Scientific Committee on Emerging and Zoonotic Diseases meets to update on Middle East Respiratory Syndrome

     The Scientific Committee on Emerging and Zoonotic Diseases (SCEZD) of the Centre for Health Protection (CHP) of the Department of Health convened a meeting this afternoon (August 26) to discuss the latest situation of Middle East Respiratory Syndrome and human cases of avian influenza A(H7N9).

     As regards Middle East Respiratory Syndrome, the SCEZD was updated that, to date, more than 100 cases had been identified in the Middle East, Europe and North Africa since September 2012. Over 80 per cent of the cases have been reported since April 2013, with the identification of some mild and asymptomatic cases, possibly related to improvement in case finding in recent months.

     So far, all cases have either occurred in the Middle East or have had direct links to a primary case infected in the Middle East.

     People of all age groups were affected, although middle-aged or older males were over-represented. The majority of the cases had reported co-morbidities. Patients usually presented with acute febrile respiratory symptoms but immunocompromised individuals may have atypical presentations. Co-infection was also observed in some cases. The fatality rate remained high at around 50 per cent. The longest incubation period has been about 14 days.

     At the meeting, Members considered that Middle East Respiratory Syndrome is an emerging infection whose animal source has yet to be identified.

     Members are of the view that the currently observed pattern of disease occurrence could be consistent with ongoing transmission in an animal reservoir with sporadic spillover into humans resulting in non-sustained clusters, but unrecognised sustained transmission among humans with occasional severe cases cannot be excluded.

     The SCEZD reviewed that person-to-person transmission had occurred in many clusters, either in household, work environment or health-care settings. With the exception of the health facility-associated cluster in the eastern region of the Kingdom of Saudi Arabia, the number of confirmed secondary cases per cluster has remained low. To date, evidence does not support sustained human-to-human transmission and the pandemic potential of the virus is considered low.

     Although the World Health Organization (WHO) has not yet classified Middle East Respiratory Syndrome as a Public Health Emergency of International Concern, Members of the SCEZD agreed that risk of sporadic importation resulting in local clusters of infections exists. Locally, the risk may increase during mass pilgrimages.

     The SCEZD meeting arrived at consensus that travellers to the Middle East should remain vigilant against Middle East Respiratory Syndrome. People with underlying illnesses should seek medical consultation before travelling and those who develop symptoms during travel or up to 14 days after their return are encouraged to seek medical attention and to inform their doctors of their travel history.

     Health-care professionals should continue to maintain vigilance for Middle East Respiratory Syndrome cases and notify any suspected case to the CHP. They should look out for atypical presentation in people with underlying medical conditions. Lower respiratory specimens should be used whenever possible for diagnosis. Health-care facilities treating patients of suspected cases should exercise strict infection control measures.

     The SCEZD hence concluded with the following recommendations:

* Continue intensive surveillance for Middle East Respiratory Syndrome;
* Strengthen health education for travellers to the Middle East;
* Maintain close liaison with the WHO and international health authorities to monitor the latest developments; and
* Health-care facilities should maintain stringent infection control measures.

     The Consensus Summary of the meeting has been uploaded to the CHP's website (

     At their meeting today, SCEZD Members also reviewed the latest situation of surveillance, prevention and control of human cases of avian influenza A(H7N9).

Ends/Monday, August 26, 2013
Issued at HKT 18:05