MERS-CoV 'kills first patient in Europe'

While the number of new cases of MERS-CoV in South Korea seems to be slowing down, the threat posed by the emerging virus continues with reports of the first death involving a patient in Europe.

According to a German company operating private clinics, a 65-year-old man who had recently travelled to Abu Dhabi died from what is now suspected to be MERS – or Middle East Respiratory Syndrome – earlier this month. There have also been unconfirmed reports of a possible case in Slovakia involving a South Korean man.

New figures from the World Health Organization (WHO) suggest that the outbreak may be starting to wane in South Korea, although there remains a steady stream of cases in Middle Eastern countries such as Saudi Arabia.

To date there have been 15 deaths in South Korea among 150 documented cases in the MERS outbreak, which started with the introduction of the virus into the country with a single traveller from the Middle East, states the WHO. Other reports coming out of the country, however, put the figure higher, at 19 deaths since the first case was confirmed there on 20 May.

The WHO is holding an emergency committee meeting to review the response to what it is calling a 'large and complex' outbreak. As there are currently no approved drugs or vaccines for MERS the focus in on prevention and containment measures.

"The number of new cases occurring each day, which is the most accurate picture of whether the outbreak is slowing down, appears to be declining," said the WHO today.

"This suggests that the containment measures in place are having an effect in reducing new infections," the agency added, although it cautioned that, as these containment measures have been recently intensified, it is too early to measure their full impact on the transmission.

The WHO also provided an update on what is known about the transmission of MERS, saying fears that the South Korean outbreak may have been caused by a different transmission pattern seem to be unfounded.

MERS is a coronavirus that has similarities with the virus that caused the SARS outbreak in 2003, and while it is more dangerous (with death rates of up to 40 per cent), it seems to be harder to transmit, requiring close contact.

In South Korea, it is though the initial index case visited multiple hospitals to seek treatment for symptoms over the course of a week, helping the virus spread, before finally being diagnosed with MERS and quarantined.

"As has been seen in this and other outbreaks, lapses in early detection and isolation, and the tendency to refer patients to other facilities for testing or management, can facilitate rapid spread from a single infected person," said the WHO.

There is little coming through in the pharma industry pipeline for MERS other than a few vaccine candidates in early-stage development from the likes of Novavax and Inovio/GeneOne Life Sciences, with the latter just announcing a phase I study of its DNA-based candidate.

There has been some initial work on the possibility of re-purposing established drugs, such as HIV therapy lopinavir and antimalarial drugs like chloroquine and chlorpromazine, although this also remains in the early stages.

More immediate help could come from passive plasma treatment, which was also used in some patients infected in the Ebola outbreak in West Africa last year.

The technique, which involves harvesting anti-MERS antibodies from the blood of patients who have survived infection with the virus and administering them to new cases, is being trialled in two South Korean hospitals, according to a BBC report.