MERS-coV, the virus from camels that has caused alarm at the World Cup in Qatar

The media have published these days cases of viral symptoms in the World Cup in Qatar compatible, although not confirmed, with the Middle East respiratory syndrome (MERS), also popularly known as “camel virus”, endemic in the Middle East.

Between the appearance of cases of “camel virus” or MERS-CoV In the World Cup in Qatar, three players from the French team are cited, although no case has been confirmed and the news reports non-specific symptoms that could be due to any other infectious condition. A situation, in any case, that has given rise, as usual, to all kinds of rumors.

The coach of the French national team, Didier Deschampshas made a series of statements that have raised the alarm. Dayot Upamecano y Adrien Rabiot They are isolated from the rest of the group, after having gone through feverish processes, said the newspaper The world.

The possibility of a player, worker or fan in Qatar getting infected with this virus, although unfounded for now, is real. To reduce the risk of spreading MERS-CoV, the World Health Organization (WHO) and the Qatari authorities have carried out information campaigns for travelers coming to the country, where the virus appears to be endemic.

A recent article in The Lancet Global Health stresses that “mass gatherings, such as sporting events and festivals, create ideal conditions for the transmission of a variety of infectious diseases from person to person, which can spread rapidly around the world due to ease of travel,” notes The Lancet. And in Qatar two simultaneous mass gatherings are taking place: the 2022 FIFA World Cup championship and the Camel Mzayen Club camel beauty pageant festival.

“Both events have attracted hundreds of thousands of people from the Middle East and around the world. Many attend both events, interacting closely with each other and with the camels, creating the ideal conditions for the transmission of camel-associated zoonotic pathogens with epidemic potential”, among which is the highly lethal MERS-CoV, much less transmissible than the well-known Covid but with very high mortality rates, between 35% and 40 percent.

The source of the virus remains unknown, but the pattern of transmission and virological studies point to camels and dromedaries in the Middle East as a reservoir from which humans are sporadically infected through zoonotic transmission by direct or indirect contact with camels or raw or undercooked dairy or meat products from camels infected with MERS-CoV, common in the country.

“To reduce the risk of spreading MERS-CoV, the WHO and the Qatari authorities have conveyed extensive health messages to travelers to Qatar,” notes The Lancet, which includes avoiding direct contact with camels and their products. raw dairy. “However, these messages are easily overlooked in the festive and competitive environment. Furthermore, contact between the imported and local dromedary camels participating in the contest, the camel owners and those attending both events is unavoidable, as same as the consumption of popular foods in Qatar”.

Monitor and report symptoms for one month

Proactive surveillance of MERS-CoV during and after the 2022 FIFA World Cup is essential, as undetected infections could cause global outbreaks. One notable case was the large 2015 MERS-CoV outbreak in South Korea, where a person from South Korea visited four countries in the Middle East and fell ill after returning to Seoul. While he waited in a crowded hospital emergency room, the infection spread to others, and the resulting MERS-CoV superspreading events resulted in 184 infections with 36 deaths.

Although this large outbreak outside the Middle East should have been a wake-up call for global public health authorities, attention has been diverted over time to MERS-CoV due to outbreaks of the virus disease. ebola, Zika y Covid-19. “But the risk of visitors to Qatar returning to their home countries infected with MERS-CoV remains real,” The Lancet notes.

Although WHO does not recommend specific screening for MERS-CoV at points of entry, health care systems should always remain vigilant, especially in the month following the two events. Returning travelers should be advised to seek medical attention immediately if they feel ill, and should inform their doctor about their recent travel to Qatar, as person-to-person transmission of MERS-CoV in health care settings health has been associated with delays in recognizing the first symptoms of infection, essential to contain outbreaks.

When did it appear and what symptoms do you have?

MERS-coV first identified in Saudi Arabia in April 2012 and since then more than 2,600 cases have been detected in various Member States in the Middle East, Africa and South Asia. In Europe, eight countries have reported confirmed cases, all with direct or indirect connections to the Middle East. Most continue to report there. From early 2022 to December 5, 2022 the European Center for Disease Prevention and Control (ECDC) has reported six cases of MERS-CoV in Saudi Arabia, Qatar and Oman, including one death and all but one they had been in contact with camels. The most recent cases reported in Qatar prior to these were in February 2020 and February 2019.

The clinical presentation of MERS-CoV infection includes mild respiratory symptoms to severe acute respiratory illness and death. but it can also be asymptomatic. Typical symptoms are fever, cough, and shortness of breath. Pneumonia is common, or gastrointestinal symptoms, including diarrhea.

As with Covid, the severe form of the disease can cause respiratory failure requiring mechanical ventilation or support in an intensive care unit. “Older people, people with weakened immune systems, and those with chronic diseases such as kidney disease, cancer, chronic lung disease, hypertension, cardiovascular disease, and diabetes appear to be at increased risk of developing severe disease,” the WHO notes.

Approximately 35% of cases reported to WHO have diedbut this may be an overestimate of the true mortality rate, as existing surveillance systems may miss mild MERS cases.

Person-to-person transmission is possible and has occurred predominantly between close contacts and in health care settings. Such transmission also affects family and household members, health workers, and other patients. Currently there is no vaccine or specific treatment available, although there are several in the process of clinical development.

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