On16 June 2015 the Emergency Committee held its ninth meeting to review the situation related to MERS-CoV. The Committee concluded that the conditions to declare this a public health emergency of international concern have not been met. The description below provides additional information to help understand the rationale behind this decision.

No sustained person-to-person transmission seen

The Emergency Committee stressed that this is a very significant outbreak and that a robust response is needed to control it. However, the Committee concluded this is not a public health emergency of international concern for two main reasons.

Sustained community transmission is not being observed. By way of explanation, sustained human-to-human transmission is seen for example in influenza outbreaks where the virus passes easily from one person to another, without direct contact.

In hospital-based outbreaks of MERS-Cov such as the one in Korea, it is not surprising to see some cases in the community. However, we are not seeing sustained human-to-human transmission in the community; to date, each case can be traced to contact through a single chain of transmission.

Furthermore, there is no evidence so far that the virus has changed. Analysis of genome sequencing suggest that the MERS CoV viruses isolated in Korea are similar to those isolated in the Middle East and that transmission patterns are similar to that seen previously in the Middle East.

Robust response from the Republic of Korea

At this time, it is clear that the Government is taking necessary steps to stop transmission; the level and quality of monitoring is very high and infection prevention and control procedures are being scrupulously observed. In addition, information is being shared in a timely and transparent way.

It appears that the number of new cases on MERS-CoV in the Republic of Korea is decreasing. However, continued monitoring of the situation is crucial to ensure this apparent trend continues and that there are no changes to the disease pattern seen so far. This means, for example, ongoing monitoring and investigation of new cases to ensure they are linked to the single chain of transmission.

Gaps in current understanding of MERS-CoV

MERS is a new disease, and there are still gaps in our current understanding about how this virus is transmitted. For example, questions remain about potential role of environmental contamination, poor ventilation and other factors in the transmission of the virus. Continued research is crucial to develop a better understanding of the behaviour of MERS.

A wake-up call for all countries

This outbreak should serve as a wakeup call for all countries. In our interconnected world, many pathogens can travel rapidly, and outbreaks can crop up in unexpected places. As seen repeatedly, all countries must be prepared for the possibility of outbreaks of disease.