveillance failure.
The confirmation of MERS-CoV in the UAE represents another increase in the level of MERS-CoV in the region, which is orders of magnitude higher that the confirmed cases.
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